MEMOIR
The Cancer Finishing School
Peter Goldsworthy
Penguin, $36.99

When acclaimed novelist Peter Goldsworthy is diagnosed with multiple myeloma, an incurable form of blood cancer, his reaction isn’t one of self-pity, so much as a strong awareness that his situation is utterly unremarkable. As a GP, Goldsworthy has cared for patients with many forms of debilitating and life-threatening illnesses and having witnessed his patients’ suffering and resilience, is determined not to regard himself as “special”.

It is during a scan on Goldsworthy’s knee for a bone oedema that he accidentally discovers his cancer, for which he was otherwise asymptomatic. The scan reveals that his “marrow is ablaze”, although fortunately, his disease is diagnosed early. Counter intuitively, his first response is “cancer is a gift. I might be lucky to have it.” In fact, the most difficult part of the experience for Goldsworthy is telling his partner and family about the illness, to whom he is strongly attached.

Two contradictory impulses arise in Goldsworthy — the first is to write about his cancer; the second is a kind of self-consciousness about doing that very thing. The solution Goldsworthy finds is to interweave his own experience with reflections of a life spent in medical practice: the colourful and variegated stories of his patients, whose medical predicaments are routine, but whose individual responses are often extraordinary.

As a doctor Goldsworthy has learned the importance of listening as, “a portal into another world, another perceptual dimension, each of which is roughly the same size and shape as mine, near-infinite, but surprisingly different and uniquely flavoured”.

Reminiscent of Paul Kalanithi’s When Breath Becomes Air, though written at a more stately pace since the illness is “not yet stamped urgent”, The Cancer Finishing School becomes a meditation on how Goldsworthy should spend the time remaining to him. He finds that his dual passions: dedication to his patients, and the solace he finds in writing and literature, sustain him through the often gruelling treatment.

Goldsworthy is told that while his illness is incurable, it can go into remission for up to a decade, or longer. As a self-described “optimist” he is also aware that cancer treatments are more advanced and the statistics are retrospective, and being healthy and fit at 67, his prospects of surviving for many years are strong. His treatment involves “induction chemotherapy, followed by a stem-cell transplant” and the intensity of the treatment means that Goldsworthy must discontinue his medical practice.

Meanwhile, the stories of his patients offer poignant distractions. One patient ignored a lump in her breast for so long it became a “red-raw, fungating mass”, by which time the cancer had metastasised, and she died the night she was admitted to hospital. Another patient, who suffered frontal lobe damage in a motorbike accident that left him wheelchair bound, suffers periodic “pseudo-seizures” and angry outbursts. After this patient’s diagnosis with diabetes, Goldsworthy steals his stash of biscuits and chocolates until he agrees to submit to a blood test and insulin. He also finds himself reflecting on some of the missteps and errors made as a younger doctor, fuelling a stray thought that “I deserve my cancer”.