Mortality

  The bargaining stage, though. Maybe there’s a loophole here. The oncology bargain is that, in return for at least the chance of a few more useful years, you agree to submit to chemotherapy and then, if you are lucky with that, to radiation or even surgery. So here’s the wager: You stick around for a bit, but in return we are going to need some things from you. These things may include your taste buds, your ability to concentrate, your ability to digest, and the hair on your head. This certainly appears to be a reasonable trade. Unfortunately, it also involves confronting one of the most appealing clichés in our language. You’ve heard it all right. People don’t have cancer: They are reported to be battling cancer. No well–wisher omits the combative image: You can beat this. It’s even in obituaries for cancer losers, as if one might reasonably say of someone that they died after a long and brave struggle with mortality. You don’t hear it about long–term sufferers from heart disease or kidney failure.

  Myself, I love the imagery of struggle. I sometimes wish I were suffering in a good cause, or risking my life for the good of others, instead of just being a gravely endangered patient. Allow me to inform you, though, that when you sit in a room with a set of other finalists, and kindly people bring a huge transparent bag of poison and plug it into your arm, and you either read or don’t read a book while the venom sack gradually empties itself into your system, the image of the ardent soldier or revolutionary is the very last one that will occur to you. You feel swamped with passivity and impotence: dissolving in powerlessness like a sugar lump in water.

  It’s quite something, this chemo–poison. It has caused me to lose about fourteen pounds, though without making me feel any lighter. It has cleared up a vicious rash on my shins that no doctor could ever name, let alone cure. (Some venom, to get rid of those furious red dots without a struggle.) Let it please be this mean and ruthless with the alien and its spreading dead-zone colonies. But as against that, the death–dealing stuff and life–preserving stuff have also made me strangely neuter. I was fairly reconciled to the loss of my hair, which began to come out in the shower in the first two weeks of treatment, and which I saved in a plastic bag so that it could help fill a floating dam in the Gulf of Mexico. But I wasn’t quite prepared for the way that my razor blade would suddenly go slipping pointlessly down my face, meeting no stubble. Or for the way that my newly smooth upper lip would begin to look as if it had undergone electrolysis, causing me to look a bit too much like somebody’s maiden auntie. (The chest hair that was once the toast of two continents hasn’t yet wilted, but so much of it was shaved off for various hospital incisions that it’s a rather patchy affair.) I feel upsettingly denatured. If Penélope Cruz were one of my nurses, I wouldn’t even notice. In the war against Thanatos, if we must term it a war, the immediate loss of Eros is a huge initial sacrifice.

  These are my first raw reactions to being stricken. I am quietly resolved to resist bodily as best I can, even if only passively, and to seek the most advanced advice. My heart and blood pressure and many other registers are now strong again: Indeed, it occurs to me that if I didn’t have such a stout constitution I might have led a much healthier life thus far. Against me is the blind, emotionless alien, cheered on by some who have long wished me ill. But on the side of my continued life is a group of brilliant and selfless physicians plus an astonishing number of prayer groups. On both of these I hope to write next time if—as my father invariably said— I am spared.

  II

  WHEN I DESCRIBED THE TUMOR IN MY ESOPHAGUS as a “blind, emotionless alien,” I suppose that even I couldn’t help awarding it some of the qualities of a living thing. This at least I know to be a mistake: an instance of the pathetic fallacy (angry cloud, proud mountain, presumptuous little Beaujolais) by which we ascribe animate qualities to inanimate phenomena. To exist, a cancer needs a living organism, but it cannot ever become a living organism. Its whole malice—there I go again—lies in the fact that the “best” it can do is to die with its host. Either that or its host will find the measures with which to extirpate and outlive it.

