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Two Stories We Tell Ourselves About Cancer

Two Stories We Tell Ourselves About Cancer

Paul Genova, MDLike more and more cancer patients today, I have outlived several prognoses and am still hanging around, in a diminished life, trying to outlive the latest. Sooner or later, all of us get swept up into one or another of the collectively available cancer story lines in the culture. The following reflections come from more than 5 years of telling myself such stories, listening to fellow patients tell me theirs, having friends or doctors tell me one of these stories about myself (eg, “You’re a fighter!” [not really] . . . “You have such a great attitude” [no] . . . “You must have learned so much about yourself” [yes and no], etc).

Often, when I try my hardest to honestly relate what has happened or is happening to me, I find that people hear me selectively, tending to mold my story into 1 of the 2 basic stories I’ve identified. At other times I’ve caught myself inwardly trying to create one of these narratives, sometimes for months on end. Life gets hard without a script. My own up-and-down course increasingly refuses to fit into a coherent story line the longer it goes on. (The longer any of us survive, the more this tends to be the case.)

I aim here not to relate yet another cancer autobiography but to use my experience (1) to break down some of the limiting boundaries of story itself that may isolate cancer patients and their loved ones, each from the other, knowing surely that my readership includes both groups, and (2) to show how any story one tells one’s self may foreclose possibilities both for living life fully and for treatment and survival.

Each of these stories, by the way, can be done with or without God and with or without actually dying. The 2 stories are as follows.

The Fighter

This story is about overcoming. It is the typical willpower/mastery, American Dream, up-by-the-bootstraps, Norman Vincent Peale–type narrative (“You’re a fighter!”), in which the patient never gives up, never says die, stays “positive” in word and deed, never lies in bed despairing when he/she could possibly get up and get some exercise . . . you get the idea. It conforms with mainstream America’s denial of all unpleasant things that are not preludes to more “riches” of some sort—even if said riches are not recovery but the proverbial “good,” inspiring, exemplary death (“He was a fighter to the end; he never lost his good attitude,” etc). You see this a lot in obituary columns, which people in my situation tend to read, and to which they feel inadequate by comparison. The medical system especially is often geared to seeing people this way and wanting them to be this way. When one is doing well, one often gets the you’re-a-fighter/ what-an-attitude comments from doctors. Nurses are who you want to see first when things have gone wrong.

The Hero’s Journey

This “alternative” narrative is about spiritual refinement or maturation of the personality through a series of drastic losses and perilous tests. It derives, often in distorted and oversimplified form, from sources such as the Odyssey, the Book of Job, Jung, and Joseph Campbell. And it finally turns out to be less of an alternative than it seems on the surface. People from my neck of the psychometric woods, the more “sensitive” and/or less denial-capable types (patients and loved ones) are attracted to this story line because at least it permits despair and loss of faith as real, valid experiences that one can live through and even learn from. In the first story line, of course, despair is a weakness, or worse, a sin in the God version.

The ever more mainstream, “alternative” culture supports this second, spiritual-journey tale in the form of numerous memoirs and self-help books and in the attitudes of various health practitioners and well-meaning “spiritual” friends (which is not to say, fortunately, that all such books and spiritual friends thoroughly fall for it). As a narrative, its underlying connection with the first is that it, too, requires denial: denial of the randomness, the disproportionate nature and (in the God version) downright cruelty of the suffering endured, or inflicted upon, patients, even if they die in some more enlightened, loving and forgiving state—again, the promised “riches”—which is not always the case!

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