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Repairing Time out of Joint: Narratives of Caring for Mothers with Cancer

Sucharita Sarkar (Mumbai, India)

 

Cancer diagnosis is usually abrupt and unexpected. Such diagnosis immediately, and often irrevocably, changes the ordinary time schedules of patients and caregivers.1 Their routines are disrupted during treatment and caregiving through multiple experiences of ›extraordinary‹ time that are interwoven and negotiated. My paper analyzes these disparate yet interlinked experiences through a comparative study of two memoirs of caregiving for mothers with cancer: the graphic narrative Mom’s Cancer (2006) by Brian Fies and the literary memoir The End of Eve (2014) by Ariel Gore.2 Time can be understood in linear and/or non-linear ways. Interpreted as a linearity, time moves chronologically from past to present to future in a one-directional sequence. However, usually neither our perception of time, nor the representation of time in narratives is always or necessarily linear. Especially during illness or trauma, patients and caregivers experience time in non-linear, layered, stretched, compressed, or other ›extra-ordinary‹ ways. In cancer experiences, these ›extra-ordinary‹ temporal disruptions can ironically both mirror and resist the unpredictability of the spatial disruption of the body by the doubling and metastasizing cancer cells.
 
In his 1994 book Understanding Comics, Scott McCloud likens the depiction of time in a comic to a rope. He demonstrates how this rope is flexible and is manipulated diversely through the graphic space to depict and perceive time in multiple ways that can be synchronic and diachronic simultaneously (McCloud, 96–99). This paper borrows and expands Scott McCloud’s concept of »time as a rope« and uses it as a metaphor to explore the different ways in which this rope is twisted, knotted, unknotted, compressed or stretched both ahead in the future, and behind in the past, in one graphic and one literary text, and how this manipulation of the rope of time is used to engage with, and make sense of, cancer trauma. To broaden my understanding of the patients’ temporal experience of cancer, I am indebted to Kathy Charmaz’s concept of »temporal incongruence« experienced by patients with chronic illnesses, which »develops when time perspectives are incompatible and inconsistent with time structures« (171). I also utilize the concept of »Anomalous Time« whereby »changes between periods are marked by uncertainty,« which was developed by Susan Hannum and Robert Rubinstein to analyze chronically ill older patients’ narratives of cancer (19). For theorizing the caregivers’ perspectives, I deploy Rebecca E. Olson’s notions of »discretionary time« or »time-sovereignty, or the extent to which carers’ had control over their time, as another means of understanding divergences in carers’ experiences« (95). I must emphasize here that it is impossible to generalize the temporal experiences of patients or caregivers, as each individual’s experience of time is unique and shaped by specific contexts. As the introduction to the2015 Graphic Medicine Manifesto states, »Graphic Medicine resists the notion of the universal patient and vividly represents multiple subjects with valid and, at times, conflicting points of view and experiences« (Czerwiec et al, 2). However, it may be possible to locate resonances between separate temporal experiences of cancer, both from the patients’ and the caregivers’ perspectives. It is exactly the possibility of these resonances that make illness memoirs a rich and valuable resource for readers.

Diagnosis Time

The experience of ›extraordinary‹ time is usually initiated by the diagnosis and disclosure of cancer to the patient and the caregivers by the medical experts. The moment of disclosure is marked by shock and a sudden sense of loss of control. Brian Fies’ memoir visually depicts this abrupt and total change in his mother’s, his, and his two sisters’ lives through graphic contrasts. In the pre-diagnosis stage, the narrator’s relaxed pose, drawn in a single, full-page panel, suggests deceleration, a sense of waiting, but also a sense of being in control of the rope of time (Fies, 3). As the investigations continue and the diagnosis becomes clearer, the visual grammar indicates acceleration and disorientation (fig. 1).

Fig.1: Fies, Brian: Mom’s Cancer. New York: Abrams Image, 2006, p.5.

Instead of left to right, the panels move down and up and down, similar to a board game. The gutters are absent; icons of chess pieces and dice spill over the borders; the accompanying text emphasizes »random chance,« »dumb luck,« and a sardonic »congratulations« (Fies, 5). These visual and textual elements project a sense of rushed randomness and unpredictability, of being caught in a situation beyond one’s knowledge or control. The game motif is familiar from multiple graphic narratives of cancer, and Fies uses it again later in the narrative when he visualizes the medical expert – who is at the operating table delivering »a beam of radiation« to his mother’s brain »strong enough to kill a tumour« but which »also destroys any healthy brain tissue in its path« – as an exulting, animated superhero in a hi-tech, gadget-filled chamber who has the power to both save and destroy lives (21).3 In the next page, Fies explicitly states, »The doc in charge is almost giddy…It’s a video game to him« (22). The metaphor of game introduces not only an element of caprice, but also a sense of being manipulated by a medical establishment whose knowledge is limited and incomplete. The sense of randomness, and the accompanying gap between the optimistic prediction of the medical experts and what actually happens to the patient, is reinforced in Fies’ afterword written after his mother’s death, where he narrates: »It seems odd to say that Mom’s death came as a surprise but, even hours before the end, we and her physicians always saw a reasonable path to recovery. In fact, I’d flown to Southern California days earlier to prepare for her return home from a hospital stay. But her body had simply had enough« (117). By extending the game analogy, this unexpected death can be read as a sudden form of ›game over‹: revealing the unpredictability of things beyond our control.

