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Sharing Pain

Anne Boyer’s The Undying makes cancer a communal experience

The Undying: Pain, vulnerability, mortality, medicine, art, time, dreams, data, exhaustion, cancer, and care by Anne Boyer. Farrar, Straus and Giroux, 320 pages.

In the two books that preceded The Undying, Anne Boyer wrote about some problems with writing. “There have been years and months and days I have thought the way to live was not writing,” says a speaker in her 2015 poetry collection, Garments Against Women, “have thought . . . ‘writing steals from my loved ones’ . . . is the production of culture . . . is the world of wealthy women and men.” And writing does not feed the hungry, something Boyer remembers during a reading she gives with Fred Moten at Los Angeles’s Church of the Epiphany, described in her 2018 collection of essays and ephemera: because of a scheduling mix-up, people keep confusing the reading for the Burrito Project, where volunteers make food for those who need it. “Despite its fine qualities,” she worries, poetry is “a total fail at producing burrito.”

Of course, as Moten points out to Boyer, “a person cannot live on burritos alone.” And, as she points out to us, “words are useful for upending the world in that they are cheap, ordinary, portable, and generous, and they don’t mess us up too badly if we use them wrong . . . ” Such arguments are convincing, but they also give the impression that Boyer wrote them down to convince herself. Throughout the collection, A Handbook of Disappointed Fate, they appear so frequently as to suggest an underlying anxiety or uncertainty. They assume that writing’s value is not self-evident—like, for example, the value of a burrito—and that its potential value is in large part instrumental. At one point, Boyer imagines literature as a “cognitive rehearsal” for something we might wish would happen—say, the abolition of the hierarchy that places poor below rich.

In The Undying, Boyer’s politics have not slackened at all but her ambivalence about writing is gone. “After cancer,” she writes, perhaps by way of explanation, “my writing felt given its full permission.” In 2014, in Kansas City, Boyer noticed a lump in her breast and was soon diagnosed with triple-negative breast cancer, an aggressive form of the disease she had a 52 percent chance of surviving. Forty-one years old at the time of diagnosis, she was, in addition to being a poet and professor of writing, the single mother of a daughter about to start high school. Boyer’s treatment included a chemotherapy regimen so toxic that the first oncologist she consulted refused to prescribe it for fear of debilitating her. She also needed a double mastectomy, which she describes like this: “It is decided without ceremony that the doctors will eventually take my breasts from me and discard them in an incinerator.” The passive voice approximates the scary momentum of a medical decision that is supposedly yours to make but doesn’t feel like it; Boyer’s straightforward description, to the extent that it shocks, reveals how accustomed you are to the health care industry’s evasions and euphemisms. Here and everywhere in The Undying, her insistence on the specificity of her bodily experience makes you viscerally aware of your own.

Boyer’s own sickness and treatment play out not in a vacuum, but among other people’s sicknesses and deaths, in an industrialized world that will eventually make most of its inhabitants sick with cancer or something else.

The book is “an autobiographical account of what it is like to have a body in a specific time and place,” to borrow Boyer’s description of Hieroi Logoi (Sacred Tales) by the second-century Greek orator Aelius Aristides, one of many texts and artworks about illness and pain that Boyer references, quotes from, and argues with, placing her writing in their lineage. The prologue to The Undying explains what makes her specific time and place—and the literary forms they demand—different from those of breast cancer patients who came before. When Fanny Burney described her pre-anesthesia mastectomy in a 1812 letter to her sister, she was articulating a rare experience at the great personal cost of reliving the nearly unbearable. When Audre Lorde’s Cancer Journals were published in 1980, her first-person account of cancer rippled through a surrounding quiet. Until more recently, people didn’t often discuss their diagnoses in public. Susan Sontag and Rachel Carson each had breast cancer, yet wrote about cancer without addressing their own.

Over time, the narrative of breast cancer has evolved. “The silence around breast cancer that Lorde once wrote into is now the din of breast cancer’s extraordinary production of language,” Boyer writes. Stories of breast cancer are all over the news, social media, and the marketing platforms of the hospitals and foundations for which breast cancer equals revenue. Attributing survival to “compliance, 5k runs, organic green smoothies, and positive thought,” these narratives elide the industrial pollutants that could make any of us sick, and the health care industry’s racism, sexism, and profit motive, which give many people little chance of getting well again. “The external world is taken as a given, a backdrop against which the personal drama is played out,” writes Boyer, quoting Ellen Leopold, who observed in her cultural history of breast cancer A Darker Ribbon (1999) that first-person accounts of disease and disorder tend to interpret the outcome of treatment through the “narrow prism of individual personality.”  

