Cancer Ward (1968)
by Aleksandr Solzhenitsyn
A six hundred page book about suffering from cancer in Soviet Tashkent, Uzbekistan? Call it the literature of confinement, whether the subject be common prisoners, political prisoners or hospital patients. The literature of confinement is an important genre of post World War II literature, and Solzhenitsyn, with his 1970 Nobel Prize for Literature, is the top in this particular field. Unlike A Day Life in of Ivan Denisovich, which takes place over the course of one day, Cancer Ward takes place over a seemingly endless numbers of days and weeks and months. In Cancer Ward is not the classic "Arctic Soviet Gulag Prison Camp." Instead it is a regional hospital, treating almost entirely "eternally exiled" former Soviet military and government officials who have come into disrepute in various ways.
One of the major aspects of Cancer Ward not related to the Solzhenitsyn-proxy character's own cancer is the back story of the various inhabitants of the hospital. How each of them came to be "eternally exiled" within the Soviet Union is a catalog of totalitarian insanity. Like The Case of Comrade Tulayev published in 1949, Cancer Ward is a testament as to why totalitarianism rarely works out, even for the die hard supporters. Similar to Tulayev, the most sympathetic figures in Cancer Ward are "old Communists" who were involved with the initial Civil War or early converts outside the major Russian cities. These people were purged starting in the late 1930's and on through the early stages of the Cold War. Solzhenitsyn was one of those people.
Beyond the vintage Soviet setting, Cancer Ward is notable for the frank discussion of the subject of cancer itself, which maintained a quasi-taboo status that is still evident today. Like any work of literature that address mental or physical health, Cancer Ward addresses the role of societal stigma among the sufferers of ailments. It goes without saying that Cancer Ward is a deeply sad work of art. Throughout, there are hints of some kind of reprieve, to address the status of "eternally exiled" Soviet citizens, much in the way the cancer treatment may provide hope of recovery without providing recovery. Any humor lies in the most abstract of concepts, for example the irony that these "cancers on the state" are themselves afflicted with cancer as if to prove their tormentors right.
Both patients and doctors are portrayed. The Soviet Union was distinct from the West in having an ultra high percentage of female doctors vs. male doctors. I knew that going in, but was still surprised that male doctors were few and far between. The major dynamic in Cancer Ward is between the male patients and the female staff. Solzhenitsyn handles these fragile relationships with incredible deftness. By the end of Cancer Ward the reader is likely to be exhausted. You will crave lighter fare.