In Ariel Gore’s opening chapter, the moment of diagnosis is implicit, but the moment of disclosure by the mother (Eve) to the daughter (Ariel) is explicit. Gore grapples verbally to orient the narrative to the present moment in an »ordinary day…maybe 2, p.m.,« attempting to establish control of the rope of time. Ironically, this control is soon lost by the disruptive shock of disclosure, after which their lives cease to be »ordinary:«

Where to start? In the beginning that comes to mind, I’m…[t]hirty-nine years old…. Start anywhere, Ariel. It was an ordinary day, after all. Maybe 2, p.m. My mother stood on my doorstep wearing a coral sweater and coral lipstick…. What did she need to talk about? …. »It’s cancer,« she said. »What?« It was like I’d heard the syllables, but didn’t know their meaning. »It’s lung cancer.« Her words floated into the air between us like dandelion seeds, just hung there. »What?«. (Gore, 15–16)

The loss of control after the disclosure is represented through the sudden opacity and loss of meaning of familiar words. The time disruption is represented in two ways. Firstly, the discourse time is slowed down to match, or even perhaps exceed, the story time through stretches and pauses. Secondly, the story time is made to exceed the discourse time through flashbacks, some to the recent past (»two weeks earlier«) and some to the distant past (»summer mornings when I was a kid«): »I’d seen the scans at the hospital two weeks earlier, the little Christmas lights that filled my mother’s rib cage…. ›I have lung cancer,‹ my mother said again…. I remembered summer mornings when I was a kid, sneaking away from the violence of our home to make daisy chains in the park down the street….  ›Stage four,‹ she said, ›I’ll be dead in a year‹« (Gore, 16). These frequent, uneven flashbacks bend the rope of time back and forth in haphazard ways, creating a disorientation in the reader that mimics Gore’s own disruption. Like the moment of escape memorialized in one of the flashbacks (»sneaking away«), the deferring of meaning is only fleeting. Gore can delay but not escape from confronting her mother’s cancer, and the suddenly imminent possibility of death that is uttered by her mother. The frequent shifts between the past, present and future that Gore experiences on learning about the diagnosis seem to mirror the fragmented experience of »Anomalous Time« by aging cancer patients, where the shifts between past, present and future are unstable and uncertain because »illness has fragmented the temporal flow of the life course:«

Thus, time before illness is referred to here as the Recalled Past (Past Time); time marked by acute and penetrating illness and treatment is referred to as the Perceived Present (Illness Time); and the future as representing what was yet to come is referred to as the Imagined Future (Future Time). In this manner, time becomes an abstraction for individuals with cancer, whereby changes between periods are marked by uncertainty; this may be considered as Anomalous Time. (Hannum and Rubinstein, 19)

When Gore’s experience of extraordinary time mirrors the temporal experience of the aging cancer patient (in this case, her mother), it indicates an empathy between patient and caregiver (and mother-daughter) that exists sporadically but persistently throughout the memoir.

Both memoirs document the responses of the mother/patient to the diagnosis of stage four lung cancer: they both instinctively manipulate the present time in order to cope. Fies’ mother, whose cancer has metastasized to her brain, responds with apparent stasis and incomprehensibility: represented in an image of her floundering in a sea of words. Her aging process accelerates (»She’s aged ten years in a week.«), and she is seemingly unable to understand cancer-related terms like »stage four,« although the frustrated narrator says, »We explained all this before. Why’s she being so stupid?« (Fies, 10). However, instead of functioning as a criticism of Fies’ mother alleged ›stupidity‹, the image of her drowning in a sea of incomprehensible medical terminology functions more as a critique of medical language’s disconnect with the patients’ emotional state and mental overload at the time of diagnosis. This disconnect between the expert language or jargon of cancer and the persons affected by the disease (the patient and the caregivers) is emphasized recurrently in the graphic memoir. When the doctor informs Fies’ mother that her tumour »is 24 millimeters,« her response is, »How big is that?« (23). The simple, absolute measurement does not make sense to her because she cannot relate it to her body, and the doctor’s sparse, metric language does not explain the correlation between her body and the tumour in comparative terms. Even Fies, who »was a ninety-ninth percentile child,« indicating that his intelligence quotient was much above the average, and who can »figure things out,« finds that »this was going to be harder than I thought« in spite of filling »folders and binders with facts and theories, drugs and therapies, studies and trials« (23–24). Hence, Fies' mother's ›stupid‹ response to the medical language of diagnosis may be either a subliminal resistance to the incomprehensibility of the jargon that assesses her condition in opaque terminology, or a mirror of the incapacity of the mind to grasp the life-threatening truth of having cancer, or both.

