Last summer as I sat waiting for my first mammogram after feeling a lump, I looked around the sparse room and felt myself recoil from the pink ribbon decor. Even before I was diagnosed with breast cancer, I knew I did not want an industry — the cancer non-profit fundraising industry, which lives so closely and cozily with the for-profit health care industry — telling my story. And so, when I picked up Anne Boyer’s The Undying, a book of lyric and personal essays on breast cancer, I was glad for how she writes against all of the Hollywood tropes, the pink-ribbon saccharine self-help advice, and the cancer cliches foisted upon patients. Women with breast cancer often feel expected, even pressured, to perform a shiny, forced hopefulness; Boyer rejects that expectation by writing directly into the discomfort, the pain, the loss, the rage and the indignities of cancer and cancer “care.” The book’s subtitle, written as a vertical word column on the book’s cover, announces her intention: “pain, vulnerability, mortality, medicine, art, time, dreams, data, exhaustion, cancer and care.”
Anne Boyer’s The Undying is a book about living through something awful — a biological suffering made worse by human systems — and using art to make meaning through the disaster. And the disaster is so widespread. Boyer opens the book with a listing of women writers and artists who died of breast cancer: Audre Lorde, Susan Sontag, Kathy Acker and Rachel Carson, among many others. As one of the “undying,” as someone who has survived breast cancer, Boyer is writing into the void left by these women’s too early demise, creating new language for speaking about such a prevalent disease.
In order to begin to represent the myriad breast cancer experiences, the book defies a predictable nonfiction structure. There are ten named sections in the “Contents” that give loose shape to the book, though many of the themes and threads — capitalist medicine, pink-ribbon-industry, care, chemotherapy, illness, pain, suffering, art, history, philosophy — run throughout the book. Each section includes numbered and non-numbered sub-sections, like mini-chapters, some of which take as little as a half a page. The structure feels unpredictable, with white space sometimes followed by text, other times by new chapter titles or numbered section headings, creating at times a disjointed or confusing reading experience. The subsections of Chapter One, Section One do not seem discreet from Chapter One, Section Two. The book’s erratic form echoes the disorienting experience of entering the chaotic and paradoxical — simultaneously uncaring and caring, toxic and lifesaving — world of cancer treatment that Boyer is rendering on the page.
Reading her incisive observations while enduring breast cancer treatment sometimes felt like being hit with wave after wave of too much truth at once, and I often had to set the book down. The first time I had to stop was in the second chapter, “The Birth of the Pavilion,” when Boyer details the Western medical systems that we – those of us with access – must endure. She describes the gendered hierarchies and profit motives without flinching. “The receptionists, nursing assistants, lab technicians, and nurses are not only required to enter the information of my body into the databases, they also have to care for me while doing so… The work of care and the work of data exist in a kind of paradoxical simultaneity: what both hold in common is that they are done so often by women, and like all that has historically been identified as women’s work, it is work that can go unnoticed.” (p.54-55) As a patient and observer, Boyer keeps noticing, keeps watching and recording the multiple indignities of the system. “If it is the women who transmute bodies into data, it is the doctors who interpret the data. The other workers have extracted and labeled me: I have informaticized my own sensation. It is the doctors who read me — or rather, read what my body has become: a patient made of information, produced by the work of women.” (p. 55) In a later section, she narrates her painful experience of being “evicted” from her post-op recovery bed when a nurse wakes her from anesthesia. The writing is unflinching in exposing the brutality of our medical system.
Boyer is deft, often painfully concise, in her analysis of individualistic, often toxic, cancer self-help tropes. “Cancer Messed with the Wrong Bitch,” and “Fuck Cancer,” the T-shirts and memes pronounce. Though these phrases aim to elicit a sense of empowerment for “cancer warriors,” Boyer points to the contradictions. “When you have cancer, you have to learn to understand what is growing inside you as that which is both yourself and not yourself, as yourself and a thing that, if all goes well, will be taken out of you, too. Self-love under these conditions appears to require you to love the cancer in yourself and to hate it as a threat to yourself, too.” (p.78) Later in “The Hoax,” a section about the ways patients and industry tell cancer stories, Boyer eviscerates cancer-positive-speak by highlighting how ridiculous the same advice would sound under other circumstances. “I came across a headline: ‘Attitude is Everything for Breast Cancer Survivor.’ I look for the headline ‘Attitude is Everything for Ebola Patient’ or ‘Attitude is Everything for Guy with Diabetes’” (165). On a half page of text, surrounded by white space, she repeats her invented “Attitude is Everything for…” phrases, including “those with congenital syphilis” and “lead poisoning” and “when a dog bites your hand” and “a gunshot victim.” The list devolves into the even more ludicrous examples, including “gravity,” “the water cycle,” “varicose veins,” and “dying coral reef.” Boyer uses repetition of the absurd to highlight the way our culture insists people with breast cancer be heroic, stoic, and brave while never asking the probing, hard questions.
The book’s sections have evocative titles that do not sound like typical cancer writing, including “The Incumbents,” “Birth of the Pavilion,” and “How the Oracle Held,” and “In the Temple of Giuletta Masina’s Tears.” If pink-ribbon culture draws on the over-simplified self-help and positive-thinking cliches, Boyer’s section titles alone announce that she will write with nuance and complexity, drawing on art, history and philosophy. Many of the section titles have epigraphs that quote writers and thinkers from centuries back. “Birth of the Pavilion” is a reference and play on Foucault’s writing on illness, “The Birth of the Clinic.” Fifteen pages into writing about her treatment in her hospital’s “cancer pavilion,” Boyer writes, “The word ‘clinic’ is derived from the Greek clīnicus, meaning ‘of or pertaining to a bed.’ The word ‘pavilion,’ on the other hand, is intended for an entirely different structure… Activity inside the pavilion is transient, abstracted, impermanent, dislocated” (61-62). The section titled “In the Temple of Guilietta Masina’s Tears,” (a reference both to her imagined work of public art about crying and to the 1957 Federico Fellini film, “Nights of Cabiria”) opens with an epigraph from The Book of Margery Kempe, a text by a medieval Christian mystic.
Boyer writes about the common experience for patients with pain: doctors ask us, what number would you give your pain? Of course pain, suffering, and despair are not only beyond simple one-to-ten quantification, but also, often, beyond words. The book opens with an epigraph from The Iliad: “Not even if I had ten tongues and ten mouths.” The experience of cancer feels impossible to tell, especially while trying to survive its chaos, but Boyer set out to try, anyway. As a writer, I am moved by Boyer’s success at putting into language what feels so ineffable and nuanced and as I hurry past my hospital’s pink ribbons to get my next round of chemo, I clutch The Undying, carrying it with me like a counter-curse.
Krista Lee Hanson lives in Seattle, home of the Coast Salish people, with her partner and two children. She is a writer, yoga instructor and longtime organizer fascinated with the beauty and difficulty of living in our human bodies. Her work has appeared in The Rumpus, The Write Launch, the Rad Parents anthology, among other publications.
Assay: A Journal of Nonfiction Studies 