Those who have been forced through serious illness – I am thinking now of cancer - to confront and acknowledge the existence within them of a mindless ‘malignancy’, whose baneful efflorescence aims at their damage or destruction, will, at some point, be faced with the burden of finding some way to cope with this dark knowledge.
According to Black’s Medical Dictionary, cancer refers to any malignant tumour capable of progressive growth, unrestrained by the organ or tissue in which it originates, and which may potentially spread to other organs or tissues. Cancer has replaced tuberculosis, or consumption, as it used to be known, as the affliction most feared by the healthy. There are few people today who have not been touched, directly or indirectly, by this terrible disease.
So much of the everyday depends on how we see things, how we interpret and make sense of what happens to us, and the ways we discern possibilities of meaning and understanding in our lives. Cancer, or any life-threatening illness, asks for a context, a background and a dimension, against which it can be seen and coped with.
Recently a very interesting piece appeared in The Irish Times by medical correspondent, Muiris Houston. It was written in response to an article in the British Medical Journal by Natasha Wiggins, a junior doctor working in oncology. Ms Wiggins questioned the appropriateness of the military metaphors used both by doctors and patients to describe and deal with cancer.
Tracing this language and the metaphors it has spawned, she points to the use of military terminology used by President Nixon in a 1971 speech in which he publicly declared “war” on cancer, referring to it as a “relentless and insidious enemy”. Ms Wiggins notes that in the years since then “advances in medical knowledge have made it clear that cancer is not one but many enemies”, quoting Pulitzer-winning oncologist Siddhartha Mukherjee, who says that cancer “is a puzzle, you cannot win a puzzle, you can only solve it”.
There is some truth in this, but the metaphor of a puzzle to be solved suggests, even more so than a battle to be fought, that a solution can be found. It also tends to trivialize the issue. Battles have uncertain outcomes. You may lose, but you may also win. No one ever died for not finding a solution to a puzzle.
Houston puts forward another metaphor with deep roots in human nature, that of a journey, with its linked metaphors of the rough way and the smooth way, the dangerous way and the easy way, the roundabout way and the straight way. And, of course, a journey has an origin and a destination, though this may be shrouded in mystery. We are meaning-making creatures. It is natural for us to turn what happens to us into a narrative.
Yet it would, I think, be a mistake to jettison entirely the metaphors of battle, courage, and heroism shown by so many cancer- sufferers. Perhaps what is needed is to look again at the concepts of battle and courage.
It may seem a big jump from considering cancer in the 21st century to a battle fought in England in 991AD, celebrated in an incomplete Anglo-Saxon poem called The Battle of Maldon, and which had an enormous influence on JRR Tolkien’s Silmarillion and The Lord of the Rings.
The Battle of Maldon tells the story of an attack by a fierce army of Viking invaders. Although the Vikings are between two branches of a river and so separated from launching their full strength at the Anglo-Saxon army, Beortnoth nobly allows them free passage to do battle on equal terms. Vastly outnumbered, Beortnoth and his brave men are slain until only a small, unflinching band of warriors remain.
Among those left, who know the fate that awaits them, is Byorthwold, an old companion of the slain Beortnoth. Instead of giving way to despair, Byorthwold, hoisting his shield and brandishing his spear, urges the remaining warriors to fight on, declaring: “Our thoughts must be the braver, our hearts the steadier, our courage the greater, as our strength grows less.” Though victory is sweet, for Tolkien, defeat or death in battle, especially against impossible odds, he sees as the highest and noblest expression of courage and, so, heroism.
The one who fights on, the one who hopes the tide will turn, yet prepares for defeat, and who confronts his fate with undaunted courage, knows that not all victories are the same, and that there may glory even in defeat. For facing the worst, knowing it to be the worst, is what makes for true courage.
Here, I think, is a metaphor by which we may live and die with dignity.