When Fies and his sisters converse about the cancer with their mother during the »family meeting« because it »was time to discuss some things,« they consider her incomprehensibility »stupid« and »not funny at all,« because it generates temporal lapses between the time of telling/informing and the time taken to comprehend that information (9–10). This indicates a »temporal incongruence« which »results when intimates do not share similar ways of thinking about and structuring time« (Charmaz, 172). When Fies and his sisters (the elder is »Nurse Sis« who is part of the medical establishment and often echoes its language) expect their mother to behave in fixed, rational ways, they are imposing a time structure of disclose-and-understand immediacy on her which she is unable to conform to. This incongruence replicates the disjuncture between patient time and medical chrononormativity, where the medical experts expect fixed, prompt responses from patients who are unable (or unwilling) to do so.4 It is the medical expert who controls the cancer time of the patient (and by extension, the caring time of the caregiver) by fixing appointments and treatments schedules, and even limiting the duration of these doctor-patient encounters, expecting all patients to fit into the pre-determined dimensions of this structured medical chrononormativity. This is a typical feature of capitalist systems where time is organised for maximum productivity. The dissonance arises when patients refuse to be accommodated within these institutionalized, temporal structures because their own temporal perspectives do not match with the normative standards expected of them, for instance, when they may take much more time than is available to grasp the meaning of the diagnosis that is delivered to them, as in the case of Fies’ mother. By including and documenting his mother’s temporal incongruence (and by ironically labelling it as ›stupid‹), Fies is both critiquing and disrupting the »power imbalance« between the doctor, who »wielded power by controlling and standardizing the way that diseases are visualized,« and those who are »living with it,« like the patient and the caregiver (Czerwiec et al, 20).

Gore’s mother reacts more decisively, but even she confounds expert expectations of how the patient should behave. She asks the oncologist, seemingly unbothered as she »held out her hand to inspect her manicure, didn’t look up,« »How long will I live?« (Gore, 28). In a flash forward, she projects an imagined future that affords her more control over her body: »›Ariel,‹ she said, ›I just want you to know that if I do get sick, you don’t have to take care of me.‹ ›I don’t mind,‹ I told her. ›I can take care of you. Or we can hire someone… whatever you feel comfortable with‹ [...]. My mother shook her head, […]›If I ever need a caretaker, I’ll just blow my brains out‹« (Gore, 30). Later, she also marks »the date [of her expected death] red in her calendar, October 18, 2010. Exactly a year from her diagnosis. ›I’m running out of time,‹ she said, »I’ll be dead on ten-eighteen-ten‹« (Gore, 54). The marking of a specific future date for her death indicates that, for Gore’s mother, dying has become »the personal expectation and acceptance of death as an imminent event:« in this instance, »imminent« refers to »a specific date or time – in the next few minutes, hours, months,« as contrasted with an awareness of death as »immanent,« where »the date may not be known, but the person is aware that death may come at any time« (Kellehear, 9). By refusing to restrict herself to an awareness of death as »immanent,« and, instead, by flash-forwarding to an »imminent« death, Gore’s mother is perhaps trying to re-establish a frame of control on her own future, which has now transformed into an unfamiliar terrain beyond her control. Her temporal perspective of the future has become incongruent with the temporal structure of the future that is being projected by the diagnosis, creating a temporal incongruence as well as a need to resolve or realign this inconsistency. Manipulating the rope of present time – whether through stasis or flash-forward – is a coping device for the extreme unease of cancer diagnosis. Fies’ response of exasperation and Gore’s placatory approach are also initial signs of role-reversals as past mother-child relations transition to present patient-caregiver relations.

Treatment Time

During treatment, the rope of time is represented on the page in a multitude of contrasting yet complimentary ways by Fies (fig. 2).

Fig.2: Fies, Brian: Mom’s Cancer. New York: Abrams Image, 2006, p.26.

In a series of snapshot-like panels depicting Fies’ mother, the graphics swiftly trace the story time of her hair loss during chemotherapy within the space of a single page, while the speech balloons assemble her different reactions to the cause of her cancer, ending in a confession of defiance by her (Fies, 26). These panels are bookended by borderless texts contrasting the mother-son relationship of the past with the patient-caregiver relationship of the present: a role reversal suffused with helplessness and regret. Whereas in the past, the son had persistently pleaded with his mother to stop smoking but to no avail (»Mom smoked for forty-five years. I nagged her to stop almost from the day I could talk«), in the present, the caregiver feels no satisfaction from being proven right about his concerns (»Somehow, saying ›I told you so‹ turned out to be a lot less satisfying than I imagined«, Fies, 26).

The passing of time demonstrated through the swift corporeal changes in Fies’ mother’s appearance is contrasted with a moment of stillness. To visualize the suspension of time experienced by the patient during long hours of chemotherapy, Fies draws his mother like a portrait »arrangement in Grey and Black,« sleeping in a hospital chair (Fies, 33). The splash page fills the entire space with this single image – locating the patient’s treatment at the narrative centre, and also conveying a sense of time expectant (fig. 3).

Fig.3: Fies, Brian: Mom’s Cancer. New York: Abrams Image, 2006, p.33.

