“The Approximate Size of My Favorite Tumor” reprises some of Alexie’s recurrent concerns: relationships, traditional values versus modern society, alcoholism, and ironically doomed lives. Jimmy Many Horses retells the history of his relationship with his wife, Norma, from the initial meeting at the Powwow Tavern through their problematic relationship, including grappling with alcohol addiction and Jimmy’s death sentence of terminal cancer. Jimmy’s recollection of their relationship includes a classic Indian Country pickup line, “Listen . . . if I stole 1,000 horses, I’d give you 501 of them.” Although their wedding took place at the Spokane Tribal Longhouse and although Norma is known as the world champion fry bread maker, traditional belief and custom do not especially inform their lives.
Jimmy’s cavalier humor about his terminal condition enrages Norma to the point that she leaves him temporarily to go on the powwow circuit. She ends up in Arlee, Montana, with a “second kind of cousin” before returning to be with Jimmy in his last days because, as she explains, “making fry bread and helping people die are two things Indians are good at.” The title of the story comes from Jimmy’s description of an X ray of one of his tumors which was the approximate size and shape of a baseball—with faint stitch marks on it. Norma finds distasteful Jimmy’s attempt to make a joke out of his medical diagnosis; however, she has returned by the end of the story to be with Jimmy in his last days, and their joking together and their domestic dialogue prove the metaphorical point that Jimmy makes in narration in the middle of the story: “Humor was an antiseptic that cleaned the deepest of personal wounds.”