“No one needs to be told what their attitude to illness should be – least of all by advertising agencies.”
Margaret McCartney, BMJ, Aug 15, 2014
Penning words today as the sweet smells of rain come through the worn mosquito netting, a crisp waft to break a cursed humidity in a north Queensland town. The Great Bower Bird finds himself outside with a bossy squawk; the dull yet beautiful brown honey eater makes a dash for the torn banana on the bird feeder. And there is cancer in the air, a plumed serpent, slithering. Who will you bite next?
There is nothing quite like that most sinister and remarkable of creations. It is supreme in its killing capacity; it rents and empties gradually or immediately. Prisoners are only held captive for the duration needed to inflict the desirable damage. Humans have managed to come up with a term that sounds, in itself, less than triumphant: remission.
Cancer is a mighty force of nature, an architecture that springs around the body with seemingly committed enthusiasm. Like a distraught and eager lover, it moves in on your mind, cloaking and stifling the body. It occupies your being with battalions, annexes your soul with the might of an entire occupation force. It steals life from you through stealthy nips, meaty snaps and, at times, enormous bites. It encourages paralysis of will, entropy, the evacuation of living sentiment. Cancer be you, hybrid remarkable beast, execution mercilessly effective.
The remarkably varied and sophisticated disease has spawned what can only be described as an industrial complex in search of miracles. There are the worker ants who scurry to homes to cart away victims to oncology wards; there are the researchers who mine the mysteries of cellular structures in the hope that a Holy Grail replete with salvation will be found. Deep in the psyche of the medical soul is a faith-mad creature waiting to come out.
The metaphor of war resounds in this trillion dollar quest, and it is hard not being swayed by it. Fight, or be doomed; take up arms or relinquish your credentials as a suitable member of Homo sapiens. The disease is either coming for you with dedication or has struck a person dear to you. Insatiable, the battle ensues that torment the living, and the long run dead.
The sense that a person afflicted becomes not so much a patient but an insurgent in need of resistance suggests the magic, and the deception, of that metaphor. Morality begins to lurk in the background, and with that, a sense of judgment about disease and patient. Mobilise, goes the call, or perish. Even friends and family members diminish before your shallow judgment: Do not collaborate with the disease!
“Metaphors,” note several authors in a study “Cancer as Metaphor” for The Oncologist (Nov 2004), “illuminate complex issues and can paint a thousand words.” The laboured clichés still permit the authors to observe how the “imperative for patients to have a fighting spirit” should be balanced “with words of healing and acceptance”.
In 2014, Margaret McCartney, a general practitioner from Glasgow, would go so far as to claim that military metaphors might actually harm, less than cure, patients. (So much for the weak notion that words cannot hurt me – they gnaw and deprive, reprove and condemn).
Everywhere, bodies dedicated to battling cancer have insisted, as Cancer Research UK did, that people “show us your fight face”. The language of the CRUK was positively, and aggressively, militaristic. Cancer was to be beaten; a “war chest” would fund the campaign; cancer was the target – “Cancer! We’re coming to get you!”
Like war and judgment, none of that is particularly new. Susan Sontag, in 1978, was already lashing out against the victim-blaming culture of the disease eradicators. In Illness as Metaphor, she saw links between attitudes to cancer and tuberculosis. “With the modern diseases (once TB, now cancer), the romantic idea that the disease expresses the character is invariably extended to assert that the character causes the disease – because it has not expressed itself.”
The language suggests, loudly, that we must all muck in for the battle, and no shirkers will be allowed in the frontline. Tenacity will be rewarded; there are medals and iron crosses to be provided for the brave and those willing to add to the quest.
For John Diamond, writing in 1999, this was the true hallmark of a cruel and garbled delusion, that “only those who fight hard against their cancer survive it or deserve to survive it – the corollary being that those who lose the fight deserve to do so.”
The disease remains abstract, a bookish medical term clothed in distant terminology, till your father needs help off the toilet, assistance up the stairs, his clammy body soaked in desperation, writhing in pain, his joints aflame, and speaking about West German President Richard von Weizsäcker’s controversial remarks about Germany’s defeat in the Second World war in his May 1985 address. To paraphrase, “We lost the war, and were liberated.” To be defeated, yet be free.
Controversial indeed for those who felt that foreign forces could hardly have emancipated citizens of the Third Reich, but not as controversial as the disease itself, this most remarkable of deft killers that provides its own ministry of liberation – of a very different sort. For cancer, and its innumerable sufferers, cannot be moralised.