The visual itself, as well as the title, »Arrangement in Grey and Black« references James Whistler’s renowned 1871 portrait of his mother, popularly known as ›Whistler’s Mother.‹ The visual reference introduces a sense of continuity of mother-son relationships across generations, as well as a sense of poignant irony: unlike Whistler’s mother, who is sitting in a chair in her own house, unimpeded by any apparent disease, Fies’ mother is sitting in a hospital chair undergoing chemotherapy. Within the graphic narrative, the centralized present-time image of the frail patient under treatment is contrasted with two visuals. The first visual is a past image: a sketch of an old family photograph where the mother is visibly younger and the stepfather is present (he is now absent, having abandoned his family responsibilities). This photograph functions as a reminder of both past happiness and past losses, thus counterbalancing the present trauma through the contrasts and continuities with the past (Fies, 34). This is followed by graphics that contrast the chaos of the caregivers’ present time with the silent image of the patient (fig. 4).

Fig.4: Fies, Brian: Mom’s Cancer. New York: Abrams Image, 2006, p.42.

Fies draws a series of panels in glaring colours, metaphorizing the caregivers (himself and his two sisters) as fractious, battling superheroes to indicate the immense responsibilities as well as the frustrations of caregiving each of them feels (Fies, 42). The »temporal incongruence« that arises among »intimates,« according to Charmaz (who limits her observation to the patient-caregiver relationship) may also extend – as Fies visualizes – among multiple caregivers, when caring is a shared responsibility, and their disparate temporal priorities can result in conflict: »conflict emerges when making daily schedules and projecting timetables« (Charmaz, 172). The three siblings argue about who is the »oldest« and therefore should take »charge« of treatment procedures and schedules, about how Nurse Sis is more entitled to control because she has »got medical power of attorney,« and how Kid Sis insists on having control because, »Hel-lo?! I’ve actually got to live with her!« (Fies, 42; emphasis in original). Fies exposes the discordance that is often enmeshed with cooperation and a mutual concern in the process of caregiving, how »perfectly nice families could disintegrate in a crisis« (41).

Gore narrates her complex experiences of caregiving through a mother-daughter centric lens, and her experiences of caregiving are deeply embedded in, and influenced by, her complicated, emotionally abusive relationship with her mother. Gore’s sister, Leslie, who shares this conflicted relationship with their mother, lives away from them, and participates in caregiving only minimally. Gore calls her to disclose their mother’s diagnosis, she feels comforted, but also realizes that the labor of caregiving is hers alone: »I’m the one who has to take care of her« (Gore, 24-25).5  The rope of time is inextricably knotted for Gore, and the past mother-daughter ambiguities and conflicts intervene continuously on the present patient-caregiver relationship: »When I was a little girl I wanted nothing more than my mother’s attention. My beautiful mother. But she had more important people and things to attend to. Now I sat with her dying, sat steeped in boredom« (Gore, 171). Gore repeatedly reveals the vulnerabilities and anxieties of caregiving. Upon learning the diagnosis, she keeps having »visions« of her mother »getting sicker in a hospital bed in the little room that used to be my office,« »visions« of her mother »getting thinner« (Gore, 22). These visions emphasize her fears about how her mother’s illness will visibly and unavoidably encroach upon her sovereign space and time. A recurrent question that haunts her is, »How am I going to take care of her?« even as she remonstrates with herself, »Pull yourself together, Ariel« (Gore, 23; emphases in original). When a Facebook friend consoles her, »You did your best,« she thinks, »But had I? Done my best? I felt like a failure« (Gore, 101; emphases in original). Even as she exposes the gendered imbalance of caregiving, her guilt is produced by a self-perceived failure to perform the culturally expected role of the ideal daughter-caregiver: »People’s mothers got cancer all the time. People without sisters or money or health insurance or sex lives or salted chocolate. They didn’t whine about it. Women all over the world were caregivers even if they were breadwinners. They dealt with it« (Gore, 25). Her fear and guilt are knotted up in the rope of time: the roots of her fear of her mother’s invading her perceived present may be traced to her troubled past, but her fear and guilt both extend to an imagined future where she may be culturally judged as an inadequate caregiver/daughter. Her present autonomous time is threatened by the diagnosis in two ways—the possibility of her mother disrupting this autonomy and replicating the past, and also of future invasive judgments that may affect her precarious autonomous self.

