I have recurrent throat cancer, and although I have outlived my prognosis, my disease is incurable. What can I hope for?
I work most days in front of a large screen. The screen’s resolution, saturation, and brilliance allow me to display paintings that sometimes look even better than they do in museums or churches. For months, I studied Bruegel’s The Triumph of Death, a ghastly painting about death’s universality and certainty and the vanity of worldly attachments. I put it up after the evidence came in that my cancer had recurred for the second time. Morbid? Yes, but I didn’t hang it on my screen because I was depressed.
Pieter Bruegel the Elder, The Triumph of Death (1562).
I studied The Triumph of Death because it shows that death holds an hourglass, just for me. Cancer is cunning: you can appear healthy for an extended time and then quickly wither and die. Throat cancer kills that way. A throat tumor makes you suffer, but you’ll live. Until it infiltrates the nearby lymph nodes and spreads to the lungs and brain. Brain metastases kill quickly: your life expectancy from then on is 3.5 months.
I studied The Triumph of Death to purge myself of false hope. Palliative care specialists Brad Stuart and Rana Awdish contrast false and genuine hope for the terminally ill. False hope is attachment to the idea of a cure when that is no longer possible. Bruegel taught me where I was: alive but closer to death than I’d like. I didn’t want to be sad; I wanted to make the joys of life impervious to fear because I had already accounted for death.
The Triumph of Death reminded me that life is an emergency: every second matters. We shouldn’t need cancer to see this. Luther wrote that “God can be found only in suffering and the cross;” immersion in this painting has been a way to stand before the cross. In Thesis VIII on the Philosophy of History, Walter Benjamin argued that the world is a perpetual crisis, and the oppressed see this more clearly than professors like me:
The tradition of the oppressed teaches us that the “emergency situation” in which we live is the rule. We must arrive at a concept of history which corresponds to this.
Finally, The Triumph of Death reminded me that death is not just my emergency: it takes everyone.
Bruegel, Landscape with the Fall of Icarus (1560).
Bruegel has another painting, The Fall of Icarus, about our blindness to others’ suffering. The picture inspired W. H. Auden’s poem Musée des Beaux Arts; the name refers to the museum in Brussels where the painting hangs. Icarus is the small figure drowning in the lower right corner. No one sees him. Auden writes:
About suffering they were never wrong,
The old Masters: how well they understood
Its human position: how it takes place
While someone else is eating or opening a window or just walking dully along…
In Bruegel’s Icarus, for instance: how everything turns away
Quite leisurely from the disaster; the ploughman may
Have heard the splash, the forsaken cry,
But for him it was not an important failure; the sun shone
As it had to on the white legs disappearing into the green
Water, and the expensive delicate ship that must have seen
Something amazing, a boy falling out of the sky,
Had somewhere to get to and sailed calmly on.
Cancer opens your eyes: the emergency is always here. Perhaps not today for you, but for you soon, and always for someone you do not see. In Thesis IX, Benjamin imagines an angel standing in the present, looking back at history:
Where we see the appearance of a chain of events, [the angel] sees one single catastrophe, which unceasingly piles rubble on top of rubble and hurls it before his feet.
The Triumph of Death glows with black light: creation radiates suffering. However, the single, universal catastrophe endows everything with meaning. Wherever you are, draw your sword. You won’t win, but there is always something you can do.
***
Sandro Botticelli, The Cestello Annunciation (1489). It’s not an Advent picture; the Annunciation is celebrated on March 25. But do the math.
When Advent began, I changed the painting on my screen to Botticelli’s Annunciation. Why?
It wasn’t because the darkness was inappropriate for Advent. From a sermon by Fleming Rutledge: “Advent [is] the time of contrasts and opposites: darkness and light, good and evil, past and future, now and not-yet.” Advent is for refugee families in flight (Mt 2:13-23). It’s about light in the darkness; you have missed the point if you do not see the darkness.
However, the reason for being purged of false hope is to open yourself to true hope, to see hope within the dark. But without a cure, what hope can secular medicine offer? Doctors are not and should not be chaplains. In Being Mortal, Atul Gawande asked his dying patient what she hoped for. She wanted to be part of her niece’s wedding. Superb, Dr. Gawande can help make this possible. But if she hadn’t known what she hoped for, what could he have told her?
So, what is genuine hope? We hope for a future in which the human community escapes the emergency (Isa. 45:22-25). Hope is the passionate experience of this possibility: love in the darkness. Hope affirms the good in defiance of the facts.
That’s an unknowable future; what can I hope for here and now? The Annunciation depicts the imparting of grace, love of and from God. Grace comes to you from without, through a connection with another. It is sudden and overwhelming; if you are fortunate, you yield to it, and some of it stays with you. Botticelli depicts Mary’s response to Gabriel, a receipt of sudden, intimate, and thunderous grace, like a wave passing through space-time emanating from the collision of massive black holes.
Yet The Annunciation occurs in a bare room in a still landscape, in an instant of deep silence. Gabriel holds a lily, evoking the lily of the field and the bird of the air (Mt 6:26-34). Søren Kierkegaard teaches that we must earnestly seek to live like the lily, who does not escape death and suffering but is silent and unconditionally obedient to the will of God,
therefore [the lily] became itself in loveliness; it actually became its entire possibility, undisturbed, unconditionally undisturbed, by the thought that that very moment was its death … [And] it possesses one additional loveliness, to be lovely like this despite the certainty of downfall at the same moment.
We can hope that, through grace, we can “attain our last end by knowing and loving God” (Thomas Aquinas).
Bill Gardner is a medical school professor diagnosed with cancer during COVID, writing in the first person about the end of life. You can find more of his writing at billgardner.substack.com.
COMMENTS
4 responses to “Cancer in Advent”
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“Hope affirms the good in defiance of the facts.”
This is beautiful, Bill. Thank you for sharing. I’ll be praying for you.
Beautiful as usual, Bill. Hope is just a concept until you truly confront your own ending. Only then does hope take on ultimate meaning — your own, inner personal meaning, which is the only true meaning. That hope is yours and yours only. But because it’s ultimate, it becomes universal. Only the dying really understand this, and those who have traveled to the edge of life and gazed beyond it.
Thank you for the kind words, Joey, and your prayers.
Thanks, Brad. Your work in palliative care is of the first importance. I am very much looking forward to your book.