Why Would Anyone Want to Read a Novel about Cancer?

When I write the first draft of a novel, I normally don’t think much about marketing. I tell the story that falls into my head, the one that has the most energy and won’t leave me alone until I finish writing. And then I think about how to sell it.

Even while I was writing Don’t Tell Anyone, which I’d titled The C Word at the time, I knew I’d face some serious challenges once I published it. But I still felt compelled to complete the novel and release it, hoping it would find an audience, secretly terrified that even if it came out well-written, thought-provoking, insightful or whatever good adjective you want to plunk on it, people would hear the word “cancer” and run.

I wrote it and published it because of my mother-in-law, Madeleine. She died from breast cancer, the progress of which might have been slowed or even arrested if she’d done something about it earlier. In fact, if she’d done anything about it earlier. Panicked out of her mind because (as our theory went) the cancer treatment she was familiar with—her mother’s, a horrific experience—was so traumatic, she kept her own lumps a secret for years. I found out later that she’d sought therapy in order to gather the courage to tell her family. Which became a moot point when a health emergency outed her to my husband, his sister, and me.

That it was a shock to all of us would be a gross understatement. I’d liken it more to having our guts wrenched out. We pushed our feelings of shock, grief, pain, resentment, and anger to the side, however, as we helped get her through the now-aggressive treatment her oncologist recommended: a radical double mastectomy, chemo, and radiation. The usual things happened, some they show on TV, some they don’t. She lost her hair. She lost her sense of taste and smell. She made a few dark jokes. She fell into a deep depression. The long-awaited remission brought her little joy; much as we tried to bolster her spirits, nearly all she could think about was when it would come back. Five years later, it did, and killed her.

Now we were left to face our emotions alone. My husband’s and his sister’s are private things and I’ll leave them to talk about them publicly or not. But my mother-in-law and I had a special relationship. Sure, we had our bumpy parts. My husband and I lived in her house for a few years out of economic necessity; I was not as tidy as she would have liked me to be, and we became much better friends after my husband and I moved out. But she called me her “favorite daughter-in-law” (yeah, big joke, only daughter-in-law, yet she said it with such joy) and she was one of my biggest fans. She nagged me to finish my novels because she said she needed something good to read.

I, however, needed to reconcile my own feelings. Especially the big question: why? Why stick your head in the sand? Why do that to your children? She had no quarrel with doctors. She had decent health insurance. She lived a scant few miles from a compound of medical services. Why not get that lump checked out, particularly because of her genetic predisposition?

The questions dogged me, long after her diagnosis, long after her death. So I wrote about it. That’s my way of exploration. I gave the situation to Estelle Trager, the matriarch of the novel. Then I let it play out with her fictional family, who already had a boatload of problems of their own. I wanted to know why she’d made the choice (and not making a choice is still a choice) to ignore her condition. I wanted to explore the effect that choice had on family dynamics between and among her children, which lead to some difficult, sometimes painful, sometimes sweet, sometimes heartbreaking, sometimes funny moments.

So let me leave you with one funny story from my mother-in-law’s treatment, which I would have put in the book if the situation arose, but it didn’t.

After my mother-in-law’s double mastectomy, she was kept in the hospital a few days. But given the bottom-dollar-focus of HMOs, we were warned that once released, her aftercare would include our tending to a series of drains that filled with fluid and needed to measured, monitored against signs of infection, and emptied regularly. When we arrived at the hospital to pick her up, she was already dressed and sitting up in a chair. Four plastic drains, about the size of hand grenades, were pinned to the outside of her blouse. She gave us a devilish grin and said, “How do you like my new jugs?”

Miss you, Madeleine.