Fies focuses more on the patient, on her cancer and treatment, but he, too, shares his feelings of inadequacy as a caregiver. He »doubts« that his role as a caregiver is »gonna be enough« because »all [he] has to offer is this:« »I unhelpfully tell her things she already knows,« drives her to and from hospital visits, does the household chores that she cannot manage on her own, brings her food, lends »a steadying arm, laugh at a morbid joke, and compliment a bad wig« (Fies, 25; emphasis in original). Although the list comprehensively covers physical, practical and emotional support, Fies’ »doubt« replicates Gore’s sense of »failure.« Even when Fies emphasizes the collective efforts of caregiving, he enmeshes it with a sense of underlying inadequacy and dissonance: »Everyone is doing everything they can. But some of it conflicts, and none of it is enough. The stakes are too high.« (41) Cancer is an enormous disruptor, not just of the patient’s body, mind and time, but also, by extension, of the caregivers’ times and relationships: and one part of this disruption is caused by the unpredictability and unknowability of cancer’s future time. Like Fies, who reads and collects expert-written articles on cancer in order to (not very successfully) understand the disease, Gore also attempts to »distract« herself »with academic articles on death;« however, these articles appear to be more focused on increasing her understanding and acceptance of death rather than the more fact-oriented research that Fies does (Fies, 24; Gore, 37). She mentions one »academic« article, »Dying in a Technological Society« by »brainy doctor Eric Cassell« and concludes that the modern American attitude to death has »moved from a moral mythology to a technological mythology, so we’d come to see death as something to be overcome. Death was like a broken appliance – just a mechanical problem to be investigated, solved and fixed« (Gore, 37). Concurring with Cassell’s critique of the comparison of the human to the mechanical, of the complete absence of any metaphysical temporal dimension to the experience of life and death, Gore, too, considers the expert medical jargon of illness and death limited and insufficient. Gore’s memoir exposes how death is more than a medical process of diagnosis and successful or failed treatment; she explores the existential uncertainties that underlie the experience of cancer. At one point early in the narrative, she writes, »My mother still didn’t need much in terms of care, but I was trying to make the calls friends told me I should make, trying to plan for a future I didn’t understand« (Gore, 76). The responsibility of the caregiver is not limited to the physical duties of caring for an ill patient, but also extends to planning for an uncertain and horizonless future that has to be navigated blindly with the added stress produced by lack of any certainty of knowledge, understanding or, sometimes, support.

Rebecca Olson conceptualizes »coping strategies« of caregivers as »›internal mechanisms‹ that serve to moderate emotional responses to threatening events such as illness« which are »used to decrease the stress of the response through either changing the environment (problem-focused coping) or changing feelings about the situation (emotion-focused coping)« (56). She identifies »emotion-focused coping strategies« as including »denial, detachment, restraining feelings or avoidance,« and »problem-focused coping« as including »seeking information, assessing the problem, getting guidance;« she also cautions that »emotion-focused coping« may be linked to »negative psychological outcomes such as higher rates of anxiety, depression and burden, while problem-focused coping is linked with positive psychological outcomes, such as reduced stress« (Olson 56). Although it is evident from Gore’s and Fies’ testimonies that it is not always possible to binarize coping strategies in this way, and that the same caregiver may experience temporal phases of reduced stress as well as increased anxiety, we may also consider how Fies’ pragmatic, fact-oriented research resembles Olson’s problem-focused coping, whereas Gore’s persistent restraining of her ambiguous feelings for her mother’s illness may be considered to be an emotion-focused response, generating the need for consolation. For Gore, the consolation that she seeks as a witness and caregiver during her mother’s cancer comes not from the prevalent expert medical language that she encounters, which can neither ›solve‹ nor ›fix‹ the ›mechanical problem,‹ but from alternative sources of healing like »The Tibetan Book of Living and Dying« by Sogyal Rinpoche, where the old master tells the young writer who is witnessing death, »It’s happening now. I have no further advice for you. You are fine as you are: I am happy with you« (Gore, 180-181). Here, the consolation comes from acceptance, both of the inevitability of events in time, and of not being judged for one’s responses to these events.

There are also several instances when Gore chooses to prioritize her own time over the constant demands of caregiving, although she always makes arrangements for alternative paid or voluntary carers to look after her ailing mother. In one such episode, when she has a »writing workshop« she chooses not to cancel it, although the process is limned with guilt: she asks her partner, »Do you think…if I go to Iowa, she’ll be alive when I get back?« (Gore, 163). Every decision on future time contains a tussle between self-care and caregiving, a sense of relief versus a sense of guilt. While the emotional turbulence Gore feels inhibits her decision-making for the future, the oncologist, on the other hand, does not accommodate this factor in his prognosis. He projects a »worst case scenario« in which her mother suffers »complete paralysis within six months« and would »need round-the-clock care at home,« where Gore would have to consult the »social worker;« the same expert states, »off the record I don’t think Medicare will cover it« (Gore, 146). Such a need-focused discourse reveals a lack of empathy for the patient’s and caregiver’s situation. The expert suggests what the patient needs rather than offering possible solutions to fulfil this need, and does not consider the caregiver’s needs at all. The out-of-hospital future time of the patient is shifted as the caregiver’s primary responsibility. However, Gore is also not afraid to reach out to her and Eve’s friends to seek support in her caregiving duties. She emails these friends, informing them that her mother is in »home hospice care« and requests: »I need friends willing to come for a few days or week each to help her here at home. Please let me know if you can take on any time in February or March« (Gore, 153). She makes a combined caregiving schedule, arranges all the material, medical and temporal details, and thus shares the lonely burden of caregiving and the time it consumes with this community of carers. In this way, Gore’s memoir exposes the limitations of monopolistic medical discourses of illness and suggests alternative sources of coping and consolation.