  But, as I knew before I became ill, there are some people for whom this explanation is unsatisfying. To them, a rodent carcinoma really is a dedicated, conscious agent— a slow–acting suicide–murderer— on a consecrated mission from heaven. You haven’t lived, if I can put it like this, until you have read contributions such as this on the websites of the faithful:

  Who else feels Christopher Hitchens getting terminal throat cancer [sic] was God’s revenge for him using his voice to blaspheme him? Atheists like to ignore FACTS. They like to act like everything is a “coincidence.” Really? It’s just a “coincidence” [that] out of any part of his body, Christopher Hitchens got cancer in the one part of his body he used for blasphemy? Yeah, keep believing that, Atheists. He’s going to writhe in agony and pain and wither away to nothing and then die a horrible agonizing death, and THEN comes the real fun, when he’s sent to HELLFIRE forever to be tortured and set afire.

  There are numerous passages in holy scripture and religious tradition that for centuries made this kind of gloating into a mainstream belief. Long before it concerned me particularly I had understood the obvious objections. First, which mere primate is so damn sure that he can know the mind of god? Second, would this anonymous author want his views to be read by my unoffending children, who are also being given a hard time in their way, and by the same god? Third, why not a thunderbolt for yours truly, or something similarly awe–inspiring? The vengeful deity has a sadly depleted arsenal if all he can think of is exactly the cancer that my age and former “lifestyle” would suggest that I got. Fourth, why cancer at all? Almost all men get cancer of the prostate if they live long enough: It’s an undignified thing but quite evenly distributed among saints and sinners, believers and unbelievers. If you maintain that god awards the appropriate cancers, you must also account for the numbers of infants who contract leukemia. Devout persons have died young and in pain. Betrand Russell and Voltaire, by contrast, remained spry until the end, as many psychopathic criminals and tyrants have also done. These visitations, then, seem awfully random. My so far uncancerous throat, let me rush to assure my Christian correspondent above, is not at all the only organ with which I have blasphemed. And even if my voice goes before I do, I shall continue to write polemics against religious delusions, at least until it’s hello darkness my old friend. In which case, why not cancer of the brain? As a terrified, half–aware imbecile, I might even scream for a priest at the close of business, though I hereby state while I am still lucid that the entity thus humiliating itself would not in fact be “me.” (Bear this in mind, in case of any later rumors or fabrications.)

  The absorbing fact about being mortally sick is that you spend a good deal of time preparing yourself to die with some modicum of stoicism (and provision for loved ones), while being simultaneously and highly interested in the business of survival. This is a distinctly bizarre way of “living”—lawyers in the morning and doctors in the afternoon—and means that one has to exist even more than usual in a double frame of mind. The same is true, it seems, of those who pray for me. And most of these are just as “religious” as the chap who wants me to be tortured in the here and now—which I will be even if I eventually recover—and then tortured forever into the bargain if I don’t recover or, presumably and ultimately, even if I do.

  Of the astonishing and flattering number of people who wrote to me when I fell so ill, very few failed to say one of two things. Either they assured me that they wouldn’t offend me by offering prayers or they tenderly insisted that they would pray anyway. Devotional websites consecrated special space to the question. (If you should read this in time, by all means keep in mind that September 20, 2010, has already been designated “Everybody Pray for Hitchens Day.”) Pat Archbold, at the National Catholic Register, and Deacon Greg Kandra were among the Roman Catholics who thought me a worthy object of prayer. Rabbi David Wolpe, author of Why Faith Matters and the leader of a major congreg
ation in Los Angeles, said the same. He has been a debating partner of mine, as have several Protestant evangelical conservatives like Pastor Douglas Wilson of the New Saint Andrews College and Larry Taunton of the Fixed Point Foundation in Birmingham, Alabama. Both wrote to say that their assemblies were praying for me. And it was to them that it first occurred to me to write back, asking: Praying for what?

  As with many of the Catholics who essentially pray for me to see the light as much as to get better, they were very honest. Salvation was the main point. “We are, to be sure, concerned for your health, too, but that is a very secondary consideration. ‘For what shall it profit a man if he gains the whole world and forfeits his own soul?’ [Matthew 16:26].” That was Larry Taunton. Pastor Wilson responded that when he heard the news he prayed for three things: that I would fight off the disease, that I would make myself right with eternity, and that the process would bring the two of us back into contact. He couldn’t resist adding rather puckishly that the third prayer had already been answered . . .

