Sunday, September 25, 2011

Militaristic Language

I am generally an opponent of militarized language in my own life and the culture around me. I think that using war and battle metaphors erodes our sensitivities and normalizes the suffering of war. For these reasons and many others, I have tried to come up with a different framework for talking about my cancer, but at times, that has been hard.

Several years ago I read Susan Sontag's book, Illness as Metaphor, which I found to be an interesting and powerful critique of how many chronic illnesses have been addressed by culture and society, but the book was largely about the danger of the use of metaphor to describe illness. I have found that I needed to express how I was feeling to get through this experience. In order to express how I was feeling, I needed the tool of potent metaphor. But too often, I couldn't think of language absent of militaristic terms.

For example, in trying to describe my feelings just after getting my good test results last month, I had one clear image in my head; one truly effective metaphor. I felt like a General at the end of a war, who had been so focused on each individual battle that they couldn't see beyond what was right in front of them, now standing atop a hill and surveying the final battlefield, still coming to grips with the losses and successes, while a ticker tape parade waited at home. This metaphor captured the complexity of my relief, joy, grief and the intensity of the moment, but like so many of my metaphors along this cancer journey, is soaking with militaristic imagery.

A few weeks ago, an opinion piece appeared in the New York Times that dealt with this subject in what I felt was a thoughtful way, written by Daniel Menaker. As I continued to contemplate the ease and frequency with which I fall back on the use of this vocabulary, I was really interested in what he had to say.

Menaker opens his column:

EVERY day in obituaries, you will find combat metaphors about people who have died of cancer. "After a heroic battle against cancer," "valiant fight against melanoma" And so on. News stories routinely refer to "weapons" against the illness, the "arsenal" of drugs, "victories."

This line reminded me of something that Christopher Hitchens wrote in the first of his extraordinary columns about his cancer experience in Vanity Fair:

You’ve heard it all right. People don’t have cancer: they are reported to be battling cancer. No well-wisher omits the combative image: You can beat this. It’s even in obituaries for cancer losers, as if one might reasonably say of someone that they died after a long and brave struggle with mortality. You don’t hear it about long-term sufferers from heart disease or kidney failure.

For so long, I have struggled to figure out why these combat metaphors are so common for cancer patients specifically, and why and how they have been useful for me over the years.

I'm not sure I'll ever be able to live with the military language around cancer that label me a survivor, a fighter, a victim; but I'm not sure I'll ever be able to fully describe my experience in the vacuum of such language. Menaker does a great job of explaining the utility of these terms. He writes:

But I also endorse the militarization of cancer talk. At least for some patients, and at least when they talk to themselves or those close to them about their situation. Because all of us are — by part of our nature — combative creatures, and it can be emotionally useful to view cancer as an enemy, even when you know it’s not.

It can motivate us to follow the often complex treatment regimens (regimens!) involved. It can help us feel less frightened and more composed when facing surgery. It can strengthen our resolve to stay in the best shape possible and to deal with pain when it comes. It may be a kind of self-delusion, but it may also assist self-preservation. And it may help others to face their illness with less fear than they would have had otherwise. There is nothing wrong with being emulable.

There’s a strong reason that cancer in particular tends to elicit warfare language: it is so radically territorial in its actions. That is, it’s usually trying to take over the physical space that is one’s body, just as a foreign army tries to take over one’s country. Also, try as we may, we cannot scour the language of metaphor. “Cancer” itself is a personification — well, a crustaceanification. A malignancy doesn’t know or care if it’s “mal.” It’s not evil. It just is.

Both authors also explain what does and does not work about these metaphors in their personal experiences. Hitchens writes:

Myself, I love the imagery of struggle. I sometimes wish I were suffering in a good cause, or risking my life for the good of others, instead of just being a gravely endangered patient. Allow me to inform you, though, that when you sit in a room with a set of other finalists, and kindly people bring a huge transparent bag of poison and plug it into your arm, and you either read or don’t read a book while the venom sack gradually empties itself into your system, the image of the ardent soldier or revolutionary is the very last one that will occur to you. You feel swamped with passivity and impotence: dissolving in powerlessness like a sugar lump in water.

When I read this, I breathed a sigh of recognition. These terms didn't feel wrong only because their source is in war and violence, they also made me feel disingenuous. Words like "brave" and "warrior" made me feel like a fraud. What is valiant about fighting (there's that term again...) for your own life? Survival is the most base, simple thing we're all biologically programmed to do. And my experience reflected Hitchens'; during treatment, you often feel anything but strong or valiant. Still, the question persists: what is a new metaphor or set of terms to use to articulate aspects of this experience?

