That’s it: I’m getting up to go get my leg cut off.
13
He’d asked those he loved to be there when he woke up and they are, all there around him: his parents, his brother, his sisters, and Aurélie. The first sensation as he emerges from the anesthesia is that it doesn’t hurt anymore. The tumor had been compressing a nerve, causing pain that for the last several months had been excruciating. So he’s no longer in pain; he feels nothing. But he sees: the shape of his right leg stretched out under the sheet, the shape of his left thigh, and just where there ought to be a knee the sheet collapses, there’s nothing more. It will take some time before he dares raise the sheet and blanket, before he sits up to hold out his hand, moving it back and forth in the space where his leg used to be. He has one less leg, that’s all he thinks about—and at the same time he keeps forgetting that. If he doesn’t look at the empty spot that has replaced his leg, if he doesn’t verify that it’s no longer there, there’s nothing to remind him that it’s gone. His rational brain has registered the information, but it isn’t his rational brain that is conscious of his body and makes it move. When the day comes for him to get dressed, to put on his boxer shorts, he won’t be at a loss, he’ll have prepared for this, thinking: I’ve had an amputation and will now perform a certain action for the first time since my operation and I’ll have to do it differently this time. He will have thought this, yet when he holds out his boxers with both hands and bends over, he will first make as if to put his left foot through the left opening, knowing perfectly well, seeing perfectly clearly, that he no longer has a left foot, and he’ll have to make a conscious effort to put only his right foot through the right opening, and slowly draw the boxers up his right leg and the column of emptiness on the other side, until the left opening slips over the absent knee and he can continue as he always has up along his thighs and finally over his buttocks and voilà: he has put on his underpants. It will be like this with everything. He’ll have to adjust the program, shifting from business as usual to amputee mode. He’ll have to domesticate not only the void replacing the leg but also the place where the void and the truncated leg meet, which has a terrible name and designates something not too pleasant, either: the stump. There is another crucial moment in the apprenticeship, when the hand, for the first time, touches the stump. It’s not far away, just reach out … but touching it will inspire a certain revulsion and Étienne will need a long time yet—he’s nowhere near that stage—before he can envisage the possibility that his stump won’t always be a forbidden zone and that another person, in particular a woman, could one day touch and even caress that stump with love. All this education awaits him at the rehabilitation facility in Valenton, near Créteil, where the hospital has transferred him. Étienne passes quickly over this part of the story. What he does say is that a lot of lies get told about an amputation. They’ll tell you, The amputation will be just above the knee, the ideal height for the prosthesis, and soon you’ll be living a normal life. Then you get to the rehab center and ask the doctor when you can start playing tennis again and he looks at you as if you were nuts. Ping-Pong, sure, Ping-Pong’s fine, but tennis, forget it. And you’ll get told as well that once you’re used to the prosthesis it will be a part of you, as if you actually had a new leg. Then the day comes when you try it on; the thing goes click-clack … and you see what a farce this is, it’ll never be a new leg. Watching you cry, the caregivers tell you gently that everyone goes through this, that’s why the apprenticeship takes time, but the other amputees, the ones a little ahead of you in that department, will tell you, as at least one of them told him, Welcome to the club. From now on you’re one of us, three-quarters human with metal for the rest.
Étienne ran away. He was supposed to stay in rehab for three months, but the week he started he asked his parents to buy him a car, his first car—for the disabled (with one floor pedal)—so he could leave whenever he wanted, and after two weeks he’d gone home. Like the cancer patients at the Institut, the amputees at Valenton disgusted him. He wanted nothing to do with any friendship or even camaraderie nourished by that solidarity.
The year of chemotherapy, on the other hand, was nonnegotiable. It was atrocious. Three all-day sessions once a month, and during those three days, bluntly put, you never stop vomiting. Three days of throwing up when you’ve got nothing left to throw up. Each month, the idea of going back through all that again terrified him. As a rule, he thinks one must live lucidly, experiencing everything that happens, even suffering; that was already his credo, even then, but that—no, that served no purpose, was too disgusting, too humiliating, it was better to be unconscious, and he asked for the oblivion of drugs. He allowed his mother to come hold the basin for him, but not Aurélie; he didn’t want her to see him like that. Now, twenty years later, he’s sorry. He says it’s one of the real regrets of his life, much more lasting than having cut short his first round of chemotherapy. Aurélie wanted to be with him, she loved him and her place was at his side, but he hadn’t let her be there. He hadn’t trusted her.
Besides making him horrifically sick, the chemo made him lose all the hair on his body, just as he’d feared the first time. Almost all, but not quite; Aurélie had insisted that he shave what remained, but he refused, keeping a few long scraggles of hair that made him look even more hideous. Not without reason, Aurélie accused him of overdoing it. He’d stand looking at himself in the mirror: that white, scrawny, glabrous thing without a leg—that was him; the athletic young man of a just few months earlier was now this mutant. Aurélie hung on for almost a year before she left him. He was twenty-two. He was twenty-eight before he had another girlfriend.