Olson (whose sociology of cancer caregiving focuses only on patients who are cared for by spouses) identifies three types of carers: »time-sovereign carers« who care for patients whose »treatment« are »not debilitating« and who do not have »other substantial ›claimants‹ on their time;« »time-poor carers« who look after patients »whose cancer and treatment« are »debilitating« and so have to provide round-the-clock »personal care« as well as »social and emotional support« but who do not have »other demands on their time;« and »time-destitute« carers who have »little control over their time due to the number and time-intensity of the multiple roles« they juggle, including »paid work, other caregiving responsibilities and childcare« (103). Since Fies shares caregiving responsibilities with his siblings, he may be categorized as a ›time-sovereign‹ carer, and, as his narrative demonstrates, he utilizes caregiving time to remember, reconnect with, and record his mother’s past (Fies, 50–52). Olson notes that time-sovereign carers have more time to grow »closer to the care-recipient,« unlike time-destitute carers (111). It is more difficult to categorize Gore, because although she has paid work and childcare, she also has access to professional and voluntary carers. Olson conceptualizes »time-sovereignty« categories as »fluid,« and Gore’s narrative manifests the shifting boundaries among time-sovereign, time-poor and time-destitute caregiving which, thus, »need to be continuously reassessed« (Olson, 113). Gore’s closeness to her mother follows a troubled, uneven arc: when she is experiencing time-destitute caregiving, she feels less emotionally close to her mother than when she is experiencing time-sovereign caregiving and can reconnect more deeply with her. Often experiencing time-destitute caregiving, Gore prefers »practical support which gives [her] more time to juggle [her] competing roles or indeed, time to feel,« in the way that Fies does with his mother in possibly less complicated ways (Olson, 112).

Ending Time

Although she performs a ritual countdown, Gore’s mother lives long beyond her self-projected date of death, and even beyond the doctors’ expectations of her life span. Her »Perceived Present« rope of time stretches, extending into and fragmenting her »Imagined Future« (Hannum and Rubinstein, 19). Gore narrates, »On the morning my mother thought she would die, she marched out into the living room in her leopard-print robe« (88). This indicates another incongruence between the patient’s temporal perspective (what she thought would happen) and temporal structure (what actually happens). Her mother’s cancer is »unusually slow-growing,« although it metastasizes to her spine and brain (Gore, 145). Mirroring this latency, The End of Eve negotiates the slow-moving rope of time through multiple chapters intermeshing past and present; memories, dreams and emotionally-charged encounters. Gore shifts from being primary caregiver to visiting caregiver, assisted by paid palliative care nurses, and volunteering family and friends. She emphasizes the rising costs and unforgiving exhaustions of indefinite, long-term caregiving. At one point in the memoir, Gore writes, »My mother is never going to die... It had been two months since her release from the hospital... How could I explain the depths of my exhaustion? I knew I should be living in the present, in these ugly and sacred moments... But I was glad my mother wasn’t all I had« (180). Living through indefinitely continuing exhaustions of caregiving, Gore relies on her sovereign time for self-care. Bitter mother-daughter confrontations interrupt the Gore’s terrain of caregiving time and again. At one point, Gore writes, »She was just an abusive bitch who happened to have cancer« (97). At another, Gore’s mother shrieks, »I hate you... You’ve got everything and I’ve got nothing, all right?... You have a life and I don’t have a life« (180). Gore’s friend asks her, »What does it mean for life to bear witness to death?« (179). Gore chooses not to answer this central question of caregiving, and also of reading illness memoirs. Exposing the simultaneous, interlocked, yet irreconcilable timelines of mother and daughter, patient and caregiver, the writer and her subject, the constantly deferring narrative pulls the reader in to witness a slow wait; shifting between and blurring the binaries of »love and abuse,« closeness and distance, defiantly living and gradually dying (Gore, 165).

As Gore’s mother shifts from alternative therapy to chemotherapy, there is one vivid description that is reminiscent of Fies’ mother’s still, frail image in »Arrangement in Gray and Black:« »She sat propped in a chair, her eyes closed, head back and mouth open. Surrounded by machines that beeped and glowed. An oxygen tube in her nose. I stepped back from the doorway to steady my breath. What had I expected, anyway? The mother of my childhood? Dark 1970s perm? Defined biceps, still strong enough to leave a mark when she hit me?« (Gore, 140). Like Fies, Gore flashbacks to the past. The present disrupts and contrasts starkly with past memories, yet past and present are linked through a continuity of suffering and loss. Witnessing the two still images – of Fies’ mother and Gore’s mother – recalls Charmaz’s explication of »dragging and drifting time:«

When an individual is plunged into a serious episode, two main ways of experiencing time stand out: the dragging time of pain and suffering, and the drifting time of loss of consciousness. During the agony of pain, time lengthens. Moments expand and swell without end. […] Drifting time, in contrast, spreads out. Like a fan, drifting time unfolds and expands during a serious immersion in illness. This time is the elusive, slowed time when an immobile individual regains consciousness. Time drifts when action remains so limited. Yet drifting time also includes the amorphous, floating time when someone slips in and out of sleep or consciousness. Time elapses without awareness. Then, lengthy periods of clock-time collapse quickly into seemingly short durations. (90–91)

