Evan Handler is a television and broadway actor who was diagnosed with AML (acute myelogenous leukemia). Best known for his long-running role in Sex and the City (TV series and movie), he has also had guest roles on Lost, The West Wing, Studio 60 and presently stars with David Duchoney in Californication. His first book Time On Fire: My Comedy of Terrors was based an a successful one-man show.
The book opens immediately with the diagnosis and the shock of that moment for all concerned. I think cancer is always a shock but I suspect that the level of shock is in an inverse relationship to the person’s age. Both Evan and his family are overwhelmed. His parents are concerned about telling Evan’s brother the news, that he might not be able to handle it.
We are introduced fairly quickly to the tone of the book – irreverent, ironic, and humorous. We sense that there is exaggeration for effect in his telling of his sad, mad tale. But we also identify with the machinations he begins to endure at the hands of the healthcare system, even at famous Memorial Sloan-Kettering Hospital – the brusque nature of morning rounds; the mix of Nurse Ratchett and Angel of Mercy types among the nursing staff; being called for various diagnostic tests all throughout the day, never knowing what their purpose is or which doctor ordered them; hospital waiting rooms filled with gowned patients, staring at the floor at their feet.
I was prepared for these humorous portrayals by a comedic actor. But I was surprised at his facility with language and his sometimes penetrating insights into the singular experiences of cancer patients. He talks about early conversations with his oncologist “When terms and substances that were about to become the focus of my life, the focus of my struggle to keep my life, seemed like a foreign language that I didn’t need to learn.” He wonders about his fear of dying and all that implies “the absence of a future for which to endure the present.”
As a retired nurse, I wanted to attribute many of his criticisms to the times, hoping that we have progressed. He writing of times when patients and staff smoked together inside the hospital. I chafed at the medical uses of language when Evan observes the phrase “patients failing the protocol” instead of the other way around. I always thought that seemed oddly self-serving. Likewise a patient can only “refuse” rather than “decline” something the doctor has ordered. I felt some degree of shame in the way these specialists treated his mother. “If she ever raised questions … with the doctors or tried to participate in any of the decision making at all she was trampled. Bulldozed by technical terminology and patronizing platitudes until she shut up. Then the doctors would get out of the room fast.” I think these kind of indignities occur less often, but I suspect many of us have witnessed similar transgressions.
Evan talks about coming to the diagnosis as a newbie, informed only by sentimental movies about leukemia that suggest “If you’re the strongest, bravest, most loved person to ever walk the Earth, then you will put up a gallant, inspiring fight that will not be quite good enough.”
The author gives humorous spin to tedious procedures designed around making sure the right patient gets the right blood transfusion. The scene gives a set-up to the sperm bank, significant for me in that it is the nurses who remember to bring up this crucial subject. I used to joke with my patients that God created nurses to remember the things doctors forgot to do or say. The sperm bank episode is one that people recall with laughter after reading the book.
The book works partially because he is able to juxapose such serious/funny events with newly discovered wonderment that many of us have experienced. When he imagines his distant survival, he sees himself a different man. He sees his future life as “the sweetest candy, the milkiest pearl. That to have a day to spend with someone you love and to expect another tomorrow had become the most beautiful, lush, and soothing privilege to me.”
In wondering what might be the cause of his illness, he remembers, as many of us of a certain age must, racing after the “fog” (read insecticide) truck on warm summer evenings, getting as close as we could to the thickest, most toxic part of the sweet-smelling fog cloud.
In order to survive both the disease and its treatment, Evan comes to belive that it is up to him to fight both disease and medical system, to push the envelope of treatment options. He and his girlfriend carefully censor the world about them in an attempt to construct a wholly positive and protective physical and psychic environment. They consult book after book, magazine article after meditation tape after miracle cure claim. He is presided over by a psychic healer, a hypnotherapist, and psychiatrist. He is cheered on and prayed for by an army of friends, friends-of-friends, strangers, and well wishers. He is determined to take control and beat this disease that interrupted his propitious life at such an inconvenient time.
Reading Assignment: Chapters IV, V, VI, and VII (approx 84 pages)
Discussion Questions: Will post soon, I promise