Receiving a cancer diagnosis, and with it, at times, a harsh prognosis, is inevitably a strange and disorientating experience. It poses awkward challenges for everyone concerned – doctors, patients, loved ones. There is in the end no one “right” way to breach news of this kind, which in any case takes time to sink in. And just as there’s no proper way to tell someone that their time on this earth is being cut short, so there’s no proper way to respond to this information. When you’re addressing realities of this scope, and of this intimacy, you need some kind of higher poetry, and since that’s not possible for most of us, we stumble along with the formulas to hand.
I admire Iain Banks’ choice in informing his readers and the wider public of his situation and doing so with unaffected directness. But I also respect and fully understand other responses, including a desire for anonymity. Every time I’ve written about my on-going encounter with cancer, I’ve felt ambivalent. There’s a limit to what I want to share with strangers. And there is something uncomfortable about calling attention to one’s own medical misfortune in a world where so many suffer so much so unjustly. At the same time, I know that numbers of people welcome informed and sensitive comment on the subject, not least because it alleviates the isolation that, one way or another, often comes with the illness. In sharing his condition, Banks – as I’m sure he’ll know from the responses he’s received – touched on an experience which, though widely shared, is still grappled with largely out of public view.
Once cancer enters your life, it’s strange how ubiquitous the topic seems. You turn on the television and it’s there in charity appeals and soap operas, heavyweight dramas and even sitcoms. It’s a running theme in the news media, of which the coverage of Banks’ announcement (and this article) forms a part. Despite all that, we remain mostly ill-equipped to talk about the realities of the disease; our formulas seem paltry or glib. There is an enormous drive to pass over the matter, to move on to another topic.
For me, there was one set of problems receiving the news, absorbing it and making what sense of it I could; and then another in telling friends about it: what words to choose, what tone to take, and what to expect in response. This, in turn, I knew, posed yet another set of problems for them. How much all this has to do with our own culture and its general depthlessness, and how much is intrinsic to the human situation or the limitations of language, I don’t know. Banks’ announcement acts as a kind of brutal memento mori in a society that mostly keeps death off stage, or reduces it, Play Station style, to a distant pantomime. It’s the kind of news that stops people in their tracks – the tracks of daily life with its habits and assumptions, in which death may be inevitable but is not for today or tomorrow. Not for me and mine.
In the football world there was a similar response to the near-death of Fabrice Muamba, the 23 year old Bolton player struck down, without warning, by life-threatening heart failure in the midst of an FA Cup quarter-final. The event was a shocking one for football fans. It didn’t matter whether they’d heard of Muamba before. That death or near death could strike so arbitrarily, so suddenly, in the midst of a game, an exercise of energy and spontaneity, was profoundly unsettling.
Banks paid a heartfelt tribute to the “deeply impressive” care he’d received from the NHS. Countless others dealing with cancer will echo that. His testimony is yet another reminder of how much we stand to lose in the current make-over of the NHS. Even for those it cannot save, the NHS makes possible a death with dignity and minimal suffering. The question is, do we value that service, that final act of care and respect, sufficiently to ensure that it continues to be available to all?
Right now, for me, as a patient under life-sustaining treatment by the NHS, discussion of cancer must also be discussion of the threat to that treatment from cuts and privatisation. Cancer is the most intimate of experiences, a malignancy secretly working its way inside you, but it is also a social issue, a matter of shared common concern, and therefore necessarily a political one.