Charmaz’s observations are based on her interviews with patients with chronic illnesses, while as readers, we witness Fies’ or Gore’s mother through the filter of the caregiver/authors’ representation. Hence, it may not be possible to demarcate dragging time from drifting time while observing the patient from the outside – as we are doing – but the stillness of the graphic and word images seems to indicate an experience of immersive time, which can be elongated or collapsed or both. There are instances in Gore’s memoir where the sense of ›dragging time‹ as well as rushing time is acutely experienced by Gore, the caregiver, herself. When her mother’s illness is prolonged beyond medical expectations, and Gore is emotionally traumatized because of her ongoing quarrel and separation from her mother as well as the looming uncertainty of future time, she writes: »This was supposed to be a book about a typical caregiver – a daughter with children of her own trying to help her terminal if eccentric widow-mother through a final year. But now here we were mid-narrative, more than a year gone by, and no one had died and I didn’t have a mother anymore and the semester was wrapping up. Soon I wouldn’t have a job« (110). Whereas her own unsettled, possibly unemployed future seems to be approaching too fast, her mother’s present illness is stretching too long, creating disorienting anomalies of temporal expectations.

The terminal chapters of Gore’s memoir narrate her mother’s accelerating corporeal deterioration, but also moments of stubborn resistance. The »lead hospice nurse« comments, »Your mother isn’t following any of the normal patterns,« referring to her »unbelievable« reverse progression from »soft foods to complex solid foods,« and to »the bedsore« that is »beginning to heal« (Gore, 169; emphasis added).6 The normative medical framework of a terminally ill cancer patient is that of gradual deterioration: »Normally a patient might go from soft foods to liquids. Then she might start refusing food all together. That would tell us she had just a few days« (Gore, 169; emphasis added). Yet, Gore’s mother’s body disobeys these normative assumptions of patient time through an extraordinary temporal reversal that does not ›tell‹ or disclose any confirmation of standardized medical diagnosis or symptoms. There are several such instances when Gore’s mother seemingly refuses to conform to medical expectations. On one such occasion, Lara, the professional caregiver from a community care centre, calls Gore over to visit her mother for the final time, »Your mother is passing today. All the signs are here« (183). After Gore sits with her »for a long time,« watching her breathe, her mother »opened her eyes and jerked up, staring at the two of us sitting there. The whisper of the heart sutra, the hiss of oxygen. ›What? Did you think I was dead? I want an omelet.‹ She shook her head and cackled« (184). Gore’s mother’s appetite for living – metaphorized through her appetite for food and for arguing with her daughter and others – elongates the time allotted to her by experts and openly challenges the expected medical chrononormativity about patient time and body. Gore’s mother wants to write her own memoir, and to celebrate life-affirming feasts and festivals.

However, the resilience of body and spirit that Gore’s mother projects is always accompanied with signs of gradually increasing physical debilitation. Gore can identify the visible ravages of cancer on her mother, »she had that look of death now – eyes sunken, teeth too prominent« (155). The visibilization of illness is matched with an increase of physical suffering: »I read the caregiver logs in the mornings. Nights of vomiting and pain« (Gore, 161). Yet, in the midst of increasing pain, Gore’s mother wishes to memorialize her own life, and she also wishes to continue the family’s traditional feasts. Charmaz notes, »Increasing immersion in illness leads to becoming consumed by needs and feelings; people turn inward. Turning inward to self ranges from explicit, direct, and immediate focusing on the ill self to broader self-concerns that a person relates to illness« (Charmaz, 99). For Gore’s mother, turning inward is accompanied by a desire to memorialize her past self, possibly the self before illness, a desire for a posthumous permanence that resists the frail transience of her body: »Can I tell you a story, Tiniest? For my memoir? I am too tired to type« (Gore, 172). Her other concern – celebrating the cycle of festivals – also indicate the need for continuity and stability provided by cyclical celebrations in the face of encroaching uncertainty: »[I]t’s Passover. We have to prepare a Seder. The leg of lamb. All the dishes.« (Gore, 186).

Gore’s mother dies on Easter, but Gore celebrates because her mother had planned the menu and had been »so looking forward to her feast:« »And I set the table with my Gammie’s silver, set a place for my mother, too, poured her a glass of red Zinfandel…« (Gore, 187–188). After months of latency, the rope of time enables the daughter to ›reconcile‹ the projected future death with the present reality, as she memorializes and celebrates her mother through the glass of wine. The memoir then moves forward into the post-death stage: a time of grieving and healing, ending with Gore anchoring the rope of time between her past and present identities: »I was once somebody’s daughter. And now I am free« (Gore, 198). Within the framework of the graphic narrative, Fies’ mother’s story ends differently. It is a story of »progress,« of cancer in remission, of the fortunate »one of the five percent who makes it« (Fies, 80; 92). Fies’ mother also chooses to celebrate life-affirming occasions, like her own birthday, when she is colour-drawn as the »belle of the ball« in contrast to the monochromatic background of the party (Fies, 82). Here, as elsewhere in the narrative, Fies emphasizes the affirmative, communal aspect of caregiving: »Mom can’t do much herself, of course. Nurse Sis, Kid Sis, and I divide the duties and go to work« to plan a busy future »goal« for their mother, »something good to look forward to« (81). However, Fies also emphasizes the difference between the certainty of »cure« and the contingency of »remission« –»Vigilance will define the rest of her days… watching for anywhere a stray cancer cell might strike roots« (101). Arthur Frank’s concept of the »remission society« describes all those – including cancer patients in remission – who are »effectively well but could never be considered cured« (Frank, 8). The rope of time in remission will perpetually be unfixed and under threat. However, Fies’ epilogue expands the possibilities rather than the precarity of the future. In the final three pages, the past, present and future are reconciled, as Fies’s mother and sisters relocate to Hollywood, a place associated with their shared happy past. The crisis of cancer pushes his mother to take this risky, wish-fulfilling step: »But mom always wanted to live in Southern California. I guess she figured it was now or never« (Fies, 110). The rope of time is imaged as the long road unfurling into a future that cannot be gauged beyond the horizon (fig. 5).

