Posted by: stelladuffy | October 20, 2014

The Language Battleground

I can’t believe I’m writing about this again, but here goes …

This morning Lynda Bellingham’s death from cancer was announced. Cue dozens (no doubt more) headlines and presenters talking about how she’d ‘lost her battle’ with cancer.

No, she didn’t. She died. There was no battle, there was a disease. She was not a warrior, she was a person. When we talk about cancer in the language of war, when we anthropomorphize cancer, when we make it other than the self, we damage anyone who is living alongside someone living with/dying of cancer, but we damage those of us with cancer most of all.

I have had two breast cancers, the first time round I had a lumpectomy, chemotherapy and radiotherapy, the second time I had a mastectomy and reconstruction.*
At no time have I ever found the language of battle to be anything other than at least a hindrance, and at worst dangerous. It is dangerous because it divides the self. It is profoundly damaging to the psyche split the self off, into healthy and sick, into me and ‘my cancer’, into this self and that self.

Cancer is not stabbed into us, it does not come in from outside, it is not something we can ‘stand up to’ as if it were outside of us, it is not something other, that we might ‘kick its butt’. Cancer is the body making its own cells. It is me, my body, making my own cells, cells that are cancerous. (Not right now, as far as I know, but certainly this time last year.) Sure, I don’t want them, those cells that are cancerous, but they are me, they are as much me as the cells that are not cancerous, they are not OTHER. Cancer is not other than our own selves. And, on its own terms, those cancer cells are not even sick. They are doing what they do, what is in their programming to do, as well as they can. They are not ‘baddies’, they are just cells. In the case of cancer we call it mutation. And in many other cases, mutation is what we call evolution.

Now, of course, anyone WITH the disease is perfectly entitled to use whatever metaphors they choose to get through their days. Personally, I’m always keen on absolute honesty. So it has not been useful for me, when I have had cancer, to hear the disease spoken about as other. It has not been useful to me, when I have had cancer, to hear the disease spoken about as a battle. Because this is not the truth. Cancer is not other and it is not a war. (And we denigrate the seriousness of both when we elide the two.)
However, for those of us who do have the disease, have had the disease, the all-too-pervasive directive to ‘fight’, ‘resist’, ‘battle’, is as absurd as it is brutal. (And it IS brutal – we regularly agree to be cut, burned, poisoned in order to remove the disease.) But while the treatment can be brutal, and while the effects of that treatment can feel brutal, our emotional response, our language response (and what is language if not a way to convey emotional understanding?) need not also be brutal.
We can chose to be honest, simple, we can choose to use plain language rather than over-emotive language. We can choose to save our energy for living, rather than use it to add hyperbole to our descriptions of living with disease, dying of disease.
“He or she has cancer”, not “he or she is suffering with cancer”. (“suffering” is so subjective, surely the only person who gets to say they are a sufferer should be the one who perceives themselves to be suffering?)
Victim, survivor, battle, fight, war … we have better and more honest words, plainer words.
I had cancer. He is having cancer treatment. She died of cancer. They are now well.
There is nothing wrong with the simple and honest.
And for those of us who have already been through it, who now live daily with the profound awareness that we may, yet, die of cancer, simple and honest is far preferable to reminding us (as if we can ever forget) that we might yet ‘lose the battle’.
I’m not in a war. And I refuse to allow lazy journalism and cheap sentiment to send me into battle.

* Mastectomy was neither suggested nor recommended first time round, reconstruction was my choice the second time, a choice I currently, largely, regret and will, no doubt, write about when I – in my own body – have processed what reconstruction has done to my body and why I chose to have it. Right now, seven months since surgery, five months since the second surgery, and prior to at least one more (minor) surgery, it’s far too soon to work out the mass of complex feelings I have around my own, informed and educated, choice to have a chunk of my stomach made into a breast/not-breast … more later, no doubt.


