Cancer: a Curse and Catabolism
Humans are living organisms which are constantly susceptible to disease. Diseases are an end result of the misbehaving molecules which make up our very essence. Cancer is a disease of cellular evolution, where groups of mutant cells compete with one another for resources, evade the host immune system, and eventually metastasise to different organs. The ability of cancer cells to evolve and progress into genetically heterogeneous populations is why it is so difficult to cure cancer. The more alterations a neoplasm undergoes, the more malignant the tumour becomes, and the higher the risk of recurrence and mortality.
Cancer's effects are far more than molecular. While any major illness drastically alters the patient's- as well as their entire family's- life, cancer can affect almost all parts of the body, and is the second leading cause of death in the world. Many of us have been pained by the loss of a loved one, or at least know of a friend or family member battling against the curse. It still saddens me that I can only remember a single car journey with my grandmother, and how she flinched at the pressure of my small body leaning against her chest after her mastectomy. Breast cancer took her from us when she was in her fifties. I can recollect a single memory of her suffering, but how did my father and grandfather watch their beloved mother and wife decline into a fragile cancer patient? How did she endure the suffering? How does any person diagnosed with cancer accept their fate?
Recently reading The Iceberg by Marian Coutts and When Breath Becomes Air by Paul Kalanithi helped me to get answers to these questions by giving me a deeper insight into the impact of the disease on people's lives. Coutts is a mother, lecturer, and artist in London and she describes the two years leading up to her husband's death from brain cancer in short chapters of beautifully written prose in The Iceberg. Her writing adopts the style of fierce, desperate letters at times, particularly towards the end of her partner's illness. There is a short extract addressed to her three year-old-son that particularly touched me: 'What I feel as I watch you a living/living being and he a dying/living being seems supernatural. We have this life and we float about in it and many things continue to happen to us for very good and very ill. I am not dissolved. I do not moan or despair. I do not panic. But I am uber-naturally tired. The edges of my vision are distorted. The fibre of my muscles is weak. My tongue lacks spring. My hands do not rest. Pressure can cause me to lose my shape under tension and when this happens I lose my temper. I regret this... So, forgive.' The rawness of such passages give the book a powerful narrative force, presenting Tom's deterioration in an honest light. The juxtaposition between their son's developing language and Tom's declining speech are one of the many ways Coutts allows readers to understand the effects of a tumour located in the area of the brain controlling speech and language.
In contrast, When Breath Becomes Air is told in first-person narrative, from the patient's own viewpoint. Paul Kalanithi was diagnosed with inoperable lung cancer just before completing years' worth of training as a neurosurgeon. In the first part of the book, the reader is taken through Paul's journey to becoming a doctor: how he decided to apply to medical school instead of continuing literary studies, how he went through anatomy labs, and his frequent questioning of death. The shortness and brevity of part II, where he describes his life from the diagnosis onwards, makes his transformation from doctor to patient more poignant. I could feel his frustration at having the future he had planned clasped from him when he had come so close, and done so much. Paul's life 'had been building potential, potential that would now go unrealized. I was physically debilitated, my imagined future and my personal identity collapsed, and I faced the same existential quandaries my patients faced. The lung cancer diagnosis was confirmed. My carefully planned and hard-won future no longer existed. Death, so familiar to me in my work, was now paying a personal visit.' One of the meanings of the word 'patient' is 'one who endures hardship without complaint', and I think Paul became just that; there was immense courage in the submission and acceptance of his fate. Paul continues to influence the lives of others through When Breath Becomes Air, where his words are still very much alive.
Although clinicians and scientists are working tirelessly to advance cancer research, cancer remains one of the biggest challenges to human health in the 21st century. Prophet Muhammad said that 'there is no disease that Allah created, except that He also has created its remedy' (Bukhari 7.582). I believe this to be true, and thus, aim to dedicate my life contributing to cancer research, to turning even the most advanced cancer into a survivable disease.
