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Animal Love and Genre Stereotypes

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It’s been a hard week. One of my cats nearly died. I won’t go into the details, but I will admit that it’s involved trips to three different vets, a lot of poop, and a lot of suffering. I had come to grips with the fact that this morning I would likely need to ask for her euthanasia. But, no, after four and a half days of dire illness, she has rallied. No little kitty will last forever, and her days are numbered, but maybe she will enjoy a little while longer.

When I try to think about writing about my pets and why I love them, I encounter whole layers of prohibition, disrespect, sentimentality, and boredom. Yet they are important enough to me that I feel compelled to include them in my literary world, or at least my communicative world. What I write about them may never achieve anything near the level of art, but I think somehow there must be ways of thinking about them that go beyond “Awww, how cute.”

Perhaps, in fact, my desire to write about animals is something akin to certain others’ devotion to genre fiction. My husband sent me this morning a short example of the frequent flailing of professors of creative writing for discouraging students from writing genre fiction—in this case science fiction. It uses a long quote by Michael Chabon expressing some outrage about how he’d been “limited” by this lack of acceptance of his favored genre in his youth.

This dissing of professors this way is a tired hobbyhorse. Genre fiction was far more disrespected before creative writing was commonly taught in universities, and creative writing professors certainly didn’t create the “limitations” Michael Chabon speaks of. That responsibility would have to lie at the feet of literature professors and literary reviewers and critics, though creative writing professors no doubt have partaken in it in their attempt to get a toehold in the academic world over the past fifty years.

However, it is also undeniably true that much genre writing—and much writing about animals—is pretty uninteresting and awful stuff.

The writing professors that I know (in composition and as well as creative writing) place “limitations” on students in order to try to avoid reading the worst of this kind of thing and to encourage students to shift away from the stereotypical thinking many of them are most familiar with. Most of us have tried a variety of strategies—and it is true that some forbid any genre element (monsters, vampires, magic of any kind, futuristic settings, etc.). Some use prohibitions about “realistic” topics as well—I once knew a composition instructor who forbade all broke-up-with-boyfriend or -girlfriend stories. Another banished all first-love stories for similar reasons. Some try less blanket warnings, like “I suggest you not use a gun in your story unless you are actually familiar with guns and know how they work.” I even knew one teacher who disallowed any student from writing about pets.

Mind you, these are from teachers who may admire Mary Shelley’s Frankenstein. Who may know that Paul Auster wrote Timbuktu very successfully from the point of view of a dog. Who may even think that the Harry Potter books are good. Even those professors who disallow genre elements entirely in their workshops are not unaware of exceptions in the general low quality of certain genre-like or realist-sentimental subjects.

But there’s another, little understood issue, and that is that we try to sort in order to focus our instruction somewhat. This starts, of course, with the more basic use of the word “genre” to distinguish between fiction, poetry, drama, and creative nonfiction (which also is distinguished from journalism). Slicing further, fiction becomes “literary” and “genre,” and then genre is divided further into particular genres like sci-fi, mystery, chick lit, and so on. Those genres are broken down even further: this website, for example, lists ten primary sub-genres of sci-fi.

These designations are seemingly designed to be descriptive, not necessarily evaluative, but, because people develop favorites and antipathies, they become evaluative, too. And, I would argue, also because there are certain goals that differ between those writing for “entertainment” purposes and those who at least aspire to loftier ideals. Whether the latter ever achieve them or not is uncertain, just as entertainment purposes or other ideological pursuits in writing don’t necessarily preclude profundity.

In other words, most creative writing professors that I know combine their aversion to the worst possibilities of genre fiction in their classes with an aversion to trying to teach everything in one course rather than any blanket condemnation of genre. How many different sub-genres must we be asked to examine in one semester? How many different conventions and their upending must students be asked to critique in each others’ manuscripts all mixed in together? At my university we actually offer a course on science-fiction writing, separate from the other fiction workshops that focus on literary realist fiction. No one who teaches fiction here disses genre—a couple of them even write and promote it. This may be a new development, distinct from the experience of someone like Michael Chabon from a tonier universe. We live in an era when literary realism is getting harder and harder to publish (at least in book form) and in which there’s an emphasis on the acceptability (even, perhaps, desirability) of hybrids and mash-ups. Genre elements creep in all over the place, and an array of examples are emerging of how to use them without being dominated by clichés and formulas. (One name for this is post-modernism, I suppose.)

