The New Death Writing

Memoirs of illness are all the rage. But are they art, education or indulgence? A critic and fellow sufferer casts a dispassionate eye on this sensitive and lucrative new genre
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The Independent Culture
"When the lights come on at four,

At the end of another year?

Give me your arm, old toad

And help me down Cemetery Road." Philip Larkin

DEATH is no longer the last taboo. It seems that the dying have taken up their pens to take us through their agonies. Ruth Picardie's brave and moving Before I say Goodbye, the newspaper columns by John Diamond, and now his book, John Bayley's account of Iris Murdoch's affliction, and, most recently serialised, Robert McCrum's My Year Off, rediscovering life after his stroke. We are awash with tragedy, and the publishers with profit. But is this a genre that we should admire? Or avoid, at all costs?

Such books cannot fail to move us to tears. We are all terrified of cancer, in America it is "The Big C", faster on the draw than even John Wayne, but we are all fearful of its pain and its remorseless progress towards a miserable death, if not in John Betjeman's "What Cottage Hospital?"then in which genteel hospice?

Senility has been given a new name, Alzheimer's, but it shares with the victims of massive strokes the terror of imprisonment within our own bodies, unable to communicate with those we love, suddenly, and without warning struck unaware or dumb, turned into some obscene vegetable. The private nightmares that we strive to ignore now speak to us from the bequeathed pages of the less fortunate. Who, today, can pass a bookshop's window display without a premonition of death?

Polio, once the enemy of the young, the beautiful and the strong, lingers on in the discomfort of old men and women; including myself. But it no longer kills, it simply cripples.

If only cancer were to find its Doctors Salk and Sabine, who discovered the polio vaccine. I am at present in remission from prostate cancer, which was diagnosed five years ago. When I read Ruth Picardie's account of her breast cancer, diagnosed when she was only 32 (I was 63) I cannot do so with detachment. It is too close for comfort. Has my cancer spread, as did hers, to her lymphatic system? Is every new ache or pain proof of the insidious progress of one's Last Enemy? Happily my incipient neuroses vanish with the dawn, but for how much longer?

Perhaps I am over-sensitive. As a writer, I welcome this new phenomenon. But there are questions to be asked. Is it art? Any creative act can today be called "art", one has only to think of Damien Hirst, but are the books I have mentioned good or bad art? They all write bravely of the human condition, but is the breaking of the Last Taboo, the Last Hurrah? Should not we draw the curtains, and by ignoring our dismal fate, recapture our belief in our own immortality?

"Count no man happy until he is dead." When I first heard this classical tag (Solon of Athens) at my prep school, I failed to comprehend it. Such is innocence. Ruth Picardie's book largely consists of e-mail exchanged with an American friend suffering from Aids. In 1997, in her last piece for the Observer, Ruth wrote "Among the over 200 dying patients we have interviewed, writes Elisabeth Kubler-Ross in her classic work On Death and Dying, most reacted to the awareness of a terminal illness at first with the statement 'No, not me, it cannot be true'." Apparently, patients then move on, over a period of months, to anger, bargaining, depression and finally, acceptance. That is where Ruth's final column ended. Her twins were just two years old.

The truth is that the doctors, the oncologists, know nothing. They are in the dark. If it ever were to come to it, I hope I would have the courage to refuse "chemo", and take an overdose of Mogadon. Or attach a rubber tube to the exhaust pipe of my motorcar. How euthanasia remains a crime in what is ostensibly a civilised society is beyond me. Ruth Picardie's description of the consequences of chemotherapy tells one more than one would wish. I shall quote from her description. Besides her hair falling out, "Chemo was vile ... imagine four days of the worst hangover combined with the worst flu, where you can hardly move, feel poisoned, are half-asleep but not pleasantly out of it. Felt too wretched even to listen to the radio, and didn't want any cheering up from hovering mother and husband."

Perhaps the worst part of terminal illness is not the disease, not even the quacks' so-called cures, but the effect it has upon one's loved ones. Their agony can be relieved only by your death. Before I Say Goodbye is, in effect, a co-operative effort between two clever women, the desperately unlucky Ruth and her steadfast sister, Justine Picardie. It is finely written, gallant in its acceptance of what fate has in store, free from the euphemisms so beloved of the medical profession, and angry to the bitter end. It is a worthy monument to a brave woman.

After I had read the book, and written about it, I slept badly. My depression was lifted by a second book in the same genre, The Diving- Bell and the Butterfly by Jean-Dominique Bauby. Whereas the unlucky Ruth gazed into the pit, Bauby, in health the editor-in-chief of the French magazine Elle, looked upwards hopefully from what could be thought of as a living death. In 1996 he suffered a massive stroke, or to be more specific, "a cerebrovascular accident" that put his brain stem out of action. In the past such victims would have died; today improved resuscitation techniques have prolonged and refined the agony. You survive, but suffer from what is aptly called "the locked-in syndrome". Bauby was capable of one movement only: the flicker of his left eyelid. By this incredible means he wrote a book that is both moving and amusing and a tribute to the indomitable spirit of man.