In The Undying, Boyer’s own sickness and treatment play out not in a vacuum, but among other people’s sicknesses and deaths, in an industrialized world that will eventually make most of its inhabitants sick with cancer or something else. Noting that the “narrative spoils” of breast cancer usually go to the “victors” who have survived it, she relentlessly intersperses the stories of women who have died. Burney, Carson, Lorde, and Sontag, to begin with. Then, among others, Kathy Acker, whose friends critiqued her choice to forego chemotherapy that probably would have destroyed her quality of life without giving her much more time to live. Then a cancer vlogger, Christina Newman, who tried to treat her cancer with diet and exercise until she was close to death, at which point she began warning others against this path. Then another cancer vlogger, Coopdizzle, who died of the same kind of cancer Boyer had and spoke movingly of her experience.

“It’s a scary place inside cancer land,” Coopdizzle once wrote, in a line Boyer quotes. Like Acker (and Boyer), you might find that some of your friends abandon you after your diagnosis. Like Newman, you might fall prey to false hopes. Like Coopdizzle, you might die because your cancer hasn’t been sufficiently studied. Like Boyer, you might need treatment that will debilitate you for the rest of your life. Like more than 40,000 women, you might undergo life-threatening yet ineffective treatment based on fraudulent research. Or perhaps cancer will ruin you financially—as research suggests it is prone to do if you live in the United States—leaving you insolvent, in debt, or bankrupt. If any of this happens, it will happen in a world where the Susan G. Komen Foundation, a breast cancer charity, has partnered with the Baker Hughes corporation to produce a thousand breast-cancer-pink fracking drills.

As Boyer moves through cancer land, she pays equal attention to its machinations and the effect they have on her. In the cancer pavilion where she receives treatment, receptionists distribute forms and print bracelets; nursing assistants hold doors open with their bodies and call out patients’ names. “Then they lead the patient (me) to an examining room and log into the system,” she writes. Before she begins treatment, she learns about a study “into sensations a person (me) hasn’t yet had to feel, but will.” These eruptions of “me” (and elsewhere, “my body”) extend beyond parentheticals into a continual movement between third-person declarative and first-person narrative. “In the capitalist medical universe in which all bodies must orbit around profit at all times, even a double mastectomy is considered an outpatient procedure,” she writes, and then, “After my mastectomy, the eviction from the recovery ward came aggressively and early.” Like her parentheticals, Boyer’s shifts from general description to personal history emphasize at the level of form that she is ungeneralizably particular—a specific person having specific experiences—and yet shares with countless others the experience of moving through unhealthy environments spawned by revenue-hungry industries.

Boyer, by describing not only her sensations but their economic, social, and literary histories, restores our brains to our bodies and our bodies to the world.

That experience is largely made of sensations, and Boyer is excellent at describing—and in describing, transmitting—them. She cites a Clarice Lispector line about how trying to describe pain is like trying to photograph the scent of perfume, but goes on to demonstrate it is not quite true. You shiver or at least tense up when she writes, about the effects of chemotherapy, “fingernails lifting from fingers hurt as badly as fingernails lifting from fingers should.” Or, “My nerves begin to die, disintegrating into a sizzling sensation from their ends in my fingers, toes, and genitals.” To read The Undying is not to see pictures in your mind but to feel feelings in your body. In this way, the book echoes the work of somatic poets like CAConrad and Bhanu Kapil, whose writing includes exercises that are meant to be done, or that the authors have done, in the world outside of the poem. Like their work, Boyer’s writing explicitly uses language as a bridge from body to body.

It is this transmission of sensation that most effectively cuts through the blur of information and images that obscure, often deliberately, the reality of cancer and so much else. “Sensation is the enemy of quantification,” Boyer writes. “There is no machine, yet, to which a nervous system can submit sensation to be transformed into a sufficiently descriptive measurement.” Perhaps it is no coincidence that machines can more easily identify images, which, alongside mere data, are the other main occluder of reality as Boyer understands it. Just as prone to omission as the one-to-ten scale on which she is asked to rate her pain are the photos in the instructional materials she receives, which feature smiling multiracial groups of people who show no sign of cancer or any other difficulty. Images and data, the streams so many of us swim in, are a kind of “mystification,” which “blurs the simple facts of the shared world to prevent us from changing it.” Boyer, by describing not only her sensations but their economic, social, and literary histories, restores our brains to our bodies and our bodies to the world.

The opposite of mystification, she suggests, is “enchantment,” or “the ordinary magic of all that exists existing for its own sake.” By this definition, The Undying is enchanted. It does not improve the world because it provides a cognitive rehearsal for something new, but merely because it exists. Where Boyer’s previous work sometimes presented writing as a useful tool, it becomes here, in its enchanted state, a fundamental necessity divorced from notions of utility: “My friend Cara told me that it was clear that when I was at my lowest, what I needed most was art—not comfort—and so it was to get through cancer that I had to wish everything around me into aesthetic extremity.” It is true, to paraphrase a Diane di Prima line Boyer once cited, that no art is worth a single human life. But to read the The Undying is to see that this proposition is perhaps less relevant than the fact that art is a form of human life—one of the few, along with memories and dreams, that put the dead on the same plane as the living.