Responses

  1. The main problem for me with these phrases is that if some “lose” the battle then others “win” the battle and there is no win with cancer. Your body has changed. Your mind has changed.

    And when there are winners and losers we think of stronger and weaker. And that’s horrible.

  2. Well said. Saying that someone has ‘lost their fight’ implies it was their fault and, if only they’d tried harder, fought stronger, they might have lived. So unfair.

  3. Thank you for your thoughtful post. Having not had cancer, I did not quite think about it this way. I also do believe that words are not neutral, and that they are often loaded with political rhetoric. You’ve made me think differently about the language I might use in future when talking about cancer. I often work with people with serious mental illness. Some (not all) say the same thing. Externalising their problems is not always helpful. For some it is.

    I wonder whether cancer is often externalised, and we invoke the discourse of battle, because those of us who do not have cancer are afraid. We somehow need to feel like we are not at the mercy of this disease. Invoking the discourse of battle makes us feel that if we try hard enough we can somehow control the outcomes. I take the point from SarahD that in reality it implies that those who die, did not try hard enough.

    Thank you again🙂

    Best Wishes

    Gerhard Pretorius (Familiality)
    http://www.familiality.abft.co.uk

  4. Thank you, Stella. This needed to be said – and needs to be repeated until the related language changes accordingly.
    This kind of militaristic metaphor (interestingly, managementspeak – similarly inaccurate and obfuscatory – uses it widely) merely makes the patient feel worse.
    I have an incurable form of cancer. Whatever I or the medics do (think, feel, visualise, whatever …): this disease will kill me. I have done nothing that might put me at risk of this condition: it happened. And it is hellish.
    Calling my experience of cancer a ‘battle’ (which I am predestined to lose) is merely branding me a loser. As this language is so widely espoused, I fear that the culture of victim blaming is now endemic in our culture. Due to this, I am coping alone. Perhaps, in the final analysis, it is easier that way. It is certainly less stressful.
    I hope the bloody disease has left you for good. Go well, Stella, and bon courage!

  5. I agree and something I regularly comment on (usually when saying that while I am all for Cancer Research, I don’t much like their ‘Cancer we’re coming to get you’ style of campaign).

  6. Thank you so much for this post. My husband has cancer, as do many of our friends and you have said almost word for word how we feel about the misguided language of cancer.

  7. thank you Min. I am sorry you are coping alone, and I very much hope the honesty of those of us dealing with disease contributes to a far greater understanding.
    I like bon courage – cour/coeur for the heart!
    Stella

  8. thank you Gerhard, yes, externalising can be useful, of course, but it makes sense that for many of us – with disease – it is not. (and that for many without it is preferable, because it’s more bearable to place it outside of us, in the idea that ‘it’ – illness/disease, is not ourselves …) the splitting apart of ourselves is so damaging (to many of us). thank you for your response.

  9. I’m all for Cancer Research too, Eleanor, but yes, the ‘coming to get you’ thing feels odd to me.

  10. thank you Sandie. I wish your husband and your friends well – interesting how it seems to go in waves, isn’t it? we had many friends with cancer in the past couple of years, as well as me.
    all best.

  11. Thank you for this Stella. I had not really thought about this until my cousin was diagnosed with cancer (of which she has since died), and it was immedately apparently that the fight/win/lose language was at best irrelevant and at worst damaging.

    I particularly like your comment about using your energy for living – this was the philosophy my cousin embraced, right up to the end – she was still who she was, and saved her energy for the things she cared passionately about – her family, her friends, her work in the community…. and encouraged us to do the same.

  12. Really good post. I actually find it easier to think of cancer as cells and something that comes from within and actually find the whole cancer as an enemy outside of yourself more scary! Please keep publishing articles like this and I wish you all the very best.

  13. Well said. I always hated the phrase ‘lost the battle’ as if you hadn’t tried hard enough. All the best for the future.

