Exemplary Lives: Susan Sontag

August 30, 2023

Susan Sontag

Susan Sontag (1933–2004) was an American writer and critic who published essays, novels, screenplays, short stories, and, posthumously, her journals. I believe she will primarily be remembered for her essays on illness and photography. She was exemplary because she was a self-made public intellectual at a time when few women could establish themselves in such a role and as an outspoken advocate for human rights.

Sontag developed breast cancer in her early 40s, then had a uterine sarcoma several years later. In each case, she elected to have radical treatments and survived. She died in 2004 from complications of a third and highly lethal cancer, acute myeloid leukemia (AML). Here, I rely entirely on the exceptional memoir of her illness, Swimming in a Sea of Death, written by her son, David Rieff. His book is far and away the best cancer memoir I have read.

Sontag was also exemplary in dealing with cancer. However, when I say ‘exemplary,’ I want to be clear that what I admire was how intensely she strove to live by her values in the face of death and intense suffering. However, as I will make clear, I do not think she succeeded in living by her values.

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Sontag had strong views on cancer treatment: she was only interested in the possibility that treatment would lead to cure or remission, and she did not care about the suffering that treatment might entail. When she had breast cancer, she elected to have a bilateral radical mastectomy. Rieff writes that this experience may have convinced her that “the more treatment was done, the better her (slim) chances might be.” Further,

as the years went by, my mother began... to think of her survival not as a species of miracle, since the miraculous had no place in her thought, but rather as a result of medical progress and also of her willingness to have the most radical, mutilating treatment... fighting cancer became for my mother a question of the right information, the right doctors... and above all the willingness to undergo any amount of suffering.

Sontag arriving in Seattle for a bone marrow transplant.

This choice seems to have been motivated by Sontag’s intense desire to live and her profound horror at dying. “[Sontag] shared [the writer Elias Cannetti’s] complete inability... to reconcile himself to the fact of mortality. ‘I curse death,’ [Cannetti] wrote, ‘I cannot help it.’” As a 16-year-old student at the University of Chicago, Sontag wrote in her journal that she was not “able to even imagine that one day I will no longer be alive.” The prospect of no longer existing terrified her, but she also wanted to live because she wanted to continue writing. “The work [her writing] had to be served and served at any price. Since her adolescence, she had let nothing stand in its way.”

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Unfortunately, sometimes there is little reason to believe that more treatment will materially improve your chance of cure or remission. This was the case for AML in the early 2000s (and may still be the case today). This created a sharp conflict. On the one hand, Sontag “loved science and believed in it (as she believed in reason) with a fierce, unwavering tenacity.” She had an austere commitment to objective evidence, including statistical evidence about treatment outcomes and survival rates. That, at least, was her official view. Because on the other hand, the outcome data for AML were bleak, whereas Sontag needed reassurance that treatment would benefit her. The data did not support her hopes, and she could not endure that. Rieff: “My mother had always thought of herself as someone whose hunger for truth was absolute... but it was life and not truth that she was desperate for.” She was soon to die, but she could not talk about death.

She who could talk about anything could rarely speak of death directly, though I believe she thought about it constantly... until the moment she died, we talked of her survival, of her struggle with cancer, never about her dying... To have done so would have been to concede that she might die and what she wanted was survival, not extinction--survival on any terms.

This placed her friends in a difficult situation. Rieff reports, “It was so clear that what she wanted to hear was good news and nothing else.” However, she wanted the good news presented as if it were objective scientific truth, not an attempt to console her. When someone said ‘“I feel you’re going to make it,” she responded, “How can you possibly know that?”... “Read the statistics,” she’d say, “read the statistics.”’ But if she even read the statistics about AML, she must have misrepresented their meaning to herself.

Sontag’s need for hope meant she could not live in a way consistent with her stated commitment to objective truth. I do not sense that Sontag ever cut herself any slack, but I will. She’s an exemplary life because I find a wholehearted commitment to the truth in her writing, and that she couldn’t fully live with what that required doesn’t diminish my respect.

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But we’re left with the question of how someone can have a terminal diagnosis and still live in hope.

I can, for two reasons. First, I don’t share Sontag’s terror of death, and, in truth, I barely understand it. It’s not just that, as a Christian, I hope for life after death. It’s also that if I’m wrong, and nothing comes after death, that nothingness doesn’t horrify me. I’ll just be nothing. So what?

More importantly, my certainty that I will die doesn’t reduce my hope for the future. My hope is not that I will be cured, and it’s not just hope for me. I hope that God will redeem the universe, God’s creation. If you have that hope, you can read the medical literature on treatment outcomes for your type of cancer and accept that “Yes, I’m going to die, but we will be saved.”

Sontag would have said this hope is preposterous. You may believe that I am in denial, equivalent to Sontag’s. Perhaps. I’d counter that my hope is based on faith and my experience of being loved by God. It’s based on the conviction that, astonishingly, the creator of the universe wants me to be a friend and companion (John 15:12-15). This hope is an extraordinary, unmerited gift. I don’t claim that there is objective evidence for it, but I believe it is the right way to live. Why not live in hope?