Summary:

This posthumously published short (132 pp) collection is by a former New York Times book reviewer and essayist who was diagnosed with metastatic prostate cancer in 1989 and who died the following year. Broyard responded to his illness by writing about the experience. The book is comprised of six parts:

Part 1: Intoxicated by My Illness

Part 2: Toward a Literature of Illness

Part 3: The Patient Examines the Doctor

Part 4: A Style for Death: Journal Notes, May-September,1990

Part 5: The Literature of Death

Part 6: What the Cystoscope Said

Parts 1, 2 and 5 appeared in slightly different form in the New York Times between 1981 and 1990.

Parts 2 and 3 are in part from a talk Mr. Broyard gave at the Univ. of Chicago Medical School in April 1990. Part 6 is a short story written by Broyard in 1954 about his father’s death.

Mr. Broyard had long been fascinated with death and dying, before his prostatic cancer, publishing "What the Cystoscope Said" in 1954, some 35 years before his own diagnosis. It is as though he had been preparing for what he knew would be his finest work. Always an engaging essayist and reviewer, Mr. Broyard here offers what he did best--a discursive (in the best sense) soliloquy on disease, suffering, the majesty of the educated, reflective person with illness--all amplified with widely ranging withdrawals from the broad literary bank account one would expect of a professional reader and reviewer: one reads about personal fate vis-à-vis D. H. Lawrence’s Women in Love; one reads, as one can read nowhere else, about illness, dying and sexuality and its relevance to Hemingway’s The Sun Also Rises.

Part 1, Intoxicated By My Illness, is a personal statement about the effect of this illness on Broyard’s attitude and is rich with his own and others’ literary sense of how he should and did react to it. Part 2, written later than Part 5, deals with literature and illness as opposed to the emphasis on death in Part 5. Within Part 2 are references to Susan Sontag, Norman Cousins and Siegel, among other students of this subject. It is interesting to compare the more powerful and personal and moving appeal of the later writings on illness (Part 2) to the more abstract, critical ruminations on death (Part 5) at a time when, in fact, Part 5 was a literary exercise. Part 2 is written with the pen of the heart.

Part 3 is a wonderful account of Broyard’s first meeting with his personal physician. While Broyard analyzes this man, he reflects on what he would like in his ideal doctor. Part 4 is a brief (7 pages) collection of short diary entries reminiscent of Dag Hammarskjöld’s Markings. Part 5 includes essays on death and dying in literature and what these books, e.g., Robert Kastenbaum’s Between Life and Death and David Hendin’s Death as a Fact of Life and Ernest Becker’s Denial of Death, have to offer us.

Part 6 is a short story about his father’s death, the son’s sexual escapades and the relationship between the two. Clearly sex, death and their nexus have long been on Broyard’s mind. This is a welcome reflection and is of interest more as it compares to Broyard’s later writings on the subject, especially in Part 2, than for its intrinsic worth as a short story.

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Summary:

Sontag argues against the use of illness as metaphor. She states her main point on the first page of this long essay : "The most truthful way of regarding illness--and the healthiest way of being ill--is one most purified of, most resistant to, metaphoric thinking."

Tuberculosis and cancer serve as her two central examples of the human tendency to use metaphoric thinking about illness. In the 19th century, tuberculosis was considered a disease of passion, of "inward burning," of the "consumption" of life force. Sufferers were thought to have superior sensibility; the illness purified them of the dross of everyday life. The romantic image of the TB sufferer became "the first widespread example of that distinctively modern activity, promoting the self as an image" (p. 29). Metaphoric thinking about TB declined in the early part of the 20th century as the disease succumbed to science and public health measures.

Cancer has now become the predominant disease metaphor in our culture. Cancer is considered a disease of repression, or inhibited passion. The cancer sufferer characteristically suppresses emotion, which after many years emerges from the unconscious self as malignant growth. As in Auden’s poem, Miss Gee, reproduced on page 49, (see annotation in this database): "Childless women get it, / And men when they retire . . . . " Sontag uses the 19th century view of insanity as another example of malignant metaphoric thinking, while metaphor related to syphilis was somewhat more benign. She concludes the essay with an eloquent prediction that, as we learn more about the etiology and treatment of cancer, its metaphorical system will die on the vine. (I wonder if Sontag would consider my "die on the vine" an appropriate metaphor here?)

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Invincible Summer introduces illness and death into what might otherwise be a standard teen love story. Here, first love is also a last look at life, and the rites of passage into romance, sexuality, and intimacy are intensified and thrust into profound paradox by approaching death. Robin and Rick meet in the hospital where she has come for a battery of tests, and he for chemotherapy. Both have acute lymphocytic leukemia. He’s been sick for two years. She’s just finding out about her own condition.

