Review of The Undying: A Meditation on Modern Illness by Anne Boyer

JORDAN MCCULLOUGH

In The Undying (2019), poet and essayist Anne Boyer offers a personal and emotive account of her experience of breast cancer diagnosis, treatment and survival. Blending memoir, scholarship and textual activism, Boyer’s work addresses many of the themes we have come to expect of twenty-first-century cancer writing: isolation, objectification, loss of self, pain, suffering, care. Where Boyer’s text departs from other similar works, however, is in its open and explicit attack of contemporary care practice in the USA, particularly regarding capitalism’s “full and festering hold” on American healthcare (156).

Chiming notably with many of the critiques presented in Seamus O’Mahony’s Can Medicine Be Cured?, also published in 2019, Boyer’s text speaks to the creation of a “capitalist medical universe in which all bodies must orbit around profit at all times” (149). Out of this spring many of the damaging aspects of contemporary care provision: the lack of psycho-social support; the dehumanisation of patients, particularly (single) females; inadequate sick leave to complete treatment; and the increasingly pervasive “awareness culture”, to name but a few. This “awareness culture”, driven in part by large pharmaceutical companies, has, in Boyer’s view, become one of the greatest threats to the contemporary cancer patient. With access to unlimited sources of medical information online, the fear of what an Internet search might reveal is often greater than the fear of the disease itself.

While the text vigorously criticises the social inequalities that result from the profit-making ethos of US healthcare, Boyer also extends her critique beyond the system and addresses individual actions by doctors, nurses and the general public. She comments upon the lack of compassion in contemporary healthcare, the overwhelming focus on “getting the job done” and the inability of society to understand illness and engage with both patients and survivors, leaving them relegated to a state of “bare inexistence” (142).

Boyer also engages powerfully with questions of expressing illness, devoting particular attention to language. She is quick to refute the idea that language breaks down in the face of illness and pain: “[P]ain doesn’t destroy language: it changes it” (213). The patient learns a new language: the language of illness. In the case of a cancer narrative, the patient’s falling hair “will fall into new alphabets and new words”, she argues (48). This association of the biological and the textual, seen throughout the work, expands our understanding of what it means to communicate illness. Boyer also foregrounds this communication at a structural level, highlighting the ability of a fragmented narrative to communicate equally, if not more, powerfully than an apparently cohesive whole.

Although Boyer’s exploration of pain and suffering is mostly focused on the physical, in her social critiques and discussions of (self-)erasure we get a glimpse of the other forms of pain endured by cancer patients: social, emotional, psychological and existential. On this level, Boyer refutes a further received idea around suffering, namely that “we are always alone in pain” (242). Drawing on literary and artistic representations, she aims to “write about pain without any philosophy” (208), attempting to overcome what she sees as pain’s exclusion of literature. Boyer seeks to present a fresh and tangible representation of the suffering that results from breast cancer, writing against many of the dominant artistic and sociological depictions of cancer patients: “I would rather write nothing at all than propagandize for the world as is” (116).

This discussion of writing cancer foregrounds a central preoccupation of the work: what is the value of literature in addressing illness? Boyer offers many robust responses. Literature reminds us of our “un-oneness”, communicating “pain’s leaky democracies, the shared vistas of the terribly felt” (239). Literature allows for the expression of bodily experience: ‘Everything about being sick is written on our bodies first and sometimes written in notebooks later’ (43). Literature is also inherently personal: Boyer’s text offers an account of a singular experience of illness, which refuses the generalization of “[w]omen’s suffering […] into literary opportunity” (117). The Undying is never presented as a paradigm for the understanding of contemporary illness, but rather acknowledges the fundamentally individual nature of each illness experience. That said, with its proliferation of intertextual references, the text demonstrates the ability of literature to help the reader make sense of and express illness: “in my forty-first year I gathered these writers around me […]. I imagined a new structure for the world” (290). Finally, the work addresses literature’s reparative and empowering functions: “If this book has to exist, I wanted it to be a minor form of reparative magic, for it to […] grant anyone who reads it the freedom that can come through being thoroughly reduced” (284).

In shedding light on the all-too-often overlooked aspects of cancer diagnosis, treatment and survival, The Undying addresses many important questions in healthcare today. While undoubtedly a socio-medical critique, Boyer’s skilful blending of personal, scholarly and engaged writing gives this text a resonance that defies binary categorisation. By breaking down many of the expectations of cancer literature, Boyer offers a text that goes to the core of what it means to be a human being: to suffer, to love, to live and to die. In laying down the gauntlet for change, both in healthcare and in wider society, the reader is faced with the poignant, poetic question that sits at the heart of the text: “Are you going to be the snake or are you going to be the snake’s cast-off skin?” (280).

The Undying: A Meditation on Modern Illness by Anne Boyer. Allen Lane. 2019. 308 pp.