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Saturday, January 18, 2014

Cancer and Culture

"To be human here is thus not to be Everyman;  it is to be a particular kind of man, and of course men differ:  "Other fields,"  the Javanese say, "other grasshoppers."  Within the society differences are recognized, too - the way a rice peasant becomes human and Javanese differs from the way a civil servant does.  This is not a matter of tolerance and ethical relativism, for not all ways of being human are regarded as equally admirable by far...."

Clifford Geertz
The Interpretation of Cultures

Culture is the force that underlies so much of what we do and think.  Every day we follow scripts that say, "Do this, don't do that."  Most of the time we don't even recognize that we are following one - it takes stepping out of one culture and into another to bring the point forcefully and painfully home.  Culture is to man what the sea is to a fish.  Who has not arrived in a place far from home and gone about the business of trying to get his basic needs met (food, shelter, companionship) and realized that his old scripts simply will not do.  He either does not get what he needs or wants, or he discovers that it's far more trouble than he ever imagined.  In my mind I see the poor British woman at a French bakery being scowled at as she gestured toward the pastry she wanted in the display case.  She eventually got it but both her frustration and the baker's annoyance were poison in the air.

There are other situations, however, where cultural scripts and models are far more important: parent, for example, leader, or worker.  There is behaviour specific to each role within each culture and a way that each one interacts with others based on their roles.  In general a French child does not use the informal "you" (tu) for an adult stranger.  English may lack this distinction but in some anglophone countries, a child may be required to say "Sir" or "Ma'am."  And, for all ages, when one enters a French bakery, one generally says, "Bonjour" to the lady behind the counter. Deviating from the script, failure to observe the conventions, has consequences that range from mildly unpleasant to real harm.

In our lives we all cycle through different roles in our culture and we learn the scripts that go with each one:  How to be human in this place and how to interact with other humans in a way that is both predictable and individual.  Whatever the roles and role models the culture has, the combination in each individual and how well or poorly he plays them, is unique to that person.  In rare cases there is outright rebellion or an attempt to redefine the role but that, I would say, simply places the person in another very well-defined role:  that of curmudgeon or rebel.

What does any of this have to do with cancer?

When someone is diagnosed with cancer (or any other life-threatening illness) he or she steps into a role that is defined by whatever culture he or she happens to be in.  To be a human with cancer in France is not the same as being a human with cancer in, say, Canada.  Same disease but different expectations, models and scripts.  One culture may ask those in this role for quiet, dignified suffering;  another may be the complete opposite and ask for cheerful public optimism.  In some worlds it's a heroic battle;  in others simply and purely a tragedy.

Individual reactions to the role patients are being asked to play vary, too.  Some people find that it's a relief to have a predictable framework around the experience.  Here is what I'm supposed to do and be and here is how the people around me and I will interact:  patient/doctor, friends, family and the occasional stranger.  There can be great comfort in knowing the rules and using them to get through each day.  There are even rewards and honor for playing the role well.

When I say "role" I am not treating it lightly.  Cultural roles are deeply important - how we are human matters.  Roles do not exist to make individuals feel better or more comfortable (though they often do) - they exist because culture is about common meaning.   No symbols, no models, no scripts, no culture.  And a man or woman without culture is not an "individual", he is something less than human.

The process through which each cultures determines meaning is public, not private. The role of "parent" for example is of great concern to everyone in a culture whether they have children or not.  And so I think is the public meaning we give to the role of "person living with cancer,"  "cancer victim,"  "cancer survivor" and so on. (And isn't it interesting how we've struggled to name it and rename it?)   It is a role that people arrive at against their will, but it is one that every individual has the potential to play.  That makes it a public matter, one of interest to more than just those who have already arrived in cancerland.

Whatever models, scripts and cultural patterns existed around cancer, life-threatening illness and death, they are having to be redefined.  Technology is the culprit here and it's not just new treatments but new means of communication that change the cultural conversation and complicate the search for common meaning.  It is too simple - in fact, it is downright false - to say that it is just about individuals and their self-definition:  "Culture patterns-religious, philosophical, aesthetic, scientific, ideological- are "programs";  they provide a template or blueprint for the organization of social and psychological processes..."

One might think that the answer here lies in seeking out diversity.  To a certain extent this is true.  For the individual stricken with cancer who does not care for (or is violently opposed to) the role he or is she is being asked to play in his particular society, there is the Internet where one can search for the like-minded.  But then one must manage the dissonance between the culture one is grounded in and the one found on-line.  Become bi-cultural, if you will, and play two roles instead of one.

Let there be no mistake about it, what is found in on-line communities is culture with its own rules, boundaries and scripts.  Clashes occur just as often there as they do off-line - that public cultural conversation that is the search for meaning can be contentious.   What will come out of such controversies?  I wager that when the dust settles there will be a clearer view of each role and a revised script for how everyone involved is to play their part.  This field.  Those grasshoppers.

And that isn't a good or bad thing.  It's a human thing.


Anonymous said...

Nice reflections

Anonymous said...

NY Times editor Bill Keller and his wife idly trash a woman with Stage 4 cancer for blogging about her experience to draw attention to the plight of women with b.c.

Victoria FERAUGE said...

Thanks, Andrew.

Ah yes, anonymous. That was the situation I was alluding to but did not name.

Nice article from The Nation. Thank you.