Nowhere, though, does anyone talk about the less macho, might I say the less sexy issue of how to approach more domestic subjects without sentimentality. Science-fiction, fantasy, and horror have made inroads in academic creative writing circles. But the fiction world has cast the romance into the world of memoir and has dissed it one genre-definition level up: there are many fiction writers and critics who now claim that memoir (or even all of nonfiction) is inherently inferior as an entire genre to any and all fiction. In literary circles, in other words, it’s now more common for memoir to be dissed as unworthy than it is for sci-fi and fantasy to be.

Which reconnects to my own desire to occasionally write about my pets or about other animals and issues regarding them. A few years ago, I wrote an essay about an elderly neighbor of mine who was feeding strays and my efforts to help him and find real homes for these cats. (One of them became a permanent resident in my home, and I placed six others in good homes and got the one feral one spayed before she escaped capture and disappeared.) It was a great compliment to me when one of my writer-friends, who at that time was not an animal lover (though she has since become one) said to me that I had “managed to make the inner lives of cats interesting,” something, she said, she had not thought possible. Yet I still have not managed to publish this essay. I believe it’s a good essay, and I believe it’s a shame that “cats” are off-limits in most of the literary world.

Still, I have to acknowledge that this is not without reason—people react to the plethora of sentimental schlock about pets, and I can’t blame them even though I’m trying to do something different and even though I believe editors (and professors) might be able to take a little more responsibility for distinguishing value rather than dismissing entire subjects in their entirety. In fact, for a number of years, I have refused to place proscriptions on what subjects my students write about; on the rare occasion when I teach fiction, I suggest very heartily that if they would like to write something with genre elements, they need to make sure they do it in a non-formulaic way and that they toe to literary standards of character development. Few of them try it, but on at least a couple of occasions students have produced great stuff. So, I’m personally not into the proscriptions even though I find about 90% of the well-published sci-fi and crime/mystery stuff I’ve ever read to fall into the dreck category. Still, I believe it would be silly of me to attack lit mag editors for their antipathy toward cat stories.

Similarly, I believe that the genre-fiction aficionados lashing out at the literary realist world are wrong-headed. What they might more usefully do is examine what’s closer to home and begin to make real and substantial distinctions about what has merit within the realms of their specific genres.

In the usual sense of the word, of course, genre fiction refers to the kind of simplistic, poorly written, stereotypical character–filled, predictably plotted kind of stuff that creative writing professors disparage. That doesn’t mean that there isn’t terrific fiction that shares certain features of science fiction, fantasy, horror, romance, action, crime, or mystery. The many torrid memoirs don’t mean that there don’t also exist memoirs of the finest order. Whether we speak of any of this work as solidly ensconced in its specific genre or of it “transcending” its genre status doesn’t really matter to me. What matters is that we understand and make distinctions about what is art and what is on the borderland or what falls completely into the category we might call dreck.

Some people are capable of this. Jonathan Lethem, for instance. I just read his essay “You Don’t Know Dick,” in which he examines both the variable career of Philip K. Dick and his own youthful obsession with it. He notes more than once the “disastrous unevenness of his [Dick’s] prose.” Now, this is an intelligent examination of how a writer can fascinate us while we also see his flaws. I wish the same strategy could be applied more commonly to genres as a whole instead of the simplistic valorization of underappreciated genres or the alternate demonization of them.

There will always be contention in terms of the issue of quality in areas where it’s hard to pin down. Math is “easy” in this regard: either you get the right answer or you don’t. Engineering in this regard is “easy”: either the building or bridge stands up or it doesn’t. In both of those arenas, it may be difficult to master the correct answer, but you at least can identify it.

