Anatole Broyard was a celebrated New York literary critic, who died from metastatic prostate cancer in 1992. He recorded his thoughts on his disease and experience in a collection of essays published under the title, ‘Intoxicated By My Illness’,1 which for some reason has just come to my notice. It is a gem of a book, and one essay in particular, ‘The Patient Examines the Doctor’, is so packed with observations—stimulating, provocative, mischievous and moving — that no doctor with a shred of humanity could fail to learn something from it.
Broyard wants his doctor to be: a close reader of illness and a good critic of medicine; to study poetry; to imagine the aloneness of the critically ill; to resemble Oliver Sacks; not to love him, but ‘to be bonded with me for a brief space’; to grope for his spirit; to be witty; to allow him to ‘own’ his illness; to use free association the better to conceptualize his illness; to gaze directly at him; to have a voice of his (the doctor's) own, ‘something that conveys the timbre, the rhythm, the diction, and the music of his humanity’; to talk, ‘for talk is the kiss of life’; and to be his familiar in the foreign country of terminal illness. If that sounds a tall order, I think Broyard would settle for a little less, for all that he is really asking is for his doctor ‘to give up some of his authority in exchange for his humanity’.
My sister Rosie was a feminist, a lesbian and a psychotherapist, a woman who lived to the full, loved her partner and her family, danced and sang, and died from breast cancer aged 45, 6 years ago. To her illness and her dying she brought all the strength of her character. She wore blue wigs. She challenged her doctors, giving credit where due and criticism likewise. She drew cartoons imbued with black humour: in one, a woman looks out of the window, while her partner is seated behind her. The first woman says, ‘There's a bloke about to knock on the door’. ‘Is he wearing a long black hooded cloak and carrying a scythe?’. ‘No’. ‘OK: let him in then!’. I quoted this cartoon at her funeral, a funeral that left us all bereft, of course, but rejoicing too in what Broyard would call Rosie's ‘spiritual composition’. The spirit that ordered a floral cardboard coffin; that was saluted during the funeral by an a capella performance of ‘The Rose’ by her friends in the local community choir; that chose, with her partner, this ‘late fragment’ by Raymond Carver for her epitaph: ‘And did you get what you wanted from this life, even so? I did. And what did you want? To call myself beloved, to feel myself beloved on the earth’.2
And me? Well, I know that I learned things of inestimable value from my sister's life and her death. I hope that I might now be able to look Broyard in the eye and not fail him. And, though no poet, I have tried to put some of my impressions into words. This is for Rosie, for Anatole Broyard, and for all the dying patients who have taught me that a doctor must value his humanity above his authority:
Observations/Song for Ireland
A whiteout in your left lung: A living will on your mantelpiece.
Your liver craggy under the sheets: Cacti bristling beside your bed.
Malignant fluid swells your belly: But benignity is your essence.
Wisps of hair on your pallid scalp: You buy coloured hats and scarves.
Your X-ray a disaster area: Your smile a first aid station.
Your skin stretched yellow and thin: Dreams of billowing sails on boats you've built.
The tumour eats your flesh: Your grandchild sits loved on your lap.
And you, my darling, dying sister: You sing to me ‘A Song for Ireland’.
- © British Journal of General Practice, 2007.