Fig.5: Fies, Brian: Mom’s Cancer. New York: Abrams Image, 2006, p.110.

In the final panels, Fies projects further into the yet un-visibilized, braided, yet individual futures of his sisters and his mother, labelling it as »coming soon, « a future that is still being written (Fies, 111). These imagined futures (of his sisters and his mother) are written in present continuous text-boxes against the calming blue backdrop of the night sky: »Kid Sis is taking screenwriting classes […]. / Nurse Sis is getting certified […] / Mom is working hard to feel better and restart her life. Look for her in the crowd scenes of major motion pictures … coming soon to a theater near you« (Fies, 111; emphases added). The last page of Fies’ memoir comprises two separate wordless panels of the night sky, the top panel with a few twinkling stars. The absence of words multiplies the resonances of this page: whether it implies hope, or consolation, or condolence will depend upon individual readings at specific points of time. A little earlier in the memoir, Fies writes, »When I started, I thought my story was about death. It turned out to be about hope« (104). While documenting his experiences, he realises, »I knew we weren’t alone« (Fies, 103). Gore, in contrast, writes, »Trauma, by its very definition, can’t be fully experienced in the moment. Due to the suddenness or the enormity of the traumatic event, we just can’t take it in. So, we have to go back to it at some point – either literally or symbolically – to integrate whatever happened. We can do that consciously, in some safe way, or we’re destined to revisit the trauma over and over again as the violence of life« (175). Yet she also realises how the rope of time holds out possibilities: »[As] long as we’re alive there’s time for reinvention; time to imagine some way to integrate the enormity of it all« (Gore, 197).

Hannum and Rubinstein suggest that »cancer’s emotional and physical burdens« necessitate perceptions of time becoming »fractured and fragmented« (19). Although they restrict their analysis to older cancer patients, in the caregiving memoirs we have studied here – where the narration of the patient’s cancer experience is relayed through the caregiver – we may add that the experience of extraordinary, fractured time is also extended to the caregiver’s lived experience. The caregiver-narrators witness the patient’s experience and document it as they document their own responses, needs, pressures and emotions, which often echo a similar fracturing and fragmentation. In the introduction to their anthology of illness narratives, Sayantani Dasgupta and Martha Hurst write: »The illness narrative does not merely reflect the experience of illness; it contributes to that experience by giving coherence, symbolism, and meaning to what might otherwise have been a chaotic experience« (1). Although there are multiple and unique ›chaotic experiences‹ lived by countless individual patients and caregivers, there may be shared feelings and common meanings. Gore provides »nutshell statistics« that »give a universal context to a personal story:« »In any given year, almost 30% of the U.S. population will be caring for an ill, disabled, or ageing friend or family member. The caregiver will offer an average of 20 hours a week in unpaid labor and over $5,000 a year in out-of-pocket expenditures. […] The typical caregiver, it turns out, is me: An adult female with children of her own caring for her widowed mother« (55–56). The statistics that Gore cites for the United States may be expanded to include wider geographies and cultural contexts. For the writers and artists of caregiving memoirs, recording their trauma, navigating and processing the rope of time are also methods of revisiting, repairing and healing. It is a pertinent step for caregivers, for their time, too, is limited and valuable. For readers, reading such narratives – whether graphic or literary – may also help in engaging with their own timelines of dependencies, trauma and healing in consciously-chosen, safe and shared ways.

 

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Bibliography

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  • Hannum, Susan. M., and Robert L. Rubinstein: The meaningfulness of time: Narratives of cancer among chronically ill older adults. In: Journal of Aging Studies 36 (2016), p. 17–25. Web. 12 Sept. 2020. http://dx.doi.org/10.1016/j.jaging.2015.12.006.
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Table of Figures

  • Fig. 1: Fies, Brian: Mom’s Cancer. New York: Abrams Image, 2006, p.5.
  • Fig. 2: Fies, Brian: Mom’s Cancer. New York: Abrams Image, 2006, p.26.
  • Fig. 3: Fies, Brian: Mom’s Cancer. New York: Abrams Image, 2006, p.33.
  • Fig. 4: Fies, Brian: Mom’s Cancer. New York: Abrams Image, 2006, p.42.
  • Fig. 5: Fies, Brian: Mom’s Cancer. New York: Abrams Image, 2006, p.110. Abb. 1: Abb. 1: JFM, S. 94, 95.