Cancer: Fighting Words

Everey day in obituaries, you will find combat metaphors about people who have died of cancer. “After a heroic battle against cancer,” “valiant fight against melanoma.” And so on. News stories routinely refer to “weapons” against the illness, the “arsenal” of drugs, “victories.”

Following on Susan Sontag’s crusade against the metaphorization of illness in general and Barbara Ehrenreich’s denunciation of some aspects of the militant (and also cutesy) “culture” of breast cancer, especially over the last decade, many psychologists, doctors and cancer patients have raised objections to the military trope for the disease.

They say that putting the experience into martial terms means that those who die are by definition, at least figuratively, losers. Not just of their lives — as if their lives weren’t enough — but of personal wars. That they gave up. Dr. Andrew Weil says that “it’s not the best way” to think of cancer. Cancer patients writing online and bloggers have also deplored this linguistic habit. “Does it mean that if I croak it’s my fault?” one asks.

For those reasons, as a recurrent cancer patient, I’m all for the demilitarization of cancer talk. Because especially when I’m conferring with the army — I mean, the large number of doctors — I’ve been seeing recently, it seems more calming, less victimizing, to think of the disease as a problem, not an enemy. A problem to be worked on, considered from this angle and that, and solved. Or just as if not more likely, not solved. But in either case not a malevolent foe who is going to vanquish or surrender to me. There’s no “volent” involved, after all.

But I also endorse the militarization of cancer talk. At least for some patients, and at least when they talk to themselves or those close to them about their situation. Because all of us are — by part of our nature — combative creatures, and it can be emotionally useful to view cancer as an enemy, even when you know it’s not.

It can motivate us to follow the often complex treatment regimens (regimens!) involved. It can help us feel less frightened and more composed when facing surgery. It can strengthen our resolve to stay in the best shape possible and to deal with pain when it comes. It may be a kind of self-delusion, but it may also assist self-preservation. And it may help others to face their illness with less fear than they would have had otherwise. There is nothing wrong with being emulable.

There’s a strong reason that cancer in particular tends to elicit warfare language: it is so radically territorial in its actions. That is, it’s usually trying to take over the physical space that is one’s body, just as a foreign army tries to take over one’s country. Also, try as we may, we cannot scour the language of metaphor. “Cancer” itself is a personification — well, a crustaceanification. A malignancy doesn’t know or care if it’s “mal.” It’s not evil. It just is.

So why not both attitudes toward the disease: a greater reliance on the rational, problem-solving approach in public discourse, and, if it works, the perhaps irrational but nevertheless utilitarian martial one in more private, even interior, contexts?

At least to ourselves, maybe late at night — and maybe feeling a little like idiots — surely some of us may gather strength from saying of those murderous invaders, in our best Churchillian cadences, “We shall fight them in the mediastinum, we shall fight them in the lymph nodes, we shall fight them in the trachea, we shall fight them in the pleura....”

Daniel Menaker, a former editor in chief of Random House and the author, most recently, of A Good Talk: The Story and Skill of Conversation.

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