In many walks of life, however, there is no hard and fast answer. A book, for instance, may be good in a million different ways or bad in a million different ways. It can even be good in some ways and bad in others, or good and bad at the same time to different people in different circumstances. For instance, when I criticized Kris Carr and her Crazy, Sexy Cancer empire, one of my former students noted that she could see what I meant, but that Carr had been important to her in dealing with a chronic illness because it gave her a sense that she could still enjoy much of her life. I think Kris Carr is a hideous fake and her writing is awful, but I can’t and won’t try to deny that someone might find her bromides useful at times. In fact, she probably doesn’t even consider what she does “art,” and so is perhaps not the best example. But think of Ayn Rand’s The Fountainhead, think of Jack Kerouac’s On the Road, think of Harriet Beecher Stowe’s Uncle Tom’s Cabin, think Robert Pirsig’s Zen and the Art of Motorcycle Maintenance. All of these books have formed important cultural commentaries on their times, and all have inspired numerous readers to think in new ways. That doesn’t mean they are all well written or even particularly intelligent.

Well, I’ve already gone on way too long about this today. I’ll just have to revisit it later. This post will be a true rough, rough draft. There’s a place in the world for that, just as there is for laser guns and green slime creatures and murders on the orient express. Just as there is for the basic, accepting love between human and animal. Now I am off to retrieve my cat from the vet so that she may scratch out another day if not my eyes. She is not a particularly sweet cat.

Ironically, when I adopted her, her shelter name was Candy. The only remnant of that is in the sound of her name, Cameo, and in the fact that we sometimes call her Candycane Tail because she is so uptight that she never uncurls her tail. Except, I should say, when she’s very, very sick. A limp tail is a terrible thing.

P.S. I really loved this discussion of “The Top 40 Bad Books” (It’s a PDF, so works only if you search the title or paste the URL into your browser: http://americanbookreview.org/PDF/Top40BadBooks.pdf). What variety! What disagreement! It takes a village to ferret out insights about what’s good and bad.

Invisible Illness

This month marks the 40th anniversary of my diagnosis with Type 1 diabetes. Other than my trumpeting this fact to a few people (and here on the blog), there will be no fanfare. I find it more seemly that way, even though that doesn’t mean I don’t want to talk about it. And it’s not that diabetes survivors are never honored—the Joslin Clinic in Boston has a program to give certificates at the 25-year mark and medals at the 50-year mark, and last year they celebrated a fellow who had achieved 85 years with diabetes. It’s just that most people who become medalists have to nominate themselves.

Even the term “diabetes survivor” seems funny. We don’t think of it as a terminal disease, even though diabetes kills more than breast cancer and AIDS combined. Most people, in fact, have a lot of misconceptions about diabetes, especially Type 1. I’ve already written about that, years ago, in Sweet Invisible Body. The title of that book comes from the very fact that you can live with diabetes and pass for (and even be) healthy most of the time. Many people never see the disease. I even hesitate to type the word “disease” instead of “condition.”

Some years ago, I faced this issue in a different way. I was doing scholarly work on three writers with serious early-age chronic illness—Katherine Anne Porter (TB), Carson McCullers (rheumatic fever and early strokes), and Flannery O’Connor (lupus). I encountered two distinctly different sets of academic communities that were relevant to my work—one was Medical Humanities (and its sub-set Literature and Medicine, perhaps best represented by the journal of that name) and the other was Disability Studies.

Those titles speak volumes. The Disability Studies community was formed mainly by those with disabilities who desired to be recognized in all their complexity and diversity. The Medical Humanities, on the other hand, focused more on physicians, nurses, and their traumatic encounters with patients’ illnesses or how the humanities might teach humanistic values to numbers-oriented medical personnel. The trouble for me was that I didn’t conceive of myself as disabled, and I wasn’t a health-care provider. I wanted a community of those involved in “Illness Studies” or some such. In spite of the fact that people have been writing literary work about illness for as long as literature has existed, there was no such thing.

