Cancer, an existential journey

Cancer, an existential journey


An experience that is both common and deeply singular, cancer is a real existential upheaval. How do the philosophers who have been affected by it go through this ordeal?

“Everyone dies of cancer, the question is knowing when! » This joke is revealing of the banality of this disease, the number of cases of which would make it almost a collective experience. To the point that the City of Science and Industry in Paris is devoting an exhibition to it until August 8, 2023. Unsurprisingly, cancer does not spare philosophers. This is also the subject of the latest book by Ruwen Ogien, My Arabian Nights. Illness as drama and as comedy (Albin Michel, 2017), in which he describes the experience of pancreatic cancer that will soon lead him to death. But in the face of statistical banality, the first-person testimony illustrates the radical singularity of the experience. How to live with cancer? How to reflect on the existential upheavals it entails? We put the question to two philosophers who are now recovering from this illness. Virginie Pirarda lawyer and researcher in bioethics, suffered from breast cancer about fifteen years ago. Philip Smallauthor in particular of a Prostate philosophy (Éditions du Cerf, 2018) and founder of the ABC Penser site, suffered from prostate cancer. They tell their experience.

The busy body

Virginie Pirard was just recovering from an episode of pharyngitis. She was still coughing a little, and putting her hand on her chest, she felt a lump. A little worried, she talks about it to her mother, a doctor, who advises her to go see a doctor. By passing the probe to the indicated place, the ultrasound scanner immediately withdraws the instrument, seized. Two tumors. The biopsy reveals that it is an invasive cancer, grade 3.

© Virginie Pirard

© Virginie Pirard

Cancer. The doctor who announces to Ruwen Ogien his illness has however never pronounced this word. He diagnoses her with “pancreatic ductal adenocarcinoma”him “leaving the responsibility to decipher what it meant”. A pancreatic cancer that refuses to say its name.

The announcement of the disease is paradoxically done without fanfare, as if we were reluctant to translate the existential upheaval which it nevertheless accompanies. With modesty, Philip Small explains having been diagnosed “like everyone else, by a simple blood test”. Long inspired by the definition of disease given by Georges Canguilhemyet he immediately becomes aware of being transported into a “minority status”a “pathological regression”. As he describes in his Prostate philosophysort of logbook, here it is “out of the circuit, out of the world, out of history, out of everything: out of breath”. We don’t catch not a cancer, no more than one develops it. Instead, cancer seems to occur to the individual. An awareness of the patient discovering himself as such, which Ruwen Ogien describes as an occupation: “It’s the first time that I feel completely ‘overwhelmed’. » Even outdated, erased by cancer. He humorously recounts his astonishment when he learns that one of the side effects of the treatment risks “to achieve the complete erasure of {his} fingerprints”, seriously jeopardizing his chances of obtaining a passport for his next stay in the United States. Virginie Pirard also felt like “fully occupied” by cancer, both physically and psychologically. We must make way for the disease, “to be one with this question of the tumor”. Adapt to the care protocol, accept the treatments. Going through chemotherapy, she gradually loses her hair, her eyebrows, her eyelashes. However, she decides not to wear a wig, convinced that none will manage to reproduce the nuances of her natural redhead. No headscarf either. She chooses “to go bareheaded”. Like a burst of pride in the face of an illness that “denarcissism” permanently. She describes the feeling of loss of control over her femininity, over the image she sends back to others as well as to herself. At only 31 years old, she is confronted with powerlessness in the face of bodily transformations, an experience she thought was linked to old age. Losing mobility, seeing your body deteriorate despite a healthy lifestyle, is a fatality that is normally attributed to the elderly. But the body is damaged by cancer”. After radiotherapy, she switched to hormone therapy, which she saw as ” a tragedy “. Virginie Pirard describes the impression of seeing all her sensations altered, her “inner landscape ” shakes. She is rapidly gaining weight. Things no longer have the same texture under his fingers. Her body seems to be rejecting the treatment with all its might. She no longer recognizes herself. Against medical advice, she decides to interrupt after 13 months a treatment supposed to last 5 years. She knows full well that this reduces her chances of survival. But “It was either that or throw me out the window”. The relief is only partial, however. She suffers from chronic fatigue, which cannot be overcome by rest, which “eating from the inside”. Forced to constantly draw on herself in search of resources to simply ” TO DO “continue to ” be “.

“What doesn’t kill makes you stronger”, really?

