[In the following review, McCabe considers several titles which offer personal perspectives on cancer, including French's A Season in Hell.]

Death may be common to us all, but it is irredeemably solitary. Can others' experience of the imminence of death ever help us to escape that private view? In these books, four people describe—in quite different modes—their experiences with cancer. In 1997, Ruth Picardie, a former Guardian journalist, died as a consequence of breast cancer. Before I Say Goodbye contains the columns she wrote as the cancer progressed; a series of e-mails and letters between Picardie and her friends, and some editorial comment by her partner, Matt Seaton. Liz Tilberis is the Editor of Harpers Bazaar in the United States; in No Time to Die, she describes how she coped with ovarian cancer in the midst of a career in the fashion industry. A Season in Hell by Marilyn French gives an account of how her oesophageal cancer did not kill her, although its cure nearly did. John Diamond's column in The Times has, for some time, told its readers the history of his cancer of the tongue, and C: Because Cowards Get Cancer Too is the book of the column. In each case, we are invited to pity and fear, and perhaps thence to some better understanding of the solitariness itself.

The formal similarity between the four accounts is striking. The symptoms of Picardie's breast cancer were at first ignored or misunderstood; French's cancer was eventually discovered only because she herself insisted that it was there; Diamond's illness was originally diagnosed as glandular fever; and Tilberis was thought to have pelvic inflammatory disease. In each case, of course, we know before we read it that the optimistic diagnosis is wrong; we know before we come to it that Picardie will die; and we know, before we are told, that neither Tilberis nor Diamond will get away with the first aggressive therapies—the disease will recur. And in each case the cure seems to be worse than the disease, and worse still because the cure seems—again within the drama of these accounts—to be ineffectual. These dramatic ironies are exactly what create the pity and the fear; and the irony is not diminished where the story is incomplete—Tilberis speaks of “managing” the persistent cancer; Diamond has recently been in hospital for radical surgery; and French describes a life thoroughly transformed and curtailed by the sequence of illness which was caused, not by her cancer, but by the invasiveness of its cure. The question then remains whether these accounts give us any more than a description of human catastrophe. Is the pity they provoke transformed into something more substantial or more positive? But perhaps that is the wrong question; perhaps it is only pity that transcends the grim banalities of these struggles with cancer.

The narrative of Tilberis's cancer is offset against the comings and goings of fashionable high life. There is here an account of courage and determination, of a woman insisting on carrying on with her life despite what her body is doing to her, and of her grudging capitulation to the exigencies of disease. But this humanity is entirely eclipsed by the glitter of fashionable society at play, which equally casts into shadow some—potentially more interesting—anecdotes about the politics of fashion magazines. It is not, I think, Tilberis's intention to suggest that her courage was the greater because her life was the more glamorous; but the glamour element, which includes the inevitable courtesies in the direction of Princess Diana, trivializes the story of the cancer. As if the artifice of the fashion photograph were applied to the character of the author, her reader is left detached and dispirited, conscious only of dismal evanescence.

French, by contrast, has written a more vigorous book, almost entirely in a tone of passionate anger. The progress of her illness is a catalogue of disaster: the cancer is cured, but its therapy causes severe osteoporosis, kidney and heart failure, and coma. French describes all this with some irritation—she clearly feels that the division of medical labour was in some way responsible for failing both to oversee treatment of her illness as a whole, and to anticipate or even to diagnose the disasters which happened on the side. And she crossly describes the impossibility of carrying on a normal professional or social life (some of her descriptions of the latter are, I think unintentionally, hilarious: she is a member of a group of feminists calling itself, facetiously, “the coven”—there are daft passages describing the coven's attempts to help French by incantations and charms). It comes, then, as a surprise to find the last chapter arguing, with some acuity, that by robbing her of expectations the disease gave her, at last, both peace of mind and some sense of limited control over the outrageous fortune with which her body is beset.

Indeed, some measure of self-determination may be all that is left after such a diagnosis; and perhaps, as French sometimes hints, it is the irritation she feels which constitutes her control. Irritation is, however, an unedifying spectacle. Quite different is the agonizing story of the death of Ruth Picardie. Everything here is vivid, sometimes funny and ultimately grievous—most of all, perhaps, when, in the afterword, Seaton admits to the anger and the distance which the progress of the cancer caused between them, and acknowledges that the publication of the book provides him with the therapy he needs after her death. The very vigour of Picardie's words invites both admiration and tears; as a memorial it may be exact—but do we read it with more than an unhealthy curiosity? Part of my hesitation is provoked by French; she admits that her own book is in large part a kind of “writing out”, an ancient-mariner exercise which itself enabled her to recover from the trauma of illness and the devastating effects of the cure. That sort of therapy seems to me to be a private matter, and not in itself a reason to publish a book, nor yet a reason to read one. And yet in Picardie's case (and Seaton's) there remains something left over for the reader after the writing out—and that is humour. It is black humour, no doubt; and it was produced as a means of warding off what could not be faced, to be sure. But it is fiercely human; it rejects the self-absorption of a merely factual writing out of the history of a disease and a death, and it turns away from self-pity.

The same humour characterizes Diamond's more concentrated book. This may, of course, be a matter of genre; the newspaper column is inhospitable to self-pity. So the writing of both Picardie and Diamond is marked by bitter wit, by the sense of relieved complicity with which the reader recognizes in the author her own bad habits, and by a slight embarrassment at admitting to passions of any sort. Thus Diamond's book opens by undercutting itself: “hypochondria has always seemed to me to be the only rational position to take on life”, and marking a theme of the rest of the book: “… they've found some cancer cells. Well of course they had.” None the less, he admits that this ironical stance is itself a deceptive one: his attempt to “make cancer chic” was deluded by his own conviction that he was not actually going to die of it. That admission feels familiar: it is all very well to be stoical about something which you are quite certain will never actually happen to you (however close catastrophe may come), and to invite the sympathy and amazement of others for your near escape. It is quite another matter to face the reality of death—and admirable to be able to do so with irony intact. Of course, the self-deception may only have retreated to a deeper level; if Diamond can still be funny about what is happening (he has, for example, a delightful disquisition on how to arrange a consultation with “the Head and Neck Man Whose Name Is Spoken with Awe”), then he still has not come to terms with the fact that he may be dying. But this cynical view seems wrong; so far from self-deceiving, Diamond's book is both plausible and illuminating, where Marilyn French's angry discourse simply recedes into solipsism.

Perhaps this answers to a more intractable difficulty. Viewed from here, from the life we are living, death is inscrutable. The very incommensurability of life and death generates a sense of the absurd and invites irony, just because mere description will not suffice. But irony has its own cognitive mode. Just as dramatic irony makes its audience reflect on the dissonance between its own knowledge and the protagonists' ignorance, so this ironical reflection on death is self-conscious—both of its own ignorance and its helplessness in the face of what is altogether unknown. And it is here alone, perhaps, that the human spirit exerts some control over the impending disaster: by laughing in its face. This is the great strength of John Diamond's book—even though it seems to begin with the limited purview of a newspaper column, it develops a rich and moving reflection on what it is to face the absurdity of death. And this looks beyond catastrophe to something we may all understand.