Although I have kept an interest in both fields, it’s no surprise that the work in Disability Studies was a lot more directly touching to me. I was closer myself to being disabled than to being a physician, and I was tied to the “patient’s” perspective. So for a number of years I participated in online Disability Studies discussion groups. Of course, these groups did not base membership on whether or not an individual was disabled, but there were sometimes discussions of what counts as disabled. I recall a generous openness in terms of various levels of ability, both physical and mental, and a sense that disability of some sort or another is in most people’s future if not their present. I remember that one person commented to the effect that those who exclude themselves completely from the category are disabled by their own ignorance about it.

In a book called The Wounded Storyteller: Body, Illness, and Ethics (1997), Arthur Frank pointed out that this same logic holds in terms of illness as well as disability. The end of the twentieth century saw an enormous rise in chronic or treatable-but-never-cured illnesses. Diabetes is like this, and cancer has become more this way as treatments have improved. And now, through genetic testing, we even have the ability to diagnose illnesses that aren’t even manifest. Invisible illness has shaded over into virtual or nearly nonexistent illness.

This is why the distinction made by my recent commenter on the “Just Crazy, Not Sexy” post is important. She noted that, though I objected to cancer guru Kris Carr’s “claims to have cured an incurable cancer with self-help and alternative therapies,” Carr “is well aware that she has cancer still” but “believes that her diet is keeping the cancer inactive.”

Remission is indeed distinct from cure, and I should have been more precise, even though I think that the overall impression given by Kris Carr is that of illness banished pretty much entirely. What’s fascinating about Carr is the extent to which it is convenient for her to have cancer with no symptoms and no effects of her illness. In other words, she does indeed have knowledge that she has an underlying condition that could one day affect her health, but right now it doesn’t.

This goes to show that illness does have something to offer: part of the mythology of illness is that it can make one wiser (if it does not make one bitter and therefore evil). Carr claims the wisdom, however, without the pain and suffering that supposedly lead to it. In fact, her claims cut in opposite directions: Carr has the imprimatur of serious illness, but she also has the success of triumphing over that illness and restoring her own health. It’s a powerful combination that attracts many followers even though it is full of contradictions. There aren’t too many people who can stay in that position for long—a couple of years ago I wrote an essay (next to last in this e-book on The Patient) about the “Dying Professor” (Randy Pausch) who stormed the world with his optimistic reaction to a diagnosis of pancreatic cancer, only to succumb the following year. People mostly quit paying attention to him after he was truly ill. (Or they respected his privacy, if you will. Actual illness is ugly and therefore largely hidden.)

I think one reason why someone like Kris Carr has such appeal is that many people still want to think of illness as a temporary situation rather than a permanent situation or marker of identity. In spite of the fact that Frank identified us as living in a “remission society” more than twenty years ago, where illness is almost the norm, there has been no rise in “Illness Studies” and little formalizing of what it means to live as a subject of medical intervention and awareness of the body’s limits for years on end. For many people illness still seems to be short-term—they catch a cold or get a bacterial infection and are definitely ill, but soon enough their good health is restored. That’s the model of our medical world—illness properly treated ending in cure.

In 1999, when I published Sweet Invisible Body, the Guardian published a large (and very negative) article about “malady memoirs” that the author characterized as “malingering” and trivial besides. The author didn’t mention my book, but it was one of about twenty whose covers were reproduced above the article. As an example, the article’s author wrote a satire about an in-grown toenail. That, I thought, is someone who really thinks everything can be cured. That is a healthy person, someone in whose eyes illness is simply an uninteresting transient weakness or something to be hidden. Such reviewers are common, and they judge illness memoirs with a broad brush rather than making distinctions between good writing and bad.

Even many who are ill or who understand the value of examining such experiences prefer the stiff-upper-lip mentality or the “it’s a blessing in disguise” mentality more than something more complex. One of the main reasons they do, I believe, is because they are rewarded for it. It is not the depressed or symptomatic sick person who gets on national TV. Randy Pausch—because of his cheerfulness not because of his illness—gained many privileges, such as visiting with his idol Sting and tossing a football with the Pittsburgh Steelers. Kris Carr—because of her insistence on a can-do attitude not because of her asymptomatic illness—has become a self-help brand-name. The Make-a-Wish thing seems appropriate to me for ailing children, but there is a strong push for a trip to fantasy-land for adults as well, as long as they “deserve” it by being upbeat.