After his first cancer, he’d gone to a psychotherapist. This had nothing to do with his illness, he says; at the time he’d thought himself cured. Sexual problems had prompted the therapy, and that’s all he’ll say on that topic, but what seems clear to me is that his present sexual confidence is a hard-won victory over years of misery. During the second cancer and the amputation, his psychotherapist came to the hospital every day. The man was barely ten years older than Étienne, and a patient that young, with cancer, and now an amputee … that was a first for him. We’re both venturing into uncharted waters, he said: I don’t know what to do or where we’re heading. Étienne found that reassuring.
The psychotherapy turned into an analysis that lasted nine years. Throughout that period, during which Étienne attended the ENM in Bordeaux and worked as a judge in the north of France, he would take the train to Paris twice a week and never missed a session. This intense experience has given him, even more than familiarity with the unconscious, an almost religious confidence in its powers. He is not—or at least he says he’s not—a believer, but he has a liking and a gift for abandoning himself to this force that, deep within him, is more powerful than he, and perhaps wiser as well. This force is not outside him; it is neither a personal nor a transcendent god. It’s everything that while being him is not him, is beyond him, inspires him, gives him a rough time, saves him, and he has gradually learned to let it be. I wouldn’t say that what he calls the unconscious is what Christians call God; perhaps it’s what the Chinese call Tao.
At this point, I’m walking on eggshells. I suppose Étienne talked a lot about his cancer in analysis, and frankly I’m amazed that with his deep faith in the power of the unconscious he should refuse all psychosomatic interpretations of his disease. On this subject, though, he won’t argue, he shoots on sight. He tells me, People who say that it starts in your head, comes from stress or some unresolved psychic conflict—I feel like killing them, and I feel like killing them all over again when they trot out the other cliché: You survived because you fought back, you have courage. That’s not true. Some people fight back and they’re incredibly courageous and they don’t make it. Example: Juliette.
Étienne said that to us the day Juliette’s family and I went to visit him; he said it again at my first private meeting with him, and both times I indicated
that I agreed, but I’m not really sure I do. Of course, I have no theory of my own or any authority to have one on such a controversial question, and I’m aware that my opinions here say nothing about the etiology of cancer but reveal instead, at best, some things about myself. First, my gut feeling is that cancer is not a disease that hits you from outside, by accident (not always, anyway, and not necessarily). And more importantly, I’m convinced that deep down Étienne feels the same way—or that he rages so vehemently against this interpretation precisely because he fears it might be true.
In 1976 a book called Mars, by Fritz Zorn, was published. It made a considerable impression at the time, and I’ve since reread it. Here is how it begins:
“I am young, rich, and educated, and I’m unhappy, neurotic, and alone … My upbringing has been middle-class, and my life has been a model of good behavior. Naturally, I also have cancer, which goes without saying if you consider what I just told you.” To Zorn, cancer is both a “disease of the body” that will quite probably soon kill him, although he might also defeat it and survive, and “a disease of the soul,” about which he says simply: “I’m lucky it finally made its move.”
The book’s final sentence: “I declare that I am in a state of total war.”
This may seem just too good to be true, but Zorn, which means “anger” in German, is a pseudonym for the author’s real name, which is … Angst. In the course of his book, in his passage from anguish to anger, this docile, alienated young patrician, “educated to death,” as he puts it, has become at once a rebel and a free man. His illness and the terrifying approach of death have taught him who he is, and to know who one is—Étienne would say, where one is—means the end of neurosis. Rereading Mars, I could not stop thinking about the life Fritz Zorn would have had if he’d survived, about the accomplished man he might have become if he’d been granted the chance to enjoy that expansion of consciousness for which he paid so dearly. And I thought that Étienne was a man who had accomplished that very feat.
I didn’t dare tell him that or bring up another book that had impressed me almost as much as Mars. Le Livre de Pierre is a long interview by Louise Lambrichs with Pierre Cazenave, a psychoanalyst who suffered from cancer for fifteen years and died of it before the book came out. He described himself not as “having cancer” but as “being cancerous.” “When I learned of my cancer,” he says, it seemed “that I had always had it. It was my identity.” Psychoanalyst and “cancerous,” he became a psychoanalyst for “the cancerous,” grounding his approach in his intuitive understanding that “the worst suffering is the one you cannot share. And a cancer patient usually feels that suffering twice over. Because he cannot share the anguish of sickness with those around him and because beneath this pain lies another, more ancient one, dating back to childhood, and it, too, has never been shared, never been seen. And that is the worst of fates: never to have been seen, never to have been acknowledged.”
This other suffering, says Cazenave, is what he aspires to cure, by leading his patients to see and recognize it for what it is and thereby escape its torment. His patients will still die, but between Molière, who mocked doctors who “cured” their victims to death, and the great English psychoanalyst D. W. Winnicott, who asked God for the blessing of dying completely alive, Cazenave clearly sides with Winnicott. Cazenave focuses on people who approach their cancer not as the random visitation of catastrophe but as a truth that concerns them intimately, an obscure consequence of their own history, the ultimate expression of their unhappiness and dismay as they deal with life.