Bauby was banished to a grim institution in the Pas de Calais, the French Naval Hospital at Berck-sur- Mer, a building designed for the poor children of Paris and opened by the Empress Eugenie in 1864. Bauby explains the means whereby he came to "write" his minor masterpiece. He learns a new alphabet, not "ABC " but "ESA" - the sequence of the most frequently used letters in the French language. He admits that crossword fans and Scrabble players have an advantage, but, as someone recites the "code", as it is called, he or she is stopped by a flicker of an eye at the right letter. In this laborious way, Bauby, who is now dead, wrote his book.

If we are to be subjected to the literature of death (and it can only be judged by the same criteria as any other kind of book), it must surely be balanced by the literature of hope. Is the success of books like those written by Ruth Picardie and John Diamond proof of the general morbidity of public taste? Would we 50 years ago have smuggled Diamond's C as our grandparents brought Henry Miller surreptitiously through the Dover Customs? Whatever their merits they are not books for the sick: they are not to be slipped into the Christmas stocking, along with a sugar mouse and an orange. They demand almost as much courage to read as they did to write.

Would I write such a book were circumstances to make it possible? Perhaps I will be saved by my genetic inheritance? My father was diagnosed as suffering from prostate cancer at the age of 74. He had it cut out and lived until 98, when he died of old age. A highly intelligent man, he remained lucid until the end. Who can tell? As a jobbing journalist I did write about my two afflictions for the popular press. I wrote about my disability (post-polio syndrome) for the Telegraph, and my cancer for the Mail. In both cases it was not just for money. The post- polio syndrome is relatively new. I had polio in 1949 when I was 18. I limped almost imperceptibly for 40 years but bust a disc in doing so. ln 1991, the paralysis spread down my already weakened leg and I can walk only short distances, and find it hard to sit or stand. In consequence, I retired from Westminster in 1997. What has happened to me has be- fallen many others of my age.

As for the cancer, I became aware of blood in the semen in May 1993. My father urged surgery, but my urologist felt I was unfit for a major operation. Instead, I was given radiotherapy, a painless process that leaves one robbed of stamina. I learnt what a PSA test meant (a blood measurement of the cancer's extent), and felt that others, younger than myself, should be made aware of the need to take such a test early rather than late. Public life has not made me a private person. But to answer the question "would I do a Diamond?" I think I would value my privacy too highly.

Before I turn to John Diamond, a fellow hack and sufferer, I must say that Bauby's book is one of the most beautifully written I have ever come across. The cover carries the boast "One of the Great Books of the Century" - the Financial Times. That is no idle boast; I shall read it and re-read it. The beam from his lighthouse pierces the black despair that he must feel, for he is little better at the end of the book than he is at the beginning. But as an elegant story of courage it ranks with Antoine de Saint-Exupery's Vol de Nuit alone in the skies of South America.

I had never really noticed anything that John Diamond had written. Nor, until I read his book, did I know that he is married to Nigella Lawson. Clever and articulate, I could discern that he was a generalist whose opinions were not necessarily mine. Journalism suffers from too many columnists. I have my handful of favourites - Matthew Parris, Peter Riddell, and Jonathan Meades - and I stick to them. There are those, too, who I dislike, but my hate-list did not include Diamond. Although his book is very professionally written, perhaps I came to it too soon after reading of Ruth Picardie's calvary. His account of his cancer - of the throat and tongue - and of his brave struggle for life found me somewhat drained: someone who suffers from cancer himself can only take so much. We count our blessings while keeping a wary eye open for some new and threatening symptom.

Like many others I have read the serialisation of John Bayley's book about his wife, Iris Murdoch. It is yet another account of horror piled upon horror; the thought that a woman capable of writing 27 novels, and a philosophy don to boot, has been reduced by some terrible accident of fate to following her husband around the house, terrified that she might lose sight of him, is too unbearable to contemplate. Sympathy is a commodity like any other; could it be that I have prematurely used up too much of mine on myself?

A literary friend told me that his doctor had said that a copy of Robert McCrum's My Year Off - Rediscovering Life After a Stroke ought to be given to all his patients. Of the three books I have read, McCrum's gives one the most hope. He was struck down; he survived; his condition steadily improved. He has gone through the valley of the shadow of death and come out the other side. His steadfastness was, at least, rewarded.

What then should we make of this latest literary phenomenon? There must be an end to it, or is the appetite of the public for the misfortunes of others insatiable? Has the Diana Cult made us all wear our hearts upon our sleeves? Sex has been stripped of its privacy; is the same about to happen to death? Are we all to be remembered by a slim volume penned in extremis? The questions are easier than the answers.

Bernard Levin, who is ill, has kept his silence and I am tempted to write "his dignity", but that would be heartless. The Victorians encompassed death in mystery; they laid straw upon the road to dull the noise of horses' hooves. Every great novel of the period had its death scene, but I cannot recall a novelist who charted his own demise. The fact that death is inevitable does not mean that it should be celebrated, however movingly it is done.