Nursing Book Club

The Undying: Pain, Vulnerability, Mortality, Medicine, Art, Time, Dreams, Data, Exhaustion, Cancer and Care by Anne Boyer

An unflinching look at breast cancer

Anne Boyer, author of The Undying, is an essayist, a published poet, and one of the more than 250,000 women diagnosed with breast cancer in the United States each year.

Although there are many books about illness, Boyer notes that there are comparatively few about people who are ill. Her goal in publishing this book is “writing the truth for those who can use it.”

When a screening detected her breast cancer, Boyer’s life changed in the blink of an eye. Beforehand, she had not thought of herself as at all sick, but once her cancer was diagnosed, she had to immediately learn a new vocabulary and a new set of rules.

One of her first discoveries was a problem many nurses have railed against in this era of electronic medical records: Healthcare providers are often more preoccupied with computer screens and data than with people.

Becoming (Literally) Toxic

Actual hands-on caregivers are few and far between. If you’re a single mom and can’t afford to hire someone to help you at home, you may have to rely on friends for support.

Without caregivers, Boyer explains, you will have days when you are unable to care for yourself. You may be too sick and exhausted to drive, cook or bathe, which can have a big economic impact.

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Boyer found that cancer treatment also includes some unique indignities. Chemotherapy is toxic, so the person administering it to you may well be wearing a hazmat suit — and will probably remind you that no one else should share your bathroom!

Mastectomies, meanwhile, are now same-day, virtually drive-through procedures, which can leave little room to process the experience.

The sobering cost of cancer care may also make you wonder if it is worth the financial burden to you and your family. If you don’t survive, you may leave behind a mountain of unpaid medical bills for your loved ones to settle. It’s not a pretty picture.

The Heroic Survivor Myth

People reading about breast cancer patients prefer upbeat, uplifting accounts. We need the stories to have happy endings and for cancer sufferers to be uncomplaining, heroic survivors. A patient who isn’t all those things may be blamed for their plight, just as some people blame victims of domestic violence or sexual assault for not doing everything right.

Boyer urges the reader to reexamine these expectations. We often hear that attitude is everything, but is it? Is it appropriate for physicians to be less willing to fight for a patient who isn’t compliant or who tries to find alternative treatments online? How much does the demeanor of a patient who may be in pain or struggling with “chemo-brain” determine their quality of care?

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Her frankness makes this book difficult to read at times, as she confronts a lot of aspects of cancer that many of us would rather not think about. However, it may be time we did.

One in Eight

I was once at a big conference where the speaker asked anyone who had been through breast cancer treatment to stand. Several women rose.

Then, she asked anyone who had a relative who’d been through treatment to stand. More rose. When she asked anyone who knew anyone who had been diagnosed with breast cancer to stand, the entire room was on its feet.

The National Cancer Institute estimates that an American woman’s lifetime risk of developing breast cancer is roughly one in eight. Maybe all of us need to read this book to better understand the politics, cost and the emotional toll breast cancer takes on patients, survivors and families.

The Undying: Pain, Vulnerability, Mortality, Medicine, Art, Time, Dreams, Data, Exhaustion, Cancer and Care by Anne Boyer. (Farrar, Strauss and Giroux, 2019)

CHRISTINE CONTILLO, RN, BSN, PHN, is a public health nurse with more than 40 years of experience, ranging from infants to geriatrics. She enjoys volunteering for medical missions.

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