American Notebook Cancer In The U.S.: An Extended Metaphor

...The connection between cause and effect is so little understood, the number of causes so great, and their relationships so complex that we find ourselves thinking about cancer much as primitive men must think about all disease...

...He thus envisages cancer as reproduction gone berserk...

...But the commitment of body and spirit, the giving of oneself totally and without reservation has increased...

...However, we are familiar with the evils of man's perennial condition of want and too little aware of the new evils that could result from the reversal of this condition...

...THE LAYMAN knows next to nothing about cell structure and cell division...

...yet it is also a potent force in conditioning our world-view, an ingredient in our individual and collective consciousness...

...Symbols of disease are appropriate for our cultural fecundity because, as in The Magic Mountain, one doubts the authenticity of this show of life and vitality...

...If it were only the failure of progress that needed to be explained, we might fall back upon Original Sin: by the Divine punitive intention, the Fall dooms man to live by an ingenuity always insufficient to the counteringenuity of a more or less hostile environment...

...Never before has it been necessary to teach men to want more...

...We can understand the dangers of excess, and though we may choose to ignore the golden mean, we do this knowing full well that we must pay a price for too much...

...At the same time it is a generating force, coercing us into still greater expenditures of labor so that we may have the means to consume at a continually accelerating rate those commodities that have been produced...

...We conceive of the systole and diastole of life itself as the most perfect equilibrium achieved by nature...

...There is "national defense...

...they must be consumed in a double sense: they must be appropriated and they must be expended, used-up...

...But it is something quite different when you must constantly destroy so as to be able to create, when you must channel off tremendous amounts of man-power and productive energies into armies and arms so that the diseased production monster is not crushed beneath the weight of its own offspring—those goods and services which we believe we cannot really get too much of and which yet may kill us with the kindness of their munificence...

...The phenomenon is nothing if not dynamic...

...Now the utilitarian principle of production for the sake of consumption is perfectly rational...

...We tend to think of heart-disease as one thing: it strikes one organ, it always produces more or less the same effects, it seems a commonsensical disease, uncomplicated, unmysterious, and rational...

...But the sober scientific facts are less important than the attitudes they evoke...

...its name has a mysterious and disquieting sound, and no one has ever really understood why Hippocrates chose it...

...Both strike one as disorders of overproduction and excessive power in the context of environments incapable of fully assimilating or existing compatibly with the new forces that assert themselves so violently...

...The influence of this pervasive awareness may be likened to that of the automobile...

...But the wife, mother, or brother feels that the patient must take a chance, since there's nothing to lose but money...

...HARD-HEADED and pragmatic, we are not likely to lose any sleep over this matter of culture-disease in America...

...The second of these strategies has had a profound effect upon our culture...

...Not only in the endless proliferation of material goods that pour out of our factories, but in products of the mind as well, in our intellectual culture...

...A society which uses its enormous productive resources to satisfy human needs while perpetually creating insatiable appetites must pay the price, economically, culturally, and psychologically, of an almost unbearable tension between fulfillment and frustration...

...But now that awareness of cancer is becoming so prominent a feature in the landscape of twentieth century anxiety, we find ourselves needing the insights of the social scientist and the poet...

...Above all, rational—in the sense in which we make the most sense out of the idea of rationality, the Aristotelian cum Franklin notion of the golden mean...

...It is a condition of growth which causes life to decay...

...In nineteenth century Europe tuberculosis was the modern disease, and permeating its literature there is a sense of the air having been fouled, of emotional and intellectual well-being conceived of as the ability to breathe freely in uncon taminated air...

...Or was it to describe the gnawing, shooting pain caused by those claws...

...It is as if our physicians were to decide that the best way to lick cancer is to assimilate it, to train the body to live with ever-increasing doses of its poison...

...From the therapeutic point of view it is what we do not know about cancer that is so appalling...

...In themselves, abundance and indulgence are probably preferable to scarcity and austerity...

...It seems an obscure threat...

...Critics of advertising and sociologists like David Riesman frequently point out that we have become a nation of consumers, enamored of the activity of consuming and neglectful of the claims of creativity...

...The Magic Mountain is a poetic Summa of the protean disguises of disease in our time...

...Cancer then is not solely a physio logical phenomenon, it is a cultural one as well...

...We have sufficient confidence in science to expect that it will someday force cancer to yield up at least enough of its secrets to allow doctors to effect cures...

...but more important, it is also a condition which, though it cannot exist without killing, cannot exist after it has killed...

...It would be considerably more difficult to assess the influence of our American idea, technologically engendered and universally entertained, that we are in all things a mobile people...

