Born Out of Trauma: Writing About Chronic Illness

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Sara Hughes // Anya SilverIn part 1 and part 2 of this conversation series, Georgia poets Anya Silver and Sara Hughes discussed their general cancer experiences as well as the faulty rhetoric that surrounds cancer. In this section, Anya and Sara delve into a discussion of their writing process and how their individual cancer diagnoses affected their creativity.

Anya: How did your diagnosis affect your approach to writing? Both of us were diagnosed with breast cancer at early ages. I was 35…

Sara: …and I was 33…

Anya: … and I was pregnant. So there’s a strong division that marks my pre-diagnosis life from my post-diagnosis life. I think of my life in terms of “Pre-cancer” and “Post-cancer.” Before I had cancer, my poetry had stalled. It was kind of self-indulgent and egocentric. Not that I’m saying there is a sunny side of cancer, but cancer made me feel called to write about something in a way I’d never been called before. Writing about cancer became a very strong part of my vocation of writing. I needed to write about it for other women with cancer, so I had a definite audience in mind. Cancer became a central subject for me, and enabled me to get out of my trivial poetry and into something deeper. The poems I wrote about death before I had cancer are just laughable and absurd, because I had no experience with death. Cancer matured me as a person, and that helped my poetry.

Sara: I feel the same way. My diagnosis was only two years ago, but when I look back at what I wrote before that, I feel like I’m reading something someone else wrote.  What’s strange is that those are the poems being published now, so when people read them, they’re seeing this other version of myself, and not who I am today. Cancer forced me to grow up. Before, especially in my twenties, I lived in this bubble…

Anya: I feel like I did too.

Sara: …I lived in this naïve bubble where I thought I understood what death meant. I thought I understood my mortality and that I was going to die. But my cancer diagnosis forced me to really deal with those ideas. The tumor had been categorized as a level 3, which is the most aggressive type of tumor, but it was another week and a half before I got the results from the other tests. That week and a half was the hardest of my life. Even though I wanted to be optimistic and hope for the best, I was mentally preparing to find out the cancer had spread. I remember falling to my knees in the street when I was trying to walk off my nervous energy, and just thinking, this can’t be happening to me.

Anya: I also remember thinking it was so weird this was happening to me. It makes you very aware of your body. You live in this body. You are this body. All this sense of control that you have about your life is just an illusion. It’s an illusion for everybody, but until you face a life-threatening diagnosis, you’re not really aware of the illusory nature of your life. Once you’re aware that your body is going to do what your body is going to do and you have limited control over it, that’s a really scary idea. Most people don’t want to confront it.

Sara: It felt so unfair. I was a runner. I took really good care of myself. I never smoked or did drugs or abused alcohol. I didn’t take risks with my health, so I thought I was guaranteed decades more of life. In my family, a lot of people live until their 80s and 90s, so I just assumed I would too.

Anya: Right! No one else in my family has cancer.

Sara: Even though a lot of women in my family have had breast cancer, most of them were in their 50s when they were diagnosed. So I thought if it happened to me, that’s when it would happen. I thought I was still 20 years away from even having to worry about it.

Anya: I was told by one of my doctors that I was too young to have breast cancer. But getting back to writing, how did this experience affect your approach to writing?

Sara: I’ve noticed that the removal of the first person pronoun, which I’ve recently been doing in my own writing, helps me address the topics that are the hardest to write about. In particular, I’m drawn to the second person perspective when I’m trying to describe my diagnosis and treatment to establish some sort of removal from my cancer experience.  I wonder if it has to do with how I processed that experience. I had to distance myself from it to protect myself—

Anya: Like a disassociation?

Sara: Exactly. Like I was watching cancer happen to someone else. Even when I think about specific things that I endured, it feels like it happened to someone else, or at least, some other version of me. So writing about it in first person feels inauthentic.

