Review

Living with dying

CANCER IN TWO VOICES
Sandra Butler and Barbara Rosenblum
The Women’s Press, 1994, £7.99

The impact of the diagnosis and treatment of advanced breast cancer upon the relationship between Barbara Rosenblum and Sandra Butler forms the central focus of this book. It is a moving account of the hope, confusion and despair that accompanied their three-year journey through various treatments to Barbara’s death. How do they cope with the impending death of one of them? The honesty with which they write about this process is at times astounding, occasionally giving rise to an uneasy sense of voyeurism. This unease might be allayed somewhat if one had a clearer sense of the purpose of this book or of the audience for whom it is intended. There is a strong sense of the value of writing-as-therapy, similar to the sense that is sometimes conveyed by those who write about surviving traumatic treatments, and it may be that this is sufficient reason to write and publish such accounts. Undoubtedly some interesting questions are raised — how does one partner cope with the writing of the other’s will, for example, knowing that death is imminent? Nevertheless, other questions are not raised and remain unanswered.

The most obvious gap in the account is the lack of questioning of the unceasingly distressing and invasive treatment given to Barbara Rosenblum. Until 14 days before her death Barbara was having large doses of chemotherapy with very unpleasant side effects, having already endured both surgery and radiotherapy. At no time does she seem to have questioned the value of such treatment despite the advanced nature of her disease. Perhaps this reflects a difference between North American and British approaches as in my experience of working in the breast cancer field, most clinicians, as well as patients, would have been asking ‘why?’ quite some time before this.

Certainly for women with breast cancer this makes less than reassuring reading. The unquestioning acceptance of such measures leaves me with the feeling that this book speaks so little to the British experience that it is difficult to view it as other than a well written account of an extremely personal journey.