My cancer - "It can’t be true! It can’t, but it is."

 

Liver cancer.  That was a surprise.  I knew something was wrong, but I was not expecting that.

Since the diagnosis last summer, since it was known for a fact that I had something serious, things have moved fast.  It has been like boarding a train.  Once in motion there is no way off.  I guess I have seen plenty of movies where people get off of moving trains, often with bad results.  I am going to stay on and do what my doctors tell me.

Monday is my liver surgery, a major change of direction.  When I wake up, my tumor will be in the hands of the researcher who expressed almost too much interest in getting a look at it.  He can have it.  The subsequent year of immunotherapy treatment is to keep the tumor from returning.

I have great doubts about sharing personal information of any kind, much less medical information, with the internet, but my cancer is no secret in my real life, and I wanted to explain why the schedule of my Greek philosophy reading – no, not the reading, the writing – fell apart.  How fortunate to be reading Greek philosophy – Cynics, Stoics, and others – at just this time.  The perfect companions.  But my energy was not so good, and a lot of what was left went to health care appointments.  So, so many appointments.  My writing suffered, and will likely do so for some time.

My doctors, by the way, have been superb, as have the nurses, technicians, and everyone else.  The insurance company has behaved itself.  No medical horror stories, or even irritation stories, not yet.  My greatest suffering, at this point, has been the 900 calorie per day liver-softening diet that I am currently enduring, although not for long.  Have pity on this poor glutton.

Ivan Ilych, in “The Death of Ivan Ilych” (1886), worries about the cause of his illness.  The illness, which involves, the appendix, or maybe the kidney, sure sounds like cancer.  I wish he had had my doctors.  He once heavily bumped his side while hanging a curtain:

‘It really is so!  I lost my life over that curtain as I might have done when storming a fort.  Is that possible?  How terrible and how stupid.  It can’t be true!  It can’t, but it is.’  (Ch. VI, tr. revised Maudes)

Of course, however comforting it would be to know, poor Ilych has no idea.  I had a brief discussion with the surgeon about the cause of my cancer, ending in a shrug and a laugh.  Who knows?

Leo Tolstoy’s masterpiece is the only work on illness I have deliberately sought out.  I owe a debt, though, to Nanni Moretti’s 1993 anthology film Caro Diario, specifically to the extraordinary third part where he recreates his frustrating, circular experiences with the Italian medical system (which does save him in the end – he is now 70, with a new movie out).  It’s because of Moretti’s film, backed by some family history, that led me to push hard on my doctors to look for cancer.  “Be your own advocate” is the phrase people use.  Yes, do it.

I will be out of touch – out of everything – on Monday, and I have never been a recovering patient before so I have no idea when I might respond to any well wishes, kind thoughts, crackpot advice, or angry scoldings.  Many thanks, then, in advance for any of that.

Now back to the problem that makes me fret the  most: which books to bring to the hospital?

 

Frigyes Karinthy’s brain tumor memoir A Journey Round My Skull - “Who is he, anyhow?”

John Gunther’s memoir Death Be Not Proud (1949), the account of his teenage son’s illness and death from a brain tumor, was one of the small number of actual books assigned by my high school, long long ago, but not so long that a memoir from 1949 did not seem just a bit antique.  Not that I remember it well.  It was earnest, instructive, sad. 

Frigyes Karinthy’s brain tumor memoir A Journey Round My Skull (1937) is a different kind of critter.  Karinthy, in his late forties when he becomes ill, was a comic writer, famous enough in Hungary that his operation was covered in Budapest newspapers.  He has a sense of humor about his illness, a great help in writing a book about it, and presumably in living through it.  And he writes the book himself, so it has a happy ending, for a while, at least.

A true Austro-Hungarian, however the borders have changed, Karinthy spends the first three pages sitting in a café, goofing off, doing the crossword.

And at that very moment the trains started…  Three times I raised my head, and it was only when the fourth train stated that I realized I was suffering from an hallucination.  (“The Invisible Train,” 12-13, tr. Vernon Duckworth Barker)

The interesting thing, from a literary and philosophical perspective, about a brain disease is the change in sensory perception.  We have enough trouble understanding what is around us when our senses work the way we are used to, much less when the brain starts playing tricks.  The subjective / objective split becomes intense.

The climax of the book is Karinthy’s operation, when he is under (only!) local anesthetic, adding another layer of weirdness, and recovery.  Time shifts and is compressed, recurring dreams replace reality, particularly the one described in the titles of Chapter 24, “Half a Dog Running to Telleborg,” in which Karinthy is sure he is half of a dog that has been cut in half by one of the invisible trains first heard in Chapter 1.

This part of the book gets pretty weird.

The following pages came before my eyes like a sequence from a film.  Try as I may, I cannot say for certain whether I has this experience during the operation itself or during my feverish dreams of the next few days.  My excursion in Time (which I shall describe shortly) may have begun at that moment, and is perhaps causing me to place in this chapter a series of pictures which should belong to the next…  In that film, the following sequence appears next, and it is therefore here that I shall include it.  (241)

It is a little apologia for Modernist fiction.  It is the older writers who were wrong, just putting one event after another.

The disease memoir is a well-formed genre now, and the film that most of A Journey Round My Skull resembles, not the weirdness of the operation but the earlier part, the series of symptoms, doctors, and diagnoses, is the last third of Nanni Moretti’s Caro Diario (1993), the brilliant “Doctors” sequence, in which Moretti bravely recreates his own maddening journey through the Italian medical system.

In the middle of the operation, Karinthy interrupts himself with chapter titled “Addis Ababa.”  He checks in on people back in Budapest, his son (“who was now free to do as he liked, was probably enjoying himself,” 227), his friends, strangers reading about him in the newspaper:

At the morgue in the Szvetenay-ucca the corpses were lying peacefully in their zinc cases.  The only sound came from the dripping of ice as it melted under them.  Some of them wore an expression of indifference, and some one of surprise.  ON every face, there was an expression of some kind that had no meaning, as it had no cause.  An attendant had sat down on the doorstep to eat a hunch of bacon.  His companion was reading to him from a newspaper.  When he came to the title of my operation report the attendant cut himself another slice of bacon.

“Who is he, anyhow?” he asked, in a bored tone.  (236-7)

Meanwhile, the Italians conquer Ethiopia.  Disease memoirs are a form of wisdom literature.