“I was in bed in the surgical wing of Duke University Hospital when the doctor popped his head in and smiled apologetically before flicking on the fluorescent lights. It was 4:00 AM, the end of my second night in the hospital, but nobody sleeps in the conventional sense,” writes Kate Bowler in the opening page of her poignant memoir, No Cure for Being Human (And Other Truths I Need to Hear). Shortly after, a young surgeon appears at her bedside and delivers this sobering news: “The scan revealed the liver has multiple focal lesions; the largest are seen within the caudate and right hepatic lobe in addition to several scattered subcentimeter lesions, some are noted within the periphery of the liver, and some are subcapsular. The large left transverse colon mass was what created the functional obstruction for you, hence the pain.”

BOOKMARK

Title: No Cure for Being Human (And Other Truths I Need to Hear)

Author: Kate Bowler

Publisher: Random House

Publication Date: September 2021

Price: $28.95, hardcover, 224 pages

Best Life Now

In 2015, when she was 35, Ms. Bowler, who teaches the history of Christianity at Duke Divinity School, was diagnosed with stage 4 colon cancer, with a poor chance of survival beyond 2 years. In No Cure for Being Human, she searches to find a way forward as she navigates the so-called wisdom of today’s best-life-now advice industry, which can prove to be an onerous presence in a person struggling with cancer. According to the author, the little catch phrase summed up the ethos of the entire wellness industry: “Live. I’m not sure I know how to do that anymore,” she writes, drilling down into the emotional abyss so many patients with cancer experience.

Tick, Tick, Tick

Most cancer memoirs take a few chapters of exposition before arriving at the huge inflection point: cancer diagnosis. Instead, Ms. Bowler takes the unusual approach of dropping her lead and opening with it. But it works, because it wastes no time getting there, being that time, itself is one of her central points.

In chapter 2, called “Timekeeping,” readers are immersed into the otherworld time of the patient with cancer. Here, her oncologist gives her the good news that she’s qualified for a clinical trial of pembrolizumab. As she tries to resume her role as the cheerful and tireless go-getter, she instead sees herself as a human pocket watch that needs to be rewound every few hours. Moreover, she experiences the universal phenomenon of the patient with cancer, being treated as a disease, instead of a person with a disease who is trying desperately to hold onto a shred of normal, before-cancer behavior.

“I start confidently, but if I stand, someone in my family will immediately set a chair behind me…. Every third hour I must take a small round pill and, every fourth, some yellow pills wide enough to choke a pony. One makes my nose itch and the other makes me woozy, and none makes me eat. But this is the tick, tick, tick of cancer.”

Treatment Toxicity and Survivorship

One of the books most compelling sections is when the author describes the oftentimes brutal side effects of the trial regimen of chemotherapy plus immunotherapy. More compelling is her absolute dedication to power through terrible discomfort, as her consent form clearly states that patients who do not keep to their strict regimen will no longer be eligible for immunotherapy.

“My hands and feet are numb and heavy with tingly electric pain, but I’ll be damned if I get kicked off my trial because of these side effects…. If this treatment fails, there is nothing else to choose,” she writes.

In a chapter called “Befores & Afters,” Ms. Bowler dives deeply into the emotional minefield of survivorship during a visit to a therapist she’d started seeing soon after she began the clinical trial. The good news is her tumors have all but disappeared, and she feels relatively good. But, as with most survivors, she tells her therapist she doesn’t know how to move forward without knowing what will happen next. Her therapist asks what kind of language her oncologists use to describe her current prognosis.

“My oncologist called it a durable remission the other day. I wanted to know how other patients in my situation fared, but he won’t answer, so I found the most famous oncologist I could who was in New York. I flew there and met him. He asked why it was so important to me that I know how other patients fared, and I said because I want to live…. He suggested I have a genetic screening done and come back in 6 months,” writes the author. Eventually, she understood the reluctance to give a difficult-to-assess prognosis that simply might create false hope.

One of the Lucky Ones

In the books last chapter, “Unfinished Cathedrals,” the author writes about the reality of her situation, being one of the lucky ones. “The truth is there on the chart page. Some of us on the clinical trial responded to the immunotherapy drug and lived; and many did not respond and died. I’m one of the lucky ones, but even though it sounds cruel, I know that it’s necessary…. There are approximately 100 trials being run around the world for patients like me. Scientists are focused on cracking the code of what cures patients like me, so they can apply that knowledge to cure the greater population,” she writes, summing up the reality of cancer research.

No Cure for Being Human is a good book, even if it strays a bit here and there from the central narrative. The book’s power is held in the author’s openness about her own precarious grip on life. She’s honest and frank, offering a slightly different take on the cancer memoir, which proves interesting and edifying. For that alone, this book is recommended for readers of The ASCO Post.