When Tamara Levine was diagnosed with breast cancer, she began sending e-mail letters to about fifty family members, friends and colleagues, to keep everybody in the loop.

But Hope is Longer Levine

Second Story Press, 2012

Almost immediately, these letters took on a great significance in her Healing Journey, offering a kind of ‘therapy’ (Greek for healing), “helping to quell my terrors and make sense of the changes happening in my body and in my life”.

And what rapid and dramatic change But Hope is Longer chronicles:

“This was different: my cancer was precipitous, unexpected, and unplanned. When I searched for language to describe how I was feeling, catapulted came to mind. It was as if  had been suddenly catapulted into an altered state of being by a calamitous force of nature.”

The letters are reprinted, along with narrative commentary that fits with that stage of her journey (some material is repeated, but some more intimate details are added), with some text boxes of quotations from her doctors and life coach, and the occasional point-form list of recommendations and suggestions.

At times, the question of audience seems unclear.

(For instance, her reflections regarding the diagnosis include the observation that such news should be given/received in person and, indeed, it seems unfortunate that the news was delivered to her via voice message, but the suggestion that it unfold differently would be best received by the doctors responsible for delivering the diagnosis. Alternatively, the list could have been presented as an appendix directed, instead, to health-care providers, or included in the text proper but as a list of preventative instructions so that one might be encouraged to outline for the doctors their communication preferences before test results are received and redirected.)

But for the most part, the narrative is clearly directed to the other people who have been catapulted into this new country, either as residents or visitors of those who now reside there, with content that is varied.

The book contains practical advice that you might expect to find on the pages of magazines like Chatelaine and Woman’s Day:

“Exercise supports and fuels the body in its fight against cancer. It puts you in the best possible position to receive treatment well, while resisting its toxicity. It provides fortification for what lies ahead. It is one of the most generous gifts of self-care you can give yourself.”

But it also contains elements of personal experience:

“It’s hard to describe what it was like to receive chemo and sing at the same time. It felt right: strong, defiant, and life affirming.”

Ultimately the book reads like a-little-of-everything-all-at-once. There are letters, observations, lists, comments, text-boxes and straight narrative passages that loosely follow the arc of diagnosis through recovery.

At first, I found this a little overwhelming. Which seems suitable, given how dramatic and traumatic this experience is for Tamara Levine. (Design elements might have streamlined the reading experience to a degree but, technically, the prose is clean, uncluttered.)

Nonetheless, as I read on, I felt that this was wholly appropriate: this is one woman’s perspective on the entire experience, and it is not all neat and tidy.

The health care system has traditionally treated breast cancer with a one-size-fits-all treatment plan, but this is not necessarily effective; truly successful treatment requires a tailored response.

Alongside the memoir of one woman’s experience there is solid information presented to the reader, as with the commentary offered in text boxes (which also includes Dr Joanne Meng, her radiation oncologist, Dr Leesa Kirchner, her naturopathic oncologist, and Dr Angel Arnaout, her surgeon, and Joyce Hardman, her life coach), which feels both relevant and impassioned.

Dr Shailendra Verma (the author’s medical oncologist) states:

It was only a few years ago when we started to notice that women were responding differently to treatment based on the biology of their cancers, the markers which define them as estrogen, progesterone, or HR2 positive or negative, etc. We’ve taken one disease and made it into six or nine or twelve. These markers can help predict how the cancer will behave in the future and how it will respond to treatment. We’ve entered the era of trying to target the particular breast cancer to help women survive the disease.

Just as not all women should receive the same treatment plan for their breast cancer (there are so many types of cancer, so many different situations that can arise before and after diagnosis), just as there is no predictable set of steps through which a woman will travel on this arc, just as the outcome remains mysterious…the text of But Hope is Longer is uniquely presented as Tamara Levine’s experience.

When I was nearing the end of this reading, I felt as though the narrative itself was mirroring the author’s need to combat this disease from many different directions; But Hope is Longer offers a holistic perspective on one woman’s experience of complementary treatment — with elements as diverse as Vitamin C and chemotherapy, radiation and letter-writing —  and endurance.

Note: This would also make an excellent choice for those who are reading for Melwyk’s Postal Reading Challenge; I am alternating between fiction and non-fiction for this challenge, so I’ll be plucking an epistolary novel from my shelves next.

Postal Reading Challenge

Image links to challenge site