A Season in Hell (3 page)

What makes a doctor wonderful, beyond medical competence, is one simple characteristic: understanding of suffering, personal comprehension of pain. One would think that anyone over thirty must know pain, but in fact, men in our society are encouraged to deny pain and suffering, and medical schools tend to encourage such denial. As a result, many doctors, women as well as men, become brittle and closed off. Of course, they suffer—that is inevitable—but they don’t let themselves feel their suffering, so derive no knowledge from it and cannot use it. And what we deny ourselves, we deny others.

There are no special phrases or gestures needed to communicate an understanding of pain (notwithstanding our President’s familiar “I feel your pain”). Those who have it convey an implicit largeness of spirit and a depth of feeling in utterance and gesture. For example, a Mount Sinai nephrologist who attended me in 1995–96 would visit my hospital bed early in the morning—as most doctors do. I do not rise early and was always asleep when he arrived, around 8:00 a.m. But instead of calling out sharply, “Ms. French!” and startling me awake, as most doctors did, he would stand silently by the side of the bed and lay his hand gently on my forehead. This would always wake me in the sweetest possible mood (a miraculous thing to induce in me in the morning!). I loved him for this gesture.

Dr. Strong was a man who understood pain. He reexamined the CT scan and shook his head again. He repeated that no one had been able to spot it, even using a magnifying glass. Then he said, “Ms. French,
you
know where the primary site is. You do. Think about it, and call me.”

I did think about it, and after a time, I recalled sitting on my porch in the Berkshires the summer before, eating a sandwich made of a good Jewish rye bread with a crisp crust, and as I swallowed, the bread suddenly stuck in my throat. It felt as if it was passing over a swelling. At the time, my heart stopped and I thought: Oh, God! What is that? But I pushed the question away. It was nothing. If it was anything, it would make itself known in time, I told myself.

Now it had.

I called Dr. Strong and told him that the primary site was about two inches below my clavicle. He said he would pore over the X-rays millimeter by millimeter with a magnifying glass. A few days later, he called, saying he had found a slight thickening exactly where I had said it would be.

Rob and my old Harvard friend LeAnne Schreiber went with me the next time. We had to wait four hours. Dr. Strong said he needed to perform a laryngoscopy and an endoscopic ultrasound to verify the location. I must have been distressed and shown it, because he insisted I wait and see Dr. McCormack, who would perform the endoscopy. Perhaps he thought seeing a woman would reassure me. (As I recall, I was upset mainly at being made to wait a total of seven hours that day.) A thoracic surgeon famed at S-K (and perhaps beyond), a former nun, the only female attending I ever met at S-K, Dr. Patricia McCormack was warm, direct, and nonofficious. She gave me the first (and only) words of hope I was to hear. Whatever kind of cancer I had, she said, it had been found early, was small and contained in a single area, and would be easily amenable to treatment
if
my body responded to chemotherapy.

Two days later, at some ghastly hour of the morning, Charlotte and I went to S-K for the procedure, performed under anesthesia. They found the primary tumor in the lining of the esophagus.

The prolonged search for the primary site of my cancer was the first in a series of events that cast me as an actor in my disease. Many patients receive a diagnosis as a prisoner receives a sentence: How many years? Death? The verdict/diagnosis feels like a judgment imposed by an indifferent authority. Patients passive in this process must feel like victims. But I had to fight for my diagnosis, I had to prod and nag the doctors to act; indeed, I had to tell them where to look. I did not receive a “verdict”; I wrenched a diagnosis from reluctant physicians. This was, for me, a victory of sorts, for treatment could not begin until the diagnosis was obtained. Of course, I was not happy to have a cancer, but I was relieved that it was finally named and located. Treatment was thus a positive event, like a reward for my effort.

