| HOME | HELP | CONTACT US | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
BOOK REVIEW |
Correspondence: Dwight Kaufman, M.D., Ph.D., The Jackson Clinic, 616 W. Forest Avenue, Jackson, Tennessee 38301, USA. Telephone: 901-422-0408; Fax: 901-422-0442; e-mail: dkaufman{at}usit.net
Browsing in a San Francisco bookstore while at ASCO, I was attracted by what I initially thought was a large-print cover blurb, then was completely captured by a quick skimming of the Preface—at least enough to buy A Heartbreaking Work of Staggering Genius. Having apparently missed or overlooked reviews when the hardback edition was published last year, I was hardly prepared for the brilliance of the writing and certainly was not expecting the fortuitous cancer connection. Now without reservation I commend this book. The seemingly presumptuous title is accurate.
A Heartbreaking Work of Staggering Genius is a memoir, one by the author's account, both in the Preface and in the Appendix to the paperback edition, only slightly fictionalized. During his senior year in college, the narrator's mother and father die of cancer, leaving him to raise his younger brother, Toph, with a little help from older sister Beth and a lot of help from Toph. Their mother died of gastric cancer, following three laparotomies spread over several years, chemotherapy, and a painful, wasting, inexorable deterioration with a prolonged terminal phase. Only 5 weeks before the mother's death, their father had died a short time after a diagnosis of lung cancer. The mother's decline, confinement to a downstairs couch, the bilious regurgitation onto chest towels and into half-moon basins, the bloated pumpkin abdomen, and death are graphically described in the first chapter—calls to the oncology nurse, ER visits, hospitalization, visits with the oncologist "who sometimes we liked and sometimes we did not," then a final hospitalization, despite her wish to stay at home (I wonder would not hospice have avoided much of the desperation and guilt at the end? Maybe at the cost of literary drama.) then death—"finally, finally, finally." Now orphans all, big brother, single parent Dave and nine-year-old Toph move from their suburban Chicago home to Berkeley, near Beth. Dave and several friends, seemingly all transplanted from Chicago to the Bay area, start a Gen X rage-against-the-machine satiric magazine, Might, its double-entendred title signifying power and possibility. Over the next several years, coincident with the lifetime of Might, as it flourishes creatively though never financially, then withers and dies of boredom, unmourned, the author and Toph grow up together in various apartments in Berkeley and San Francisco. And lovingly, if chaotically, Dave does a pretty good job as parent and big brother, managing the quotidian requirements of nutrition and schooling reasonably well, managing somehow with no resentment always to put Toph before those other things that occupy single 21-year-old males. They were a team, they came, saw, conquered.
Yes, a touching story lovingly told of brothers making the best of it alone, roughhousing, throwing Frisbee in the park and on the beach, amazing audiences of thousands with their unbelievable skill and tricks, stirring the hearts of all who know their story with their bravery. But beneath it all on nearly every page is the horror, the bewilderment, even more, the overwhelming anger at mother's dying and death. This is a textbook for a grief counselor. The author never really grieves, or maybe does nothing but grieve, until much later. There is no closure to life in Chicago. The cadavers were donated to a medical school for an anatomy class, there are only brief eulogies at a funeral, actually two funerals, then off to a new life. The following, minutes after she dies: Toph is asleep on a foldout bed in her hospital room. "As I am looking at him, he wakes up. He gets up and comes to me as I am sitting in the chair and I take his hand and we go through the window and fly up and over the quickly sketched trees and then to California." End of Part 1.
As an oncologist, I was particularly taken by the author's imaginings about cancer. Here in the first chapter:
"...they had ‘opened her up’—a phrase they used—and had looked inside, it was staring at them, at the doctors, like a thousand writhing worms under a rock, swarming, shimmering, wet and oily—Good God!—or maybe not like worms but like a million little podules, each a tiny city of cancer, each with an unruly, sprawling, environmentally careless citizenry with no zoning laws whatsoever. When the doctor opened her up, and there was suddenly light thrown upon the world of cancer-podules, they were annoyed by the disturbance. Turn off. The fucking. Light. ... Go. The Fuck. Away."
This isn't bad, not too far off the mark. Years later, he imagines a confrontation with the doctor who dissected his mother in anatomy class:
"Was it like caviar? Was it like a little city, with one big gleaming eye? A thousand little eyes? Or was it empty, like a dried gourd? See, I have a feeling it might have been like a dried gourd, empty and light, because when I carried her, she was so light, much lighter than I expected....Which would mean that it was something hollow maybe, not the writhing nest of worms, the churning caviar, but just something dry, empty. So which was it? ...I have been wondering for many years."
Far on the other side of C. P. Snow's cultural divide, this young intellectual has a primitive, childlike lack of sophistication about pathophysiology. But does it matter? Will my knowledge of molecular oncogenesis, multi-hit phenomena, mechanisms of drug resistance, etc., help him to understand what happened to his mother? Can I as an oncologist explain this horror to make it understandable, acceptable? How could his doctors, or counselors, or friends, or adults in his world have made these deaths more palatable, less unbearable, easier to move past? I don't know the answer. Perhaps we could give him some better metaphors.
Make no mistake about it, this narrator is self-absorbed, even self-obsessed—in short, young. The other characters are largely two-dimensional bit players. Big sister Beth appears only in cameo, and even Toph appears only as the sidekick, Robin to Batman. But in his self-absorption, Eggers is always brutally self-analytical, deferentially and perhaps pre-emptively self-mocking. And with all his anger he is also frequently wildly funny. It is certainly no detriment for a writer to be self-obsessed. See Mailer. Roth. Compare young Dave Eggers with young Stephen Dedalus. Ah, but that is heresy, of course. A Heartbreaking Work of Staggering Genius compares possibly more closely with the first-draft memoir Stephen Hero than with the polished but detached A Portrait of the Artist as a Young Man. But this is indeed very fine, frequently powerful writing and I, for one, am looking forward to being Staggered again by Mr. Eggers' next book.
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| HOME | HELP | CONTACT US | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
| THE ONCOLOGIST | STEM CELLS | CME | ALPHAMED PRESS JOURNALS |
