Introduction
In 2014, at the age of 41, poet and essayist Anne Boyer received devastating news - she had aggressive triple-negative breast cancer, a type that kills about half of those diagnosed with it. What followed was a harrowing journey through six months of aggressive chemotherapy, a double mastectomy, and reconstructive surgery.
"The Undying" is Boyer's unflinching memoir of this traumatic experience, written five years after her diagnosis. It's a raw, honest, and often rage-filled account that goes beyond just detailing her personal struggle. Boyer also turns a critical eye on the cancer industrial complex, exposing the profiteering, patriarchal, and institutionally racist aspects of cancer care and treatment in America.
This book is not an inspirational cancer survival story. Instead, it's a fierce indictment of a system that dehumanizes patients, bankrupts them financially, and leaves them to deal with devastating long-term effects. Boyer's powerful prose brings to life the physical and emotional toll of cancer treatment, while also examining broader societal issues around illness, healthcare, and mortality.
The Shock of Diagnosis
Boyer's cancer journey began like many others - with the discovery of a lump in her breast. What followed was a whirlwind of medical appointments, scans, and ultimately, the devastating diagnosis. Boyer vividly describes the surreal experience of sitting in a climate-controlled room, dressed in her casual summer outfit, while a somber woman in gray delivers life-altering news.
The author struggled to process her diagnosis. She felt fine physically, yet medical science was telling her she was gravely ill. To help visualize her odds, Boyer found a simple online graphic - 100 emoji faces, with 52 smiling green ones representing survivors, and 48 frowning pink ones representing those who didn't make it. This stark visual representation drove home the gravity of her situation.
Boyer's oncologist, whom she and her friends nicknamed "Dr. Baby" for his cherubic appearance, delivered more frightening news. Her tumor was growing at a rate four times faster than what doctors consider "very aggressive." The recommendation was immediate chemotherapy. As Boyer saw it, refusing treatment meant certain death, while accepting it meant feeling like death but possibly surviving.
In the weeks leading up to chemotherapy, Boyer turned to the internet for guidance. She found a barrage of advice - tell loved ones, negotiate with employers, deep clean the house, find a pet sitter, buy clothes to accommodate a chemo port. Meanwhile, her untreated tumor began to cause pain, a tangible reminder of the growing threat inside her body.
The Brutal Reality of Chemotherapy
Boyer's description of chemotherapy is far from the sanitized version often portrayed in media. She paints a vivid picture of the "cancer pavilion" where treatment takes place - a name she finds ironically grand for a place of such suffering. The pavilion, she notes, is organized for maximum profit rather than patient comfort.
Inside, patients are stripped of their individuality. Everyone looks the same - swollen, bald, leaking bodily fluids. The toxic nature of the treatment is evident in the instruction to flush toilets twice due to the potency of patients' urine. Boyer describes the pre-chemo routine as a bizarre combination of preparing for a houseguest, a winter storm, childbirth, illness, and a holiday - all rolled into one recurring nightmare.
The chemotherapy drug Adriamycin, which Boyer received, is so dangerous that nurses must wear hazmat suits to administer it. Patients whispered that it could melt linoleum if spilled. The immediate side effects Boyer experienced were horrific - untreatable pain, loss of hair and nails, and nerve death. Long-term effects can include infertility, secondary cancers, heart failure, and cognitive impairment.
Boyer doesn't shy away from the brutal truth - some women say they would rather have died from cancer than endure this treatment. Yet after four doses of this powerful drug cocktail, Boyer's tumor hadn't shrunk at all.
The Dehumanizing Nature of Medical Care
Throughout her treatment, Boyer became acutely aware of how differently she was treated as a cancer patient - by friends, doctors, and society at large. She critiques the popular cultural narrative that expects cancer patients to be brave, strong, and inspiring. This oversimplified view, she argues, fails to recognize the complex and unique responses individuals have to cancer.
Boyer found the medical system equally lacking in its ability to see patients as whole people. It struggles to accommodate human behaviors like asking questions, bringing in outside research, or simply running late to appointments. When her initial treatment failed to shrink the tumor, Boyer switched oncologists, finding one with a more aggressive approach.
Even as her physical condition improved, Boyer grappled with constant thoughts of death. She pushed back against friends who tried to steer her away from these reflections, seeing them as a natural part of her lived experience with cancer.
The author also observed how people in her life reacted to her illness. Some friends disappeared, while others became overly attentive. She even encountered what she calls "cancer daddies" - men seemingly attracted to cancer patients, perhaps subconsciously comforted by the non-transmissible nature of the disease.
Boyer challenges the popular "Fuck cancer" slogan, arguing that our anger might be better directed at the industrial world that exposes us to carcinogens, the medical system that bankrupts us for treatment, and a society that often leaves the sick to fend for themselves.
The Trauma of Mastectomy
Boyer's experience with mastectomy highlights the callous nature of profit-driven healthcare. As a single mother with no savings and no partner, she represents a demographic that faces higher mortality rates from breast cancer. She had to continue working throughout her treatment, fearing that disclosing her condition to her employer could jeopardize her career.
The author contrasts her mastectomy with historical accounts, like that of writer Fanny Burney who underwent the procedure without anesthesia in 1811, and poet Audre Lorde's experience in 1978. While medical advancements have made the surgery less physically traumatic, Boyer argues that modern practices can be emotionally and psychologically devastating.
Boyer describes her double mastectomy as an outpatient procedure, driven by the profit motives of the healthcare system. She was discharged from the hospital before she even learned how to manage her post-surgical drainage bags, despite her protests that she wasn't ready to leave. Just ten days after this major surgery, she was back at work.