One thing that it’s important to note is that plenty of avowed healthy self-help gurus give us the same basic message that Kris Carr does, only they don’t have the added value of supposedly having overcome cancer (even if in the fine print it’s only “remission”). The cancer’s remission is added “evidence” of the effectiveness of her self-help recommendations.

Why does it matter to me that Kris Carr isn’t symptomatic, that she hasn’t actually experienced much sickness over the years she’s been building her cancer guru empire?

The status of someone in a particular identity category is something we grapple with every day in the field of creative writing. Male writers write women characters, and black writers write white characters, and vice versa. Sometimes fiction writers even use a first-person narrative voice for a character completely unlike him- or herself. We reserve and defend the right to do so. That is what imagination is for, and much good writing takes this kind of imaginative habitation of another life. The best of such efforts, of course, produce great literature suffused with empathy and near clairvoyance.

Yet I believe it does take a sense of responsibility to inhabit a different kind of persona—it is not something to be done in a cavalier fashion. That is why even fiction writers do a lot of research. That is why it’s a perfectly legitimate criticism of certain macho male writers that their female characters are flat and inaccurate. That is why I was so ecstatic and relieved a couple of years ago when one of my students (a young white twenty-first-century male) wrote an honors thesis that was a novel set in the 1930s with an African-American main character, and the African-American historian on his committee said, “I don’t know how you did it, but you really nailed it.” (He did it, I note, by a deep desire to understand, not by a desire to use, usurp, or pretend.)

In memoir writing, this issue is perhaps just as complex and vexed though in different ways. In spite of many naysayers like the Guardian reviewer, memoirs about chronic illness continue to proliferate. I’ve read a lot of them, and sometimes I even sympathize with the Guardian reviewer because a lot of them are poorly written with little insight. In fact, even supposedly literary ones tend to be characterized by a kind of rah-rah boosterism or tried-and-true emotional answers. James Frey’s infamous A Million Little Pieces, which was, after all, essentially a story of overcoming the illness of addiction, turned out to be a false memoir. Some of us suspected it was before the scandal hit—because his story of curing himself of alcoholism seemed way too easy.

As a person who writes fiction as well as nonfiction, I think frequently about identity and identity categories. Certainly, the fact that “it really happened” is never enough to justify a piece of writing. Many in the world of memoir-writing, including me, also support the use of the imagination in writing them. But it’s all too easy for us to ridicule the many slavish readers who thought that Frey offered them hope and a method for overcoming their ills and then became naively furious when he turned out to be a fraud. Yes, they were naïve. Yes, there is often an unfortunate confusion between self-help books and memoirs. But he’s the one who was a fraud. Both fiction and nonfiction should be more truthful than the bull he sold.

So, what is the distinction between imagination and fraud? The two are often closely tied, and many terrific writers are known as frequent fabulists in daily life as well as on the page.

What, in fact, constitutes a truly inspirational story? Do such stories always need to end in triumph?

As a person with a long-lived illness who encounters frequent and ever-increasing symptoms, but who manages to hold death and more severe disabilities at bay for now, I have to answer in a certain way. I have to say that for me Samuel Beckett’s narrator in The Unnameable, sums it up well: “I can’t go on. I’ll go on.” This is the balance of emotional honesty, and it is based on genuine experience, not what sells. It also, it seems to me, reflects a deeper optimism than “I’ll go on” by itself would. I also have to say that imagination is distinct from fraud, and that there is such a thing as emotional honesty in whatever genre.

It’s the difference between a discreet poisoning and a mere threat, between a stomach ache and gold-bricking. It’s the difference between what is there that we can’t see and what isn’t there at all, at least not yet. It is a tricky little devil to put a finger on.

Smile or Die

Accusations of “hate” and “unhealthy” negativity are frequently made by those in the positivity camp against those who aren’t. It’s one of the ways that they shut down discussion and examination of the actual claims of positivity.