Robin lives with her father, who can hardly bear to be around her illness, and her grandmother, who, since her mother died years ago in a car accident, is the primary caretaker. The father’s love has to be understood and accepted in light of his emotional limitations. The book thoughtfully explores how sickness rearranges family systems as well as treating familiar young adult themes of separation from friends, wanting sex, embarrassment about physical appearance, uncertainty of remission, and how to talk about the future.

After Rick’s death, at which Robin is present, Robin recalls a game her mother used to play, called "The Worst Thing." "What’s there to be afraid of? What’s the worst thing that could happen?" The aim of the game is to look at the worst case until it seems manageable, because for every worst thing, there is some way through to remedy or acceptance. The game, reproduced as internal dialogue, drives to ultimate questions, ending with something like Pascal’s wager--a version of intellectual comfort that will do in the absence of positive faith in the promise of afterlife.

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Will Farnaby, reporter and underground agent for an oil magnate, is shipwrecked on the island of Pala, where for 120 years an ideal society has flourished. In the mid 19th century, a Scottish doctor successfully treated the enlightened Raja of Pala and settled on the island. These two men then designed a perfect society in which (according to the book jacket's description), "sex lives are unabashed; children are carefully conditioned from infancy and none is at the mercy of one set of parents; jobs are assigned according to physique and temperament," and everyone uses "moksha medicine," a drug that sharpens and deepens powers of consciousness.

The Palinese also practice hypnosis, eugenics, and a form of sexual yoga that leads to virtually perfect sexual experience. While Pala has enormous oil reserves, the people are uninterested in developing them because they are happy with their way of life and do not feel the need to become wealthier or more Westernized. Pala's companion island of Rendang is ruled by a ruthless dictator, Colonel Dipa, who plans to develop its oil resources and industrialize the island, while, at the same time, enriching himself.

After his shipwreck, Farnaby is injured climbing a cliff from the beach. He spends time recuperating, during which he meets a number of Palinese people, including Dr. MacPhail (descended from the original Scottish physician) and Murugan, the young man who will soon become the new Raja of Pala. As he learns more about the society, Farnaby comes to respect it and turns away from his plans to promote oil development on the island.

However, Murugan (who was raised largely in Switzerland by a fanatic mother who runs a fundamentalist Christian movement) frowns upon the sexual freedom, drug use, and general lack of "ambition" among his countrymen. He secretly conspires with Colonel Dipa to sell-out Pala. At the end of the book, the army of Rendang has invaded Pala and declared a joint kingdom of Rendang and Pala with Murugan as king and Colonel Dipa as Prime Minister.

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An epigraph preceding this 28-line poem, apparently from notes by the physician-writer’s physician-father, sets the action of the poem in Wales in 1938. In the operating room, the surgeon attempts to locate the brain tumor of a patient who was under only local anesthesia because of his blood pressure. In those days in that place, finding the tumor was a "somewhat hit and miss" procedure that seems to have involved looking for it with one’s fingers.

A grotesque image, but all goes well until the patient, in a "gramophone" or "ventriloquist" voice not his own, cries out, "Leave my soul alone, leave my soul alone!" The doctor withdraws from the brain, but the patient then dies, after which the mood in the operating room is shocked and speechless, as "silence matched the silence under snow."

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Nicholas Baran, a one-time student activist, is now in his 40s, teaching at a community college in rural Connecticut after having been denied tenure at an Ivy League school. The tenure denial, despite consistent teaching awards and high performance was clearly politically motivated and instigated by a right-wing professor protecting his turf and the school from a labor-oriented, media-challenging progressive. Nicholas has leukemia, and, upon noticing that he appears to be living in a cancer cluster, begins a private investigation of the large chemical company located just upstream on the river that runs through the town near his neighborhood.

The investigation becomes more intense after he comes upon a local rescue squad retrieving the body of a small boy who has drowned in the river, but whose body reveals effects of considerable acid in the water. Though his wife fears for him and resists his efforts, even to the point of temporarily allying herself (and engaging in a dailliance with) a powerful local real estate broker, Nick finds an ally in his son's teacher, hesitant, but committed to finding out the truth.

Though Nick's disease is progressing rapidly, he and Sandy, the teacher, manage to break into the company's files and retrieve enough damaging evidence to expose deliberate deception of the public as well as documenting the high incidence of cancers in the immediate neighborhood. Before his death Nick manages to supply enough material to the major media to expose the scandal, and leaves a hard-won legacy of truthtelling to his children.

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This is a collection of poems written about breast cancer, many of the poems by women who have experienced the disease. A very full range of response to the disease is evident in these poems, from dry humor regarding prostheses; to fear and denial of the disease; to one’s often painful adjustment (along with family members) to a different body; to emotional transcendence of the experience of breast cancer.

