I am intrigued by Mortality for one main reason, which is this: Hitchens’s beliefs about his advanced cancer and its treatment were, for a man whose fame rested on his scepticism, uncharacteristically optimistic. I hesitate to use the word delusional, as he admitted that he would be very lucky to survive, but he clearly steadfastly hoped, right to the end, that his particular case of advanced cancer might lie on the sparsely populated right side of the bell-shaped curve of outcome statistics.
He famously mocked religious folk for their faith in supernatural entities and survival of the soul after bodily death, yet the views expressed in Mortality are just as wishful and magical. “The oncology bargain (oncology is that branch of medicine which deals with the treatment of cancer),” writes Hitchens, “is that in return for at least the chance of a few more useful years, you agree to submit to chemotherapy and then, if you are lucky with that, to radiation or even surgery.” Years? I must now confess to a professional interest. I am a gastroenterologist in a large acute hospital, and I have diagnosed many patients with oesophageal cancer. “Years” is a word not generally used when discussing prognosis in Stage Four oesophageal cancer, “months”, in my experience, being a more useful one.
I’ve no watched two friends – an atheist and a Christian – go to extraordinary lengths to extend their lives against great odds. They were both relatively young – especially David at 34 when he found out. No one wanted them to go. But I wonder if all that medicine – which was, in fact, a form of poison – was worth it. David got ten more years, and two young children. But he also endured a disfiguring, disabling, brutal physical battering from the surgeries and chemo-sessions that tackling a tough brain tumor allow for. I say “allow for” because “required” is not the right word. What the chemo did to Christopher was beyond description – and what’s left of your body, even if the chemo works, can be extremely vulnerable to infections and diseases that can be worse than the cancer.
It seems odder to me for Christians to be as exercized by life-extension as the atheist. Put that down to the strange extremism of Ratzinger’s innovations on the question of “life”. But our culture’s gradual alienation from the fact of our deaths – our distancing ourselves even from the old and infirm in ways previous cultures didn’t and couldn’t – is not, in my view a healthy thing.
No one should seek to die or give in to a disease they can legitimately fight. God knows how many pills I take a day to keep the virus – and all its and their side-effects at bay. But I get to live healthily and meaningfully. The way some elaborate and cutting edge treatments all but kill the patient in order to save her troubles me. It’s a loss of perspective as well as immensely expensive for the entire system. Unquestionably, these sophisticated treatments are taking healthcare money away from the young, taking up more and more of our collective healthcare resources, and extending lives only be perpetuating continuous agony and nausea and pain for the patient and devastating consequences for families and friends.
We will all die. We should not seek it. But we should not flee from it for ever. I walked a 94-year old friend home last night in her wheelchair after a visit. She told me that she had worse and worse panic attacks. What are you afraid of? I asked. “Death,” she replied, with characteristic candor. I cannot blame her. And I cannot blame all of those who do everything and anything to avoid it. But at some point what seems to me to matter more is not the length of our lives but the content of them and the manner of our deaths.
At some point, medicine is a function of a social disease of modernity: the flight from our own mortality. But fleeing it does not defuse it. Only facing it does.
(Photo: John Moore/Getty.)