The Undying: deeply thought-provoking account of living with cancer

The Undying: A Meditation on Modern Illness

Author: Anne Boyer

ISBN-13: 9780241399729

Publisher: Allen Lane

Guideline Price: £17.99

The men’s health charity, Prostate Cancer UK, recently ran a campaign aimed at football fans, encouraging men to help “relegate prostate cancer”. A similar campaign by Cancer Research UK urged men to “give bowel cancer the boot”. The same organisation also launched a drive, in partnership with the crispbread company Ryvita, encouraging people to take up sponsored walking: it was called “Walk All Over Cancer” and was soundtracked by Nancy Sinatra’s These Boots Are Made For Walking. Its website sells T-shirts carrying the message: “Cancer, We’re Coming to Get You.” Fundraising for research into deadly diseases, which was once a staid and dignified business, must now be conducted in a register of inane jollity redolent of estate agents on a team-building exercise at a paintball centre.

The Americans, who invented this nonsense, have it worse. In a footnote in Anne Boyer’s The Undying, the American author and poet observes that “there are currently enough varieties of ‘F*ck Cancer’ T-shirts that a person could dress exclusively in ‘F*ck Cancer’ T-shirts for at least a month, and probably two, and never have to repeat a shirt or do laundry”. Another T-shirt tells cancer: “You messed with the wrong bitch”. At the less crass end of the spectrum are the pink ribbons associated with the “Pinktober” campaign for breast cancer awareness, which has been going since the early 1990s under the auspices of Estée Lauder and the Susan G Komen Foundation. Boyer has misgivings about these initiatives: with their culture of relentless platitude and enforced positivity, they foster in the public mind a false correlation between sanguinity and vitality – which implies, cruelly, that those who do not survive their illness have somehow let the side down.

Strangeness of data

Boyer was diagnosed with triple-negative breast cancer at the age of 41. Her account of her illness, treatment and survival is in some respects exactly what you would expect from a cancer memoir: she tells of having to rely on the internet to find out what to do after being diagnosed; she recounts the chemotherapy and its side-effects, enumerating the various drugs and their respective properties; she writes about the strangeness of a human being being reduced to a set of data; and of the impact of her illness on the dynamics of her social interactions. Boyer recalls how obscure male acquaintances would come out of the woodwork with self-indulgent displays of solicitude – “men who expected me to absorb their own excessive feeling on the occasion of my devastation”.

In other respects, however, The Undying differs markedly from your average illness memoir. While there is plenty of introspection, Boyer’s gaze is just as often directed outwards, towards the social structures that determine the experience of cancer at every stage – from the likelihood of getting it in the first place to the chances of surviving it. Environmental destruction looms large in this analysis: “Our genes are tested: our drinking water isn’t. Our body is scanned, but not our air.” The planet has been turned into a “ruinous carcinogenosphere”, and to continue to regard cancer as something that strikes people entirely arbitrarily is to be complicit in the concealment of a politically inconvenient truth.

As with access to treatment in general, an American person’s chances of getting the necessary recuperation time after an operation are index-linked to their social class: “So many people with breast cancer don’t get . . . adequate pain control on leaving surgery, nor physical therapy of postmastectomy pain and mobility issues, nor time off work.” Meanwhile, thousands of people a year are subjected to debilitating treatments they don’t actually need, because the commercial imperatives of Big Pharma incentivise healthcare providers to overdiagnose and overtreat.

Marketing of empathy

While writing this review, I stopped myself from remarking that some of the details in The Undying are harrowing, for fear of sounding trite. This illustrates a dilemma that is explored in the book itself: how can a person tell their story – or, for that matter, write about someone else’s – without lapsing into one or other strain of cliche? From the commercial memoir to the corporate-sponsored charity fundraiser, the marketisation of empathy has generated its own peculiar vernacular; if it feels vaguely exploitative, that’s because it is. Boyer summarises the standard blueprint for a saccharine cancer story as follows: “If she lives, she will be heroic. If she dies, she will be a plot point. If she lives, she will say something fierce, her fierceness applauded, or perform absolutions of gratitude, her gratitude then praised.”

The Undying pointedly eschews this template. With its fragmentary structure and associative forays into cultural history, it has rather more in common with a number of literary essay-memoirs published in the past couple of years, such as Marina Benjamin’s Insomnia and Charlotte Higgins’ Red Thread. Boyer revisits the experiences of three women writers who died of breast cancer – Fanny Burney, Audre Lorde and Kathy Acker – and considers illness as a theme in literature, invoking writers from Lucretius to Virginia Woolf. Woolf once wrote that there was no great literature about being ill – “a claim,” Boyer quips, “made in almost all great literature about being ill”.

In a 2014 essay in the London Review of Books, the late Jenny Diski poured scorn on the platitudinous cant with which cancer victims are routinely patronised: “Under no circumstances is anyone to say that I lost a battle with cancer. Or that I bore it bravely. I am not fighting, losing, winning or bearing.” Diski showed it was possible, by reclaiming language itself, to wrest the narrative from the demands of banality. Boyer picks up this theme with intelligence and grace in this deeply thought-provoking book. For all its lyricism and candour, The Undying is essentially a work of political economy: “The moral failure of breast cancer,” writes Boyer, “is not in the people who die: it is in the world that makes them sick, bankrupts them for a cure that also makes them sick, then blames them for their own deaths.”