...Suburbia, consumer-habits nurtured in the super-market, a courting code designed for encounters in the back seats of automobiles, the revival of the Renaissance idea of educa tion through travel—these manifestations of the automobile as a way of life have wrought profound changes in our culture...

...Time expended in labor has indeed diminished...

...For there is indeed a striking similarity between the massive and always potentially uncontrollable energies unleashed by nuclear fission and cancerous growths...

...Since such an emphasis stresses the fact that cancer is alien to the impulse of our society, we can be reasonably certain that it will fail to recognize any symbolic affinities between the disease and other aspects of our culture...

...The very notion is likely to strike us as metaphysical and mystical—to use these terms as they are commonly meant: that is, simply as pejoratives...

...As in the fable of the sorcerer's apprentice, nuclear fission threatens to assume a revolutionary role and to become independent of the master's powers...

...Such an economy is bound to impose upon those who live in the society a psy chology of austerity...

...Nobody knows, But the name, perhaps on account of its enigmatic quality, brings to mind with singular clarity the condition to which it belongs.—CuAULEs Oaxarixc: The Riddle of Cancer Cancer is the twentieth century disease...

...Put it to the man who reads Time that cancer-awareness is a peculiarity of American civilization and he is likely to see in this one kind of irony: though we are the most vigorous and culturally healthy nation in the world, we seem to have been badly bitten by an excessive fear of cancer...

...Since the creation seemed insufficiently endowed, man knew that he must live by the sweat of his brow...

...There is advertising, economic medicine from a prescription by Mithridates...

...Here, the principle of growth, ordinarily subservient to the total organic process, has assumed an independence and an autonomy so powerful that one begins to think of what is after all a process as if it were an animate and individualistically constituted thing...

...Thus the articles and books which exhort us to view cancer with "commonsense"—that is, without fear...

...Unfortunately, they cannot simply be accepted...

...What we find is not simply an illusory progress, a lag between the rate of technological advance and the diminishment of man's labors, but something worse...

...The doctor has told his family that there is little to be hoped for from X-ray, radium, or cobalt treatment...

...WE MAY REJECT the Marxist prognosis, but can we deny the prophetic accuracy of the diagnosis that described capitalism's inherent weakness as one of under-consumption manifesting itself as over-production...

...In a similar fashion, the economic system purges itself of its unassimilable surpluses by creating vast amounts of military armaments and destroying these, either directly or indirectly by means of inventions which render existing armaments rapidly obsolete...

...THE STUDY OF CANCER has been the special province of the biological scientist...

...Abundance is the consequence of skillful and assiduous labor...

...and if he has been given abundance and much that he never dreamed of asking for, does he dare refuse these blessings...

...He knows, for one thing, that there seems to be no predictable pattern as to who, when, or why it strikes...

...Far from being good in themselves, these have been responsible for much that is ugly, brutal, and inhumane in man's dealings with his fellow man...

...IRRATIONAL THOUGH IT IS, the proliferation of labor expended and goods produced can be controlled...

...Gout is the rich man's disease, tuberculosis the artist's, and so forth...

...Give us this day our daily bread," he asked...

...The authority of Thomas Mann's work would support this thesis...

...we have learned to ride with its punch...

...President Eisenhower's politically dramatic heart attack created a journalistic image of this disease that for a while seemed to challenge the hold of its older rival, cancer, in the popular imagination...

...What we do know about it is, however, fearful enough to the man who sees himself as a figure in the actuaries' tables...

...He must convert the concepts of biology and physiology into vivid and emotionally meaningful language...

...But an ounce of prevention is still worth a pound of cure, and doctors who only cure are never publicly canonized with the Pasteurs and the Salks...

...Rotting noses, rheumy eyes, and spavined legs take on a symbolic character alongside a cluster of images mirroring the genesis of the disease in prostitution and its hopedfor cure in pharmacy...

...It is now evident that in its main function of providing rapid, cheap, and efficient transportation, the automobile has not effected changes as radical as the secondary developments that took place once this primary function had been fulfilled...

...The more one thinks about the symbolic nature of disease, the less one is likely to dismiss its manifestations as the observer's errors of pathetic fallacy...

...It is real in the sense which no sane person would dream of questioning...

...Similarly, we find ourselves dealing with elusive material once we begin to chart the currents of cancer-awareness...

...Inevitably, the person stricken with incurable cancer finds his way to the radiologist's office...

...The generals who ask for and get astronomical military appropriations from Congress thus succeed as economic therapists to the state where the radiologist often fails in using similar techniques to minister to the body...

...Seldom in the course of history, and then only among an elite minority, do we find anything but scarcity and austerity...

