An Empress of Maladies
I can’t decide if reading Siddhartha Mukherjee’s Pulitzer Prize winning book The Emperor of All Maladies after you’ve had cancer twice is better than reading it before you’ve had cancer at all. Of course, this is a false comparison, as I’ve only just been brave enough to read it, and I’m celebrating one year post chemo for that second cancer.
On the one hand, it allows me to understand this thing that’s happened to — and in — me in far greater depth, for which I am grateful, because I like to know what’s going on clinically, and I like to at least appear well-informed when I speak to groups about my own book on cancer. On the other hand, I think the take-away message is that cancer is inevitable the longer you live, simply because of the nature of both human aging and cancer itself, and that if you’ve had cancer, chances are pretty likely that it’s going to do you in eventually, unless some other accident befalls you first.
Then again, once you’ve had cancer, you pretty much have to know this, right? Right? If you learn anything about having had cancer is that it’s not a one-night stand: it’s a lifetime affair, a condition you live with whether it’s active or not. Hence the semantic difficulty you encounter when trying to update your cancer status, an existential declension: I have cancer; I had cancer; I will have cancer; I have absolutely no idea.
The experience of reading this book as someone who’s had (has?) cancer is that you inevitably find yourself placing your own story on the timeline of cancer itself; I was first diagnosed in 2007, which means that all the major discoveries described in such detail in the book had already happened, and I was the happy beneficiary of those treatments they allowed. I underwent the now familiar ritual: surgery, chemo and tamoxifen — then six years later, surgery, different chemo, radiation, and more hormonal therapy. I know I carry the BRCA2 genetic defect that predisposes me to breast and ovarian cancer; I had a prophylactic oopharectomy too. I had two different kinds of breast cancer; both had different profiles.
Ultimately, if you’ve had cancer and managed to read Mukherjee’s extraordinary book, the message is perhaps that life is where you find it. At times, when reading, I wanted to root for the cancer — it was so clever and self-reliant and successful at doing its thing. It’s the Yin to my Yang, my anti-self, my invisible mirror, a formidable antagonist. For now, it’s gone or hiding, I don’t know which. All I know is that I can’t tell, which is a good thing. It gives me time to read.