  So there are some quite reputable Catholics, Jews, and Protestants who think that I might in some sense of the word be worth saving. The Muslim faction has been quieter. An Iranian friend has asked for a prayer to be said for me at the grave of Omar Khayyam, supreme poet of Persian freethinkers. The YouTube video announcing the day of intercession for me is accompanied by the song “I Think I See the Light,” performed by the same Cat Stevens who as “Yusuf Islam” once endorsed the hysterical Iranian theocratic call to murder my friend Salman Rushdie. (The banal lyrics of his pseudo–uplifting song, by the way, appear to be addressed to a chick.) And this apparent ecumenism has other contradictions, too. If I were to announce that I had suddenly converted to Catholicism, I know that Larry Taunton and Douglas Wilson would feel I had fallen into grievous error. On the other hand, if I were to join either of their Protestant evangelical groups, the followers of Rome would not think my soul was much safer than it is now, while a late-in-life decision to adhere to Judaism or Islam would inevitably lose me many prayers from both factions. I sympathize afresh with the mighty Voltaire, who, when badgered on his deathbed and urged to renounce the devil, murmured that this was no time to be making enemies.

  The Danish physicist and Nobelist Niels Bohr once hung a horseshoe over his doorway. Appalled friends exclaimed that surely he didn’t put any trust in such pathetic superstition. “No, I don’t,” he replied with composure, “but apparently it works whether you believe in it or not.” That might be the safest conclusion. The most comprehensive investigation of the subject ever conducted—the “Study of the Therapeutic Effects of Intercessory Prayer,” of 2006,— could find no correlation at all between the number and regularity of prayers offered and the likelihood that the person being prayed for would have improved chances. But it did find a small but interesting negative correlation, in that some patients suffered slight additional woe when they failed to manifest any improvement. They felt that they had disappointed their devoted supporters. And morale is another unquantifiable factor in survival. I now understand this better than I did when I first read it. An enormous number of secular and atheist friends have told me encouraging and flattering things like, “If anyone can beat this, you can”; “Cancer has no chance against someone like you”; “We know you can vanquish this.” On bad days, and even on better ones, such exhortations can have a vaguely depressing effect. If I check out, I’ll be letting all these comrades down. A different secular problem also occurs to me: What if I pulled through and the pious faction contentedly claimed that their prayers had been answered? That would somehow be irritating.

  I have saved the best of the faithful until the last. Dr. Francis Collins is one of the greatest living Americans. He is the man who brought the Human Genome Project to completion, ahead of time and under budget, and who now directs the National Institutes of Health. In his work on the genetic origins of disorder, he helped decode the “misprints” that cause such calamities as cystic fibrosis and Huntington’s disease. He is working now on the amazing healing properties that are latent in stem cells and in “targeted” gene–based treatments. This great humanitarian is also a devotee of the work of C. S. Lewis and in his book The Language of God has set out the case for making science compatible with faith. (This small volume contains an admirably terse chapter informing fundamentalists that the argument about evolution is over, mainly because there is no argument.) I know Francis, too, from various public and private debates over religion. He has been kind enough to visit me in his own time and to discuss all sorts of novel treatments, only recently even imaginable, that might apply to my case. And let me put it this way: He hasn’t suggested prayer, and I in turn haven’t teased him about The Screwtape Letters. So those who want me to die in agony are really praying that the efforts of our most selfless Christian physician be thwarted. Who is Dr. Collins to interfere with the divine design? By a similar twist, those who want me to burn in hell are also mocking those kind religious folk who do not find me unsalvageably evil. I leave these paradoxes to those, friends and enemies, who still venerate the supernatural.

