John Donne and Cancer

 

In 1993, Margaret Edson wrote a play called Wit that talks about the experience of having cancer and going through chemotherapy. In the early 1990s, discussions like this were not common. The play tells the story of Vivian Bearing, an English professor, who is diagnosed with Stage 4 ovarian cancer that has metastasized. It’s not surprising that Bearing would be Stage 4 because there is still no method of screening for this cancer. In the play, Bearing knows there is a problem when her abdominal pain doesn’t go away. 

The oncology doctor puts her through eight rounds of toxic chemotherapy, and Bearing describes the procedures, their invasiveness, the indignities of being treated like a test subject and not a person, the nausea, her growing weakness, the shaking, and always feeling cold.

Bearing is under the care of the chief oncologist as well as his resident oncologist who is more interested in research results than in how she is physically and emotionally coping. To him, she is a lab rat and he wants to gather as much data as he can before she dies. Bearing is also tended to by Susie, an RN, who cares for Bearing as a person and eases her suffering. Susie tries to tell the doctor that Bearing had a DNR when she goes into cardiac arrest, but the doctor brushes her off and calls a Code Blue.

Besides presenting how it feels to have terminal cancer, what also caught my interest was the discussion of John Donne’s Holy Sonnets. Bearing loves the wit in Donne’s language and quotes passages from the poems. A student in one of her classes once asked why Donne doesn’t simply share his insights about Death rather than coding his messages in wit. Bearing thinks that his wit is not simply a literary style but the key to figuring out Donne’s puzzles, and finding those answers takes on more urgency as she slides closer to death. 

Her mentor, however, while she thought death was a subject worthy of contemplation, did not regard Donne’s poems as puzzles to be figured out. I think that for Donne language was his medium for working out his grief over his wife’s passing and understanding death. Being witty and playing with the language allowed him to regain some control. 

Bearing uses Donne’s poems to joust with her chemotherapy, and they offer her an escape from pain and a place of refuge. Near the end, when she challenges the resident doctor to set his research aside and treat her like a human being who has feelings, she has an awakening and realizes that she acted the same way in her classes, preferring scholarship to interacting with her students and caring about what was going on in their lives.

When my wife Evelyn died unexpectedly in her 40s, I struggled with what seemed like the arbitrariness of Death, and I found refuge in Donne’s poetry, especially his Holy Sonnets. I didn’t understand then, for example, what Donne meant when he said he believed the death of a loved one was not a breach between two people, but an expansion, like gold that is beaten into airy thinness. I was miserable and it felt like the rhino of grief was sitting in my living room, and there was nothing golden or airy about that. But a year later I came to understand it when I felt Evelyn’s presence beside me when hiking in Yosemite. 

The play illustrates the tension that exists in the medical world between advancing science through research to help others later on and caring for patients who are suffering now. What the patient wants should always come first because it’s their body. Research comes second. Once it was discovered that Bearing’s chemotherapy wasn’t affecting the areas that had metastasized, it should have been discontinued. 

I know men with prostate cancer who were on leuprolide, an anti-hormone drug, that was so disruptive of their daily lives that after two years on it they told their doctors they weren’t going to take it anymore.

For medical people, the lesson is to listen to their nurses and listen to what your patients are telling you about their bodies. For patients, the message is that you are the one who decides what is done to you, and that you have to advocate for what you want.

(Some of my words about Donne were first published as “John Donne and the Rhino of Grief” in the Antler Journal, 2014.)