  14. My mil has just died from cancer. I would say she lost the battle. Human instinct is to survive.
    I would never say or infer that she didn’t try hard enough. I would never take credence from anyone saying “we’re going to beat this” .
    Cancer is something you don’t have control over, your treatment is mapped out for you & along you go to appointments. Whether you survive is dependent on if it was caught & treated before it spread. Perhaps your post code may influence your drug options.

    As my Mil lay in bed, gasping her final breath, losing the battle couldn’t be closer to the truth.

    I’m very sorry about your cancer, your dismissiveness at your reconstruction. i have a friend in similar circumstances, with similar operations. She is thankful for all her treatments. I feel your post is very angry, unnecessarily so.

  15. Great article Stella.

    I always instinctively disliked this type of language being used in relation to cancer for many of the reasons you set out. I still do.

    However, I understand why it is used rather better after having witnessed my wife Harriet go through secondary breast cancer over the last two years.

    She was diagnosed six years ago, had a mastectomy and chemotherapy, and spent four years without cancer symptoms (she didn’t get ‘the all clear’, which is perhaps my most disliked inaccurate cancer term). Following her diagnosis of secondary cancer in the lungs and liver in 2012 she spent much of her time ‘fighting’, ‘battling’ and ‘being brave’ as she went through four more different kinds of chemotherapy, two chest drains and innumerable other invasive and painful procedures.

    She died at home in July. She expended a huge amount of energy, mental and physical, on living as normally as possible for as long as she could.

    I’d call myself a pacifist, and I recoil from the language of fighting and aggression. But during the last two years I struggled hard to find alternatives to those warlike verbs and adjectives to describe what Harriet had to do to survive.

    She did fight for breath, she did struggle to eat to give herself strength, she did battle fatigue to pick the kids up from school. She bravely proffered her arm for yet another canula. And she did resist her cancer, without anthropomorphising it, because although it was part of her those mutating cells were killing her. ‘It’ might not have been brutal, but what it did to her was.

    Having witnessed it all, I don’t think that such language is dishonest.

    I strongly believe however that it is death that requires more honesty and matter of factness. Harriet died. She is dead. That is what I say, and what I encourage the children to say if people ask. That is honest, and it doesn’t make what happened any worse. Fighting language I’ve found I can live with; euphemisms for death I can’t.

    Danny

    http://www.theguardian.com/theguardian/2014/jul/23/harriet-barber-obituary

  16. I am so glad you posted this. I have always felt very uncomfortable with this metaphor, that cancer is a battle. A friend just passed away, four years after his diagnosis. The memorial card said “a long, courageous battle”. For me, it did not seem a battle that was lost, but a triumph! He lived fully for many years and realized many dreams that others put off until it is too late. He passed peacefully, surrounded by love. What a gift, that many people are not lucky enough to experience. Why do we feel we need to “fight” nature, our bodies, each other, our planet? Until we see our own life as a process that is whole, including death, we will not change our world view.

  17. Thank you so much for saying this. My partner is recovering from surgery to remove cancer, chemotherapy and a subsequent aortic aneurysm. He did not “fight” cancer: he is not a winner. It happened. He had treatment which was brutal (and awful to stand by and watch) and he is, for the time being, better. I can’t be doing with the winners/fighters/losers terminology that comes with this. Keeping it all simple and not letting the terminology slide into saccharine goo is, for us, the best way of speaking of it. Others find the factual (sometimes blunt) approach a little off-putting – perhaps I am expected to glide sentimentally into victim-by-proxy mode. I now take each day as it comes, and hope that you are recovering we

  18. Oh. Darn. Recovering well!! Fat fingers on iPads….

  19. Thank you. I cannot bear the fight/battle/stand up/kick butt stuff that is bandied around. To say someone “lost their battle” implies if they had only tried harder, they would have “won”. It is lazy and tiresome and ignorant. I find the Cancer Research use of these terms deeply frustrating & offensive, to the degree I now choose other charities to donate to/fundraiser for.
    We all get cancer a thousand times a day – the immune system generally tidies up the rogue cells, but like all overworked cleaners sometimes it misses one. That is not a battle with an outside force but an unfortunate accident that takes a lot of clearing up.

