A book that rethinks cancer

Book: Malignant Metaphor: Confronting Cancer Myths by Alanna Mitchell (Toronto: ECW Press, 2015)

Cancer is one of the mythological illnesses and in this spare, riveting book Alanna Mitchell confronts the myths that surround cancer diagnosis, treatment and living with cancer as few writers have done. To do this she uses the premise provided by Susan Sontag in Illness as Metaphor (New York: Farrar, Strauss and Giroux, 1978.) Sontag’s premise is that we build mythologies around illnesses we don’t understand. Cancer is one of these illnesses.

This book is personal. Mitchell follows her brother-in-law’s and her daughter’s journeys with cancer. With dignity and an open mind, she examines the fictions that persist around the diagnosis of cancer and, in particular, that nagging view that, if you have cancer, then you’ve done something wrong. Most poignant was Mitchell’s account of her daughter’s brush with cancer and the myths she immediately encountered:

“Above all, I felt guilt. That it ought to have been me…That I ought to have been able to forestall this somehow…I replayed every second of her childhood that I could remember, wondering what I had done to fail her in this way.” (p. 155)

What is most important about Mitchell’s book is that the science is so thoroughly explored. She does a very credible job of examining what science exists around the homeopathic and naturopathic treatments of cancer. However, she also examines the most prevalent metaphor that health care systems and providers use in relation to treatments: the metaphor in which treatment is likened to conflict or a war. We have all heard those metaphors, even use them – fight cancer, combat heart disease, an arsenal of treatments.

How does the war metaphor benefit the treatment of cancer? Does it give us the energy to cope with the rounds of investigations, treatments, hospitalizations? Perhaps it does. What this metaphor does not do, however, is help us to understand the randomness of cancer in many cases. Cancer sometimes strikes out of the blue. We all know people who have no family history of cancer, who live healthy lives, eat organic food, exercise, and still get cancer. Do you notice how we seek reasons for these anomalies? Do you see how strongly we believe the myth that science will find all the answers – even when we know there are questions we haven’t even considered?

For the question Does science have the answers? Mitchell makes this point:

“The point is that if you think you can pinpoint the cause, then you can fool yourself into thinking that you can avert the cause. It’s deeply egotistical. It’s life played as a grand insurance policy. Our myth-making around cancer stems from the same impulse. Because we don’t know exactly why most of it happens, we weave a makeshift wisdom around it, a false prophet, which seeps into the common story and feeds our hunger to understand why. The guilt is a byproduct, a way to assign blame and seek absolution. It’s a lesser evil than the forces of randomness. And it gives us the illusion of control.” (p.163)

Mitchell posits that other metaphors might serve us better in our quest to understand our lives in the context of cancer. To me, this may be where other knowledge: literature, philosophy, faith may serve us better in managing disease. We speak of “random acts of kindness” but aspects of all illnesses are random, too.

Think about how so many good events in our lives are seen as serendipitous: falling in love, meeting a best friend, finding the “perfect house”. We don’t seem to agonize over why these things happened. We have a view that the best things are often random. Why can the worst things never be random?

In medicine, our excessive reliance on science (e.g. double blind trials, evidence-based practice) blinds us to the realities that we might confront illness more effectively if we remembered that the root of science is not just science. As Mitchell states: “…dream, experiment, fail and then dream again.” (p. 184)

Trying to understand cancer, or any illness, scientifically fails to help most of us live well with illness. The only thing certain about our lives is death. As the illnesses that will kill us develop, we need metaphors that feed our souls as well as sustain our physical comfort. Death is not our fault.

2 thoughts on “A book that rethinks cancer

  1. I appreciated Mitchell’s book very much and appreciated your insights Gail. After spending much of my career in oncology I have developed a particular view about the guilt and weakness of character that we impose on those with a diagnosis of cancer or who die wit the disease. We talk about people “losing their battle”, “succumbing to the disease”, “Giving up their fight” or “surrendering”

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