Yesterday, I got a new comment on one of my earlier posts—the one called “Not Sexy, Just Crazy.” The commenter accused me of “hate” because of my critique of those I see as promoting the false idea that positive attitude and vegan diets can be effective linchpins (all by themselves) of treating serious illness. On Thursday, I’ll take up an important distinction that this commenter made—that between cure and remission—but today I give you another wonderful RSA Animate video of Barbara Ehrenreich talking about how it is that positivity is often itself much more cruel than realism. In this video, Ehrenreich focuses on economic cruelty, but elsewhere she has addressed the issue in terms of her own experience with breast cancer.

I think that “hate” is much too strong an emotion for what I feel toward Kris Carr and those like her in the “heal yourself” and “be happy [whether you really are or not]” school of thought. However, this raises the question for me of what is actually deserving of hate. One reason why I don’t hate Kris Carr is that I don’t really know what she is thinking, and so perhaps she is sincere and perhaps she is deluding herself as much as everyone else. In that case, she certainly deserves pity more than anything near hate.

However, even though I reserve my hate for those who participate in less well-intentioned forms of harm (such as genocide and war-mongering), I do believe that those in the positivity movement often harm others and therefore deserve at least some kind of approbation. I think that group-think of most kinds is detestable, and I think that people who are so insecure about the “positive” path they are following that they can’t even hear or consider other kinds of paths, that they get furiously angry about anyone who questions whether or not their path is right for everyone…well, there’s just something supremely ironic about that.

I am bemused by all those positivity types who are so angry with me (and others) for not being one of them. They can tell me repeatedly that my anger isn’t “healthy,” but, whoa, they seem more angry than I am. That, I believe, is the result of false positivity—ultimate anger, disappointment, even cruelty and marginalization of others. Genuine positiveness is something else entirely.

Not Sexy, Just Crazy

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Probably every single person who reads this will have made use of at least some of positive psychology’s tenets and recommendations at some point or another: visualize success, believe in yourself, take charge of your life, think good thoughts and good things will come. All fine to a point.

When it comes to discussions of health and illness, though, this makes me crazy. Not sexy, just plain crazy. Yes, there is much we can do to positively affect our health. No, we cannot cure illnesses with positive attitudes and wheat grass, not unless they are psychosomatic.

One of the purveyors of the idea that we can cure ourselves and defy illness is a woman named Kris Carr of Crazy, Sexy Cancer fame. This woman is a charlatan, and yet she has been trotted out by all kinds of experts as an example of a cancer patient who cured herself with her positive attitude and alternative therapies including a vegan diet. She started off with a documentary film about herself and followed that with three Crazy, Sexy Cancer books. She has become a New York Times bestseller, lectured at universities and medical schools, and, I presume, made a killing. She has a huge following as a cancer lifestyle guru.

On Carr’s website she calls her illness merely “a rare and incurable stage 4 cancer.” This sounds dire indeed and is the one and only credential that has given her the right to tell millions how to live. Yet, after the original film, we find in her work very little discussion of the cancer she has: epithelioid hemangio-endothelioma. Her focus is all on nutrition, yoga, support groups, and can-do attitude. However, H.E.A.R.D., a support group for this and other vascular cancers, notes on its webpage that, due to the variable rate of tumor growth in this cancer, “Some cases are totally asymptomatic (no adverse symptoms) for more than 15 or 20 years,” and “some cases … have been known to go into spontaneous remission.”

I don’t mean to say that receiving such a diagnosis would not be daunting and that it wasn’t a meaningful moment in Kris Carr’s life. I don’t object to her writing or making films about her experience. I have done so about my own illness experience, and I have read many truly wonderful and insightful memoirs about people’s illness and disability experiences. It is quite true that illness can be a wake-up call and can affect the life choices we make.

But for her to claim that she cured her own cancer, and for her to note that, “I created the ultimate blueprint for a healthy and happy life, and I want to share my secrets with fabulous you!” is a grotesque trickery. Her blueprint for life dumbs down illness experience and panders to the desperate masses over any kind of integrity and truth-telling. In the film, her own father tells her that he caused her cancer by putting stress on her during high school. Who can take this seriously? It is magical thinking, no matter that there are even physicians, supposed men and women of science, who participate in it.