I called my friends to tell them the news, and heard in their voices the same odd mixture of feelings I had: sadness that the condition existed, but relief that it had been located and treatment could now proceed. Thus far I had not told my father anything. I hesitated to tell him over the telephone—he was eighty-six years old and very fond of me—and I was unable to drive out to Suffolk County to tell him personally. I called my sister, who lives near him. She knew of my problem with my voice and was not surprised to hear that I had cancer. I asked her to visit my father and give him the bad news. My sister has serious health problems, having only one functioning kidney, and for over a decade has been warned that she may need dialysis or a transplant. She has avoided both by faithfully (and uncomplainingly) adhering to a low-protein diet. Although she rarely mentions it, everyone in the family knows of her condition.

She drove to my father’s house one summer afternoon. Isabel always invites our father to
her
house, so he recognized this as an extraordinary event. He received her solemnly. She said she had to tell him something. They sat down, and he spoke first.

“Isabel, you don’t even need to ask,” he said. “Of course you can have one of my kidneys.”

I do not now remember much beyond dread and being dazed, but during the month of June I sometimes jotted down notes about my feelings. These notes reveal great tumult. I was full of grief at losing my life and about leaving my children; I was also in a permanent state of silent terror. I imagine such emotions are ordinary, even universal. But if dying was my great anxiety, it was not my only one.

I was concerned about the fate of my book
The War Against Women
. I had had many interviews, and there was considerable interest in me personally (some of it hostile, as has been the case since
The Women’s Room
was published), but almost no reviews had appeared. Even my scholarly book on James Joyce, published in 1977, before
The Women’s Room
, had received over a dozen reviews; my novels usually received an inch-high pile of them, and
Beyond Power
, a scholarly analytical study, had been covered well. But
The War Against Women
had received only five reviews, all hostile. The
Newsday
reviewer (a woman) called the book “malignant”—a strange description of a book that is essentially a compilation of facts. The shocking facts are accurately reported; they are distressing, but they make the book essential reading. Indeed, it helped bring to widespread attention facts about the genital mutilation of women, selective abortion of female fetuses, starvation of female babies, and domestic abuse worldwide, subjects that have since been given considerable scrutiny in the
New York Times
and other widely read journals. But the book itself was either ignored or—dare I use the word?—censored.

I say “censored” because in early May I received an anonymous letter from a book reviewer in Britain, saying he or she had been assigned the book and, thinking it was important, written a good review. The review had been returned with instructions on how to attack the book. The reviewer, fearing the loss of her/his job, did the dirty work but felt like a coward, and wrote to tell me about it.

This letter brought home to me how successful the media drive (which has since become even more marked) to censor feminist and democratic ideas had been. Instead of trying to fight or adapt feminism to corporate purposes (as they did in the 1970s and 1980s), male-controlled institutions were now ignoring it, blotting it out. At present, 1998, feminist voices are rarely heard in any medium—print, television, or radio. The few women who are promoted in the media are those who have proved their fidelity to male institutions. The same thing is true of democratic thinkers, called left-wing thinkers these right-wing days. We are told the media are left-wing; but I cannot recall the last time I heard any true leftist voice on television. As the powers that be have shifted to the extreme right, people in the bland middle have been renamed leftists.

This situation, as I became aware of it, weighed me down. I felt that not only was I dying, but everything I had worked for my life long, everything I believed in, was dying too. I sputtered to my friends that I’d been born during the Depression and was going to die in one—a shorthand way of expressing the sorrow I felt about what was happening throughout the country as it was manipulated into a culture that exalts greed and condemns poor and working-class people to greater hardship.

I had for some years seen my life as blessed because it paralleled a magnificent period in American history. I grew up among the poor; poverty and ignorance are not abstract terms to me. As a child, I was familiar with oppression; I saw every day how poor people—and their children—were treated by the world, how women were treated by men, and I had a glancing experience of bigotry against blacks and Jews. But gradually, over the years, many oppressions had been lightened. Assistance was given to poor people so that children were no longer taken from their mothers and incarcerated in orphanages (as my widowed grandmother’s were, breaking her heart). Work programs like the WPA and the CCC helped take the edge off the Depression. After decades of struggle, labor unions won the right to exist and strike; following World War II, they became legitimate forums (however exclusive and corrupt). And then, in the sixties, like dawn rising, the civil rights movement began, forcing passage of humane and just social laws. And finally my sun rose too: feminists were able to utilize recent civil rights laws and create a new dialogue, a new language of justice. In the past twenty years, this wave of decency and fairness began to include people of various sexual orientations. My country had begun to forge a world more people could breathe in. These events made me proud to be an American and optimistic about the future of the human race.