Anya: Wow. I found that when I was first diagnosed, and started writing about it, I wrote very personal first-person poetry because I wanted to really attack the subject head-on. I asked Yusef Komanyakaa how to write political poetry, and he said, “You have to address it directly and as specifically as you can.” So I tried to be as representational as I could. But as time has gone by, I feel like I’ve worn out that mode, so I’ve moved more toward the third person or ekphrastic poetry and fairy tale poetry and other ways to address cancer because I did what I wanted to do in first person already.

Sara: I wonder if that’s going to happen with me. Will I move away from the second person in my writing?

Anya: it’s interesting – we’re moving in opposite directions in our writing!

Sara: We’re pretty different when it comes to our dispositions and how we approach the world. I’ve always insulated myself from trauma. I projected all of the suffering that went along with my diagnosis and treatment onto this other version of myself because it was so difficult for me to accept that it was happening to me. Having cancer is a very surreal experience. Even though I can intellectualize what I went through, it almost feels like it happened in a dream.

Anya: It IS very surreal because you’re all of a sudden taken out of your normal life and put into this world of sick people and faced with your own mortality. It’s incredibly traumatic, but you’ve come through it and you’re on the other side. For someone who has Stage 4 cancer, like I do, it’s not really possible to disassociate. I’m still living with it every single day. Maybe that’s why I feel like I have to write about it at a remove, for my own mental health.

Sara: I think it’s the opposite for me. I write about cancer in the second person because it feels more authentic or representational of my experience. But I also wonder if I processed my cancer diagnosis in the second person because I have a twin?

Anya: Oh, that’s interesting!

Sara: Since so much of my life experience is a shared experience with my identical twin, sometimes I feel like I have a split personality.

Anya: Maybe you feel disassociated from your cancer because Amy didn’t go through it, therefore you only feel like half of yourself actually went through it?

Sara: That’s probably it! Amy was definitely beside me through the whole experience, but she wasn’t feeling it the same way I was feeling it. In our relationship, I’ve always been more empathetic. She has a very strong signal, and I receive everything she’s going through, but it doesn’t really work the other way, which was good in this situation. She was able to stay cheerful instead of being dragged down into the misery of chemo. But because I was receiving her upbeat energy 24 hours a day, it was easy to convince myself that I was not as sick as I was.

Anya: There’s this great book called Intoxicated by My Illness by Anatole Broyard that I return to a lot. It’s about his experience with cancer. He said cancer made him feel very smart. It’s like a secret is unlocked. You gain a secret knowledge about the universe, and I feel that way too. I look back at myself before cancer and I just think, “What a stupid little girl!” <laughs> I feel totally alienated from that person. I was so silly before, which is not a fair way to look at myself before cancer. Having cancer is awful, so I’m not romanticizing it in any way, but it has given me a perspective on life. I feel like I’m a member of this secret club of people who know something that other people don’t know.

Sara: I agree. But even though I feel that way, there are definitely times when I wish I could go back to who I was before cancer, when I was just floating through life in my bubble of ignorance.

Anya: Oh, of course! I’d much rather not have had this experience and have not gained this knowledge. But when you think about people in traditional societies who are shamans, they’re almost always people who have gone through some sort of near-death experience and recovered from it. So, there’s a price we pay for wisdom. I would like to have not paid that price, and I’d sacrifice the wisdom that I gained and the better poetry, if I could.

Sara: I’d give up the wisdom too. The hardest thing for me to deal with was how this would affect my twin. My identity is so wrapped up in being an identical twin, more so than any other aspect of my life. So what made me crumble in the street after my cancer diagnosis, was thinking, I can’t let Amy be a twinless twin.  I couldn’t let her go through life without me. Being part of a pair has been our identity from day one. No other aspect of my life had been determined but my twinness when I was born. Nobody knew that I was going to be a teacher or a writer, but everyone knew I had a twin.

Anya: I’m not a twin, but since I was pregnant when I was diagnosed, my first thought was I have to live for my child. I didn’t want to leave my child motherless. So that would be sort of my equivalent to your experience.

