Illness as More Than Metaphor

David Rieff writes about his mother Susan Sontag’s battle with cancer, medical futility, the instilling of hope against odds, and the outer reaches of experimental oncology:

“There are those who can reconcile themselves to death and those who can’t. Increasingly, I’ve come to think that it is one of the most important ways the world divides up. Anecdotally, after all those hours I spent in doctors’ outer offices and in hospital lobbies, cafeterias and family rooms, my sense is that the loved ones of desperately ill people divide the same way.

For doctors, understanding and figuring out how to respond to an individual patient’s perspective – continue to fight for life when chances of survival are slim, or acquiesce and try to make the best of whatever time remains? – can be almost as grave a responsibility as the more scientific challenge of treating disease. In trying to come to terms with my mother’s death, I wanted to understand the work of the oncologists who treated her and what treating her meant to them, both humanly and scientifically. What chance was there really of translating a patient’s hope for survival into the reality of a cure? One common thread in what they told me was that interpreting a patient’s wishes is as much art as science.” (New York Times Magazine)