Written shortly after the 2016 election

Post-Election Lessons from Oncology

Shai White-Gilbertson, PhD

When you are a cancer researcher, it can seem like cancer is EVERYWHERE. It shows up in friends, family, co-workers, strangers, pets, celebrities, even plants. Then, if your job is thinking about cancer, it makes for a lot of cancer. A lot. Of cancer. And you still don’t really get used to it. I wind up being the go-to person to talk about cancer when someone in my world has a cancer scare or worse, a cancer diagnosis. The diagnoses that knock the breath out of your body are the ones where you know it’s actually very, very bad. Whatever the doctors are saying in appointments, whatever prayer circles are engaged, whatever chemotherapy or herbal extracts are lined up on the counter, it’s bad. This is the dreaded Stage IV metastatic cancer and it’s a gut punch when it finds someone you love. You say: “No.” As in, “No. This cannot be happening. This CANNOT be happening.”

The hardest days for everyone are often right after the diagnosis. Everything goes into free fall. The plan you’d made for the weekend now seems so stupid, so pointless. When someone gets a diagnosis of metastatic cancer, it feels like the world is ending on that day, even though things may not be materially different from the day before or the day after. But now, you’re watching someone’s future dissolve in front of your mind’s eye. It gets thinner and more transparent, bleeding away until only nothingness remains. It’s terrifying. It’s not just the uncertainty that frightens. Frankly, the known natural history of the disease is enough to stab the heart with dread. If it is prostate cancer, it will tend to metastasize to bones, creating terrible pain. Breast cancer will tend to show up in liver and brain, with all the nausea and confusion and despair that entails. Other cancers have their favorite haunts for metastatic spread, and knowing this means seeing the destruction in advance, and trembling.

This airless, gasping place of “no” is also where I landed after the 2016 election. Many of us landed there. We knew there were problems in our country, but we’d hoped that things were solid enough to keep the body as a whole plowing forward on its usual schedule of daily life, with work and diversions. Only a handful of days ago, many of us were going about life more or less normally, worried about some troubling symptoms, but confident that it would all turn out to be fine. It’s not fine. And it wasn’t fine then, either. The madness and violence inherent in bigotry and entitlement have been here, on the streets of Ferguson, at a club in Orlando, at a church in Charleston, at Standing Rock.

On November 8, our collective test result came back, and it was very bad news. When xenophobia fuels the rise of an authoritarian figure, the diagnosis is dire. The country is sick, systemically sick, with something that has a known natural course of progression. When fascist ideology runs the executive offices of a country, there is decay of the judicial system, corrosion of the press, and collapse of civil liberties. We know this from seeing it happen over and over throughout the world, and now we envision the end of our democracy as the gears start to turn against minorities and power is consolidated. It’s textbook, it’s terminal, and it’s terrifying.

I’m educating myself as fast as I can about the history of political resistance, of reconciliation, of recovery, but I am way behind. What I already know about is the history of treating cancer, and I think there might actually be something to notice there: miracle recoveries DO happen. They are hard to study because there aren’t lots of them, but they are absolutely documented. Healing is a real possibility, even healing from aggressive, systemic disease. I keep thinking about an old, pre-chemotherapy approach that had some interesting successes. A doctor named William Coley found that if he induced an extreme fever in a cancer patient-and he injected pathogens into people for this specific purpose-sometimes they would recover from the infection and then recover from the cancer. Research into this mechanism has since suggested that putting the immune system on emergency alert helps it to recognize the other dangers in the body it has been charged to protect. Cancer is a tough target. Because it begins inside, it’s harder for the immune system to recognize. A high fever can forcibly wake up the system.

I’ve been thinking about this because so many people I know have felt physically sickened by the election. They’ve been in bed with cold sweats, or feel a fire in their marrow that flares with each news update. Could we be feeling the heat of transformation? In medical terminology, the immune cells I just mentioned would be called going from “immature” to “activated.” In their immature state, they couldn’t register the disease. They hadn’t encountered it directly enough (or under intense enough conditions) to be sensitized. After activation, these cells are astonishingly attuned, engaged, and relentless. There must be huge numbers of us who would’ve called ourselves pro-equality but hadn’t been activated to seek out the disease of oppression, to confront it directly as part of our daily work. That it should have to come to such a desperate diagnosis before the immaturity burned off is both predictable and depressing. Now, we have a shot at a miracle recovery only if we work together. Otherwise, the whole democracy dies on our watch, because we weren’t watching. Of course, now it is impossible not to see the rash of swastika graffiti on buildings, to see internment camps being cited on TV as precedent for policy. It hurts all over.

There’s one other thing to mention about a terrible diagnosis finding a loved one. After the “No,” after the initial horror, there is something important to say. To the stricken, through your own grief, you say, “I am with you.” This is what I say to America now. I won’t abandon you to this.

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