Sara: Before I had cancer, I tried writing about my relationship with Amy, and while I wouldn’t say those poems are superficial, I didn’t really know what I was trying to say about being a twin. After my diagnosis, I realized exactly what I had been trying to get to in those poems: What do you do when your entire identity is entwined in something that could be lost? My diagnosis forced me to face my own mortality, but also Amy’s mortality. I really had to admit to myself that one of us is going to die before the other.

Anya: How do you have a sense of self if your identity is so wrapped up in this other person? How would Amy have a sense of self if something happened to you?

Sara: Exactly. Those thoughts were my motivation to not let this cancer destroy me. But that way of thinking might also be another reason I’ve pretty much stuck to second person pronouns in my writing about cancer.

Anya: Are there any particular poets you’ve read who write well about cancer or chronic illness? What do you think makes a poem about cancer a good poem? What are the risks that a poet takes in writing about cancer?

Sara: Those are good questions, but they’re hard for me to answer because I don’t seek out poetry written specifically about cancer. Lucille Clifton wrote about breast cancer and I really like her poems about cancer, because she brings in other issues, like what it means to be a woman and what it means to be African-American. I love that she layered all of these experiences into her poems, while still writing in a way that was very honest and accessible.

Anya: I think most poetry written about chronic illness is bad because it is too easy to slip into very sentimental and clichéd language. The poets that I’ve read that write well about it are Jane Kenyon, Claudia Emerson, and Jason Shinder, because they’re good poets who happened to write about cancer. They address cancer honestly and with particularity but they also maintain the dignity of the person with cancer.

Sara: Have you read poetry about cancer written from the perspective of the caretaker or friend? Do you think that anybody does this well?

Anya: The problem with poetry written about cancer by someone who doesn’t have cancer is that it becomes very easy to turn the person with cancer into a metaphor or something grotesque. Those poems lose the personhood of that person. So the best cancer poems are written by poets who have experienced cancer first hand.

Sara: I often think about ethos and poetic voice. What gives a person the authority to write about a subject? Should writers only stick to that cliché of “write what you know” or do writers have the authority to write about any aspect of life whether they have experienced or not? Henry James suggested that a keen observer could present in his or her writing a “direct impression of life” without having lived a specific experience. Do you believe that’s possible?

Anya: I do think anyone can write about cancer. But if you’ve never had it, then you better know what you’re talking about. You better do your research because when I read a story about cancer that gets it wrong, I really resent it. Unless you’re willing to put the time and effort into writing about this well, just don’t do it.

Sara: As a reader, I’ve become a lot more sensitive to the language that people use to describe cancer since I’ve been through it. I’m quick to challenge a piece of writing that doesn’t authentically capture the experience.

Anya: I’m that way too.

Sara: I’ve always been immediately on guard when the subject of twins shows up in a story or essay or poem, and now I’m that way about cancer. It’s important to me that whoever has written about either subject has done it right. I’m not saying you have to have a twin to write about being a twin. But you have to present the experience in a way that feels authentic. If you get it wrong, I won’t trust you as a writer, and I won’t trust anything else that you write.

Anya: That’s how I feel! If you can write about cancer without ever having cancer and you can do it well, then that’s awesome. There are writers like Zadie Smith who can get into other people’s consciousnesses and write about their experiences. So I’m not making this an identity politics issue.

Sara: A few years ago, I read a prize-winning short story about identical twins, written from the perspective of one of the twins. After reading it, I thought, this author clearly isn’t a twin because this story does not get the experience right. The writer was actually really talented; the language was musical and evocative. A lot of effort had gone into this story. But this writer relayed the twin experience in such an absurd and incorrect way, it was offensive.  I found it disgusting, not only that the story got published, but that it won a big prize.

Anya: Anytime you’re writing from the perspective of someone who is in any way marginalized in a way that you don’t understand then you should tread softly. I’m really sensitive to people using cancer as a metaphor because it dehumanizes people with cancer. Don’t call a politician a cancer on society; just say that politician is a bad politician.  Cancer doesn’t have to be a metaphor for everything horrible in the world.