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Julia’s sister, Kara, has a recurrence of leukemia, and, because of the horrors of chemotherapy along with a dismal prognosis, decides to forgo treatment. Kara asks Julia, along with two of her closest friends, to participate in a "sweat," an Indian purification ceremony intended to "recenter" one’s spirit prior to death. The idea of her sister dying has caught Julia off guard, despite Kara’s dismal prognosis, her baldness, her gray color in the mirror.

Kara lives life to the fullest, without fear; in sharing her life, Julia had forgotten about the reality of death. Julia is surprised when in only five days the ceremony takes place, and thinks of all the practical reasons this ceremony makes no sense. Against her will, Julia takes her sister to the sweat tent and participates in the ceremony. Even though it might have hastened her sister’s death, Julia comes to realize the importance of the ritual, for as her sister dies, she, herself, feels closer to her than ever before, and is finally able to see how Kara’s life had fit into a larger design.

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An imaginative recreation of profound personal loss, the resulting changes wrought by unexpected responsibility as well as opportunity, all occurring during the progression from late adolescence into young adulthood, this work is centered on the death and its aftermath of the author’s parents 32 days apart, when the author was 21 years old (in 1991). With two siblings embarked on their own careers, it was Dave who took on "parenthood" of their eight-year old brother, "Toph."

The book details first, the mother’s death, then, the life that Eggers and Toph negotiate for themselves and with each other after they move from suburban Chicago to Berkeley, California, and, finally, Dave’s return visit to his hometown, wherein he seeks to exorcise some ghosts. In between these landmarks are reflections on family relationships, including that with a shadowy, alcoholic father; the launch of a satiric magazine, "Might" (a title meant to signify both power and possibility); concern for wounded friends; attempts to lead a "normal" life.

While the bare facts of Eggers’s story are unusual enough, the writing is arrestingly original--performative, conversational, brash, yet self-deprecating, funny, and often moving. It is not inaccurate, and will give a flavor of the writing style, to describe the book’s "themes" in the author’s own words (from the 21-page Acknowledgments), for example: "The Unspoken Magic Of Parental Disappearance"--the admission that this traumatic experience of loss "is accompanied by an undeniable but then of course guilt-inducing sense of mobility, of infinite possibility, having suddenly found oneself in a world with neither floor nor ceiling" (xxv); "The Brotherly Love/Weird Symbiosis Factor"; "The Knowingness About The Book’s Self-Conscious Aspect"--an acknowledgment that self-reference is "simply a device, a defense, to obscure the black, blinding, murderous rage and sorrow at the core of this whole story" (xxvii); "The Telling The World Of Suffering As Means Of Flushing Or At Least Diluting Of Pain Aspect"; "The Putting This All Down As Tool For Stopping Time Given The Overlap With Fear Of Death Aspect."

Dave Eggers is on his way to New York with Toph as the book ends. They currently live in Brooklyn, where Eggers produces a quarterly literary journal (Timothy Mcsweeney’s Quarterly Concern, A Journal Created By Nervous People In Relative Obscurity) and a related Web site.

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This extraordinary graphic work began its life as a Web comic, posted anonymously, tracing in image and word the story of a son, his sisters and their mother who was diagnosed with a brain tumor, metastatic from her lung.  This comic caught on, and news of it was passed by email and link from reader to reader. About a year later, the author, Brian Fies, was presented the Eisner Award for Best Digital Comic. The entire sequence has now been published in a small, wonderful hardback book that will fit into a lab coat pocket.
 
Fies has managed to capture, in word and graphic panels, the thousand emotions and moments that swirl about a family when cancer changes their lives. He shows us the small, personal gestures and thoughts that we look back upon--how he "didn't lose any sleep" (3) when his mom first fell ill; how his mother both denied the severity of her illness and, at the same time, fell into the abyss of medical examination, radiation, chemotherapy; how he and his sisters assumed various roles in their mother's care and, soon, morphed into "superpowers," each defending his or her own territory (41-44).

Most amazing is how Fies exposes, in honest and poignant visuals, the many points of view of illness--his mother's, his siblings', his own, even the physicians'. His portrayal of how the medical system both confuses, abandons and supports his mother is alone worth the price of the book (39-40). We watch his mother, through his "cartoons," as she moves deeper and deeper into the world of illness, and we see the author's own anger in response to this loss.

He lashes out at smokers (pp 55-56), perfectly portrays the ever-smiling doctor (48-49), captures the odd suspension of a transient ischemic attack (TIA) (68-70), and lets us walk the tightrope of treatment alongside his mother (59-61). He also cleverly interweaves the back-story of his mother's youth, marriage and divorce, his childhood, and a vignette of the sickness and death of a favorite uncle, one whose dying prophesy impacted Fies's life (73-77). The moment when his mother truly understands the severity of her prognosis (94) is stunning.

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