The variable progression of Kris Carr’s disease has little if anything to do with whether or not someone takes up a macrobiotic diet and takes to meditating. It is simply a variation in the disease. If I can find this out with a few Google searches, why don’t the journalists and physicians who promote this woman bother? How can they not know that this woman is a sham? Or do they know and simply decide that her “positive” message is more important than what ails her or doesn’t? Why would that sort of misrepresentation seem worthwhile to them?

We have a strong social impetus these days to believe stories like this. It’s all part of a highly scripted “reality” TV that has nothing to do with real life and that casts us into a highly social Darwinian universe. Maybe it’s one thing when it has to do with the supposedly democratic selection of the next American Idol. Even when it’s the loonies in Landmark Forum convincing people to pay to be told that they create their own destiny, I can laugh and roll my eyes. The ideas that we live in a meritocracy and that talent rises magically to the top over the advantages of power and wealth seem to be part of the American fabric. I’m used to that.

But when they start talking about health that way, I get angry. Barbara Ehrenreich has noted about her own experience with breast cancer how she became disturbed by the constant celebration of survivors, as though they were somehow better people than the ones who died. David Rackoff, after a second type of cancer before age 50, published Half Empty with an anti-positive psychology twist, and noted, “It is the duty of society to take care of its individuals, plain and simple. We will never be healthier than our sickest member.” Years ago, in a wonderful book called Teratologies, Jackie Stacey noted how the discourse around cancer was designed to make people feel responsible for their own illnesses. As far back as 1978, Susan Sontag’s Illness as Metaphor noted how the discourses around cancer often harm patients further. So, I am not alone, but we are shouted down by the people who want us to believe that it’s all a matter of will power and positive thinking.

I have to keep repeating this to believe that it’s true: in the U.S., people believe that if you are sick it is your own damn fault. If you can’t cure your own cancer with yoga and spinach, then there’s something wrong with your character as a human being, not just your body. If you can’t cure your diabetes (my illness) with herbs and exercise, then you are weak. If you have cancer, you must have brought it on yourself. If you are obese, it is because you are lazy and worthless.

Part of this has to do with our desire to understand causation. Think of the biopic Erin Brokovich and how the title character set out to uncover the poisoning of a California community by Pacific Gas & Electric. The Chromium 6 they had allowed to leak into the ground water had caused rampant cancer. Think of Terry Tempest Williams’ Refuge that outlines the increased risks of cancer to those living in Utah when the A-bombs were tested. Even in terms of responsibility that has a personal (as opposed to corporate and governmental) element, think about cigarette smoking: the National Cancer Institute attributes 440,000 premature deaths a year to lung cancer and other diseases caused by smoking. There are indeed cases where blame can be cast legitimately, though in the case of individuals that may not be a helpful strategy.

One U.K. study I read, for instance, conducted on cardiac patients, showed that many of them blamed themselves for their illness, said they got what they deserved based on their bad smoking and eating habits. They even avoided medical care because of fear that doctors would be disgusted by or dismissive of them and would blame them further. Perhaps most telling, the study found that these attitudes were more common among the economically disadvantaged.

When Kris Carr suggests that you interview your doctor as you would someone you were hiring at your corporation, she breezes over the fact that many health care plans don’t allow such options. I’m all for patients being active participants in their own care, but those who don’t have top-of-the-line insurance and a ton of money in the bank can’t turn their cancer into a full-time “self-transformation” project.

Nor does her story point out that what has turned many cancers into survivable illnesses is not mainly the lifestyle stuff she promotes, but actual new or newly refined detection techniques, medical treatments, and drugs. In the hands of positivity health gurus, causation becomes a twisted story of personal overcoming.

Part of the reason we are so drawn to the overcomers among us may also be that illness has become more complicated, more long and drawn out, more chronic, the causes more complicated. With the advent of antibiotics and vaccines in the 1940s, and the development of effective vaccines in the 1950s and 60s, many long-term lethal scourges—TB, polio, mumps, measles, smallpox, chickenpox—were knocked so far back as to become almost irrelevant in most people’s lives. Nowadays the raging (yet identifiable) germ that comes out of nowhere is a rarity, and contemporary illnesses stem from vague and multiple sources. And they have more variable outcomes. The doctor has no simple cure, so the cure is put on the shoulders of the ill.

