Thursday, August 5, 2010

'I love the imagery of struggle." Christopher Hitchens on "battling cancer"--lessons for the rest of us.

Christopher Hitchens, the well-known pundit and essayist, writes gracefully and intelligently about his cancer in Vanity Fair, just as he writes gracefully and intelligently about everything else.  In one significant passage, he takes up the issue of "fighting" cancer:

Unfortunately, it also involves confronting one of the most appealing clich├ęs in our language. 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.

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.

Let's unpack this passage a bit, starting with the phrase in the second line: "battling cancer." Hitchen is absolutely right: everybody says "I am battling cancer," or "You should fight your cancer," or some variant of such martial talk.   Moreover, anybody who has read or heard anything from or about Hitchens knows that he is notoriously combative, at least with words.

So it would make sense that Hitchens would be militant in his cancer-fighting imagery.  Except, of course, that he isn't militant, at least not in this essay.  As he observes, "When you sit in a room . . . [receiving cancer drugs] 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."  That's not very combative.

Hitchens is entitled to his opinions, of course, and for all we know, he will come out swinging tomorrow.

But we might step back a little bit and consider Hitchens' situation--and the situation we all face, sooner or later.   Here at SMS, we think it's perfectly reasonable to think that we are fighting a disease.  Indeed, we think that the disease struck first.   And disease is, after all, trying to sicken, incapacitate, or kill you.

So why not fight back?  Why not seek to remove, irradiate, poison, or otherwise destroy the disease agent?   After all, it's kill or be killed.   As America GI's said at D-Day, back in 1944,
if we stay on this beach, we are sure to get killed, so we might as well advance and take our chances.   And what do you know--the Americans took the heights overlooking the beaches, on their way to victory against Hitler.  Active is better than passive.  Proactive is better than reactive.

But here's a point on fighting cancer: Such fighting is best done in advance.   When cancer strikes a victim, that victim might not be in a good position to fight.  We can analogize the situation to that of a soldier on a battlefield: The time for maximum heroics is when the soldier is healthy.  After the soldier is hit, well, it's harder to score a victory.   As George Patton said, the goal of war is not to die for your country--it's to make the enemy die for
his country.  

Moreover, while we all celebrate the heroism of Patton and others in World War Two--from Audie Murphy to John Basilone to Mike Strank to thousands and millions of other heroes--we should remember that we won World War Two mostly because of superior technology.  It takes nothing away from the heroism of our troops to note that we had superior materiel to pile on the Germans and the Japanese, culminating, of course, in the atomic bomb.   It's perfectly fair to say that World War Two was won in the foundries of Pittsburgh, and the shipyards of Oakland, and in the laboratories of Cambridge and Pasadena.

It's also safe to say that we will win our next war--or not--based on the technology we have, or don't have.  Will we attempt another counter-insurgency with insufficiently armored vehicles, or with
heavily armored vehicles that tip over on narrow roads?  Let's hope not.  Because if we go to war, once again, with the army we have, as opposed to the army we need, we might find the results to be disappointing.  Or worse.

And the same holds true with disease.  We needed Hitchens' fighting spirit, on the issue of cancer,
before he got cancer.  When the disease strikes, it might be too late.   We needed Hitchens thinking about nuking cancer when he was at the peak of his intellectual and rhetorical powers--not once he has been sickened and weakened.   Yes, he has moral authority now, and his story speaks to us with human interest and compassion, and so we still can benefit from his voice.

But by his own account, he is less able to concentrate, and he might not have much time left to write anything.  Hitchens is 61.  He had decades to help persuade others that cancer was a war--instead, he fought other wars, intellectually.  Quite possibly, he doesn't regret any of the choices he made, but just as possibly, he might wish that he had more time on this earth to keep fighting those fights.

As the Roman military strategist Vegetius is
believed to have said, "If you want peace, prepare for war."  To which we could add, "If you want victory, prepare for war."   And the time to prepare is in advance.   

That is, the time to develop Serious Medicine is now.

Let's hope and pray--even if Hitchens, a notorious atheist, might not want us to bother--that Hitch makes a full recovery.  But let's also think to ourselves: The cancer war is coming, and we should be ready for it  --with maximum firepower.    If we wanted to, if we bothered to make the effort, we could fight the cancer war with the same overwhelming force that we used during World War Two--and all of our successful wars.  

Hitchens' essay can thus serve as a rallying cry, an inspiration for the rest of us.  But I am sure that he himself would rather be around to toast the victory.  


  1. I read somewhere that we are all born with a handful of genetic mutations that, if triggered by such environmental factors as a viral infecton or cigarette smoking, will cause cancer. Perhaps we should spend more time studying the genetics of people who don't get cancer rather than environmental factors that we cannot always avoid - which is how we approach cancer prevention now. Hitchens smoked and drank too much and got cancer. Others did the same and did not get cancer. It was not his fault, it was merely his fate.

  2. Hey Jim--

    Well put... echos a little bit, at least in thesis, to Nixon's "War on Cancer."