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

  • By Anne Boyer
  • Farrar, Straus and Giroux
  • 320 pp.
  • Reviewed by Rose Rankin
  • October 22, 2019

A lyrical, stream-of-consciousness response to a name-brand illness’ pervasive “pinkwashing.”

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

There is a sardonic irony in Anne Boyer’s The Undying being published so close to October, also known as Breast Cancer Awareness Month, since she skewers the inadequacy and hypocrisy of this once-well-intentioned marketing ploy.

On the other hand, the honesty and accuracy of her book in capturing the disorientation of breast cancer and its treatment deserves to be heard at the zenith of pinkwashing.

Boyer’s account is not a typical survivor story; in many ways, it even eschews the label of “survivor.” Instead, it’s a sprawling examination of the personal suffering, public mythology, and persistent societal failings surrounding the treatment of breast cancer and those who endure it.

The Undying isn’t a strictly linear memoir, but it does begin with the author’s diagnosis of triple negative breast cancer in 2014 when she’s only 41 years old. One of the lessons this book shares is the fact that “breast cancer” is an oversimplification for many types of breast cancers, a reality unknown to most people until one is sucked into the maw of this disease and its trappings.

Boyer’s is the most frightening kind of all — the one without a targeted treatment, the most aggressive, and the type about which those of us diagnosed with a hormone-positive variety say, “At least I don’t have…” She acknowledges all of this and proceeds to bring the reader through the strange world of a lifestyle dominated by cancer and the devastating ferocity of treatment — in particular, chemotherapy.

As she explains, “There is a choice, of course, and you make it, but the choice never really feels like yours. You comply out of a fear of disappointing others, a fear of being seen as deserving of your suffering…a fear that you will be blamed for your own dying.”

The expectations that women should be stylish while bald, be joyful as our breasts are removed, and be confident when every symbol of femininity is destroyed are the persistent and damaging lies foisted upon patients by a society that won’t allow suffering yet will criticize women for not playing by unwritten rules.

These complexities are downright refreshing for breast cancer patients and survivors to see articulated on the page, but they’re illuminating for non-sufferers, as well, whose good intentions of sending books about cancer patients and endless treatment advice ring hollow and tone deaf.

How would they learn without hearing a blisteringly honest account such as this?

The other reality of breast cancer that Boyer exposes is its racial and socioeconomic disparities. Women of color and women not in married, heterosexual relationships suffer disproportionately from the disease. Black women are overrepresented in triple-negative cases, yet it has no targeted treatment. In general, black women have a lower rate of breast cancer diagnosis and a higher rate of mortality. “These women’s deaths are racist and unnecessary, and our grief over them should tear open the earth.”

The insurance industry prioritizes profits over healing in all cases — Boyer’s double mastectomy was an outpatient procedure, and she was forced to go home when she was in too much pain to walk and too drugged to think. And, because of insufficient workplace protections, she was back at work just 10 days later.

Relatedly, only spouses, parents, and children count as legal caregivers in the United States and are afforded protections for taking time off work. If a patient doesn’t have someone available in one of those socially determined categories, she (or he) may end up with no caregiver at all.

Highlighting these truths is the greatest contribution of Boyer’s book, and she does so without being didactic or producing a screed. Instead, The Undying shares the many sides of breast cancer in poetic prose, almost dreamlike reflections that capture the dissociated mode of thinking that comes with treatment by poison, the threat of early death, and having your entire life suddenly upended.

She moves from explorations of quack remedies and pharmaceutical fraud to ruminations on the way society characterizes survivors versus those who die. She writes of the incredible pain and exhaustion, but in a stream-of-consciousness style that is weighty enough to convey the message, yet lyrical enough to entrance the reader. Perhaps only a poet like Boyer could express these many absurdities in a way that is still beautiful.

The Undying is a cathartic read for breast cancer patients and survivors, and anyone caught in the relentless machine of treatment, suffering, and withstanding the ordeal. But it’s equally valuable for allowing the uninitiated to peer behind the pink ribbon and the tropes and, instead, see what so many parts of our society can’t or won’t countenance about this disease.

Rose Rankin is a writer outside of Chicago. She focuses on history and gender issues, in particular women’s literary history. She is also a breast cancer survivor.

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