By Susan Gubar
I’ve been lucky that most of my care is delivered with tenderness, despite the fact that cancer patients are routinely exposed to brutal procedures.
Often I have lain under a sheet on a gurney in a hospital hall, dreading what would happen during some ghastly procedure related to my ovarian cancer. One incident, filtered through a narcotic haze, still haunts me, though it must have occurred more than five years ago. I watched the ceiling roll by as someone pushed me down a corridor into a freezing operating room. Under bright lights, I had to be moved from the cart onto a table and repositioned on my stomach.
The rough grip of a nurse shocked me. She jerked me sideways, hurled me over and tightly bound my wrists to what felt like boards. The pressure of her grasp and the bindings left dark bruises.
In retrospect, it astonishes me that the event was idiosyncratic. I’ve been lucky that most of my care is delivered with tenderness, despite the fact that cancer patients are routinely exposed to brutal procedures. On numerous occasions, we have to be prodded and pierced. Our skin is shaved and painted, our bodies sliced open, various growths excised, sundry organs lopped off, and then we get stapled or stitched back together. At subsequent office visits, fingers press into our flesh, pushing into mouths, necks, armpits, breasts or bellies. Without any preparation, we must devise tactics for dealing with the physical intimacy of treatment.
Throughout 10 years of cancer treatment, I have wondered how the considerate physicians, nurses and technicians I encounter manage not to violate my sense of myself, especially because I have always felt anxious about being touched by strangers — even in benign circumstances. Before cancer, relatively painless encounters like haircuts and dental cleanings were a challenge. After diagnosis, fear rendered me more thin-skinned, touchy. I marvel at friends complaining about doctors who, instead of examining them, gaze at computer screens: If only, I think.
“Do you undress for exams?” an aide asks every other month, offering me a robe. I would rather meet the doctor clothed, but she probably needs to tap my ankles, listen to my lungs, feel for lumps and inspect the ileostomy. In part to offset embarrassment when the snaps or ties of the gown fail to keep me covered, I will direct our conversation to her research.
While waiting for radiologists to insert tubes into my body or for nurses to instruct me on wound management in the past, I tried to keep up a continual patter of questions. The humiliation of bending over for a rectal exam, the discomfort of a gastrografin enema; before the creepy corporal proximity of exams, I queried those in charge — not to take my mind off my body, but instead to somehow embody them. How long have they worked here? Where did they come from? I wanted to remind us that their touching me meant that some part of me was touching them.
Maybe the bruising inflicted by that nurse in the O.R. happened because, in my drug-induced speechlessness, I couldn’t call out to let her know that she was hurting me. Even when we seem insentient, we may be sentient. At the conclusion of that procedure, I heard a voice asking about me, “She’s a doctor?” My surgeon responded: “A professor of English, but she cannot hear us.”
To offset the indignities of treatment, an acquaintance with stomach cancer goes weekly for what is known as healing touch. During this supplementary therapy, she finds herself soothed by a practitioner’s hands hovering over parts of her body or sweeping across its contours. It might not benefit me since you are probably not supposed to be chatty during such sessions.
The nurses whom I recurrently see expect me to be curious about their holiday vacations. Has Becky picked out a dress for the wedding that motivated her weight loss? How many boxes of Girl Scout cookies have Alesha’s daughters sold? I poke and pry with tactful talking, trusting they will reply with tactful touching. If after de-accessing the port implanted in my chest, Becky removes her gloves to pat my back, if Alesha gives me a hug before she schedules the next CT scan, I am heartened by the fleeting skin-on-skin contact that assures me of our mutual humanity. We share “a little of that human touch,” as Bruce Springsteen puts it.
[Read more about the importance of medical touch.]
In his brilliant sequence of poems, “Duino Elegies,” Rainer Maria Rilke considers “the caution of human gestures” carved on ancient gravestones: the hands of one figure lying weightlessly on the shoulders of another. The poet realizes that “the gods press harder against us. But that is the affair of the gods.” The wisdom of human beings consists in knowing “This is ours, to touch one another this lightly.”
When I was at my lowest — hairless, emaciated, enervated — and we were all convinced that I was dying, my first oncologist, Dr. Daniela Matei, plunked herself down on the floor next to me. I was sitting in one of those bulky recliners in an infusion room, attached to an IV. She gently rested her palms on my knees. Only years later did Dr. Matei send me an image of doctoring that speaks to the emotions that must have impelled her back then: Goya’s stunning “Self-Portrait With Dr. Arrieta.”
At the bottom of this rendition of an intimate couple — the attentive physician cradling the enfeebled patient — against an ominous background, the inscription serves as a dedication. “Goya, in gratitude to his friend Arrieta: for the compassion and care with which he saved his life during the acute and dangerous illness he suffered toward the end of 1819 at 73 years of age.” Infirm Goya plucks the bedcovers, but the arms of the doctor steady him in an embrace that evokes a Pietà for some viewers.
The poignancy of the picture is filtered through hopefulness, for Goya’s mastery conveys the realization that after its scene became a memory, the painter brushed the colors on his canvas with firm strokes. Confident in his craft, he surely realized, as I do too, that distinctive forms of artistry are needed to assure ailing patients of our being in good hands.
Susan Gubar, who has been dealing with ovarian cancer since 2008, is distinguished emerita professor of English at Indiana University. Her latest book is “Late-Life Love.”
This article was published by The New York Times.