Now, sick and probably dying, I watched the entire structure being shattered by greed and mendacity. A President who is still revered broke the air traffic controllers’ union, undermining the already demoralized labor movement; he adopted economic policies that enriched even more the top ten percent of the population and led to an extraordinary situation—hordes of homeless people sleeping on freezing streets in every major city in the country. So common has this sight become that we no longer remember it did not always bruise our eyes. The Presidents who followed lazily let the new right-wing thrust—which, I am convinced, arose because of television coverage of the 1968 Democratic Convention, focusing on women, people in wheelchairs, and blacks—continue. The humane experiment had lasted only as long as my puny lifetime.

All these elements combined to create a negative force, a downward-pulling energy. Late at night, in bed, I would sigh, thinking I would not mind leaving this world. It would be a relief to die and no longer feel the corrosive rage aroused by injustice. I was drawn toward death, toward rest, the end of pain, the silencing of a consciousness more sorrowful than pleasant.

This feeling became more powerful later, when I was sicker. But at this point, I could let myself down into this despair and fury as if it were a cold lake, and emerge from it without struggle. I was sustained by my children—Jamie and Rob and his Barbara—and my friends, especially Charlotte Sheedy, the coven, and Barbara Greenberg. It was a shock to me, who had always lived in proud independence, unwilling but also unable to ask for help, to discover how much I needed them: their company, their sweet words, their concerned expressions.

When I was first diagnosed, Charlotte sent me a dozen or so books on cancer, most by megalomaniacal doctors who imply (even as they deny) that they have magical powers to cure cancer. They describe miraculous cures, attributing them to their patients but emphasizing their own openness and understanding direction. I believed in the cures, but not in the doctors. Some books were written by patients who claimed to have cured themselves of cancer without medical treatment. I believed they had good luck. I did not believe people could just decide to cure themselves.

Now that we knew what kind of cancer I had, Charlotte checked with her medical contacts and sent me xeroxed reports on esophageal cancer from medical journals. These professional essays utterly lacked the optimism of the books: dealing only with nonmetastasized esophageal cancer, they reported that treated with strong chemotherapy combined with intense radiation, one of five people survived for five years. Most died within a year. The odds were not great even if the cancer had not metastasized: mine had, and widely, forming tumors outside the esophagus and in two lymph nodes.

Someone else sent me an article from, I believe, an old
New York Times
. It described Susan Sontag’s courageous handling of a breast cancer that, when she developed it, was considered terminal. She went to Paris for a severe treatment no American hospital of the time—decades earlier—was willing to risk. I do not now recall whether it involved radiation as well as chemotherapy, but it made Sontag very ill, and it saved her life. That, I thought, was what I wanted to happen to me. But even as I wished it, I knew I was thinking wishfully.

Being a lung specialist, Dr. Strong could not handle my case, alas, but he arranged for me to see an oncologist in the gastrointestinal service. The night before my appointment, Barbara Greenberg flew down from Boston. I thought she was coming just from affection, which touched me; I did not suspect any other motivation. She had called regularly, and I had kept her up on my condition, but unlike my other friends, she knew I was doomed. She was married to a surgeon who frequently treated cancer and knew that no one survived metastasized esophageal cancer. Barbara came because she wanted to be with me when I saw the doctor who would preside over my dying, and to hold my hand after I heard the news.

The night she arrived, we went out for dinner, Barbara and I and the coven. We ate at Jezebel’s, owned by an African-American woman, who has draped the restaurant with antique lace and linens and who serves a luscious Midtown version of soul food. Over dinner, we held a coven meeting, complete with eagle feathers, light-up plastic wand, crystals, and incantations. The other diners paid us not the slightest heed; as far as we noticed, not a single head turned. New York is indeed wonderful.