XVII (Roman numerals seem apt) slays me: “Now, this bell tolling softly for another, says to me: Thou must die.” He languidly, almost pleadingly, writes of the communal nature of survivorship:
Who casts not up his eye to the sun when it rises? but who takes off his eye from a comet when that breaks out? Who bends not his ear to any bell which upon any occasion rings? but who can remove it from that bell which is passing a piece of himself out of this world? No man is an island, entire of itself; every man is a piece of the continent, a part of the main. If a clod be washed away by the sea, Europe is the less. . . . Any man’s death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bell tolls; it tolls for thee.12
After Donne, survivor loses its communal reference, coming to describe not the individual reminded of his mortality by the death of another, but rather the one distinguished by his longevity. The survivor exists as temporally dislocated from the collective.13 The combination of Siegel-type notions of the exceptional patient and the ways in which prognoses have come to situate individual patients underpin and enable Chip’s notion of survivorship.
The noted biologist Stephen Jay Gould wrote something of a how to survive statistics guide after his diagnosis with abdominal mesothelioma. In “The Median Isn’t the Message,” Gould shows us that hope can be found in the “right skew” of a curve that describes his own gloomy odds in which half of those diagnosed will die within only eight months (fig. 2). The gradually declining curve to the right, though, indicates that some of those who survive the first eight months will live for years and even decades. As he points out, “There isn’t much room for the distribution’s lower (or left) half—it must be scrunched up between zero and eight months.”14
FIGURE 2. Francois Colos, diagram appearing in the original publication of Stephen J. Gould’s article “The Median Isn’t the Message” (Discover, June 1985, 61).
Everyone hopes to be represented by that right side of the graph, which floats gradually back down and eventually correlates with those few who live out a normal lifespan; that is, they die of something else. Gould did indeed remain in that latter side of the graph for twenty years. Early-twentieth-century novelist Hilaire Belloc wrote that statistics offer a “victory of sterility and death.”15 In my estimation, that victory can be experienced in the plummeting feeling of the search for oneself in the graph. Or the victory might be one step removed; after all, the graph encourages this self-centered search for oneself in a way that Donne’s communalism would not brook.
This graphed representation could not differ more from another version of survivorship: the Holocaust memorial. Museums, web pages, documentaries, and Hollywood movies have all developed a unique material culture that aims to breathe historical life into those who underwent the brutalities and genocide. The familiar images of barbed wire; emaciated, bald bodies with loosely hanging striped uniforms; piles of corpses; bodies in mid-crumple after a shooting—these stand as markers of precisely what we must remember, the deaths and the specific vicious way in which those deaths occurred.
The last few Jewish survivors have been ascribed the role of bearing witness to the Nazi devastation. Their tattoos and their children—fleshy repositories of that history—haul the burden of ensuring that history “never again” repeats itself. At the Holocaust Museum in Washington, D.C., observers are ushered strictly through the displays and one can’t shy away from much. You arrive on the second floor to a pile of the thin black and brown midcentury shoes taken from people before they entered the gas chambers. Hundreds? Thousands? At once universal—anyone could have worn them—and also specific, each bears the particular moldings of the foot upon which it was worn.
Each single, anonymous, stiffened shoe tossed into the haphazard pile recalls the body and life that inhabited it. One shoe, thin at the heel, must have rubbed a callus; another, irreparably worn through, would have let the frozen dirt cut directly into the sole of its owner. The sheer height of the pile, emphatically not a bell curve, raises a sense of sickening disbelief.
The dead bodies depicted as data in Gould’s graph orient mortality, too, though shorn of fleshy references. But the stories of those who died before or after the eight-month median—those in some way described by the graph—dissipate into the universal, timeless curve. The stories lent to the prognosis will come to be inhabited by other people—others who will wear those stories in their own ways, leave their own imprints. The search for oneself in this chart will always end in disappointment, for numbers are not shoes. A number will not mold to your arches; it will not record the shape of your life.
The graph abstracts the lives it represents, painting Gould as a victor against the odds rather than as one who literally vanquished those who landed to his left. In reading the graph, we can all hope that we might find ourselves on the right side of the graph, even though we know this is logically impossible. Yet justifying one’s own life in the numeric death of the collective makes a dangerous bedrock for hope. Fickle adulterers, numbers make love with the generations who move through them. These data have no allegiance.
Statistics render another sort of violence by abstraction. Gould’s disease is virtually always caused by asbestos exposure; according to historians, the disease exists only because of a massive, decades-long cover-up by the asbestos industry. In different circumstances, mesothelioma might easily have never existed, which would have led to a different curve entirely (a flat one). The spread of the disease was enabled, arguably, by the impersonality of aggregates—it is as if a gun was shot into a crowd, and fifty years later someone from that crowd keeled over and died. Given this cloak of anonymity (who was it who had the gun all that time ago?), a would-be assassin might well be more likely to shoot.
Gould’s graph offers a seemingly objective view of the natural course of a cancer, rather than a glimpse into the politics of diagnosis—a politics that could easily fill a museum in the nation’s capital. Ovarian cancer, for example, is known as a particularly aggressive form of cancer because women often die relatively soon after diagnosis. But like most cancers, life chances have to do with how far the cancer has advanced at diagnosis, and so the label aggressive masks the fact that patients and doctors may have ignored subtle symptoms until the cancer advanced to a stage at which it was no longer treatable. In other words, skipping over the causes of cancer gives it an apolitical mystique. Statistical aggregations provide a logic through which bodies become interchangeable numbers for which nothing need be felt, neither guilt, nor pleasure, nor horror. They enable prediction.
Donne’s bell can neither notice nor toll for a statistic. Donne can’t rationalize survivorship. Gould aims to comfort us with the possibility that in the coin of life in prognosis, we could each flip tails, even if some of those in a group of one hundred will invariably stare at the nickeled eyes of Thomas Jefferson. The Holocaust shoe project refuses statistical logic altogether; it’s not about the six million who died, but about each one of those people who died.
Built of the dead—people we’ve never met nor could meet—survival prognoses contain homogeneous units with only one variable: alive or dead. These Frankenstein numbers do more than scare each of us. They become something sinister: they feed on our friends’, acquaintances’, and enemies’ deaths, and they will feed one day on each of our deaths, just as they feed now on our lives.16 The statistics that offer the promise of beating the odds also evacuate the politics of prognoses.
STAND UP AND BE COUNTED
After my treatment, I went to the hospital to see if I carry a cancer gene. The genetic counselor congratulated me on my negative result; I had won the genetic roulette and could avoid a horrid conversation with my offspring about what I had done to them. But a strange chat still ensued. The genetic counselor told me she was pretty certain I am a carrier of something, they just don’t know what. She then showed me a
