Abstract
Speaking of pain and the social relations that surround it in cancer, Dwaipayan Banerjee attempts to ‘disrupt the distinction between what makes up cancer’s center and periphery’ (p. 10). He begins his journey of extensive ethnographic fieldwork at AIIMS, New Delhi, and his engagements with the NGO CanSupport, by uncovering the concept of concealment—which often fills up a lot of space in the academic and non-academic literature on the disease—in the opening chapter itself, and wounds it on the plane of trade-offs made by the families, the medical staff, the patients and also those whom they encounter in the everyday, to navigate and test the vulnerabilities which are (only) reaffirmed and restructured with the diagnosis.
Belief, spirituality and biology are often probed in the case studies presented throughout the book, not to reach stable, exhaustive explanations, but to invite the reader into a world of complexities intertwining the body, the mind and the social over a condition that continues to remain irreversible for most Indian patients. With diversities spanning across symptoms, prognosis and outcomes, Banerjee critiques the singularity that cancer is often subjected to, in representation. Further, it is suggested that ‘endurance’ seeps in so organically in the patients, that strategies of speech and the management of psychosomatic pain exemplify the strength and capabilities of patients to manoeuvre their actions in regular exchanges, and cope with the intimidating nature of the disease. This reminds one of the importance that the acceptance of one’s identity has, as a function of the ‘illness careers’, and how a predictable course of action in overarching illnesses, like cancer (or depression), creates scope for the replacement of old identities by the new ones, under the theorised observations of symbolic interactionism (Karp, 2010). The second chapter in the book is dedicated to these arrangements within familial ties, and how they may not be as helpful in transforming relationships of the present from their vulnerable pasts.
The aetiologies of pain are discovered in the medical, social and familial networks, where statements as deeply informative as ‘pain physicians understood pain as part of a social relation between them and the patient’ (p. 14) are used to jut out the embeddedness of the biological in the social, and this, therefore, justifies the very aim of this sociological inquiry. Further, ‘empathy’ is brought up repeatedly in the text, with special attention in the third chapter, to do litmus tests of emotions, medical possibilities and support in the biopolitical world. Systemic inequality and institutional lacks play similar roles in the narrative that Banerjee, very carefully (and sympathetically), weaves. He also does not forget to acknowledge the precedence of ‘western’ lifestyles as the main reason—according to the Indian population—for cancer emerging as the new national epidemic, and justifiably discredits this claim; for him, this trope undermines the actual history of cancer in the subcontinent and simultaneously aggravates opacity in the understanding of this disease. This is also linked to the futility of the wall between diseases of the rich (population/world) and those of the poor, as for the dichotomy of urban and rural.
In the latter half of this book, Chapters 4 and 5 on the memoirs and visual display of cancer warn of aestheticisations that belittle the sheer physiological pressures on the patient. However, Banerjee also believes that in invoking the socio-cultural symbols that are represented in these works of art and literature, perspectives on what truly constitutes cancer—in the world that we come to inhabit—take the foreground in ways otherwise skippable. He is inspired to obtain Lochlann Jain’s diverse ‘cognitive dissonances’ in the cultural depictions of cancer while finding disjunctions with the lived realities of the hospital ward. The accounts of will and hope leading the patient towards daylight, as is the case with most literary texts, certainly contradict—and offend—the biographies by scholars like Ann Jurecic, which remain suspicious of the meddling between critique and compassion directed towards the same representations. The book, still unceasing to meander from its promise, offers both (and more) perspectives, essentially to promote continued discussions on the matter, and prove yet again that these contradictions (and also the ones that encircle the dyadic experience of life/death) are ‘irresolvable’. Responsibility to society and one’s own family is also brought up as a theme in the second-last chapter, with illustrations drawn from a number of popular Hindi films. These help in sharing resemblance to the observed realities on the field, but sometimes also contrast with it to support the dualism of cinema and life. The disease remains imprinted on the social world, and the delineation of whether the plot is exclusive to the narration of sadness and the struggle of/caused by cancer alone will always remain doubtful. But surely, these alternative arrays provide ‘adjacent entry points’ into the understanding of the lived experience of Dwaipayan’s respondents.
The final chapter (Chapter 6) ties all the loose ends through the different concepts discussed in the book together, while subtly explaining the advantage of using the method of ‘hesitance’ that the author prescribes in the introduction. Improvisation and style, employed in the field by interlocutors, become the basis to determine the nature of pain, empathy, violence and care associated with cancer in Delhi. The struggle of living and dealing with cancer is imbricated on the planes of language and performance, which were uniquely modified for each encounter. In this way, the lines are blurred between content and method, offering a closer insight for the reader, who can easily gauge the lack of clarity in the text, which Banerjee advertently (if not proudly) accepts at the outset. The inaccuracy and uncertainty in identifying and packaging concepts mark the brilliance of this work. Reflection is urged not only on account of the details presented around cancer but also for the method, especially to the benefit of those who pursue questions that involve ethnography.