Most cancer memoirs have a similar thread: life suddenly interrupted by arguably the three most dreaded words in the English language, “You have cancer.” Readers anticipate the high-drama uncertainty leading to diagnosis, treatment, and hopefully survivorship, with multiple human storylines woven into the narrative. However, seasoned journalist Mary Elizabeth Williams chose to delay the compelling moment-of-truth of diagnosis in her book A Series of Catastrophes & Miracles: A True Story of Love, Science, and Cancer. She opened her wonderful memoir at her support group, Gilda’s Club, as she’s battling advanced melanoma. She took a risk, but instead of dulling the anticipation for readers, she actually sharpened it.
Title: A Series of Catastrophes & Miracles: A True Story of Love, Science, and Cancer
Author: Mary Elizabeth Williams
Publisher: National Geographic
Publication Date: First edition, April 2016
Price: $25.95, hardcover, 304 pages
“It’s a bad time for the phone to ring. Jeff is already down the hall at his caregiver support group…. My own support group is just about to start, and our facilitator Marlena is strict about outside interruptions.” As readers wait on Ms. Williams’ hesitancy to answer the phone, she gives them an intimate peek into the stressors of living life in the balance of chemotherapy and radiographic scans. Although there is comfort in support groups, Ms. Williams notes: “Sometimes this little clubhouse is a hard place to be. Eventually, everybody leaves it—and there are only a few ways out. The hoped-for option is by getting better.”
On the night of the urgent phone call, Ms. Williams had a lot to talk about. She is 3 months into a cancer clinical trial, and her next treatment is 2 days away. Here, she gives readers a glimpse into the time warp of cancer: “This morning, I had examined my shampoo bottle as I washed my hair and wondered if I would make it to the bottom of it. Lately, I weigh the practicality of renewing my subscription to The New Yorker and the uncertainty of making plans for summer vacation when it’s only January.”
She scurries guiltily out of the support group and takes the call, which is from an oncologist familiar to the readers of The ASCO Post: Jedd Wolchok, MD, PhD, Director of Immunotherapy Services at Memorial Sloan Kettering Cancer Center in New York. Dr. Wolchock delivers good news: “We got your scans, and the tumor on your back is gone, as well as the one on your lung. You present no evidence of disease.”
When a buoyed Ms. Williams returns to her support group, she sits next to a friend, Cassandra, and they clasp hands, comrades against a common enemy. Ms. Williams writes: “Tonight is the last time I will see Casandra. She will be dead within a month. Her sons, who are downstairs screaming circles around the girls, will be the next to leave the children’s family group and go into the children’s bereavement group.” This intimate scene illustrates that no matter what type of cancer a person has, coping with its emotional toll can continue long after active treatments are over. The aftermath can lead to a tangle of complex feelings including survivor guilt and anxiety over recurrence.
The Promise of Immunotherapy
Before detailing her melanoma surgery and subsequent treatments, Ms. Williams offers a brief interlude on immunotherapy. She turns back to 1890 and the surgeon William Coley’s early foray into immunotherapy, when he discovered that postoperative patients with bone cancer who developed bacterial infections had far better outcomes. The author uses this explanatory interlude device several times, a smart way to inform the lay reader of the science behind the treatments and their side effects.
As a journalist and a patient with cancer, Ms. Williams has a unique opportunity to examine the health system that she’s entrusted her life to. For the most part, she does an admirable job, detailing the scans and blood draws, the side effects of surgery and immunotherapy, and, perhaps best, how the totality of cancer affects one’s life (such as friends who stop calling and the subtle changes in how people treat you).
Ms. Williams digs into the quagmire of the U.S. health-care system, giving a fair evaluation of its shortcomings without the unnecessary potshots leveled at doctors and Big Pharma that sully many books in this genre. The running narrative of her experimental treatment on ipilimumab with Dr. Wolchok illuminates the day-to-day grind of being on a clinical trial, punctuated with apprehension and, in her case, elation. Lay readers will also gain new respect for the oncology teams that fight day and night for their patients with cancer. Life outside the clinic is also part of the book’s tapestry—a father dying of colon cancer, an exploding marriage, kids who need extra attention, careers, and even the mundane trivia of the day, such as negotiating the traffic and crowds in Manhattan.
Losing a Friend
Ms. Williams’ successful treatment and survival against very steep odds are counterpointed by her close friend Deb, who loses her fight against ovarian cancer toward the book’s end. Although their back-and-forth banter on cell phones about their treatments can feel a bit forced and overly chatty at times, that’s a small gripe considering what they went through and shared with readers. During one conversation, Ms. Williams offers: “I am so tired of feeling chipped away. They got part of my head and my hair, they got my lymph nodes, they got my thigh. Now they’re going to take out part of my lung.” Deb replies: “I know. A huge team of people took a piece of my abdomen to rebuild my vagina.”
Very few cancer memoirs capture the full scope of the cancer experience so much so that even lighthearted banter is underscored by looming mortality. A Series of Catastrophes & Miracles does just that and is recommended for readers of The ASCO Post.