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This is part of the full text of the medical memoir "Cancer Patient" written by Hugh Cook. The full text has been published online on a free-to-read-online basis. This autobiographical non-fiction account deals with the author's initial health problems, diagnosis, and treatment with chemotherapy and radiation therapy.

The complete text of "Cancer Patient" is here on this web site but is also available for purchase from amazon.com as a proper printed paperback book. The full text may also be purchased as a download (a PDF file) from lulu.com for US $5. Go to lulu.com/hughcook

For a chapter-by-chapter breakdown of what's in the book (in its online version, in the PDF version and in the paperback version), see:-

Table of Contents


diary       site contents       essays       stories       flash fiction       poems       novels

CANCER PATIENT is a medical memoir which deals with the author's autobiographical experiences which involve, amongst other things, chemotherapy, radiation therapy, a brain biopsy, a lumbar puncture (and then some more lumbar punctures), treatment with Ara-C, treatment with vincristine, treatment with methotrexate, treatment with radiation from a linear accelerator, and a vitrectomy (an operation to remove the jelly from an eye). This is a non-fiction account but it does contain a couple of fictional stories, clearly identified as such, and it also includes some poetry.

Table of Contents

Chapter Thirty-One


The author assesses the chemotherapy process, in particular with reference to the question of literary productivity. The author writes about the relationship between cancer and creativity. In brief, there is none. Cancer does not impact on creativity.

        The topic of this chapter is writing - the art of writing - considered in relation to the cancer experience. Or, to put it another way, cancer and creativity.
        After that first chemo cycle, my main impression of cancer treatment was of the sheer endlessness of being in hospital, and I was not looking forward to another five cycles. However, I figured, correctly, that things would go better for me if I focused more on my writing projects while hospitalized, and made more disciplined use of my time. And, indeed, in the long term, that was how it worked out.
        One of the great advantages of writing is that it's a portable profession, something you can do while marooned at the airport, while sitting on trains, or while waiting in your cell on death row for one of the more important appointments of your life. (I say "profession" because, although only a comparatively small part of my life has been spent making my living as a writer, I still think of myself as being, amongst other things, a professional writer.)
        For most of my life I've been scribbling away in all kinds of places, usually with complete indifference to my surroundings. A seat on a Greek passenger ferry, a room in the YMCA in New York, a hut on a hillside in the Nepal Himalaya - as a rule, it was all the same to me. The only occasion that I can remember on which my surroundings most definitely distracted my attention from my writing was when I found myself on a very sick aeroplane flying out of Dhaka, the capital of Bangladesh. The likelihood of crashing proved distracting. Fortunately the pilot opted to turn back ("Because of technical") before that happened.
         Writing has been, then, for much of my life, a habit to be pursued regardless of my circumstances and surroundings. It was natural, therefore, for me to think of my hospital bed as yet one more place where I could write. The fact that people would be disturbing my concentration from time to time by sticking needles into me would not, I thought, be a significant impediment.
        As it worked out, the business of writing in hospital was not, at first, as straightforward as I had anticipated. During that first chemotherapy cycle, I lost track of the date and became profoundly depressed. I more or less ceased to exist as a thinking individual. However, during subsequent cycles I was more alert, more productive and, generally, more cheerful, though always a bit stir-crazy toward the end, even though each of the subsequent cycles was limited to the planned four nights and five days.
        The initial shock of adjustment to life as a chemotherapy patient, then, did negatively impact on my creativity. But the impact was transitory. Like, I imagine, your first week on death row - after the shock of the first week or so, life, I imagine, settles into a kind of routine.
        For me, the word "routine" is the key to literary productivity. The secret of literary creativity, as I see it, is "head down and bum up" (a standard colloquial expression in New Zealand English for planting yourself somewhere and knuckling down to work). Creativity boils down to hard work.
        The world is moved forward by people putting in the work, regardless of mood and mental state. If you're lying back in the dental chair, for example, it's not standard practice for your dentist to pause in silence, waiting for inspiration to arrive from the gods. (If in fact your dentist does seem to be floating in a mood of meditative inertia, then this, I suggest, would probably be more likely to have something to do with substance abuse than with some arcane method of artistic mood-setting taught in the dental schools.)
        Great chefs, people who cook french fries for a living and the individuals (presumably human) who are responsible for the manufacture of hospital food - none of these rely on something as chancy as inspiration for forward momentum. They'd be out of a job if they did. And people who write professionally (journalists, for example) do not typically hang around waiting for inspiration either. They sit down and get on with the job. Literary creativity, at the professional level, is very much a matter of a set of effective work skills, the most important of which is the ability to sit down and apply yourself to the task as your schedule demands.
        And yet, embedded in our culture, there is, very strongly, the notion of the creative artist as someone waiting around for inspiration from the muses. Waiting for fire from heaven. Artistic creativity is seen as being something which occupies a higher plane, elevated above the world in which gas is pumped, onions are sliced and teeth are drilled.
        And so I was asked:-
        "How has cancer affected your creativity?"
        The assumption behind the question being, plainly, that there would surely be an effect. That creativity is a delicate mechanism which, in the face of cancer, might malfunction. Might cease, like a butterfly hit by a meteorite. But no such thing happened.
        Rather than being a kind of mystical process of inexplicable complexity, literary creativity is, for me, by and large the application of a set of techniques which are always available, ready to be applied to whatever task is at hand. Creativity is like eating with chopsticks. It's a skill, or a set of skills, something which may take a painfully long time to learn, but which, thereafter, is always available on demand.
        At the level at which one eats with chopsticks, I am still doing fine. Consequently, my creativity still functions. Has there been brain damage? Yes, certainly. But not to the point of causing perceptible disability.
        Brain cancer damages the brain, undeniably, and in my case the lymphoma ultimately left a hole in the brain (or, to use more elevated language, a "partially cavitated area", a kind of partial hole) some four millimeters in diameter.
        Objectively, that alone tells me that I must have lost some of the sharpness to my razor. Add to that the fact that chemotherapy ultimately caused my brain to shrink (or, in the technical language of an MRI report, caused "moderate generalised brain atrophy") and the term "brain damage" becomes hard to avoid.
        However, subjectively I feel fine, and certainly I've had no practical problems with creativity. No shortage of ideas and no problems implementing the ideas.
        As I experience it, creativity is the ability to make connections. Sometimes these connections can be obvious. For example, depending on what has been in the news recently, "bus" may provoke the thought of "bomb". (We live in troubled times.) Similarly, "beetroot" might prompt a connection to "blood", on account of beetroot's bloody color and bloody juice.
        The passage below features a set of associations. The passage is from the BAMBOO HORSES novel, in which a woman is talking about some uppers she is taking:

