The Undying: A meditation on modern illness by Anne Boyer

Anne Boyer’s The Undying is one of the most extraordinary books I’ve ever read. I read it so slowly: it took me from early April until the end of June. Boyer is a poet and her prose is dense and resonant as poetry. It’s so loaded with … meaning? Undoing of meaning?

That this book is impossible to race through is one of its great virtues. In this and many other ways, it’s a perfect text for pandemic 2020: it forces you to slow down, to be deeply attentive and considerate, and, in particular, it brings home the fierce reality of a body in pain – and of the life-saving and life-destroying powers of the modern medical and pharmaceutical industries, their ruthless, violent, cost-minimising service to late capitalism in this age of digital media, data and screens.

Part memoir part history part philosophy part poem part meditation on writing and language, The Undying is about the extremity of illness and suffering. Aged 41, Boyer was diagnosed with advanced triple negative breast cancer, one of the deadliest kinds. She must fight to be allowed to undergo the most extreme form of chemotherapy, recommended in frank words by the second specialist she consults. She tells Boyer it is her only chance of living. The chemo will be devastating, its side effects horrendous: it may kill her even as it’s her only chance at life.

Boyer chooses her chance at life – and is catapulted into a hinterland of medical nightmares, a broken healthcare system, broken political economy, misogyny and suffering physical, psychological, social and economic.

At times The Undying is breathtakingly beautiful; at others, it’s excruciating as Boyer probes the personal suffering as well as the science, history, metaphors, politics, sociology, economics and writers of breast cancer – and of illness and pain more generally. The North American subtitle makes clear the vast reach of Boyer’s concerns: Pain, Vulnerability, Mortality, Medicine, Art, Time, Dreams, Data, Exhaustion, Cancer, and Care.

There’s not a cliché in sight, all truisms and euphemisms are exploded. As Jennifer Szalai says of Boyer’s treatment of the pink ribbon, that ubiquitous emblem of breast cancer awareness: ‘Anne Boyer doesn’t just pull it loose, unfastening its dainty loop; she feeds it through a shredder and lights it on fire, incinerating its remains.’

Boyer is brilliant on the economics of cancer and the environmental costs of its cures. She names capitalism’s carcinogenosphere. She interrogates the power and limits of writing and the impulse to turn experience into words, into stories. She’s fascinating on this idea of narratives. She’s astute and moving on love and dating and friendship and motherhood and the toll cancer exacts on them all. And she’s devastating on the dying of our planet too, on the waste and pollution and tragedy of our earth.

She is particularly penetrating and iconoclastic on pain. She annihilates the truism that pain is beyond language. As she powerfully argues, it is the most vocal of affects. She says: ‘I wanted to write pain without any philosophy. I wanted to describe an education in pain and that education’s political uses. But in literature, pain mostly excludes literature.’ (208)

Boyer says ‘if this were a work of philosophy’ … then claims ‘but I am not a philosopher’. Nevertheless, this book moves with an inexorable logic akin to philosophy, the logic of the poet drawing together the many threads that spin out from cancer in all its facts and metaphors and platitudes and clichés and euphemisms. The Undying has taught me that I know not what pain is. Here I’d imagined myself in some kind of pain these last three years just because my old life was dying and I couldn’t string a word.

It’s almost impossible to choose sections to quote because each of the book’s small fragments is mesmerising and provocative. But here are two:

‘Visibility doesn’t reliably change the relations of power to who or what is visible except insofar as visible prey are easier to hunt.’ (159) This is part of Boyer’s argument that making things visible does not always help them; we live with the idea that bringing truth to light somehow magically alleviates the suffering of those concerned, but as she points out, this is not necessarily the case.

And here’s one of the most extraordinary passages I’ve ever read. It perfectly conveys the fact that this work of prose has the compact density of an extended poem.

‘My new calamity meant it was possible to feel every cell at once and, in these, every mitochondrian, and that it was possible, too, to have a millionfold shitshow of sensations in locations newly realised, and that also these sensations were conspiring toward the knowledge that something called something like an ‘arm’ is a lie to obscure its actuality as a city or a war or an avalanche and something called an ‘armpit’ is a misprision of all that crumbles or a coral reef drying and something called ‘a body’ does not end at the end of its flesh and that this disproves Europe and the Enlightenment and that something called a ‘metaphor’ was too narrow a technique to describe the diversity and number of agonies that could now be acutely and all at once perceived.’

And in this passage I heard a snatch of Cormac McCarthy, in the steady beat and syntax of the closing lines and thought: I must show this to my friend the poet tomorrow for have we not travelled a lifetime aboard vehicles such as this?

Of her need to write The Undying, Boyer said: ‘I had to write the book for two reasons. The first one was gratitude for all that kept me alive and made life worth living, and the second was vengeance against all that diminishes life, the arrangement of a racist, misogynist, capitalist world that sickens people, profits from their illnesses, and then blames them for their own deaths.’ Published in 2019, The Undying won the Pulitzer Prize in 2020. If you love and value words and truth telling, I urge you to read it.

And if you love books and writing, I also highly recommend Jemma Birrell’s fantastic new book podcast The Secret Life of Writers. Jemma is a gifted interviewer and finds wonderful writers to chat to about this turbulent year and what inspires them. It’s been a necessary fortnightly dose of writing and comfort for me these past few months. Next up, I’ll be writing about Jenny Offill’s Weather.