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In June of 2023 I was diagnosed with Stage 3 cancer of my larynx. I had a large and rapidly growing tumor on my voice box that had to come out, and with it my entire voice box. The first indication came when I visited an emergency room because I could not swallow, my voice was choking out, and I was beginning to have difficulty breathing. The doctors told me I had a mass in my throat. They remarked at how well I seemed to be taking the news. And they set up the appointments with the next round of doctors. Months later, and two surgeries, radiation treatments, speech therapy, physical therapy, and dentists later (they pull your teeth for radiation. I only have ten teeth as I write this), I have no larynx. The surgery also lifted me of a few lymph nodes and half of my thyroid. I will get a PET scan in two months to see if all the cancer is gone. Until then, I just try to adjust and recover.
The thing that struck me most is the observation that I took things well, that I was taking it all in stride and not reacting with open grief, fear, sadness, shock—whatever it is they expected. The problem with this is that being informed that I had a deadly disease was not something I could properly understand. A moment like this does not fit into the narrative, as it were. Being diagnosed with cancer did not fit with the flow of “what-there-is,” and there was simply no place to put that information, and there was nothing I could conceive of that would allow me to accommodate this information to my sense of who and what I am. This is the problem with a diagnosis of this kind. No matter how real, concrete, scientifically verifiable, complete with a vast array of medical evidence, this information does not fit, and it does not fit precisely because it is real. A diagnosis of cancer, or any other catastrophic illness, is of the order of what the French psychoanalyst Jacques Lacan called “the Real.” The Real, according to Lacan, “is what resists symbolization absolutely.” This is to say that the real defies language; it cannot be rendered in any intelligible form, and it awaits some form of linguistic representation to situate it within what can be known. In other words, the real has to be placed within narrative and representation to be understood. The real must be contained, redirected, and channeled away from the traumatic impossibility of its existence. So, I was not taking anything in stride. I was catapulted into a space and a place that had no meaning. What I had instantly become was not just ill, but meaningless absolutely.
The writer Siri Hustvedt has documented her experiences of going through a cancer diagnosis with her husband, the writer Paul Auster. Hustvedt uses the metaphor of “Cancerland” to talk about what Auster is going through. It is a great way of talking about cancer because with a cancer diagnosis I was instantly transported to another place that is entirely foreign to me; a place where I cannot even recognize myself. I am like Alice. The bottle said drink me, and I did, and now I am small. I am cut up and missing important parts of myself. I have scars. There are parts of my body that work differently or do not work at all. I can no longer talk without a prosthesis. I did not have a choice either. When the bottle said drink me, I had to drink up or I would die. Head and neck cancers are some of the most treatable, but they are some of the most lethal if untreated. The average life span with an untreated head and neck cancer is four and a half months. I have already passed that expiration date. But I am still here in Cancerland.
While in Cancerland I remained committed to writing. I became even more resolved to working on a major book project I have been writing for months, and I churned out many pages. I have gotten back to some of my professional writing work. But Cancerland has remained the place where I am but do not care to know. I do not want it, and like an obstinate child, I close my eyes and ears until it goes away. But it does not go away, and though I will likely recover, I will never be the same. I will always be a part of Cancerland, and Cancerland will always be a part of me. All of us in Cancerland are in exile. None of us are colonists. We were all sent here, or rather, we were all pulled here by cancer. There are the guilty who have cancer because of our bad decisions, in my case smoking, something that adds no small measure of shame to my experience of Cancerland. But there are children here—literal innocents who should not be here at all. And we are all so common, so ordinary and unremarkable precisely because we are all just like everyone who is not in Cancerland. We are just like each other. And ultimately, none of us are doing anything remarkable. Doctors, nurses, technicians, therapists of all kinds, machines, drugs, etc. do all the work while all we do is either get better or we do not. There is no “triumph of the will,” no god or gods, we live and die whether we are loved or not. None of it is in any way remarkable or interesting. However, all of us in Cancerland remain here, and the rest of the world has to contend with us just as those of us who do survive must contend with the world. We are not in the world, and we are in the world. We need to be intelligible. We are not allowed to remain in the Real.
