The unspeakable spectre of 'Big C'

TERATOLOGIES: A CULTURAL STUDY OF CANCER. By Jackie Stacey. Routledge, 290pp Pounds 45.00 and Pounds 13.99. ISBN 0 415 14959 2 and 14960 6

Teratologies is a book that tells stories. But the stories are not always easy ones. They concern the body in trouble, its vulnerabilities, its betrayals and, most significantly for this study, how it becomes culturally inscribed by illness. Cancer has become an unspeakable spectre in a culture that is arguably obsessed with the control and presentation of the body. "The Big C" haunts the contemporary western imagination. But as Jackie Stacey's subtle and intelligent account of the contemporary cultural discourses of cancer eloquently illustrates, cancer is both unspeakable and persistently spoken of.

The word teratologies has several connotations including the production of monsters, the study of abnormal growths, and tales of marvels. This confluence of medicine, monstrosity and narrative signals the interdisciplinary nature of the study. The book is organised into eight thematic chapters: "Heroes", "Metaphors", "Monsters", "Bodies", "Visions", "Selves", "Responsibilities", and "Endings". Stacey discusses these themes by combining an autobiographical account of her own experiences of cancer with theoretical analyses drawn from feminism, sociology, film studies and cultural studies.

Cancer invokes anxieties about the body at war with itself. It is figured as a potent and malign force that threatens to destroy the self from within. It has thus tended to be represented (in both conventional biomedicine as well as alternative and self-help therapies) metaphorically.So, the cancer comes to represent repressed desires, emotional vulnerability, psychic disharmony and so on. But Stacey, following and developing the work of Susan Sontag, argues that such tropic readings of illness do not successfully contain the meanings of cancer. Rather they suggest the ways in which it exceeds and displaces interpretation. In this way "the power of metaphor in the case of cancer makes the silence speak (or at least whisper) the forbidden word".

The ways in which cancer functions as a cultural taboo is, for Stacey, also curiously resonant of her experiences as a lesbian. Both cancer and lesbianism (the "C word" and the "L word") are rendered unspeakable and shameful, provoking discursive subterfuge, euphemism and disavowal. In this astutely argued section of the book, Stacey deploys an experiential and theoretical knowledge of both these stigmatised categories. Drawing in particular from the work of Mary Douglas and Julia Kristeva on taboo and abjection, she explores how the perceived monstrousness of cancer signals more diffuse anxieties about "the body and its desires".

The cultural representation of cancer raises wider questions about how the body is conceptualised. The objectification of the body by biomedicine,which treats the body in isolation, has been opposed to more holistic approaches. But Stacey questions whether alternative practices do in fact overcome the mind/body dualism which has dominated western thought. As mind and body are seen to be mutually dependent so health increasingly becomes a matter of individual responsibility based on self-knowledge. Both conventional and alternative approaches to cancer to some extent cast the cancer as a symptom of wider problems in a patient's life. The body has become constructed, particularly in the pervasive discourses of contemporary immunology, as a system rather than a machine. The body's exterior has thus come to represent a textual system that can be read and decoded.

This engaging and astute analysis of how cancer is represented and experienced in contemporary culture demonstrates cultural studies at its most imaginative and incisive. Stacey refuses to allow her readers the possibility of an easy academic distance and forces us to confront the vulnerabilities of our own embodiment.

Ruth Gilbert is a fellow, Hartley Institute, University of Southampton and part-time lecturer, School of Cultural Studies, King Alfred's University College, Winchester.