S.L. Wisenberg on How We Talk About Cancer

In the wake of the news that Kate Middleton, the Princess of Wales, has cancer, author S.L. (Sandi) Wisenberg joins co-hosts Whitney Terrell and V.V. Ganeshananthan to talk about the control that public—and private—figures should have over the disclosure of their diagnoses. Wisenberg, who survived breast cancer, and Terrell, who was recently diagnosed with prostate cancer, name books they have read that have helped them discover humor in their journey from testing to treatment, and reflect on the challenging nuances of what it means to have cancer. They talk about how and when they decided to tell their loved ones, friends, and students about their condition. Wisenberg reads from her 2009 book The Adventures of Cancer Bitch, which will be reissued in paperback in October.

Check out video excerpts from our interviews at Lit Hub’s Virtual Book Channel, Fiction/Non/Fiction’s YouTube Channel, and our website. This episode of the podcast was produced by Anne Kniggendorf and Jasmine Shackleford.

*
From the episode:

Whitney Terrell: I have found that doctors use metaphor to try to explain. The language that I’ve remembered the most is non-technical language—when a doctor has given me an image that is helpful. One doctor was talking about what’s called nerve-sparing surgery, which people sometimes have for prostate cancer. He said, “Well, the nerves around the prostate are kind of like the sticker on an apple. You can peel them off and then save them. Then you take the apple away and the sticker is still there.” 

A friend of mine who had radiation said his doctor uses an image for radiation therapy: There’s a bunch of flies in a glass, and everyday we’re killing a few of them. We’re watching where the rest of them go, and then we kill more and more each time, until there are no flies moving in that glass, and then we’re done.

I find it interesting that doctors need to resort to that kind of metaphor. I find that to be a useful use of language. I remember you were talking about getting an MRI and having these fruit strawberry baskets placed on your breasts that they use for a biopsy. That was a striking image that I remember.

Sandi Wisenberg: Yeah, that’s all I could think of to describe it. It’s weird they would use the image of a sticker on an apple, because a sticker on an apple is not a natural thing. Maybe the doctors are young enough that they think apples come with stickers. 

Did you get a book? They gave me a fat booklet, and it explained a lot of things. Dr. Susan Love, who died recently, was big on explaining cancer to women from a feminist point of view. She talked about different ways of treatment. She said some are like fast food and some are like a restaurant. Outpatient surgery is like fast food, where you just go in and go out. That didn’t seem necessary to me. It’s weird. Who was the fast food? Who was the customer?

WT: You felt like the language needed some workshopping?

SW: It did need a little work, yes. Did you feel that way?

WT: I was just happy to get something that was a word I’d heard before in some visual language that I could picture. It was helpful. Though, I didn’t think about your point about the apple metaphor. Good point.

SW: Oh, I could never decide if I wanted to have reconstruction or not, and reconstruction is such a funny word because sometimes I write about race and history.

WT: I don’t like that term at all.

SW: If you do that, then you think of Reconstruction, which we were told in school was a bad thing. But, you learn later in life that it was a good thing—when the South was supposed to undergo reconstruction and there were the feds occupying it and trying to make it a more equitable place. There were Freedom Schools for Black people. There were Black people in the legislature. That’s Reconstruction with a capital R. 

Reconstruction with a small r is getting a new breast, and you’re getting it because they’re either gonna put this bag of saline under your skin and force it there, or a bag of silicone, or they’re going to take fat that you have and put it in there, from various places. At first I was thinking, “Well, I’m never going to get reconstruction.” And then I thought, “Well, maybe I’ll get reconstruction.”

I talked to some doctors, and I talked to some of their patients, and then my surgeon said, “We will give you a skin-sparing mastectomy, which is also called SSM. They take away the breast, but they leave a little more skin than normal, so, if you want to, you can expand that into another breast, or you can just have it there. It’s slightly lumpy, but I was very distressed. 

Recently, a friend of mine talked about when you have breast surgery, your skin and your breast is misshapen, or your body is deformed. And I said, “It wasn’t deformed, it was just like…” Remember Señor Wences, he had a little hand puppet made out of his hand where his thumb is his chin, and he’s talking. That’s what the skin sparing-mastectomy looks like, or it just looks like two fingers that are flattened on the place where your breast was. It’s not disfigured. It’s just this little skin there. 

I’m still ambivalent after 17 years. I’m ambivalent about my decision not to get reconstruction. I’m also sometimes defiant because I feel like that’s my little political statement that if one in eight women gets breast cancer, and everybody gets reconstruction or wears a prosthesis (a breast prosthesis, as opposed to a cranial prosthesis, in other terms a wig, which I had a prescription for)…

WS: Cranial prosthesis, my God.

SW: I don’t know if I saved it or not… I didn’t get it, but I could have gotten a cranial prosthesis. I feel like not having a breast and having it show makes people uncomfortable. When I say people, I mean my mother. I don’t know anybody else who’s uncomfortable. But yeah, cranial prosthesis was great.

V.V. Ganeshananthan: That is wild. I remember when I was in high school, going shopping for wigs with the mother of a dear friend who had sons. I was very close to her, and I went shopping with her for her cranial prosthesis. That was not the word we used; that did not come up. 

As you’re talking, I’m reminded of a book—have you read Michael Ondaatje’s Running in the Family?

SW: I just got it.

VVG: One of my absolute favorite moments in that book has to do with, I think it’s his mother. It’s just the sly wit of it. She’s on public transportation in Sri Lanka, and someone is groping her. But she has no idea because she’s had a mastectomy, and she has a piece of foam or something under her shirt. And so this guy is groping her and he’s standing there all smug like, “Look what I’m getting away with.” And she looks down and just starts laughing to herself… It was one of the first depictions of breast cancer I’ve ever read. I loved how in that scene, she’s kind of getting one over on him. That’s the way that it’s portrayed. He thinks “I’ve accessed this woman’s breasts, and I’m harassing her, and I’m completely getting away with it,” which honestly, on public transportation happens all the time. But she’s snickering to herself a little bit.

Transcribed by Otter.ai. Condensed and edited by Mikayla Vo. Photograph of S.L. Wisenberg by Adine Sagalyn.

*

S.L. (Sandi) Wisenberg:

The Adventures of Cancer Bitch • The Sweetheart Is In • Holocaust Girls • The Wandering Womb

Others:

“Princess of Wales Apologizes, Saying She Edited Image,” by Mark Landler and Lauren Leatherby | The New York Times • Kate Middleton announces her cancer diagnosis | NBC News • Time on Fire: My Comedy of Terrors by Evan Handler • Cancer Made Me a Shallower Person: A Memoir in Comics by Miriam Engelberg • Memoir of a Debulked Woman by Susan Gubar • Our Cancer Year by Harvey Pekar and Joyce Brabner • The Cancer Journals by Audre Lorde • Dr. Susan Love’s Breast Book by Susan Love • Senior Wences • American Splendor • Running in the Family by Michael Ondaatje • Dick York • Nora Ephron • Carl Bernstein