Though the surgery and preceding chemotherapy ultimately eliminated her tumor, Boyer feels the price she paid was too high. She states that even if she lived another 41 years, it wouldn't be enough time to avenge the medical system for its treatment of her.
The Pink Ribbon Problem
Boyer's critique extends beyond her personal experience to encompass broader issues in breast cancer awareness and treatment. She points out that while having breasts is the primary risk factor for breast cancer, affecting people of all genders, women bear the brunt of the disease and its social implications.
The author is particularly critical of breast cancer awareness campaigns, especially the commercialized "Pinktober" phenomenon. She describes the ubiquity of pink ribbons on everything from police cars to assault rifles as a superficial show of support that does little to help actual cancer patients. Despite decades of pink ribbon campaigns and millions of dollars raised, a cure remains elusive.
Boyer takes aim at large breast cancer charities, particularly Susan G. Komen for the Cure. She highlights the organization's questionable corporate partnerships, such as with fast food chains and fracking companies, the latter of which ironically releases carcinogens into drinking water. She also notes the high salaries of charity executives, questioning whether these organizations truly prioritize finding a cure over sustaining their own existence.
The author challenges commonly held beliefs about breast cancer, citing research suggesting that many women receive unnecessary treatment due to overdiagnosis. She argues that early detection doesn't necessarily save lives and can instead lead to overtreatment, causing unnecessary suffering and financial burden.
The Myth of the Cancer Survivor
Boyer pushes back against societal expectations of how cancer patients should behave and the narrative of the brave cancer survivor. She emphasizes that surviving cancer is largely a matter of chance, not a result of having the right attitude or following a prescribed set of behaviors.
The author highlights the contradictions in how society views cancer and cancer patients. There's an expectation for patients to be brave, positive, and willing to undergo grueling treatments, even when the benefits are uncertain. Those who don't conform to this narrative often face judgment or abandonment.
Boyer stresses that cancer kills indiscriminately. People can do everything "right" and still die, or do everything "wrong" and survive. She argues that attributing cancer deaths to moral weakness is misguided, and that the true moral failings lie with the industrial world that causes cancer and the medical system that profits from it.
The long-term effects of cancer treatment are another focus of Boyer's critique. Her six months of chemotherapy left her with heart problems, transforming her from a cancer patient to a cardiac patient. Yet, financial constraints forced her to return to work before fully recovering, highlighting the challenges many face in balancing health needs with life's practical demands.
The Ongoing Impact of Cancer
Even years after her treatment, Boyer struggles to fully process her cancer experience. The trauma of diagnosis, treatment, and recovery continues to affect her daily life. She grapples with the knowledge she's gained about the flaws in the healthcare system and the societal attitudes towards illness.
Boyer uses a powerful metaphor to describe the transformative nature of cancer. She likens it to encountering what appears to be a snake on a path, only to realize it's a discarded snakeskin. The snake has renewed itself by shedding its old skin. She poses a provocative question to readers: In the face of cancer or other life-altering challenges, will you be the snake that renews itself, or the lifeless skin left behind?
This metaphor encapsulates Boyer's approach throughout the book. She encourages readers to question accepted narratives about cancer, to rage against injustice in the medical system, and to find ways to renew themselves in the face of trauma and illness.
Final Thoughts
"The Undying" is a powerful, uncompromising look at the reality of cancer diagnosis and treatment. Anne Boyer's raw honesty and poetic prose bring to life the physical and emotional toll of her experience, while her sharp critical analysis exposes systemic issues in healthcare and societal attitudes towards illness.
This book is not an easy read. It doesn't offer false hope or saccharine inspiration. Instead, it presents a fierce indictment of a system that often fails those it's meant to help. Boyer's account challenges readers to confront uncomfortable truths about illness, mortality, and the shortcomings of modern medicine.
At the same time, there's a underlying resilience in Boyer's words. Despite the trauma she's endured, she continues to question, to critique, and to create. Her ability to transform her suffering into art offers its own form of hope - not the kind that promises easy answers or happy endings, but the kind that comes from facing reality head-on and refusing to be silenced.
"The Undying" is more than just a cancer memoir. It's a call to action, urging readers to question the status quo, to demand better from our healthcare systems and society at large, and to recognize the humanity in all who suffer from illness. It's a testament to the power of the human spirit to endure, to rage, and ultimately, to create meaning from even the most harrowing experiences.
For anyone who has been touched by cancer - whether personally or through a loved one - this book offers a brutally honest look at the realities of the disease and its treatment. For those fortunate enough to have avoided this experience, it provides crucial insights into an all-too-common journey that's often misunderstood or oversimplified.
Boyer's work reminds us that while we may not be able to control whether illness touches our lives, we can control how we respond to it - both individually and as a society. She challenges us to strive for a world where profit doesn't trump compassion in healthcare, where patients are seen as whole people rather than collections of symptoms, and where the complex realities of illness are acknowledged rather than glossed over with pink ribbons and platitudes.
In the end, "The Undying" is a profound meditation on what it means to be human in the face of mortality. It's a book that will likely leave readers changed - angrier, perhaps, but also more aware and potentially more empowered to advocate for change.
As Boyer so powerfully demonstrates, the experience of serious illness is not something one simply "gets over." It becomes a part of who we are, influencing how we see the world and our place in it. Her unflinching examination of her cancer journey offers valuable insights not just about breast cancer, but about how we as individuals and as a society deal with sickness, suffering, and the ever-present reality of death.
"The Undying" is a vital contribution to the literature on illness and healthcare. It's a book that demands to be read, discussed, and acted upon. In sharing her story with such honesty and critical insight, Anne Boyer has created a work that has the power to change how we think about cancer, patient care, and the human experience of serious illness.