Cancer Ward

It had been a while since I read something from the bookslut 100 list, so I picked this book up and it blew me away.

What is this book about? What isn't it about? It takes place in a cancer ward in a mid-size Soviet town in 1955. Since cancer doesn't discriminate, in the ward's beds are exiles and good party members, young men and men trying to secure a pension before retirement, men with hope and men without. Adding the orderlies, nurses, and doctors (most of whom are women), Solzhenitsyn is able to tell the stories of an amazing cross-section of post-war Soviet society.

Given this wealth of characters to work with, Solzhenitsyn asks and ventures to answer dozens of questions: What do men live by? How much should patients know about show more their own treatment? How does one prepare for death? What price is worth paying to remain alive? What is necessary for happiness? How should one deal with workers who won't pull their weight? How does one hold on to hope?

While Solzhenitsyn ventures answers here, he never hammers down with the answers. The different characters unsurprisingly come up with different answers, and even Kostoglotov, the semi-autobiographical character, changes his mind about some of these questions as his health changes along the way. Despite not offering answers from on high, it is still a deeply moral book.

More people should know about this book. show less

This is simply stunning. Possibly not the greatest, but certainly the most powerful novel ever written. Compared to this War and Peace is just entertainment, The Plague is just a shallow morality story, and Ulysses just a minor exercise in introspection. All these are 'great' novels, but you can't imagine them bringing down a government (but don't forget Zola...). That is not to say that Solzhenitsyn did, but he certainly intended to. You would have had to be there to appreciate what his 'One Day in the Life of Ivan Denisovich' did to the romantic myth of Soviet Communism. But if that was a Katusha rocket, 'Cancer Ward' was a hydrogen bomb, for those that took the time to see it. Or to put it in another context, Solzhenitsyn bears as show more much (to my mind) responsibility as Reagan or Gorbachov or Lech Welesca for bringing the Soviet Empire to an end.

But the power of this novel transcends these events (who remembers Lech these days?), and even Solzhenitsyn. But Solzhenitsyn, tapping perhaps into some of the most profound suffering of any man alive, wrote a story - tore it out of his own life - that ultimately faces the question 'what is it to be alive'. And perhaps the imminence of death - for he was in that Cancer Ward, is the key to the ability of this novel to rip the ground out from underneath you, and leave you standing on, just nothing except perhaps (if you can at least pretend to believe) some shred of personal decency and integrity. But Solzhenitsyn gives you no assurance on that, none at all. Which means that this is not a comfortable or easy book, which is why I talk about its power rather than it's greatness. Oddly enough I find that this book works even better if you start with Ivan Denisovich; it's the context, what he comes from, and what he returns to. What we have come from, what we may return to. show less

This expansive novel follows the lives of a group of patients in the cancer ward of a provincial hospital. Solzhenitsyn based it on actual experience and used the sickness as a metaphor for the Soviet gulag system - "A man dies from a tumor, so how can a country survive with growths like labor camps and exiles?"

At first, the narrative follows Pavel Rusanov as he checks into the ward and endures discomfort both from his tumor and the surroundings. Then the focus expands to other characters including nurses, doctors and other patients. The central character, Oleg Kostoglotov, and Rusanov serve as foils to each other. Rusanov is a dogmatic and arrogant bureaucrat while Kostoglotov is a sardonic troublemaker who served time in the labor show more camp and is condemned to exile in perpetuity. Kostoglotov evokes more sympathy than Rusanov, who is constantly whining and rather irritating.

The constant allusions to the camps - and repression of such allusions - serves as one thread that connects disparate stories in the novel. Hospitals and sickness also provide another thread, and parallel the camps - the constant denials, authorities lying to the patients, who are powerless, and a pervasive atmosphere of hopelessness.

Solzhenitsyn doesn't just focus on the political, he also creates realistic portraits of people reacting to cancer. The depiction of pain allows the author to develop the parallels - real, physical pain, mental anguish over the disease and the unhealed wounds caused by the gulag system.