...Destroyed is the inner microcosm, the orderly and rational process in which new life is coming to birth while other parts of the living whole wither away...

...Physiological torpor generating intellectual passion, intimations of death evoking intense ardor for life, clerical fascism speaking the language of bolshevism—these are some of Mann's paradoxes...

...The language of those men of good will who deplore the military application of the principles of nuclear fission, suggests the inevitable metaphor: cancerous...

...Doesn't this translate into the proposition that, unIike heart-disease, there is no morality of cancer...

...Heart-disease seems to be such a price...

...I1 In the French anti-war film, "Grand Illusion," there is a scene in which the captive soldiers (of the First World War) discuss the connection between disease and the various social and professional classes...

...The answer must be that if our culture is diseased it is precisely in its enormous fecundity that this symbolic cancer manifests itself...

...Is it an exaggeration to claim that economic means and ends have nearly been reversed in America and that to a remarkable extent we consume, irrationally, for the sake of production...

...The idea is not particularly original, though in the film it is expressed with a kind of Marxian mordancy...

...Paul Dudley White's tough but optimistic face is part of that image which, on the whole, is a surprisingly beneficent one...

...This idea has been expressed in many different ways, but it has usually arisen in societies in which economic scarcity or the threat of it has been present...

...And the metaphor cuts deeper than the obvious rhetorical intent...

...Described in such a way, cancer becomes an appropriate symbol for phenomena that are apparently healthy while exhibiting a dubious fecundity that may be both benign and danger...

...It seems to have greater vitality, less vulnerability to natural enemies which might attack it, and immense fecundity...

...If not in scientific fact, then surely in the fear-ridden depths of our imagination, cancer seems to be the special nemesis of our age...

...From the farmer, mechanized and yet enslaved, to the new "organization man," working amid physical comforts and yet deeply harried, we find men expending themselves— spending their very selves—in labor to a degree that seems to surpass what may have been imposed upon us by the Fall...

...Cancer is a most notable example of recalcitrant nature defying our attempts to control it for the betterment of man...

...It is not, therefore, too difficult to imagine cancer as a kind of grotesque and chaotic perversion of this process, with cells wantonly and arbitrarily multiplying themselves...

...One poeticizes these cancerous cells as actively willing their reckless proliferation, a notion that must be attributed to the powerful anthropomorphizing instinct, no doubt, but a compelling one nevertheless...

...Medical white magic finds its apotheosis in preventive therapy...

...We must first see cancer in its paradoxical dimension— in its image of demonic energy, as a self-generating, self-sufficient but otherwise purposeless and ultimately destructive potency—if we are to discern the quite different irony of its symbolic relevance to other parts of American culture in which growth and decay show similar symptoms...

...As I recall, cancer is not mentioned...

...and at their center, giving them form and unity, there is the basic oxymoron of disease masking itself as health, of feverish vitality where one might expect waning powers and anomie...

...In itself a kind of super-health, cancer is the enemy of the total economy of the body which we call health...

...From this point of view, cancer represents a more advanced development...

...And do we not everywhere find evidence of great cultural vitality...

...Is it not equally useful to be reminded that we have become enslaved to the production behemoth as an end in itself and that at bottom what we like to think of as commonsense materialism reveals a strange irrationalism that cannot be explained as simple utilitarianism...

...It you are rich enough you can destroy much, even most of what has been created for you as a jest, a rich man's gesture— and this too has a certain rationality...

...Benign cancers (differentiated by the less sinister term "tumors") can be attacked and sometimes destroyed by the radiologist's machines...

...English literature in the seventeenth and in the eighteenth century, where the obsession reached its apotheosis, is haunted by the spectre of venereal disease...

...The great philosophies and religions have sought to educate men to want less, so that purged of indiscriminate and promiscuous desires, they might be free to want what is most excellent...

...The freeenterprise method of increasing consumption is a dual one: it seeks to put more dollars into more pockets and to increase our desires for more, better, and a greater variety of commodities...

...It seems to ex hibit precisely those health-preserving strengths with which healthy organisms are insufficiently endowed...

...Was it to portray the outline of certain cancers of the breast, whose ramifications suggest a crab with its claws buried in the living flesh...

...Apparently cancer behaves in a way that is not easily distinguishable from the processes that go on within healthy organisms...

...But Adam and Eve cannot help us to make sense out of gradually increasing labors that cannot be measured by eight-hour days and forty-hour weeks...

...These developments can be observed and roughly measured...

...like the real thing—cancer—which kills visibly...

...And now the threat of atomic and hydrogen warfare imposes a schizoid pattern upon our anxieties: like spectators seated in mid-court at a tennis match, we must nervously keep the health of the world's body and of our own under surveillance...