Like Odin den’ Ivana Denisovicha (1962; novella; One Day in the Life of Ivan Denisovich, 1963), V kruge pervom (1968; The First Circle, 1968), and other works by Aleksandr Solzhenitsyn, Cancer Ward has a close connection to the author’s life. Like Kostoglotov, he was diagnosed with cancer and had to find his own way to a hospital. Like Kostoglotov, he took a folk cure that may have kept him alive until he reached the hospital. Kostoglotov is most clearly the author’s mouthpiece, although the other patients also express his views. Rusanov and a few minor characters present contradictory views and show, through citing examples, the flaws of the Soviet system.

On the surface, Cancer Ward is an examination of the patients, and to a lesser degree the doctors, in a cancer treatment ward of a Soviet hospital. The novel is far more about the characters than about the setting; the experience of cancer forces them to come to terms with their beliefs. The novel could be analyzed as a political allegory, but it is not apparent that Solzhenitsyn meant it to be read as such. Politics figures in the novel primarily because it was so much a part of Soviet life at the time, not because it is an overtly political novel.

Rusanov, a party bureaucrat introduced in the opening sections, sets the scene. The disparaging view of the hospital and of the other patients, coming from an obviously officious and snobbish man, induces the reader to sympathize with the other patients and defend the hospital.

Rusanov later fades into the background. When he is mentioned, it is to show his metamorphosis. Particularly telling is the section in which the technologist and supply agent Maxim Petrovich Chaly joins the ward. Rusanov becomes friends with Chaly, an operator in the black market who brings in numerous luxury food items, even though this is contrary to party principles; through Chaly, he comes to see the value of letting people act in their own best interests. He is still chagrined, however, when his son, acting as a government investigator, fails to charge a truck driver for losing a case of macaroni from his truck. The truck broke down in a snowstorm, and the man left it for his own safety; when he returned, the macaroni was gone. Rusanov believes that the man should have risked death to guard his cargo and that he should be punished for not having done so.

The political exile Kostoglotov is the novel’s primary character. One of the patients reads an essay on the subject of what it means to be a human being, which starts a general discussion. Kostoglotov illustrates various aspects of that discussion in his own life. He clings to the hope offered by the folk cure from the birch tree mushroom, even though the cure is unproven and potentially dangerous. He struggles literally with the meaning of being a man; the hormone treatment recommended for him will render him impotent, and he desires, for a while, a sexual relationship with Zoya. He also discusses with Dr. Gangart the relative merits of living a few more months in peace against the option of undergoing treatment that will make him weaker and sicker, with only a hope of prolonging his life.

The setting of Cancer Ward is important. Facing death, the characters are free to rebel. Few of them, perhaps only Kostoglotov, would dare to express their opinions in front of Rusanov in any other setting. Although discussions focus on the meaning of life, they also touch on political principles. With the exception of...