Sara: Do you ever feel like your identity (both professionally and personally) is defined by cancer? Do you just get sick of thinking about it and being associated with it? How do you distance yourself from cancer? Or, do you embrace that? 

Anya: I do feel that cancer sometimes defines me as a poet, as in being called “a cancer poet.”  I get tired of writing about cancer, but then again, it keeps reappearing and I have to let it in to the poems.  I’ve learned to accept writing about illness as part of my vocation.  But on the other hand, I chafe at limitations.  I write about all the other aspects of life that poets tend to explore, from faith to nature to love to memory, and I resent being pigeonholed.  I feel that it’s an unfair characterization of my work.  Personally, I don’t tend to talk about cancer very much with my healthy friends because I don’t want to be perceived too narrowly as “someone with cancer.”

Sara: Exactly. While cancer seems to be my flood subject these days, when I meet someone new who asks to see a sample of my writing, I don’t show the cancer poems first.  I want people to see me as a poet, not as a “poet with cancer.” Even though I’m open about my cancer experience, it is also not the first thing I tell people. I let it occur organically in conversation. Do you ever feel as if you’re in a rut when it comes to your writing? How do you cope with writer’s block, when weeks might go by without writing something that you like?

Anya: I have suffered extended periods of writer’s block.  Since discussing writer’s block with other poets, I’ve come to terms with it as a vocational hazard.  I will let a couple of weeks go by without writing and just let my mind rest.  But at some point, I force myself back to the task because it’s too easy for me to get lazy and out of practice.  Months have gone by when nothing that I’ve written has been any good, but I trust that eventually poetry will return to me. I think that patience comes more easily as you get older.

Sara: I had to learn to accept my own rhythm of creativity, and not try to mimic what others had recommended.  It’s impossible for me to write every day. Since I teach a full course load in the fall and spring, I rarely have time to get into the right head space to produce new writing.  So, I wait until the summer, when I have a few months of uninterrupted time. I allow myself to generate a lot of raw material in the summer, then I spend the fall and spring revising and submitting, which require a different type of intellectual engagement—a type of engagement that is less emotionally and psychologically draining. 

ABOUT THE AUTHORS

Sara HughesSara Hughes earned a PhD in English from Georgia State University in 2014. Her poems have been nominated for the Pushcart Prize, The 2015 Best of the Net Anthology, and the 2015 Independent Best American Poetry Award. She has published in Rattle, Reed, Rosebud, TAB, Atlanta Review, Emrys, and Atticus Review, among others. Sara has also received two writing fellowships from I-Park Foundation and one from The Hambidge Center for Creative Arts and Sciences. She teaches literature and writing at Middle Georgia State University in Macon, Georgia.

Anya SilverAnya Krugovoy Silver is a poet living in Macon, Georgia. She is the author of three books of poetry, The Ninety-Third Name of God (2010), I Watched You Disappear (2014), and From Nothing (forthcoming in September 2016), all published by the Louisiana State University Press. Her work has been published in many literary magazines, including Image, The Harvard Review, The Georgia Review, Five Points, Crazyhorse, New Ohio Review, Witness, The Christian Century, Poet Lore, Prairie Schooner, Southern Poetry Review, Shenandoah, and many others. Her work will be included in Best American Poetry 2016. Her poems have been featured on Garrison Keillor’s “The Writer’s Almanac,” in Ted Kooser’s syndicated column, “American Life in Poetry,” as an Academy of American Poets’ poem of the day, and on Poetry Daily. She was named Georgia Author of the Year/Poetry for 2015. She currently teaches in the English Department at Mercer University. She shares her life with her husband, son, and cockapoo. Since 2004, she has been living and thriving with inflammatory breast cancer.

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Atticus Review is a weekly online journal that publishes stories, poems, flash prose, creative nonfiction, mixed media, book reviews, and other genre-busting words of wisdom and interactive literary whimsy.

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