In his article, Menaker says that he has found it useful to think of cancer as a "problem." He writes: seems more calming, less victimizing, to think of the disease as a problem, not an enemy. A problem to be worked on, considered from this angle and that, and solved. Or just as if not more likely, not solved. But in either case not a malevolent foe who is going to vanquish or surrender to me. There’s no “volent” involved, after all.

I see his logic here, but I wonder if the term "problem" doesn't bring along its own set of issues. A "problem" is something that, with the right set of resources and the correct strategy, you are able to solve. There have been times when, in order to cope with the reality I was facing, I had to acknowledge that this might be a problem without a solution. And, does the notion of cancer-as-problem make those who do not live less effective problem-solvers? That just doesn't resonate with me.

My own shaky version of a solution to this larger question is to instead, try my best to think about cancer as a journey. A journey is neither positive nor negative on its face, but does bring with it the inherent positivity of forward motion. A journey doesn't imply a struggle per say, but does evoke the idea of stops and lessons along the way.

To reframe and make more accurate the metaphor of the General on the hill, I have sought out the right words to describe not the war, but the journey.

I think that the emotions of the past few weeks have been made more complex because of my embrace of the journey metaphor, but that in the long run, I am better off for that. It has enabled me to understand that this significant stop along my path is not the final one, not an ending of any kind, but rather a milestone to be celebrated and contemplated as I continue down the road.

Friday, September 9, 2011

A Deep Clean

For nearly five years, cancer has been a persistent backseat driver dictating the twists and turns of my ride even as I have tried to maintain control of the wheel; gripping it tightly, shoulders clenched. These days, I feel like I am finally driving alone, windows down, music playing, with my destination in my hands alone. It feels good - euphoric sometimes - and no doubt is an interesting adjustment.

As I conclude my recovery time here in Chicago, and plan to return to Washington on September 15(!), I have found my time divided between two main efforts. The first has been an on-going alchemy challenge with my doctor to maintain the right combination of medications - especially the three that do the job of striking the ideal balance between the donor graft and my own immune system. I have had some tougher days: some flare-ups of graft versus host disease that leave me tired and nauseous, followed by dosage changes that can be hard on my body. I've also begun to face the follow-up and fall-out from all these different toxins I have been necessarily exposed to. Seeing specialists to deal with permanent damage, and doing tests to compare baselines, is going to continue to occupy attention and time in my life, but it feels good to finally address some things that have had to wait to deal with until after treatment was finished. Mostly I have had good days, and feel like I have had the luxury of some time to organize and think ahead in a way that I haven't in many many months.

One of the manifestations of this new energy has been the second effort occupying my time and attention: a massive house-cleaning project that I've dragged my whole family into. While I was never destined to star on
Hoarders, those who've been in my room in Chicago or my apartment in DC might characterize it as clean but cluttered. Piles, full shelves and sometimes brimming closets are my standard. If only you could see me now.

I've sorted through every drawer, every bin, and each piece of clothing; every book, button, and piece of paper in my childhood bedroom. I have cleared out each college box stashed in the basement and sifted through childhood projects, old paperwork, toys, games and books. Everything has been sent off for donation, recycled or thrown out, and in rare cases, saved. The effect is very satisfying.

This instinct to purge makes some cancer-related sense. The desire to start fresh, to step up to all those things I'd been putting off when treatment had left me so exhausted and overwhelmed, and the urge to control my environment after years where control felt so lost, all seem like a natural reaction.
But another byproduct of this mass cleaning effort has been a prolonged and sweet episode of "elissa froman, this is your life."

I've found items ranging from the hilarious (my 3rd grade school paper article polling the class on the ’93 Bush-Clinton election, a lot of pictures from my bowl-haircut days) to the telling (a VHS tape recorded off the TV that contained both Judgment at Nuremberg and Sesame Street Presents: Follow That Bird!) to the reflective (my first lesson plan as a religious school teacher, 14 years of hand-written cards from one close friend) to the once-thought-lost (favorite earrings from eighth grade, my first oil painting) and about everything else in between.

There's something surprising and poignant about how this cleansing expedition has turned out. As I feel a renewed opportunity to let myself look forward to my future, significantly less encumbered (though not completely free) by the "what-ifs" that have been present for so long now, I feel that this little protected period of time between the good news and rushing back to life in Washington, is an oasis. And having the opportunity to look back so deeply and thoroughly: reading birthday cards and book inscriptions; seeing toys, art projects and stories that bring back great memories; holding little landmarks of my past in my hands; has prepared me well for continuing to contemplate my future.