Many people will be familiar with the voice of Paul D’Alton on RTÉ radio, where he offers advice on psychological issues and challenges. I always find him extremely comforting – he is knowledgeable and compassionate; above all everything he says makes perfect sense to me.
Head of psychology at St Vincent’s Hospital and associate professor of psychology at UCD, he has curated and edited this impressive collection of 14 essays by psychologists, oncologists, psycho-oncologists and others. The subjects range from a survivor’s story to an account of the physiological nature of cancer and medical treatments for it, to advice on how to talk to children about the illness. The majority of the pieces, however, deal with the psychological impact of the disease on patients and their families and friends, and give advice on how to handle the inevitable emotional and mental trauma a diagnosis and treatment cause.
D’Alton has contributed two essays, Typical Emotional Reactions to Cancer: Four seasons in one day, and Understanding Stress and Cancer. Shock, fear, sadness, anger, guilt, hope are the usual emotions. No surprises there! Ever practical, he advises people to name the emotions (“Give sorrow words”, as Shakespeare wrote.) “Naming emotions can be an important way of managing them.” He recommends talking about feelings aloud to a trusted friend – or writing about them (Shakespeare’s way, no doubt.)
As in his radio talks and podcasts, D’Alton’s voice in the essay is warm and convincing. That he expresses anger at psycho-babble, and the “cultural obsession with positivity and the cult of the positive that seems to have wrangled its way into cancer care” reinforces one’s trust in him: he is not nice about everything.
He also expresses annoyance at the lazy use of the cliche “battle against cancer” by people in general and the media in particular. This word “battle” reinforces the erroneous impression that somehow patients are responsible for their cancer, and that bravery and optimism can defeat it – and by implication, if they die they have failed. All of this is nonsense – being an optimistic person doesn’t give you any protection against cancer, or aid your survival (although obviously it may make you feel a bit happier.) As Julian Barnes writes in his account of his wife’s cancer, we don’t battle cancer, it battles us.
Disapproval of alternative therapies which are without scientific foundation, and of disinformation on the internet, find expression in other essays too. In her beautifully clear chapter on the nature of cancer, Dr Michaela D Higgins cautions that too much Googling is bad for your health, and that “there are many individuals online who have ulterior motives for recommending various therapies”.
Anxiety, depression, fatigue, physical changes, survivorship, talking to children, and incurable cancer are dealt with. The essays are uniformly well-written. They project reliability and they are practical. For instance, in their essay on Fatigue, Sonya Collier and Anne-Marie O’Dwyer explain what it is, what causes it, how it’s linked to depression and also give tips on what to do about it.
“Just acknowledging that it is a real and valid problem that affects many (though not all) who have cancer” is the first step. (This theme, of acceptance and naming, runs though the book.) They add that nutrition, exercise if possible and cognitive therapy can help.
The book deals with almost every aspect of cancer one can think of, but not much attention is given to pain. My guess is that fear of pain is one of the most common anxieties of patients and of those who love them. David Shannon, who also discusses that thorny issue, death, gives pain some attention but on the whole it is mentioned en passant, as if on a par with fatigue or anxiety. I would have liked more detail – how bad can it get? Can it really be alleviated?
That’s the only fault I can find with an excellent collection. The editor is to be congratulated, along with the contributors: Sonya Collier, Anne-Marie O’Dwyer, Orla Crowe, Michael D Higgins, Mary Moriarty, Siobhan McHale, Caoimhe McLoughlin, Susan Moore, Tara Kingston, Susan O’Flanagan, Louise O’Driscoll, Natalie Hession, David Shannon and Louise McHugh. They are almost all professors, doctors, consultants and all but two of them are women. Perhaps the gender imbalance is accidental. Whatever its cause, it is heart-warming that so many brilliant, highly-qualified women have created this superb book.
It is “primarily written for you – the person who has cancer – it might also be helpful for family members, friends and loved ones”, writes the editor in the introduction. Certainly it is a wonderful vade mecum for anyone with cancer, but I think it should be of interest to everyone, especially since “one in two of us born after 1960 will develop cancer in our lifetime”, as Higgins gently reminds us.
Éilís Ní Dhuibhne’s latest book is Look! It’s a Woman Writer! Irish Literary Feminisms 1970-2020 (Arlen House)
