Cancer Will Not Defeat Senator McCain

Whatever transpires in 2018, cancer will not defeat John McCain. 

Cancer is neither an opponent nor a binary condition, and the sooner we stop pitting humans against a disease, stop using war metaphors in the field of medicine, the better off we all shall be, especially cancer patients and their loved ones. Many a mislabeled loser has been quietly valiant and privately heroic.

A war veteran, prisoner of war survivor, and presidential candidate, Senator McCain’s courage has never been in question. But glioblastoma cares nothing about mettle or fortitude. Only 5 out of 100 people outlive the illness, and, according to the best studies available, their survival was not due to willpower or fighting spirit. Teddy Kennedy and Beau Biden lacked for neither, and both were felled by the disease. 

If “battling cancer” has long been a misguided metaphor, it seems spectacularly inapposite in connection with the redoubtable John McCain. Cancer is not an adversary to be conquered or outflanked; cancer is the emperor of all maladies. An oncology team finds it, cuts it out, poisons it, irradiates it, and prays for the best. If they are successful, your cancer will go into hiding and lurk just outside the gates of good fortune for a long time. The idea of winning or losing is just cruel, as it has been since Susan Sontag made the point 40 years ago in her classic “Illness as Metaphor.”

When first diagnosed, unspoken shame strikes all patients: You must have smoked or drunk too much, eaten unwisely, exercised insufficiently, loved incompletely, or mangled your emotions into some sorry state. And then, should you succumb to cancer, the unuttered implication is you did not fight doggedly enough, or you chose the wrong hospital or wrong protocol or, God forbid, the wrong God. 

It is all unnecessary and untrue. You do not declare war on nature; cancer has been with us since ancient Greece, when Hippocrates, the father of medicine, removed tumors around 440 B.C. Just like my doctors did for me in 2015. 

Tonsillar squamous cell carcinoma is not as lethal as glioblastoma, but it’s a serious disease. Cancer of the head and neck is the sixth most common malignancy in the world. Possessing neither the energy nor inclination to charge into battle, I surrendered to the new realities of the constant companionship of mortality and the hard work ahead.

After CAT and PET scans, I took drugs, took notes, had teeth removed, then a tonsil (by a robot) and dozens of lymph nodes. No food or water for eight days. Thirty-five radiation sessions scrambled my taste buds like eggs, burned my throat like toast, and fried my saliva glands. Eating was a chore. Forty pounds disappeared. Talking was difficult, breathing was compromised, and any social life was fantasy. Hardest of all, perhaps, was trusting total strangers who introduced themselves as my doctors and nurses and technicians and dietitians and therapists — far from a battalion of warriors, they made up a gentle, lifesaving team. They addressed my cancer. I dealt with my psyche. And my family. I can only hope I did as well as they.

Battle cancer? At 67 years of age? At 80? At 8? Other than “following orders,” military language never came into play. If a metaphor were needed, weather provided a more useful lexicon. Weather can surprise, strike hard, and then dissipate. Cancer was akin to a great northeaster; once spotted on the radar screen, you batten down the hatches, consult the experts, follow the playbook, gather supplies and community, and hope for the best. You don’t fight weather. You don’t blame its victims, and you don’t put the onus on the stricken.

Then, as now, support and encouragement can be salutary during hard times and health challenges, but they are not magical. With cancer, the only real war is the war of words. People mean well, but their best wishes can be laced with unintended meaning. 

And even a wordsmith like Barack Obama, ever empathic, could use some re-education.

“Give it hell, John,” is what Mr. Obama tweeted to Senator McCain last year.

You cannot give cancer hell. Cancer is hell.

Some metaphors work.