A symptom of cancer that is rarely talked about is loved ones and the medical community, who begin to adopt the vocabulary sometimes of coach of life, sometimes of the military general. “You have to fight! », “You’re going to get rid of that filth!” », “You are stronger than that! »… Implicitly, the image of an ordeal from which we will come out stronger, provided that we survive it. Cancer would almost be a chance, an opportunity to test its resistance. It is the idea that Nietzsche develops in the Twilight of the idolsaccording to which ” What does not kill you makes you stronger “. With the promise of gaining vital energy by overcoming disease. Ruwen Ogien distinguishes the traces of these discourses everywhere in popular and philosophical culture, which values “morally suffering as a school of lucidity”. In this context, illness is an opportunity for “withdrawal from the world” making us “available to thought”. An observation shared by Philippe Petit, who sees in the popularity of Nietzsche’s precept the idea that it is possible to “transform powerlessness into the power to live”, to make his suffering a strength, the tension towards death a springboard towards life. According to him, however, we have no interest in “to be too strong”, “too much on the side of mastery or power”. Against the ideal of a vital rebirth, he would side with a “weak force”which would make it possible to hold together the contradictory forces of the patient, and a fortiori of man. The combative metaphor indeed suggests a frontal struggle against an easily identifiable enemy. He much prefers her “the idea of ​​crossing, of travel, whose destination would be unknown”. Because to apprehend cancer as a battle is to enter into a confrontation with oneself.

Philip Little.  © Hannah Assouline

Philip Little. © Hannah Assouline

Virginie Pirard says that she often felt embarrassed by warlike speeches. This type of assertion amounts to considering the body as a place of which one should “to extract dirt”. However, a tumor is nothing but a “part of the body that has lost its mind”. Rather than considering the tumor as an enemy, it should be considered in its continuity with being. Cancer reveals the fluidity of identity. It is a part of the body, brought to disappear and perhaps to reappear: “There is an inseparable interdependence between all the components of being, illness included. » For her, we have an ambiguous relationship with cancer: “It’s like a kind of embrace, painful, but an embrace with something that is inside you, that is you, and yet has to leave you. » Indeed, for the patient to survive, this embrace can only be temporary. After making room for the disease, you have to make room for the treatment. Agree to spend hours waiting in the corridors of the hospital between a consultation, a blood test, an examination result. It describes a form of making the being available in the direction of care: “All my personal energy was consumed by the need to deal with these moments. » Not so much furnishing warrior resources as accepting the place that disease and treatment take, “not to revolt, because there is no other way”.

A philosophical object?

Can we make sense of cancer? One might be tempted to opt for the tragic register: “Why me? », « What did I do to deserve this? But as Philippe Petit points out, “Illness is not justice. We do not protest against the fact of being sick”. This is, moreover, the conclusion of Thousand and one Night by Ruwen Ogien. Quoting Marcel Prousthe reminds us that illness confronts us with the fact that we cannot “ask for pity” to our body. “Going back down to the ground of physical suffering without grandiose existential justification is a brutal transition”. What posture to adopt, then? To resign ? Admit that cancer is “useless”? Describing the disease “above all as a collective experience”Philippe Petit quickly knew after his diagnosis that he wanted his disease “use for something”that his “personal history can be combined in an impersonal mode”. He launches into reading, observes “the organic unthought” what is the prostate in the literature and in the concept of virility (the prostate is the organ of pleasure in men, and plays a role in the secretion of sperm). On the contrary, before this interview, Virginie Pirard rarely publicly mentioned her cancer. It took five years to feel like the gun was being taken away from him. ten years for “begin to forget”. From this point of view, philosophy has been a resource for her. In this discipline, uncertainty is not an injustice. She is existential. “It is more the very condition of life than the exception within it. » Cancer is then only one “forms of uncertainty” inherent in the human condition. “So I didn’t spend any time angering fate or harboring any sense of injustice. » The experience of cancer obviously leads to experimenting with new sensations, to deepening the knowledge of fear, pain and anguish. All this forms a kind of “emotional and human dough”, which infuses existence. She knows for example what it feels like to have “bone ache”having briefly felt “to have the skeleton on fire” during his chemotherapy. She also faced helplessness. Faced with a loved one suggesting that she do without treatments that cause her terrible side effects, she realizes that she is in fact deprived of this choice, of any other outcome: The tragedy is that we cannot. It’s either that or die. » An existential vertigo. “I understand what collapse is. The physical collapse, the collapse of life. » Should we then study cancer, take it as an object of study, analyze it? She didn’t want it. His proximity to the disease prevents him from approaching it with the necessary distance. “It’s like a ball of fire. You can approach your hands, feel the heat, but putting your hands in it wouldn’t have been reasonable. » Cancer comes into contact with his philosophical practice, without defining it. This is not a taboo: she mentioned it during a speech at the Free University of Brussels. She captures it through photography. But cancer does not delimit it. After chemotherapy, her hair grew back. Blondes.

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