A Manly Response to Disease

While learning this spring that the coronavirus was taking a disproportionate toll on men, I was reading David Lehman’s account of his bladder cancer, a disease that also disproportionately afflicts men. His brilliantly circumspect 2019 memoir, “One Hundred Autobiographies,” reminded me that a conventional model of masculinity inhibits some men from expressing their emotional responses to assaults on the body.


Credit…Cornell University Press

An accomplished poet, editor and scholar, Mr. Lehman exhibits grace under the pressure exerted by disabling treatments. He thereby provides insight into the benefits and liabilities of masculine reticence about disease. Like him, quite a few men may judge it unmanly to discuss medical procedures that can unman them. Is this stoicism empowering or disabling?

The refusal of my dear husband to talk about his physical disabilities first taught me about the incommunicative fortitude of a number of older men whom I admire. I witnessed a similar reluctance to speak when I was invited to attend a meeting of prostate cancer patients who seemed decidedly tongue-tied. Quite a few depended on their wives to communicate for them. (No woman in my gynecological cancer support group has ever entertained the idea of inviting a husband to join us, much less to speak for her.)

Unaffected by more recent gender paradigms, the standard of a strong-and-silent masculinity to which these men conform depends upon their upbringing. They are of generations of boys brought up not to cry or rant: to button up, soldier on and not indulge in messy emotions. The novelist Anthony Trollope put it best: “Men but seldom tell the truth of what is in them, even to their dearest friends; they are ashamed of having feelings, or rather of showing that they are troubled by any intensity of feeling.” Though it has long roots, this model of masculinity continues to shape the identities even of people engaged in the expressive work of creative literature.

In “One Hundred Autobiographies,” Mr. Lehman informs us that he is telling and not telling his cancer story. After he discovered blood in his urine, he produced 100 vignettes to recount his life. The brief sketches were composed while he underwent several cystoscopies, a succession of transurethral resections of bladder tumors (TURBTs), eight weeks of an immunotherapy regimen, four months of chemotherapy for metastatic disease and a five-hour surgery, “in which they remove your bladder, some lymph nodes, and choice other parts of you and reorganize your insides,” along with a slew of side effects: a “heart stop,” neuropathy, infection, weight loss, digestive complaints. “And mostly I kept my cool. Mostly.”

Throughout the book, Mr. Lehman refrains from relaying specifics about the nature and consequences of these medical events. He also emphasizes his own reserve by incorporating the accounts of his wife, Stacey, to supply background information; by admitting that he lies about his condition to well-wishers; and by referring to his publication as a “fake memoir.” Why?

Mr. Lehman explains in the book that he does not want to “make cancer the sun around which the rest of the planets revolve”: “I don’t want to talk about it, think about it, do anything about it except show up on time for every last appointment and try not to complain.”

While the downside of this approach means we don’t learn much about bladder cancer, the upside means we learn a good deal about Mr. Lehman: about his immigrant parents, who met in New York City after fleeing the Nazis; his observant upbringing in the Inwood section of Manhattan; his education at Columbia University; his famous mentors and friends — Lionel Trilling, John Ashbery, Kenneth Koch, Edward Said — as well as his favorite travels, songs, jokes, movies, authors and sports teams. It is intriguing to get acquainted with an artist-critic who has shaped the contemporary poetry scene since 1988 as the founder and series editor of the annual anthology The Best American Poetry.

In a work evasive about the here-and-now of cancer, the past becomes pervasive and, as Mr. Lehman’s title suggests, multiplied. The shock of imminent mortality that disease administers sparks retrospection. A possibly truncated future after diagnosis expands the period of time before diagnosis, as Mr. Lehman recasts resonant “spots of time” in his youth.

Throughout “One Hundred Autobiographies,” the act of writing revivifies Mr. Lehman’s memories. Into every waiting and hospital room, he carried a pocket notebook in which he wrote daily, regardless of his pain levels. Prompting reveries, the composition process “was keeping me alive — more, it was asserting my will to live.”

When I asked Mr. Lehman directly why he sidelined his physical experiences as a patient, he said, “Not dwelling on the pain I am enduring … has something to do with the belief that readers aren’t interested in clinical details; the desire to avoid self-pity; and most important, my wish, when writing, to escape from the medical circumstances, not to wallow in them.” Then he added, “While sick and in treatment, I told few people and made no public declaration,” and “I still maintain a general reticence” about ongoing consultations with urologists, ophthalmologists, dermatologists, cardiologists and gastroenterologists.

Acutely aware that his wife’s research and caregiving freed him to downplay the “unpleasant but banal” degradations of scans, scopes, chemicals and scars, Mr. Lehman refuses to let disease define him and thereby supplants cancer as the main character of his book. A traditionally gendered division of labor works on his behalf, especially during interactions with hospital personnel: “Stacey is taking notes so I can tune out.”

“One Hundred Autobiographies” reminds us that many guarded patients keep their most frightful reactions to treatment locked inside themselves. It also raises concerns about what happens to those without a partner able to intuit their troubles and act or speak on their behalf. Surely, men unaccustomed to sharing their qualms and questions would be especially vulnerable when undergoing cancer or Covid or another appalling ordeal.

Source: nytimes.com

Tags: health

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