  20. Thank you! Thank you! Thank you! Finally someone who can understand how offensive it is. I cared for and held the hands of two very close family members who died of different cancers a week apart from each other. As someone lefr behind I find it so offensive when people say ‘they lost the fight/battle with cancer’ it implies that they didnt try hard enough to rid their bodies and cure themselves of cancer which is ridiculous! Those who are told they are ‘loosing the battle’ feel just that; that they are a looser, a failure and no one when they are dying deserves to feel like that. As a society we need to stop using such ridiculous hyper emotive language to dramatise when anyone who has watched their love one/s die of cancer or indeed have cancer know that its all pretty dramatic enough as it is.

  21. Whilst I understand and appreciate where you are coming from with the article. I have to disagree. I have battled and survived cancer twice. Why was it a battle? Because it was a battle with myself and my body. If you are taking the philosophy that the term ‘battle’ is wrong then I assume someone who is dealing with mental issues isn’t battling with themselves mentally, are they merely mulling over problems in their life? Does someone who was born blind or disabled not face a battle each day? If they were born this way then surely from your article, you are saying they can’t face a ‘battle.’

    Just because cancer can’t been seen or it’s a result of own bodies letting us down, it doesn’t mean that we are not in a battle with ourselves and if someone is fortunate enough to overcome cancer, it is unfair to say they are wrong to suggest that they survived their battle.

  22. Thank you. …I did not want to take on all the language when I was diagnosed as a new mum at 35…I found it far more painful than anything else. I was me, the idea I was suddenly meant to battle or lose….how do you stand up to cancer or go and get it?? Really? I did have to work out how to carry my 1 yr old on my back as I crawled from the bathroom to her bedroom so that could mean she and I had fun and how ill I was affected her as little as possible. Those were my challenges. ..to make my children feel as loved and safe as possible. The idea that if I didn’t eat the right food I would be bringing it on myself or or or…?I was not brave, I did my best and hoped.

  23. Thank you! I found your view of this every clear. Even if many don’t agree I find comfort in not labelling things as ‘good’ or ‘bad’. Like rain, I know a minor example, but a first step in understanding perhaps. Many complain when it rains… it’s this, that and the other, all bad things of course. But in the end it’s just rain. Water from the sky. And, for me, yes, you are right: cancer is just cells, gone crazy. But I do understand if others see it differently, as is their right. The media should stop sensationalising it. I agree. It helps no one to push against something. I wish sometimes they would highlight the need for health and feeling fantastic, instead of negative ‘fighting against’. Because if you ask anyone with cancer they rather be healthy, then fight cancer, I’m sure.

  24. thank you, yes, I have the same view. and yes – it is just rain …

  25. I think doing our best (or our worst on belligerent days!!) – and hoping – is the most any of us can do. good luck Lisa.

  26. hi Tom, I have never suggested anyone who uses military terminology for themselves is wrong – if you read the piece you’d see that. I suggested that I think the MEDIA are wrong (and above all lazy) to continually use the battle/fight/loss metaphor. Having had cancer myself twice, I’d never use any of the military metaphors. I choose not to see my life (or my death) as a fight. Each to their own when it comes to those of us with disease, but I still think the media can do much better.

  27. thank you Kate, I’m sorry for your losses.

  28. thank you Elizabeth. I still donate to Cancer Research, I’d just prefer they used other metaphors …

  29. thank you Fairybasslet – (fat fingers on ipads & all), I am recovering. (well, I think!)

  30. thank you Lise. I think that, for so many people, blatant language around death and illness is just too hard to hear, and so we ‘cushion’ it with euphemisms, be they ‘fought bravely’ or otherwise. And yes, the ‘fight against nature is definitely an odd one.