Love in Solzhenitsyn is mainly Kostoglotov's ephemeral relationship with the nurse Zoya and a deeper, unspoken attachment to shy but competent Dr. Gangart. Vera Gangart's relationships with the senior doctors and other patients are also well developed. Highly recommended. show less

An absolute masterpiece.

Having only read Ivan Denisovich, Candle in the Wind, and Matryona's House prior to this, I knew Solzhenitsyn as a masterful crafter of the short-form. How fulfilling to find that his strength there is only compounded here in over 500 pages as he weaves together a perfect convergence of characters and themes and commentary and allegories.

On the surface, it's an engaging tapestry of personal stories, of the varied lives that cross paths in a Russia hospital post-Stalin. Every character was fully fleshed out, distinct with their fears and desires and opinions.

In much the same way that One Day in the Life of Ivan Denisovich was not actually just about that one day, or just about Ivan Denisovich, Cancer Ward delves show more into the myriad provoking scars that are so particular to early 20th century Russia. Yet the themes are universal and depressingly relatable: our need for connection and survival, our thirst for knowledge, our flaws and vanities. He humanises the political, showing how the villains and criminals become interchangeable with the heroes and innocents, just depending on what day it was.

But no matter what day it is, this book will remain an incredible feat. I'm still boggled by its immense artistry and the multitudes that it contains.

Aside: Chapter 14 of Part Two is a perfect chapter and a perfect short-story pay-off. show less

I originally purchased and read Cancer Ward back in 1980 when most educated Westerners would have known who the author was if not the story of his life and works. Nowadays if I happen to mention that I'm reading a novel by Solzhenitsyn I can be pretty certain of getting a blank stare by way of a response. In any event one of the features of growing old is that you can pick up a book you read forty years ago and it is a brand new experience.

Cancer Ward is set in the mid 1950's in the era of the "Thaw" that was initiated and short lived following the death of Stalin in 1953. It is to some degree informed by the author's own experience as a cancer patient following eight years in a labor camp and in the midst of what turned out to be three show more years' internal exile. It is a powerful meditation on what it means to be truly human and features an eclectic cast of characters, medical staff as well as patients, and Solzhenitsyn portrays his characters with a skill and sympathy (where warranted) that make this a beautiful and moving novel.

The main protagonist is one Oleg Kostoglotov, who bears some resemblance to Solzhenitsyn, in that he was a soldier in the Soviet army during World War II, was arrested and sentenced to the labor camps for the crime of criticizing Stalin, was sentenced to "perpetual exile" in a remote part of the Soviet Union, contracted cancer and was treated in the cancer ward of a hospital somewhere in Central Asia. Kostoglotov struggles against his disease and struggles against his treatment which includes hormone injections that result in a loss of virility, though he becomes well enough to get a discharge that allows him to return to his place of exile.

His "opponent" is one Rusanov, a lifetime party hack, who works in Personnel where he carries on the ideological struggle for socialism by combing through the records of the firm's employees, snooping on them and writing them up for discipline, termination or arrest. He is a convinced Communist but he loves his privileges and the bourgeois pleasures of his lifestyle, his home, his car, and his upwardly mobile family. It's hard to read the passages in which Rusanov considers informing on his fellow patients without calling to mind Clint Eastwood's line from the film "The Enforcers" - "Personnel, that's for assholes".

The ward is home to nine patients at a time with a waiting list that is never eliminated. Some of them are "goners", some are cured at least to the extent that they can be discharged with instructions to return for a follow-up checkup. Some are treated with a combination of X-rays and injections. Some go under the knife to get a tumor cut out or a limb removed. Some patients are located in the hallway outside the ward as there isn't any space to accommodate them and they are too sick to be sent home. The staff for the most part is professional and hard working, but there are still the doctors who do next to nothing and whose limited skill and motivation adds to the workload of their more competent and conscientious colleagues. Nor are the doctors protected by their knowledge and skill from being brought down by the same disease they spend their lives diagnosing and treating. The head of the radiology section, Dr. Donstsova, contracts cancer likely from overexposure to radiation in the course of her duties. (The doctors have occasion to do paperwork at tables set up in the X-Ray rooms as there's no other place to get work done.)