        Opening the delicate little box, Valencia takes out a single capsule and puts it on the lacquered surface of the table. It glistens there, red and yellow. She looks at me, smiles.
        "For me?" I say, with surprise, looking at the capsule.
        "Did I say so?" says Valencia. "No. It's for me."
        "What is it?" I say.
        "Viciousness," says Valencia. "Drive. Ferocity. Ambition. Decisiveness. The pounce of the moment that grabs you by the throat and takes you down. Action, in a word."
        Then the capsule is in her mouth and she is dry swallowing it. She grimaces. Wipes the back of her hand across her mouth. Then speaks of Atakana.

        There are a series of words in the passage above which all relate to the idea of energy, a kind of intense and driving energy. The words are "viciousness, drive, ferocity, ambition, decisiveness, pounce, grabs, action".
        Making connections of this kind does not require much in the way of intellectual gymnastics. It's a journeyman's skill, a journeyman being defined as someone who can reliably do a job in a competent fashion, usually without breaking through into the realms of genius.
        There is nothing mysterious about the ability to connect words such as "viciousness" and "pounce". To do this, the muses are not required. Rather, it is a learned skill, a skill which can be applied to any material which happens to be to hand.
        Material can be anything from dreams to real life experience. And, in terms of life experience, cancer has impacted on my creativity in that it has been, in effect, a journey into a different country. Finding myself in this different country I have a new perspective on my life and, also, on the wider world. Chiefly, I have come to experience myself as more of a social animal, enmeshed in my family context. The brother of my sister, the son of my parents, the husband of my wife, the father of my child.
        But, as for the mechanics of writing, after a lifetime of practice the relevant skills are rock solid and remain unshaken by the cancer experience. In that sense, the impact of cancer on my creativity has been zero.

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The text on this page is part of the cancer memoir "Cancer Patient" which has been posted online. All the chapters of this book are on this website and can be read for free online. However, the text is copyright - all rights reserved. For permission to use this text or any portion of it contact Hugh Cook.


        This personal memoir of the writer's encounter with cancer (non-Hodgkin's lymphoma of the large B-cell type) attempts to cleave to the truth. However, the text may contain information that is wrong, outdated, incomplete or otherwise misleading.
        This memoir has been written in a time of illness by a cancer patient who, though he feels sharp enough, must admit to sometimes misinterpreting things, forgetting things, or, on occasion, quite simply not hearing things.
        This memoir is designed to communicate the writer's personal experience and is not intended as a source of medical information. Got a medical question? Ask your doctor.

Cancer Patient Copyright © 2005 Hugh Cook.

Hugh Cook