Cazenave is speaking of himself as well when he says that in such patients something has gone wrong during the developmental stage of primary narcissism, leaving a profound flaw in the oldest core of the personality.fn1 This means, he says, that there are two kinds of people: those thus damaged, who often dream about falling into a void, and everyone else—all those who have been well supported by a “holding environment” and can thus stand and live confidently on solid ground. The damaged ones, though, will suffer all their lives from vertigo and anguish, from a sense of not really existing. This infantile malformation may persist a long time in the adult as a kind of background noise, a depression—unrecognized even by its victim—that will one day become malignant. Such patients, informed they have cancer, are not surprised, for they somehow recognize the malignancy, knowing that it was themselves. All their lives, they have feared something that has in fact already happened. Cazenave believes that in patients damaged by this childhood malformation of the self (and who have of course forgotten it), the memory of the wound awakens at the news of their mortal illness, as the fresh disaster reactivates the old one, causing an intolerable psychic distress whose specific origin they do not yet fully understand.
In that panic and distress Cazenave sees the desperate flailing of a deeply flawed creature that never really felt it had a right to live and now suddenly hears its days are numbered. For someone who has always felt alive, a death sentence is sad, cruel, unfair, but it can be integrated into the order of things. But for someone who deep inside has always had the sense of not truly being? Of never having lived? For that person, Cazenave holds out the promise of transforming illness and even the approach of death into one last chance to be really present in this world. He quotes Céline’s wrenching, mysterious words: “Maybe that’s what we seek our whole lives long, nothing more: the greatest possible sorrow, so that we can become ourselves before we die.” Pierre Cazenave is not a theoretician, he speaks only from experience, his own and that of his patients, to whom he is bound by “unconditional solidarity with what the human condition holds of unfathomable distress.” (That is the formula with which he defines his art, and I would like to be worthy of claiming it for my own.)
In the clinical picture described by Cazenave, I recognize once again Jean-Claude Romand, who—it’s horrible to say this—was not lucky enough to have cancer and so invented one for himself, because in some dark way he knew that malignancy was his truth and he longed to have his cells recognize this truth. Since they did not, his only recourse was to lie. I also recognize a part of myself, the part that recognized itself in Romand, but I was able to make books out of my “illness” instead of metastases or lies. And I recognize as well something of Étienne, who had awful nightmares, wet his bed for years, and is convinced his father was raped as a child.
Well, of course I don’t believe this is the explanation for cancer, but I do believe that certain people have been damaged at their core almost from the beginning and cannot, despite their courage and best efforts, really live. I also believe that one of the ways in which life, which wants to live, works its way through such people can be in disease, and not just any disease: cancer. That’s why I’m so stunned by people who claim that we are free, that happiness can be decided, that it’s a moral choice. For these cheerleaders, sadness is in bad taste, depression a sign of laziness, melancholy a sin. Yes, it is a sin, even a mortal sin, but some people are born sinners, born damned, and all their courage and best efforts will not set them free. These people who are damaged at the core are as cut off from the rest of humanity as the poor are from the wealthy. It’s like the class struggle: we know some of the poor will manage to escape their lot but most won’t, and telling a melancholic that happiness is a decision is like telling a starving man simply to eat cake. So when Pierre Cazenave insists that mortal illness and death can offer such people a chance to live at last, I believe it, and all the more readily since at certain moments of my life, I must confess, I was wretched enough to long for that fate. As I write this, I think I have put those days behind me. I’ll even venture to say, presumptuous though it may be, that I am cured. But I want to remember. I want to remember the person I was and the many others like me. I never want to be that person again—but I never want to forget him, either, or to despise the man being gnawed at by the fox and who began, three years ago, to write this account.
The Scorpion-Fish, the Nicolas Bouvier book
I was reading in Sri Lanka, ends with another line from Céline: “The worst defeat in everything is to forget, and especially what did you in.”
14
After finishing the ENM, Étienne made two choices: to join the left-wing Syndicat de la Magistrature, a public and active union of judges, and to take a difficult position as a sentencing judge in Béthune, a city at the tip of northern France.fn1 The Syndicat was widely seen as a haven for lefty judges who refused to join the elite, enjoyed chasing after white-collar criminals, and raised hackles by dispensing their own form of class justice. The classic example of that last tendency was the brief imprisonment of an unpopular notary in Bruay-en-Artois accused of rape and murder not because of convincing evidence but because he had a fine house, a fine car, and a bourgeois potbelly. As for Béthune, it’s just like Bruay, in fact: the dilapidated North, with unemployment, poverty, abandoned slag heaps, parking-garage rapes of illiterate alcoholics by other illiterate alcoholics.
Other Lives But Mine Page 10