The philosopher Alain Badiou tells us that there is something that occurs that fundamentally and in every way alters what-there-is. This is to say that the situation in which we live can and does experience moments through which something changes not only the situation but the way we must understand situations in the broadest sense. These moments Badiou calls events. An event occurs. Examples include Schoenberg’s invention of the twelve-tone musical scale which shifted musicality itself and the way we understand the very idea of musicality. On a grander scale, the French Revolution fundamentally altered life and thought in the western world. It was an event. Love also is an event in Badiou’s terms. When we love, when we recognize our love of an other or fall in love with an other, we offer deep and abiding fidelity to both that person and the love of that person. This moment is an event, and all of these events are what Badiou calls a truth event. These kinds of moments re-orient life and thought and our relation to life and thought. You can read the basis of this in Badiou’s book called Ethics. The longer and more comprehensive book in which he explains all this in mind-boggling detail is called Being and Event. It should be clear that Badiou’s truth event has a certain resonance with the Real. When these kinds of things happen, they defy all conventional language and representation. They resist symbolization absolutely. Yet, Schoenberg’s twelve-tone scale is written down in musical scores and in the form of essays and criticism of music composed in this form. The French Revolution is well-known to us, and not just on conventional historical texts. People can and do study the art, poetry, and literature of the French Revolution. When one falls in love, one can compare thee to a summer’s day and count the ways, but most of us simply render that love in the language of life. Though most are not writers, they nevertheless write their love into the narrative of their everyday, their what-there-is. The event becomes a truth only after it has been given the fidelity of writing the truth.
Badiou explains that a truth comes about through a “process of fidelity to an event,” and this constitutes “a real break (both thought and practiced) in the specific order within which the event took place” (Badiou. Ethics, 42). We render the truth of the event with our fidelity to its having occurred within the ways we think and live our lives. It is possible to deny the validity of an event, of course, but that would not be true, and we would know it. To deny my cancer diagnosis is a lie and it is just stupid. The cancer diagnosis is still there even if I refuse to acknowledge it. No, cancer and coming to Cancerland are things that are true. These events are undeniably true because they come with the absolutele certainty and finality of death. I think I still question the degree to which I maintain a fidelity to the event, or am I simply stuck with it whether I like it or not.
I appear to be at the beginning of sending messages back from Cancerland to bring it into what-there-is, because it is no matter how much I do not want it to be. But I think my fidelity is not specifically to the event but to writing itself. When I came back from surgery I got back to writing immediately. I also got back to reading, and the things I focused on in my reading were those things that spoke most deeply to what I had begun to experience. Part of what is specific to my diagnosis is the fact that I have physically lost my voice. I have been silenced. While I now have the ability to speak with a voice prosthesis, it is still not my voice. It is something artificial (I have a prosthesis implanted in my throat. It is made of plastic and functions by vibrations. I am not talking about the electronic tools many people are familiar with which I have this far refused to use). The two writers who have been most important to me in the past several years are Samuel Beckett and Maurice Blanchot. Beckett has been called the poet of silence, and Blanchot placed tremendous value on things like silence and forgetting. Blanchot also wrote at length about death. I find Blanchot’s exploration of writing and death to be comforting rather than morbid. The point is that I am now writing from a place of silence, and while the craft and art of writing may be associated with the silent space of the solitary writer, I am writing from a space of the pathologically silenced. The written word is now a much more intimate thing for me.
The voice has historically been understood as the primary source of being. The voice is what has presence, and this is what Jacques Derrida deconstructed all his life. Derrida showed us that the voice has always been seen as the being-present of a self, of a living person. For those of us who have lost our voice, we have lost our being-present, and this means we have lost our being. We are not here. I am not here. I have no Being. But Derrida went further and revealed that the reliance on the voice depends entirely on a prior idea—that our being is written into the world, and that presence is always receding away from us. While we feel presence, it is already gone. What is back there, or deep in there as the case may be, is writing. And that means I am back there or down there. This is what writing is now.
When I wrote my memoir, The Chief of Birds, I found that I had spent my time in recovery from addiction writing myself back into the world. With the diagnosis of cancer and what has unfolded, I am writing myself out of the world. My voice, which was the sign of my presence, is gone. No prosthetic will replace that presence because that presence was nature. Derrida also deconstructs this distinction, and as a form of nature that is always already culture, I am now acutely aware of my tenuous status as a function of textuality. The voice designated my uniquely human ability to signal my presence and all that constitutes my presence, and this is gone forever. I am nothing but the textual space of my being.
What I have left is all that is written, and writing always signifies an absence. It begins in nothing and reveals the interior nothing as something. Just like this essay, which came about reluctantly, I find “value, truth, and reality only through the words which unfold in time and space” (“Literature and the Right to Death.” From The Work of Fire, 304). And so, I “begin to write, but starting from nothing and with nothing in mind.” As I fade to nothing, the writing becomes the only thing in the world of any importance. Writing for me now “becomes the perfect act through which what was nothing when it was inside emerges into the monumental reality of the outside as something which is necessarily true, as a translation which is necessarily faithful since the person it translates exists only through it and in it” (305). The final part of this statement is essential. I am the person in the writing only to the extent that I wrote the person in the writing, the person who is nothing until he/it becomes something on the written page. The cancer and subsequent removal of my voice removed me from the Real, and my fidelity is now to the truth of what I write. I am not here, nor do I even want to be here, except as a figure of the words I create and write. I no longer want to be anything but the ghost figure behind the words. As I write this now it is with the fidelity to the truth of the fact that “(t)he word gives me the being, but it gives it to me deprived of being” (322). Writing now renders my presence in place of the absence I have become.