  Pursuing the prayer thread through the labyrinth of the Web, I eventually found a bizarre “Place Bets” video. This invites potential punters to put money on whether I will repudiate my atheism and embrace religion by a certain date or continue to affirm unbelief and take the hellish consequences. This isn’t, perhaps, as cheap or as nasty as it may sound. One of Christianity’s most cerebral defenders, Blaise Pascal, reduced the essentials to a wager as far back as the seventeenth century. Put your faith in the almighty, he proposed, and you stand to gain everything. Decline the heavenly offer and you lose everything if the coin falls the other way. (Some philosophers also call this Pascal’s Gambit.)

  Ingenious though the full reasoning of his essay may be—he was one of the founders of probability theory— Pascal assumes both a cynical god and an abjectly opportunist human being. Suppose I ditch the principles I have held for a lifetime, in the hope of gaining favor at the last minute? I hope and trust that no serious person would be at all impressed by such a hucksterish choice. Meanwhile, the god who would reward cowardice and dishonesty and punish irreconcilable doubt is among the many gods in which (whom?) I do not believe. I don’t mean to be churlish about any kind intentions, but when September 20 comes, please do not trouble deaf heaven with your bootless cries. Unless, of course, it makes you feel better.

  Many readers are familiar with the spirit and the letter of the definition of “prayer,” as given by Ambrose Bierce in his Devil’s Dictionary. It runs like this, and is extremely easy to comprehend:

  Prayer: A petition that the laws of nature be suspended in favor of the petitioner; himself confessedly unworthy.

  Everybody can see the joke that is lodged within this entry: The man who prays is the one who thinks that god has arranged matters all wrong, but who also thinks that he can instruct god how to put them right. Half–buried in the contradiction is the distressing idea that nobody is in charge, or nobody with any moral authority. The call to prayer is self–cancelling. Those of us who don’t take part in it will justify our abstention on the grounds that we do not need, or care, to undergo the futile process of continuous reinforcement. Either our convictions are enough in themselves or they are not: At any rate they do require standing in a crowd and uttering constant and uniform incantations. This is ordered by one religion to take place five times a day, and by other monotheists for almost that number, while all of them set aside at least one whole day for the exclusive praise of the Lord, and Judaism seems to consist in its original constitution of a huge list of prohibitions that must be followed before all else.

  The tone of the prayers replicates the silliness of the mandate, in that god is enjoined or thanked to do what he was going to do anyway. Thus the Jewish male begins each day by thanking god for not making him into a woman (or a Gentile), while the Jewish woman contents herself with thanking the almighty for creating her “as she is.” Pre
sumably the almighty is pleased to receive this tribute to his power and the approval of those he created. It’s just that, if he is truly almighty, the achievement would seem rather a slight one.

  Much the same applies to the idea that prayer, instead of making Christianity look foolish, makes it appear convincing. (We’ll just stay with Christianity today.) Now, it can be asserted with some confidence, first, that its deity is all–wise and all–powerful and, second, that its congregants stand in desperate need of that deity’s infinite wisdom and power. Just to give some elementary quotations, it is stated in the book of Philippians, 4:6, “Be careful for nothing; but in everything by prayer and supplication and thanksgiving, let your requests be known to God.” Deuteronomy 32:4 proclaims that “he is the rock, his work is perfect,” and Isaiah 64:8 tells us, “Now O Lord, thou art our father; we art clay and thou our potter; and we are all the work of thy hand.” Note, then, that Christianity insists on the absolute dependence of its flock, and then only on the offering of undiluted praise and thanks. A person using prayer time to ask for the world to be set to rights, or to beseech god to bestow a favor upon himself, would in effect be guilty of a profound blasphemy or at the very least a pathetic misunderstanding. It is not for the mere human to be presuming that he or she can advise the divine. And this, sad to say, opens religion to the additional charge of corruption. The leaders of the church know perfectly well that prayer is not intended to gratify the devout. So that, every time they accept a donation in return for some petition, they are accepting a gross negation of their faith: a faith that depends on the passive acceptance of the devout and not on their making demands for betterment. Eventually, and after a bitter and schismatic quarrel, practices like the notorious “sale of indulgences” were abandoned. But many a fine basilica or chantry would not be standing today if this awful violation had not turned such a spectacularly good profit.