Full disclosure: I’m a survivor of breast cancer, now ten years out from diagnosis. I have a particular interest in reading cancer memoirs, comparing the author’s observations to my experiences and perspective. Given the ubiquitous nature of cancer—it was second only to heart disease as a cause of death in 2018 (Covid has everything beat in 2020), and almost 40% of Americans will experience cancer based on 2015-2017 data, not to mention all the spouses, family, children, and friends affected— we all have something to gain from this reporting and reflection. As with any memoir, it is important to remember that this is one person’s experience and interpretation, not to be generalized to others, given the uniqueness of perspective. One hopes that some universal truths are reached— perhaps the author desires that— but don’t assume that upon completing this, or any memoir.

I read Jaouad’s New York Times column, Life, Interrupted, with great interest in 2012. It was accompanied by several videos, that dramatically illustrate her experience. Her perspective was the as-yet unreported experiences of a young person, someone in her twenties, living through extensive, life-threatening cancer and treatment. Part of the drama of the series was the cliff hangers— would she survive? When would she and her endlessly loyal partner finally marry and live happily ever after, cancer-free? It had the hallmarks of great drama, unfolding in real time. Part one of the book covers the same territory in greater detail, with full disclosure and reflection; part two covers her post-treatment road trip to discover a way forward.

I agree with many of Jaouad’s observations about life in treatment, and the reactions of others. especially a young person’s experience. Being young, she had the advantage of better energy, and just looking better in general. As debilitating as cancer and its treatments are to one’s energy and appearance, one is at a bit of an advantage as a younger patient, bouncing back to a more normal appearance, healing quicker, having a better baseline of energy, as opposed to an older person. Society may misattribute the physical effects of treatment and illness to other things, such as drug use or laziness. She was told by others to give up her bus seat to an elderly woman, even when she was quite depleted herself. Spending a lot of time in chemo clinics means you will meet the more average patient cohort, elderly, or at least middle aged patients more often. Young patients are far fewer at adult clinics, and many are in pediatric facilities. Honestly, I was offended by her attitudes toward older sufferers—Jaouad clearly hated being around them, and actively sought out younger patients. I don’t entirely fault her for that, but she denigrates them, and does not describe even one attempt to get to know anyone other than young patients. She might have had much to learn from an older adult walking the same walk, and could have brought the lightness of sharing a load with someone more mature. She will not know what she missed, in the way of interesting relationships by excluding them from her orbit. It was immature and selfish for her part.

My other gripe was the way she treated Will, her boyfriend for most all of her cancer experience. They met before her illness seriously manifested. Jaouad goes to Paris after college graduation, exploring possible career paths, and invites Will to come live with her there. It is a beautiful romance, and she describes him as giving, loving, and totally selfless. When her illness turns very serious and she must return home for treatment, Will bonds with her parents and becomes part of her support team, putting his own life and career on hold for five years. He understands in a very mature way what being a partner and spouse means. At the first sign of Will trying to take a break, restart his career, and nurture other family relationships and friendships in his life, she acts out, behaving manipulatively to elicit his guilt. It is the patient-care giver conundrum— a complex set of behaviors and emotions that bond two people in an unhealthy way. Jaouad does a good job describing the dynamics from her viewpoint, but I am not convinced that she understands the part she played in sustaining the dynamic, and not actively working past it to a healthier, equitable relationship that would move past cancer. She describes the inadequacy of psychological therapy to address these couples issues, leading to the deterioration and unsatisfactory ending of her relationship with Will. For someone who played such a key role in her survival, Will is discarded in the end, with no resolution. She doesn’t even give him so much as a nod in her acknowledgements. Again, I view her handling of this as immature and selfish.

The entire failure of the medical cancer complex to address the psychological needs of an individual reintegrating into normal life is a key take away from this book. The medical treatment complex is all about survival of the patient, and eradication of the cancer. How you live life on a daily basis through treatment isn’t much considered. Life after treatment is not even an afterthought. One is left with a great deal of uncertainty and anxiety as one tries to repair relationships and career. We are changed, we will never be the same. We will have to deal with people’s discomfort and uninformed, at times bizarre comments. We have the opportunity, should we choose it, to be a strength for others, as an ambassador from the world of cancer, that it can be survived with a great deal of luck, with grace and humor intact. Life can be rebuilt, although cancer will always cast a shadow on our futures. Reoccurrence is always a possibility. Ironically, death waits for all of us, although those who’ve experienced cancer have at least brushed shoulders with it. Those who haven’t had cancer often give away their bias, that they are somehow more protected from their demise. We who have experienced cancer know that we are all a breath away from meeting death. It is a hard-won knowledge, that should make this moment so much more precious.

Jaouad described so much of what needs to be said about cancer, its treatment, what medicine gets right and wrong. I appreciate her willingness to show her fuller humanity, her failures, sadness, joys, and grief. It was a courageous book. It was also a young person’s book, showing her lack of wisdom, her immaturity, her youthful self centeredness. I hope she comes to a more mature understanding with time, and learns to expect more of herself, even in dire circumstances. That is the character-building opportunity suffering offers. Recommended, with reservations.