Among the most moving portraits is that of patient Shulubin whose story is poignantly told in the chapter entitled Idols of the Market Place. His story is, in a way a summing up, of the repression under the Stalin regime from 1930 right to down to the time of the novel's events.

I commend Cancer Ward to any serious reader. It is a beautiful yet somber reflection on the human condition and on the suffocation of the spirit by the Soviet experiment in remaking mankind. show less

The story takes place in the men's cancer ward of a hospital in a city in Soviet Central Asia. The patients in Ward 13 all suffer from cancer, but differ in age, personality, nationality, and social class (as if such a thing could be possible in the Soviet "classless" society!). We are first introduced to Pavel Rusanov, a Communist Party functionary, who enters the hospital because of a rapidly-growing neck tumor.
"The hard lump of his tumor--unexpected, meaningless and quite without use--had dragged him in like a fish on a hook and flung him onto this iron bed--a narrow, mean bed, with creaking springs and an apology for a mattress."(p 10)

Solzhenitzyn himself was released from a labor camp in early 1953, just before Stalin's death, and show more was exiled to a village in Kazakhstan. While incarcerated, he had been operated on for a tumor, but was not told the diagnosis. He subsequently developed a recurrence, received radiotherapy in Tashkent, and recovered.

The narrative places its focus on the central character of Oleg Kostoglotov, a young man who has recently been discharged from a penal camp and is now "eternally" exiled to this particular province. Only two weeks earlier, he was admitted to the ward in grave condition from an unspecified tumor, but he has responded rapidly to radiation therapy. Among the doctors are Zoya, a medical student; Vera Gangart, a young radiologist; and Lyudmila Dontsova, the chief of radiation therapy.

Rusanov and Kostoglotov respond to therapy and are eventually discharged; other patients remain in the ward, get worse, or are sent home to die. In the end Kostoglotov boards a train to the site of his "eternal" exile: "The long awaited happy life had come, it had come! But Oleg somehow did not recognize it."

In The Cancer Ward Solzhenitzyn transforms his own experiences into a multifaceted tale about Soviet society during the period of hope and liberalization after Stalin's death. While Cancer, of course, is an obvious metaphor for the totalitarian state there is also a penetrating look at mid-century Soviet medicine and medical ethics.
“But substantial X-ray treatment is impossible without transfusion!” “Then don’t give it! Why do you assume you have the right to decide for someone else? Don’t you agree it’s a terrifying right, one that rarely leads to good? You should be careful. No one’s entitled to it, not even doctors.” “But doctors are entitled to that right—doctors above all,” exclaimed Dontsova with deep conviction. By now she was really angry. “Without that right there’d be no such thing as medicine!”
Of course, the paternalism evident here (e.g. lack of truth-telling and informed consent) was also characteristic of medicine in other countries in the 1950's and remains an important concern in professional ethics.

The novel also explores the personal qualities and motivation of physicians, and the issue of intimate relationships between doctors and patients. The most incisive aspects of the book are its insight into human nature and the realism of its characters. show less

There is something phenomenally modern about this novel. The physical and mental fatigue of the doctors and the patients. The differences in cast and how they translate into disdain or fear. The hopes and anger against fate, dogma, systems or even of our very own selves. Solzhenistyn constructs an incredibly powerful novel around a variety of voices which express every human emotion from shame to vindictiveness, friendship to solitude, love to isolation. Never is it dull, even in its political criticisms: on the contrary the reader is constantly pulled from a now dead world of communism to the still real world of disease, power struggles and helplessness.