Chronically ill people also can be a long-term burden. I myself have been living with Type 1 diabetes for nearly 40 years. It’s understandable that people around me get tired of taking care of me. I get tired of taking care of myself. My illness won’t end until I’m dead, and that could be another 40 years down the road. Recently, in my different kind of medical experience—a brain hemorrhage that fortunately turned out to be benign—I had cause to think about the different kind of care I was getting. The attitude toward this acute illness was heroic and sympathetic—I got round the clock care, myriad expensive tests, a plethora of support from friends and family. But the chronic illness gets boring.

The cost of treating a major illness, whether acute or chronic, is enormous in our current medical system. (My own recent brain event cost well past $100,000, and I and my insurance providers have spent thousands on my diabetes, too.) People who are ill sometimes can’t work or otherwise contribute economically. Sometimes they can’t support themselves. As far back as 1951 (in The Social System), Talcott Parsons pointed out that because of the “privileges” of the sick role, ill people also have the “obligation” to try to get well as quickly as possible, even though Parsons notes they are not held responsible for their condition.

Also because of these privileges, there are many scam artists of an even greater severity than Kris Carr. Every now and then someone without any diagnosis whatsoever is discovered claiming (usually) cancer and putting on a show to borrow money from family and friends and collect donations in public places, including on the web. In an ironic twist, many of these, including Ashley Anne Kirilow, Ann Crall, and Dina Leone, have now been labeled as having mental illnesses rather than physical ones and are still considered in need of help.

And since the ill take so much from the healthy in the way of financial support, emotional succor, and attention, we want them to get better in miraculous ways. If we believe that people can visualize themselves healthy, then there’s a theoretical way for everyone to improve their lives. There is no limit on health—not based on wealth, not based on health insurance availability, not based on health insurers paying for needed treatments, not based on chance.

There are even many so-called political progressives who believe that we are individually in control of our health (and by association to blame if it goes bad), and I wonder how they can fail to see the radical-right implications of that. Oprah Winfrey, one of the biggest promulgators of positive psychology (and one of Kris Carr’s promoters) has also conceived of herself as a crusader for social justice. For Oprah, it seems to be all about “empowerment”—giving people tools for improving their lives. Yet, she doesn’t seem to see that taken to an extreme the implication is that if an individual can’t triumph over illness it’s a personal failure. In other words, it’s a blame-the-victim stance that doesn’t take into account the myriad circumstances that can contribute to failure. I have a great deal of respect for Oprah—anyone who could keep the country reading books for so long has my admiration—but this aspect of her storyline is a huge disappointment to me.

The crux of the fundamentally conservative layer of assumptions in positive psychology is the delusional belief that we humans can control our own fates, not just to some extent, but virtually completely. Perhaps in a world where more and more seems beyond our control, it’s understandable that some people need to feel as though we can determine at least our own bodily fates. And no doubt it’s good to do what we can do for ourselves—I exercise regularly and eat fresh foods, too. But to be a true “liberal,” even just to be a person who is not living in a dream world, we need to remember that, do what we can, illness will come. The body does not last forever. People do not always get what they deserve. It would behoove us not to condemn the truly ill and not to celebrate those who turn their triumph over illness into a claim of personal achievement.

I wish that instead, we could offer support and encouragement to ill people without offering snake oil. I wish that tales of overcoming could be tempered with honoring those who don’t overcome. I wish that the media in our culture would practice some responsibility and not promote shallow, pretty people who have turned illness not so much into insight, but into a business opportunity.

I would rather stand with the people who have died of cancer instead of remaining in spontaneous remission for seven years with no sign of a symptom anywhere. I stand with those vomiting into the basin from their chemo, who don’t look so great with their hair falling out in clumps from the brutal treatments that will extend their lives. I stand with the ones who make meaning out of their experiences and appreciate the good days they have even though they know that cancer is not a gift, that even if a person with cancer sometimes can be sexy, the disease itself never is.