Being diagnosed with a rare kind of bone marrow cancer (myelodysplasia) proposes not so much challenge as invitation to enter investigation of the very nature of things. I mean – what is bone marrow? What does it do? Why is it there? What happens when, as a major bodily organ (it should be considered as such according to my doctors) it simply decides to go haywire, mutant, or, in my case, proliferate dysfunctional stem cells that work to shut the system down?
Under the microscope my bone marrow biopsies revealed “cosmic mayhem” as my haematologist, with characteristic and in his own way charming bluntness put it. Expected architecture and increasingly, healthy function, were being wiped out. Soon there would be no space for the production of any blood, hence the ‘dysplasia’.
Such, need I say, constitutes a terminal impulse in that the cancer cells, in producing themselves more and more effectively, manage, parasitically, to destroy their own abode, their own potential, their own ability to host themselves in the wet juicy spongy habitat of an organic system that is not Ross exactly, but the body of Ross.
When my diagnosis first became apparent (it happened not in one hit but in stealthy stages revealed through increasingly frequent blood tests revealing increasingly bizarre and deformed biological metamorphosis) I naturally began to reflect on the specifics of the marrow – dare I say I felt the urgency to do this “in my marrow” One thinks of Shakespeare’s “the marrow of my understanding” (The Two Noble Kinsmen) where marrow refers to what is pithy, fecund and rich. Yet there is an apposite meaning signifying powerlessness, becoming bereft of courage and strength: “Thy bones are marrowless, they blood is cold.” (Macbeth). Oscillating between these extremes, I found myself unsecured, swimming away as it were, from consideration of both metaphoric functions and healthy regard for the marrow as vital biological function. There was not a repudiation of the marrow – what living organism would be brave enough to even suggest such a thing? Rather, it was indication that the ability (even if a function imagined and superimposed) of the marrow to contain or house the essence of my being, my being, in Ross’s core, Ross’s nature, Ross’s true nature, that had somehow began to slip and fail.
The question exceeding metaphysics: why was I any more central to my marrow than my marrow was to me? And, despite any musings, soon bone marrow cancer was going to kill me. Its capacity in this regard was disclosed by the scientific literature which I had inevitably Googled and pondered in exhausting late night vigils that were the very food of ghosts: “Thou hast no speculation in those eyes/which thou dost glare with!”(Macbeth).
Yet it finally dawned: the bone marrow cancer wasn’t all to blame in making me terminal, a person destined to die. While epitomizing my capacity to collapse as a viable living organic system, it wasn’t the real culprit (certainly not any moral or retributive one), nor cause of my morbid attack. What had happened was that it had somehow just got implicated in a bigger picture. If not the marrow, then why not the heart, the liver, the brain, the lungs? Take your pick. None harboured, intrinsically nurtured, the dark seeds of self-destruction as their somehow deepest hidden or true nature. Sure the marrow was implicated but to brand it a culprit, more-over, a wilful one, was grossly over-stating the case.
In the exact same manner the perennial question found in so much often distraught and usually sentimental death and dying literature – ‘why me’?, or even ‘why is this so unfair’? – dissolved into something substantially less solid, evaporated as it were, not into abstraction, but into the lucidity of open air: ‘Why not me?’ ‘Why not the marrow’? Why not now? ‘Why not this disease’?
A certain liberation arrived with this awareness that the cancer itself was merely an example, though of course an immensely popular one, of one possible reason as well as manner, in which one may be made to die, be forced to exit from the body which had been on loan for a period of fragile, always fragile, time. I’m not being chivalrous here, nor frivolous. Surely that would be worse, given the grievous anxiety generated by death and dying in our culture, physically disinclined to accept that death and dying even occur, or occur other than that of unfortunate accidents, unfair displays, the betrayals of life and their commitments, violations of our relationships to our loved ones and friends, our untimely being snatched away from them.
What am I saying? That it struck me that death and dying are both natural and in some very ordinary sense quite a mundane even straightforward thing to do. What my diagnoses achieved was something philosophy hadn’t: a realization that death was at once everywhere and nowhere, endemic to our very condition, yet at the same poignant time, a luminous shadow installed in the primordial evolution of a single cell.
It was, as Siddhartha Mukherjee put it, the emperor’s malady – an ancient disease affecting even the highest of pharaohs – yet the birthright of us all.
 Siddhartha Mukherjee, The Emperor of All Maladies: A Biography of Cancer. New York: Scribner, 2011. He describes how “the first medical description of cancer was found in an Egyptian text originally written in 2500 BC: “a bulging tumor in [the] breast…like touching a ball of wrappings” (p.273).