Bloomsbury, £16.99, 360pp. £14.44 from the Independent Bookshop: 08430 600 030

[sic], By Joshua Cody

Susan Sontag's Illness as Metaphor (1978) famously appealed for the retirement of symbolism from cancer. But her heartfelt, unlikely aspiration has long been supplanted by popular culture's reporting and embellishing of the "realities" of carcinogenic illness, from sheer schmaltz (Terms of Endearment) to a brace of second-generation accounts, like the film 50/50 and Joshua Cody's [sic]. Siddhartha Mukherjee's acclaimed The Emperor of All Maladies would surely appall Sontag, as it openly "biographizes" cancer, endowing it with motivation, predilection, the lot.

As medicine and prospects of recovery advance, the growing number of "survivors" has paradoxically led to a proliferation of stories about how effectively mortal cancer still is. Newer narratives virtually approach the reader from the other side. In Cody's case, a harrowing near-death experience literalises the fact. Yet he also couches the story of his diagnosis as an aspiring American student of musical composition in these arresting terms: "You'll go through it too, almost certainly: it's part of life in the twenty-first century." Such paradoxes appeal.

Cody first experienced a neck pain, blaming a pulled muscle. Doctors next thought a virus responsible. Finally, a biopsy revealed a malignant tumour. He ran the gamut of treatments, each comprehensively detailed. The initial chemotherapy is, he's informed, definitely "working". (It wasn't). Next came full-body radiation; then last-ditch chemo, combined with a "relatively endurable" bone-marrow transplant (his oncologist's quaint phrasing). Hospital bills approach a million dollars, as a Google search informs him that patients in Cody's situation face a 13 per cent survival rate.

Throughout, Cody details a parallel insanity in his peers' responses. One friend, lacking breasts, embraces her cancer, proclaiming: "You're dead. But in a good way!" His agnostic mother fervently prays to St. Catherine. One girlfriend disappears to attend rehab; another leaves for Alcoholics Anonymous. The last flame is a beautiful, self-absorbed pain-management specialist who was treating Cody. Nicknamed only "Nothereal", she walks out on the eve of his life-or-death scan results, revealing she "could hardly bear the sight" of him and that "the disease came for a reason." Her blunt conclusion? "I deserve more."

Ugly indeed – yet the account rings true. Many survivors relate how their biggest shock was not biomedical but interpersonal. Deep friendships inexplicably implode. Relationships expire, as partners "take a break."

Manifest literary interests sustain Cody's thinking, as well as the aesthetics of editing. Cody insists he isn't a writer, and will never write (words) again. An art lover, he deliberates on the sexuality in Paul Klee's paintings. Music features prominently as do maths, philosophy, science and Manhattan architecture. The result is a brain-spinning account of a high-wire experience, sustained largely by unapologetic "high culture" diversions. [sic] pulls no punches, but, winningly, the louche, heavily-drinking, cocaine-snorting Cody is never idealised.

British reviews to date have largely missed the point. One questioned Cody's supposedly extravagant lifestyle. Another objected to him showing off - as if, post-diagnosis, sustaining cultural interests or intellectual aspirations were improper. Be smart; ignore them. For when Cody asks of his near-death period, "Didn't I go a little mad?", this reader's grateful response was: "Perhaps – yet in such 'madness' lies a truth that needs telling."

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