Possibilities, not prescriptions

After rejecting “on quirky, not rational, grounds” several alternative forms of treatment for the suffering that accompanies chemotherapy, Susan Gubar discovered the therapeutic potential of writing about her cancer. “At the worst times,” she observes, “writing helps us remember” and can lead to “reconstitution of the self.”

The activity helps writers discover meaning, clarify ideas, and keep track of details. It can, at times, liberate and empower cancer survivors by distancing them from the disease. Writing is as “uplifting and inspiring for me as meditation is for others: a way of steadying myself, gaining perspective, quieting anxieties, and shifting my attention from my ailing body to words, to sentences, and (best of all) to the experiences of other people.”

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Gubar’s own writing led her to explore the work of other cancer survivors: accordingly, her book surveys a wide range of voices, genres, and approaches. Gubar’s primary aim is to encourage people with cancer to write, and she offers practical advice for doing so. She also introduces readers to published works that “instruct us on the physical, mental, emotional, social, and economic repercussions of various cancers and treatments” in order to “discover multiple ways to live with the disease.” Her discussion of these works provides a powerful overview of the emotional and ethical complexities of cancer and its treatment.

Each individual’s experience of cancer is unique and may shift from moment to moment. Gubar writes as a frustrated patient, then a passionate advocate, then a gentle teacher, then a rigorous scholar. She can be in turn angry, funny, compassionate, or indignant. Some sections of the book function as catalogues, with reviews and close readings; others serve as a guide for inexperienced writers. Gubar shares a few personal stories to invite familiarity, but she is primarily a gracious host who introduces readers to other voices. She intentionally avoids creating an “advice manual” for coping with cancer; she offers possibilities rather than prescriptions.

Her practical suggestions for overcoming writing anxiety include a long list of prompts to help generate ideas: “Remember the moment of diagnosis or of telling a sibling about it”; “celebrate or castigate a doctor or nurse”; “In my most snarky mood, I attribute the cause of my disease to…”; “I am not yet ready to confront….”; She mentions her own experiment writing an “Obitchuary,” an obituary with a second layer of candid commentary about its content.

She celebrates the privacy of diaries and unsent letters but also addresses issues that emerge when one writes for a public audience. As a blogger for the New York Times, Gubar has struggled with the “audience effect,” the tendency to self-censor in anticipation of readers’ comments. Her chapter on blogging is perhaps the most self-revelatory section of the book.

If writing is therapeutic, so too is reading. Gubar quotes C. S. Lewis: “We read to know we are not alone.” She asserts that “reading the vibrant works of others eases the anxiety of cancer and clarifies what we are going through individually.”  Gubar cites dozens of authors and reveals a surprisingly rich emerging canon of cancer art. She describes memoirs (by, for example, Barbara Creaturo of Cosmopolitan, author Reynolds Price, physician Edward Rosenbaum, actor Evan Handler, and comedian Gilda Radner); works of fiction (by Tolstoy, Tillie Olsen, Lorrie Moore, and J. M. Coetzee); and hybrid works (including David Small’s Stitches and Terry Tempest Williams’s Refuge). These works reveal recurring themes: “fury at the medical establishment,” personal fear, defiance, and the liberty to take risks.

She shares a “patchwork” poem she has composed using lines from several other poems. The resulting chorus of voices and images reinforces the complexity of Gubar’s project and the experiences it seeks to honor. She includes visual art and graphic novels (a series of paintings called Hollis Sigler’s Breast Cancer Journal; David Jay’s photographs in The SCAR Project, and Robert Pope’s paintings superimposing Christian iconography on images of bedridden hospital patients). Gubar often juxtaposes radically different responses or interpretations, but always with respect and dignity.

Through her exploration of many of these works, Gubar raises ethical and social questions. Christian Wiman’s My Bright Abyss is one of the few works in which she explicitly identifies the role of religious faith and doubt. She quotes Wiman: “The god that comes at such moments may not be simple at all, arises out of and includes the very abyss that man would flee.” Wiman’s faith, Gubar observes, reflects his identification with the crucifixion rather than the resurrection. She explains that compassion is crucial to Wiman’s understanding of God and human relationships.

In fact, the greatest value in Gubar’s book may be its ability to invite compassion. Cancer survivors will undoubtedly find affirmation here. Those experiencing cancer secondhand will encounter some of the questions, sufferings, complaints, and victories their loved ones face. Individuals with no firsthand experience of cancer may benefit the most as they begin to consider the complex range of responses to pain, suffering, and treatment. All of these readers will know that they are not alone.