Friday, June 21, 2013

I Have Cancer, But Don’t Call Me Brave - One Eyed Dog

There is a special lexicon reserved for people with cancer: we talk of survivors and journeys. The verbs we use tend to be martial: we "fight" or we "battle" cancer. This vocabulary of struggle is partly a response, cells on the march, its positions firmly entrenched in our organs, its stealth troops quietly setting up distant outposts in our bodies.

As part of this lexicon, cancer patients are almost universally thought of as brave. It is rare to see a headline about someone's death from cancer that doesn't describe the deceased as brave. "Swinton Man Loses Brave Cancer Battle." Since my diagnosis many people have said they have admired my courage — and I thank them for that, as it's certainly better than being regarded a spineless, simpering worm — but it always leaves me thinking: How exactly am I being brave?

People have told me that if it were them, they would be curled up in a ball, locked inside a dark room, not wanting to be around people. They wouldn't be on Facebook, or blogging about cancer, and certainly wouldn't be making jokes. They imagine a kind of mental shutdown, a recoiling of mind and body, where they essentially place themselves in quarantine.

With this notion of how they think they'd respond to having cancer, just living a normal-enough life is seen as being brave: going to work, looking after the kids, climbing mountains, running marathons. But ask any one of those people with cancer if they would regard themselves as brave and most likely they'd tell you, no, absolutely not. The default response to cancer, from the patients I have met in real life and online, is normally one of resilience: a very practical sense of just getting on with it and making the best of things.

Courage is often defined as being afraid of something but carrying on regardless, like jumping out of an airplane, or charging a Taliban position to save your stricken comrades. The key difference is that such displays of courage come with a choice and those choices have consequences. We weigh the consequences, do the calculus, and make the decision. But for most people with cancer, there is little choice. I am sick and I will take the treatment to try to get better. It is no different to any other illness, no more gallant than undergoing surgery for heart disease. My treatment is a life raft extended in a storm and there is nothing remotely brave about clinging on for dear life.

Brave (or perhaps stupid) would be looking my cancer in the face and saying, "I'm confident I can beat this on my own. I'm going to the pub." Or brave might be refusing life-saving surgery and chemotherapy, well aware of the grave consequences, because it is against deeply held moral or religious convictions. Brave would be choosing to meditate my cancer away so confident I would be in the curative power of energy pathways.

People have also said I'm brave for talking so openly about my cancer, but in a world overrun with cancer memoirs, cancer blogs, survivors' forums, I'm not exactly breaking any sacred ground here. It is not 1910 and we are not shunting off cancer patients to windswept sanatoriums to die in a veil of silence. Nor do I have AIDS in early 1980s San Francisco, where prejudice, ignorance, and fear prevented people from talking openly about their conditions. And anyone who knows me knows I am something of an attention whore. I wrote a book about my feelings surrounding my father's death, so I don't exactly need much encouragement to share my inner-most feelings with a bunch of strangers. For me, having cancer and not writing about it would be truly courageous.

There was a piece recently in USA Today about Angelina Jolie's decision to have a double mastectomy and go public about it. It was a sneery, uncharitable piece, written by someone with breast cancer, but it raised the question of courage.

To paraphrase, the author was basically saying that Jolie isn't the brave one, the head-scarfed women battling metastatic breast cancer are the brave ones, fighting their terminal cancer with a dignified silence. That's brave, not Jolie, with her looks, her publicists, and her army of stylists.

I suppose, being charitable to the author, I could see what she was trying to say and I certainly agree with her on the inevitability and laziness with which journalists use the "brave" word, but what was distasteful about the piece was her setting herself up as a judge of other people's courage.

Going for an operation, let alone having a double mastectomy, is a frightening prospect for anyone. (I wept like a baby just before having my anesthetic for my resection. No stiff upper lip here.) Even if your chances are good, just having cancerous cells at large in your body with even the slimmest possibility of recurrence is a scary business. Cancer is not a competition of who suffers the most. I wouldn't necessarily label Jolie as particularly "brave" for taking a sensible decision about her health as I just think that word is inadequate and unhelpful, but I certainly wouldn't want to diminish what she went through by comparing her to others in trickier situations. There is no leader-board for courage.

So while I don't think Jolie is particularly brave, nor do I think it is the best way to describe those women on the cancer ward. I bet they wouldn't think of themselves as brave either and reducing their complex feelings and emotions to that easy catch-all "brave" is the kind of reductivism the author seems to dislike. People with more advanced cancers, with poorer prognoses, are just getting on with it because they have no choice, facing their own expiry date as people have always done, with faith, humor, fear, solace, sadness. They might regard themselves as fucked, unlucky, pissed off, sad … but brave, I'm not so sure.

So "brave," while well meant and certainly not offensive, just doesn't seem quite right to me. Ultimately, it is just semantics. Having cancer and being described as "brave" is just a linguistic tic, where a default terminology becomes so pervasive that we just use it without really thinking.

It is part of a lexicon that likes to give people with cancer almost super-hero-like powers, great warriors doing battle against an evil disease. It isn't a lexicon that allows much humility in front of a rapacious enemy. Whenever I hear those martial verbs, or hear people being described as brave, I feel a little sorry for people with heart disease or Alzheimer's, who, rather than warriors, tend to be portrayed as passive, voiceless victims, who never get to "fight" their illnesses but only ever "succumb."