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The Red Devil: To Hell with Cancer -- and Back
By Katherine Russell Rich
Crown Publishers
256 pp $22

A woman I don't know was diagnosed with breast cancer the other day. I did not know what to say, not even to her husband, and so, on hearing the news, I stood in front of him opening and closing my mouth, doing a pretty fair imitation of a fish.

Don't we all feel awkward edging around cancer? Who really knows what delicate language to use? There are a few recent books that claim to know, or are trying to change the words we use about cancer and, from there, shift the social politics of disease. Every season, there seems to be a round of new books with new prayers, new heroines. Deep in these stacks there is at least one noteworthy book, Katherine Russell Rich's The Red Devil: To Hell with Cancer -- and Back, written by an antiheroine who peppers her cancer journal with sex, blind dating, and a few choice rants.

In her life prior to cancer and in its early stages, Rich could have been a cast member of the boy-crazy HBO series "Sex in the City." At the time of her diagnosis, Rich was a newly single woman in New York City, a magazine editor living the kind of life that deposits minor celebrities into her social schedule and her Rolodex, an elite life that can have a girl partying in St. Bart, diving into a pool in a black mini skirt, and ducking out of a disco at dawn with a Frenchman in a perfect white linen suit.

But the long skirmish with errant cancer cells within makes Rich into more of a Riot Grrl -- the type to curse at cancer, shake her fist or middle finger at the moon. Rich does not hesitate to name the internist who, when she first discovers the lump in her breast, offers to "feel your breasts anytime you want me to." Rich rails at the Freudian therapist who refuses to discuss the cancer because it wasn't a "real" issue. She offers opinions on the shortcomings of caregivers, medical systems, social workers, and just about anyone who tries to brush her off. Not exactly the spiritual transformation one expects.

But after time spent with the kind of chemotherapy she calls the Red Devil, how does one define transcendence? "The second drug, bright Kool-Aid red, zapped my body with a violent buzz that warmed me horribly and made me squirm. 'Andrianycin,' he said. 'It's called the Red Devil.' Later, to myself, I called it Drano, or Agent Orange, for that's what is felt like rushing through my veins."

To understand why Rich's book is unusual, you first need to know the milieu from which it springs. In the early part of the century, women died quietly. But decades of donning pink ribbons and publicizing new fund-raising telethons took the stigma off breast cancer. Women could proudly call themselves survivors, and many spoke with new energy of the battles ahead. Today there are 2 million women across the United States who have outlived breast cancer and many of them are talking. Now, Gilda's Club, the cancer group named for comedian Gilda Radner, has asked speakers to refrain from using the warlike language endemic to cancer circles.

In Speak the Language of Healing, another recent cancer-language book from Conari Press, authors Carol Matzkin Orsborn, Susan Kuner, Linda Quigley, and Karen Leigh Stroup detail their campaign to portray cancer survivors as more feminine and less aggressive. They have even thrown out "cancer survivor" (too warlike) in favor of "cancer initiate." These authors go so far as to claim they are riding the crest of a new wave. "The role model for women and men is no longer Odysseus the Hero, but Penelope the Weaver," the authors assert as they offer the model of a woman, pliant, raising herself to a higher spiritual plane as she accepts the stages of wellness and chemotherapy.

Somewhere far outside of this uneasy shifting is Katherine Rich -- an outsider by nature, it seems, who sees cancer as the ultimate alienator. In a Washington Post article she quotes "cultural observer" David Berreby as saying, "All outsiders inhabit the same country." Then she says, "For years, I was (an outsider), and I hated it. It tore me up to be a cancer patient; I wanted back in. But at no particular point I can remember, I decided, who cares? I am one. So what? And from then on I began investigating new identities."

Do not look to Rich for uplifting platitudes; she will tell you up front of her aversion to the saints who suffer disease only to dole out insipid, predictable advice. Do not assume she will always be logical in any conventional sense; this is a woman who repeatedly refers to her own breast cancer, discovered at age 32, as "break-up cancer" because she discovered the walnut-sized lump on her breast within weeks of leaving her husband.

What really sets Rich apart is her honesty, her dark humor, and her absolute unwillingness to tell anyone what to do or how to feel. There is no list of things she learned from breast cancer, nor the expected claim that illness made her a better person. After living through a lumpectomy, chemotherapy, remission, new episodes, a bone marrow transplant, experimental surgery, and the loss of two inches in height when her vertebrae collapsed under the pressure of standing up, Rich instead comes away with a different sensibility.

Cancer, she says, is a chronic disease; it's not your life.

Rich believes there is strength in fury, but she is not unaware of the self-destructive tendencies of the dark side of rage. She talks openly about emptying her fears into a bottle of gin, engages in a bout of smoking just outside the cancer ward, and falls into nearly anonymous sex to stave off the loneliness that comes from cancer. This sort of wild behavior is absent by the book's end: She is studying meditation and getting onto prayer lists, but never claims a righteous path. Best of all, being a magazine editor who has immersed herself in language all her life, she is capable of telling us about it with style:

"And yet the cancer, too, is you. It's not, as far as we know, brought on by an airborne microbe. It's not a foreign agent, not the flu; you don't catch it. It's a cellular part of you turned wild, ungovernable. It is you divided against yourself. It is your body made sinister, made into its own assailant -- its own assassin, if medical treatment or stasis fails."

Rich's writing is not without its failings. In the book's early chapters, she confuses the act of divulging her favorite albums with revealing her state of mind. It doesn't. Sometimes she relies too heavily on reporting conversations with friends, which comes across as passed-around wisdom rather than revelation. These are small faults, however.

After studying this language of cancer, from Rich's raw emotions to the careful politics of word choice, I can't say that I now know any better what to say to that woman whom I barely know who has breast cancer. If I send a note offering courage, will that be the language of war? If I send Rich's book, The Red Devil's unvarnished truth might be too strong.

In the end, maybe that is the thing so unsettling and fine in Rich's book: her truth. Honesty is a great thing in an arena like cancer, as clouded as it is with emotion and politics. The question remains, however, whether we can handle the truth about cancer, about death duplicating in the cells, about our own human frailty. One thing is clear: those of us without cancer are the outsiders.

-- Emily Adams is a journalist and fiction writer who has written for the Los Angeles Times and Copley Newspapers, as well as various magazines. She won the California State Bar's Golden Medallion for her legal writing and lives in North Carolina.

First published September 22, 2000
Last updated January 14, 2008
Copyright © 2000 Consumer Health Interactive

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