  31. thank you Danny. I am sorry for your loss, I too have seen much beloved ones struggle to survive against the odds (though thank fully not my partner), until the very last. My choice would always be to use non-warfare terminology (not least as one who despises war), and yes, I fully agree that what disease does to us is brutal indeed. Thank you for your reply and I do hope your grief is not exacerbated by too many euphemisms for death – I think, as with the warlike metaphors for those of us who don’t like them – they can be meant with the best of intentions, and yet be excrutiatingly painful.

  32. thank you for your response Pumpkins. ‘Dismissiveness’ at reconstruction? that’s not what I wrote, I wrote I needed longer to process it before I would be able to write about what feels (at the moment) like a mistake. And no, I’m not angry about having had cancer twice, I am angry at lazy journalism. As I said in the piece. I’m sorry for your loss.

  33. thank you Ruth.

  34. thank you Bea.

  35. thank you Natasha. I am sorry for your loss. And yay for living until we can’t!

    (and oh dear, it seems all my comments are one after the other – hopefully you can see where I’ve tried to reply!)

  36. Thank you.

  37. Most people I know that have had Cancer would agree with you. What a burden to put on someone to expect them to “fight” “battle” be “brave” “strong”? For some people that might be their way of coping, others may find that that is not their way and the pressure to be that way the last thing you need when faced with a life threatening disease. And Scientific research shows that it doesn’t matter whether you are positive and brave, or bury your head in the sand, or get depressed and negative, or angry, all perfectly normal responses, your chances are the same and more to do with the hand you were dealt by as yet largely not understand factors, and the treatments available to you. I quite appreciated indulging in a bit of anthropomorphism, but only to think of my Cancer cells as a bunch of disorganised demented mutant hooligans that had got beyond the control of my immune police and needed some slash/poison/burn reinforcements

    I look forward to your thoughts on reconstruction. I felt it too big a burden to have reconstruction straight away alongside the shock of diagnosis and surgery and chemo. Since then I am torn between why would I put myself through major surgery, and recovery, with possible long term effects to put a lump of stomach muscle Frankenstein like on my chest to please society’s expectations on one hand and the inevitable feelings of at best difference and at worst, admittedly only occasional, embarrassment and self consciousness. Thankfully my boobs were never central to my identity or sexuality, I understand for many they are and reconstruction is important to them. So far for me, though a return to two symmetrical mounds would be nice, it is not important enough to put myself through it.

    @pumpkins, frankly your post made me angry, why do you think you have a right to place expectations on how someone else feels and reacts to their Cancer diagnosis and treatments? Until you have experienced it personally might I respectfully suggest that instead of expecting people to feel the way you think they should, and a lot of that rhetoric has a lot more to do with making those who have not experienced Cancer feel better about it, you listen to how they actually feel, however uncomfortable it might be for you. You will find that is a much better way to provide comfort and support others through the intense trauma of facing a life threatening disease.

    As to thinking people are not entitled to feel ambivalent after going through a traumatic and serious 11 hour operation to transplant a piece of their stomach on their chest, in the process potentially compromising core muscles and causing other potential sources of long term pain, words fail me. My Consultant fully understands that it is far from an unmitigated blessing and would allow any woman to go through feelings of ambivalence, why can’t you?

  38. thank you Walkinthepark. I too, look forward to a time when I have had a chance to work out the mess of extremely complicated feelings and confusions I have around reconstruction. I wish you all good things in your recovery.

  39. My Dad has small cell lung cancer – I forwarded him your blog (he isn’t massively computer savvy) he asked me to reply thus

    “‘Brave Doreen (or whoever) finally lost her battle for life against cancer.’ – Even before my present circumstances became apparent I almost used to scream at this trite sentence; invariably trotted out by newspapers and magazines. The implication of it is quite awful. Poor Doreen (or whoever) would have made it if she’d just fought harder or more cleverly. It’s just the most cheap, insulting epitaph ever coined.”

