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Review: Charles Bock’s Alice & Oliver could be the greatest novel ever written about cancer

Charles Bock

Nina Subin

Title
Alice & Oliver
Author
Charles Bock
Genre
Fiction
Publisher
Random House
Pages
399
Price
$37

On Dec 22, 2015, I pitched Mark Medley, the Globe & Mail's Books Editor, to review Charles Bock's new novel Alice & Oliver. When he wrote back asking why I'd be a good fit, I replied as follows:

I loved his first book, Beautiful Children. And this new one's about a young family dealing with cancer and caregiving (Bock's own wife died of leukemia when their daughter was a baby), and cancer care is something I have personal experience with. I'm also super-interested in mortality and how we deal with it, fictionally and otherwise.

My phrase "cancer care is something I have personal experience with" referred to my mother's death of lung cancer in 2008 – I'd written a fictionalized version of her in my most recent book – and my father's struggle over the last two years with a non-Hodgkins lymphoma that chemotherapy routed into remission. These events left me with a burning interest (and, okay, a morbid fear) of the illness.

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To allay my anxiety (or possibly to feed it) I'd since read Siddhartha Mukherjee's magisterial history of cancer, The Emperor of All Maladies, as well as Atul Gawande's powerful treatise on death, illness and suffering, Being Mortal. The poet Jason Shinder, who died of lymphoma, wrote of his experience: "Cancer is a tremendous opportunity to have your face pressed right up against the glass of your mortality." And reading about cancer, I would argue, provides us with a version of this opportunity.

Medley agreed, and I received the novel on January 4. However, on that very same day, I also received a call from my brother, informing me that when my father returned to work after Christmas holidays, his co-workers had gasped. He'd lost 30 pounds in mere weeks and his skin had taken a greyish tinge. His lymphoma had returned, and metastasized. CAT scans indicated spots on his lungs, his liver. I booked a flight and was with him as he began treatment. But the enemy this time was a rare "grey-zone" lymphoma (an aggressive type that bears features of both Hodgkins and non-Hodgkins), the behaviour of which even his oncologist struggled to understand. Then came more treatment. A hospital admittance. Steroids. Hydration. Kidney malfunction. Fluid in his lungs. And after a final dip into the poison waters of chemotherapy, my father died on February 2.

I normally refrain from injecting personal details into book reviews. I've watched my own work become a trampoline upon which other writers execute the acrobatics of self-serving anecdotes, all under the auspices of criticism, and it never feels good. Such reviews are the print equivalent of the audience member who asks a lengthy and unnecessarily complex question of a speaker, really just as an excuse to prattle on about their own vaguely similar experiences, experiences that the audience certainly wouldn't have paid $30 at the door to hear.

So if I am somehow committing this sin, I'm sorry. My intent is not to hijack Charles Bock's achievement (which is considerable, and which I'll get to, I promise) with my own tragedy. But my father died of cancer while I was reading this novel about cancer. And to leave that unsaid would feel even stranger than it does to admit that I'm writing this review with pieces of my heart rattling around inside my chest.

The story itself concerns a young couple (Oliver, an ambitious computer coder, and Alice, a fledgling fashion designer) and their new baby, Doe, living in a converted industrial space in pre-Bloomberg New York's Meatpacking District, described in all its ungentrified punk swagger and gritty beauty. Their enviable lives are upended in the book's first pages when Alice is diagnosed with leukemia while on vacation and rushed to hospital. Friends and parents charge in, a battle plan is concocted, a bone marrow donor match is sought, as the couple fight to retain some shred of normalcy and connection amid creeping dread at the seriousness of her illness.

Bock's extensive medical descriptions are where his real-life history lends real weight of authenticity and authority. He nails the daily setbacks, scares and guarded triumphs of a fight with cancer, the very same details I experienced with both my mother and father: the ice chips, the mesh hospital undergarments, the untiable gowns, the constant tests, the curt night nurse who pushes sleep medication so the patient will be less trouble, the rolling tables, the IV sites, the plunging white blood cell counts, the powdery blue latex gloves. He also nails the odd, yet understandably brisk personality of oncologists: "smiling in a manner neither welcoming nor insincere, his handshake strong without being warm."

And so the family soldiers on. A wig is purchased. Care is given. But make no mistake, despite doses of comic levity and life-affirmation: Alice & Oliver is a descent into medical hell. You'll find no mention of the cancer "journey" here, thank goodness. Some moments are nearly too sad to bear. Like when Alice can't see Doe, her daughter, for months, because her white blood cell count is too low, and the baby's fledgling immune system could be harbouring some bug that could inadvertently kill her own mother. Or the detailed plans for dealing with a baby after her mother has died (what to tell her, where they'll live…). Or the young child who wants to "take a plane" to find her dead mother in the sky. Declaring that she would "search every cloud."

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But I'm happy to report that the most frustrating, inhuman details of Alice's treatment were unfamiliar to this Canadian. If ever you need reminding of the incredible treasure we possess in our healthcare system, look no further than the story of a man tending his dying wife while bottle-feeding a screaming baby who can't drink her mother's milk because chemotherapy has rendered it toxic, while he scrambles to upgrade his medical insurance coverage because the plan he'd purchased has a cost ceiling that his wife's treatment is about to smash through, after which she'll be denied care. "Let's just say I'm a believer in universal, single-payer healthcare insurance," Bock said with wry understatement in an interview.

Alice's condition worsens, and, surprisingly, the couple's fidelity to one another is strained (yes, both of them). Though the story is told in mostly a linear fashion, with welcome digressions into the couple's past, details are presented unfiltered, fugue-like, in staccatto eruptions. Which works, mostly, but occasionally the disjointments of the prose style fumble the narrative ball, straying from pleasantly jarring to plain jarring. And the case studies of other cancer patients that are interspersed seemingly at random throughout the story, though they are at times moving, feel orphaned and out of place.

However, if you're looking for a clear-eyed, objective appraisal of this novel, you'll not find it here. Despite our pretenses of objectivity, we encounter books at certain moments in our lives. And this timing wields an indelible influence upon the reading. I read this novel sitting in an oncology ward, to the sound of my father's IV, and I wept through much of it. Some of that, I can guarantee, was the work of Bock, and the rest the work of the rapacious cells decimating my father's body.

But the best fiction weaves itself into the fabric of our experience, and in the end, a book's value must be discerned from the richness of the response it conjures in the reader. All I can say is that Alice & Oliver is the most honest, unsentimentally powerful novel about cancer that I've ever read. Discounting Alexander Solzhenitsyn's Cancer Ward, it could be the greatest novel ever written on the subject.

"It's understandable why someone might not want to take on a book they think is emotionally hard," Bock said in an interview, and I agree that this novel's subject must be a tough sell. But I can personally attest that "to have your face pressed right up against the glass of your mortality" is the very thing that can best attune us to the true sweetness and splendour of our lives.

"The specter of one of those hospital beds," Bock writes with harrowing power, "the beeping IV tower, the fluorescent light – it's all coming." You might not want to read about death, dear reader, but the greatest – and yes, the most difficult – fiction serves to remind us that right now, even as you read this very sentence, death is reading about us.

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Michael Christie is the author of The Beggar's Garden and If I Fall, If I Die.

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