  40. I’m with your dad. I wish him well, thank you Katy.

  41. I have a defective gene that causes cancer and although checked every 2 years for bowel cancer and stomach cancer I got the very rare small intestinal cancer and will be going in for my operation this week. So at the grand old age of 43 I am the oldest person in my family with the gene. At 8 years old my Mum died after losing her (battle) with cancer. I can’t express enough how much children are effected by this term! I grew up feeling my Mum could not have loved me enough to fight harder to be with me. I have 3 children that are not told I am fighting, or in a battle with cancer. I hope nobody ever uses this language to them but sadly with this language being used in the media every day, I worry what my children will feel when I am no longer here.

  42. thank you Anne, I wish you well with the surgery, and I too hope your children come of age in a time when we are all more careful and generous (and honest!) with the language we use around disease.

  43. @walkinthepark – have you got lost in your own self importance ? perhaps re-read my post. I have, less than a week ago, lost my Mother in Law. My best friend has had breast cancer, double mascetomy, reconstruction, planned nipple replacements & will need a full hysterectomy ‘thanks’ to faulty genes. Whether I have personal experience of cancer, or whether its from being exposed by loved ones, I’m entitled to an opinion.

    Your belittling comments on breast reconstruction (“to please societys expectations” ?) are not supportive or sensitive to the 1000’s of women that have chosen this. What a shame my friends breasts were tied into her sexuality <>.

    @stelladuffy – my friend has silicone implants rather than reconstruction & feels much better in herself…she feels like her normal self. is this something you could consider ?

    @Danny, I am so very sorry for your loss.My friend is coming up to her 4 years post diagnosis & you’ve reiterated the fragility of her current remission.

  44. @pumpkins – no, silicone implants are not usually recommended when the skin has already had a long run of radiotherapy (as mine had done, after my first breast cancer), hence having the more radical DIEP surgery. the previous radiotherapy, in my case, according to my consultant, was why there were further complications, and those complications are why I feel very conflicted about the whole issue of reconstruction. I also feel conflicted about it because – as you say – 1000s of women have chosen reconstruction. But I would like us, as a whole, to consider the reasons for this more widely, I am very aware that I probably made my own choice too quickly (to do with my own recurrence nightmare coming true), and that had I felt I had more time (not anyone’s fault, just the preferred desire to get a second cancer out of the body as soon as possible) I MIGHT have made a different choice. I think it is perfectly permissible for any of us who have made these choices to question them, and that questioning them is not negating the choices of others, but acknowledging that they are fraught, complicated and never simple.

    re your response to @walkinthepark – of course we’re all entitled to our own opinions, but this is my personal blog, and I can – and will – delete comments as I see fit. please keep your comments more polite in future. I don’t have a blog in order to create a forum for argument (there are more than enough of those internet-wide), but because I chose to have a space to share my own views. I’m under no obligation to air anyone else’s opinions, and definitely not their arguments.

  45. Thank you Stella – it’s 2 years since I had a diagnosis of breast cancer and your blog echoes my thoughts on the language used around that – thank you for saying it.

  46. Good. It seems all one step at a time. One day we’ll look back to discover we all climbed the mountain🙂

  47. It seems to me one has to make decisions when one is in emotional turmoil and obviously afterwards you might be unsure if the decisions were the right ones. I can’t believe your comments pumpkin, sitting in judgement of something you can’t possibly understand. It wasn’t you it was happening to.

  48. […] Stella Duffy on cancer and The Language Battleground […]

  49. […] to work with them or go past them. The inestimable, incomparable Stella Duffy has written about the language of cancer, about for many living with the disease, talking about ‘battling’ or […]

  50. Yes! I totally agree with you. I wrote this (less eloquent) note on the same subject – http://nonchalantly-devastated.com/cancer-terrorism/


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