Had I not been a writer, I would have liked to be a singer, a parrot, a spy, or a neurosurgeon. Unfortunately, the only singing I do is in the shower, I only ever fly in economy class, and the closest I’ve come to espionage or brain surgery was when I dressed up as a doctor back in my college days, to sneak into the National Medical Center. Donning a white coat I had bought on the black market, each Tuesday I greeted the hospital guards with Hippocratic aplomb, and made for the language therapy room, where treatment was offered to aphasia patients, whose brain injuries impaired their ability to speak. In those days I was more interested in neurons than people, but in that somber room, shielded by a white coat, I began to find my way back to literature.

Not long ago, I discovered a striking coincidence: thirty years earlier, my father also dressed up as a doctor to sneak into the same hospital, with a different purpose—to visit his older brother who had lung cancer, and slip him prohibited foodstuffs outside of visiting hours. My uncle’s terminal illness became the nucleus of family stories of loss and misfortune, and meant I grew up in the shadow of a corpulent man felled in his prime by a rare carcinoma at the age of forty. In time, I realized this preoccupation with cancer wasn’t limited to my family, but that it distills most of our society’s fears and obsessions. Guilt, luck, karma, heredity, suffering, and mortality are just some of the coordinates that guide or mislead us when we face the emperor of all maladies, as Siddhartha Mukherjee calls it.

My father loathes the word cancer, to which he attributes ominous powers. A taboo. On the other hand, many people overuse it, to refer not to the out-of-control proliferation of cells, but to politicians, corruption, and bad habits. Reggaetón is the cancer of our society, they say. A man recently wrote on Facebook that feminism is the cancer of our age. (If I didn’t object to the metaphor in general, I’d say guys like him are the cancer of our age.) Maybe we should all dress up as doctors to tame this word, so feared yet overused; to tame the word cancer in a cultural sense, and at the same time, through science, free ourselves from its fury.

*

Rather than singing ballads, salsas, or Italian arias as I would have liked, I spent my childhood shouting the word “kihap!”—“shout” in Korean, according to my tae kwon do teachers. “Shout! Shout! Shout!” I shouted over and over, kicking the air in my belted white uniform. (By virtue of sheer perseverance, the belt turned red then black). “Shout! Shout! Shout!” I shouted, for fifteen years, all because my parents thought it a good idea to counteract my innate idleness with this ancient far-eastern practice. “SHOUT!” I later learned that the word’s Korean roots refer to vital energy (ki) and to the exercise of channeling it into an action (hap), but alas, I didn’t know that when I spent six to twelve hours a week thinking I was shouting, “Shout!”

Shouting in Korean was exceedingly liberating. Maybe it’s thanks to those sessions of ritualized violence that I never adopted the habit of constantly cursing aloud like my father. No matter how much other people annoy me with their incompetence, commotion, political views, or pets, I don’t feel the urge to hurl insults at them. A whisper is all it takes for me to channel (ki …) and liberate my inner energy (hap!).

Verbal venting is impossible for many aphasia patients, who, in their misfortune, are denied even the consolation of telling the universe to go fuck itself. I met a woman at the Medical Center who, due to a condition known as Broca’s aphasia, couldn’t utter a single word. When we spoke to her, she understood perfectly, but was silenced by a massive injury to her left prefrontal cortex. I remember her heartrending gaze, the eloquence of her facial expressions. After her stroke, her husband had filed for divorce and taken their children, claiming that life with a mute mother would be detrimental to their psychosocial development. Some wretched family court agreed with him, and left her not only disabled but without her children, whom she was only allowed to see once or twice a month. I remember her tears, her anger, her deafening silence. What a relief it might have been for her to send her husband to the devil and to the chingada, insult his mother, and suggest that he copulate with himself. But her furious ki was forced to simmer inside her. She had no outlet. Certain neuropsychological studies show that swearing can increase our ability to tolerate pain, and psychological pain is the worst of all. Sometimes the healthiest response to bad luck is to curse it aloud. But what if you can’t? This is the question that drew me to Ramón, the mute protagonist of my novel, The Mutations, and Benito, the foul-mouthed parrot who lends him a voice to relieve his pain. I tried to explore how losing the power of speech deprives us of our humanity, of the emotional ties that language allows, and of the verbal reins that control the raging beast we can sometimes become.

*

José José, Mexico’s most famous singer, is the son of a tenor and the brother of a countertenor. Apparently, something about the Sosa family’s genes (believe it or not, their last name isn’t José) gives them beautiful potency, pitch, and timbre. But José José, otherwise known as the “Prince of Song,” has lost these qualities. His abuse of his vocal cords, of cortisol to soothe them, and of alcohol to have a good time has laid waste to one of the world’s most beautiful organic musical instruments. These days, he speaks in a voice hoarse and faltering, as if he were choking.

In the spring of 2017, José José recorded a video in which he broke the news to his admirers—we are a legion—that he’d been diagnosed with pancreatic cancer. In his deathly, quaking voice, he explained that the director of the hospital where he’d been treated had told him: “I want you to know why you got that [tumor] there [in the pancreas] … you have absorbed all of the evil things that people have wished on you: lies, insults, painful betrayals; your organs have absorbed all this and as a result, your pancreas suffered a massive blow and began to develop that negative stuff. Don’t worry, it’s very small …”

I don’t know if José José was already delirious from drinking too much, or if the director of Mexico’s finest hospital actually believed that the cancer was caused by “evil things that people have wished on you” and not by a combination of chance, genetic heredity, and the industrial quantities of alcohol the singer had imbibed. José José is Mexico’s most notorious alcoholic, and studies show that alcohol is a key risk factor for pancreatic cancer. If by “evil things” the singer’s doctor meant white rum, tequila, whisky, and brandy, his pancreas had indeed suffered “a massive blow.” But if by “evil things” he meant morally reprehensible actions, destructive passions, envy, and lies, then he deserves to be known as a charlatan in a white coat (maybe he bought his in the same place I bought mine, and snuck all the way up to the top of the institute).

When learning of any new diagnosis, people often ask: why him? He’s such a good guy. He must have been so angry! She isn’t a resentful person, so why did she get colon cancer? The moral theory of cancer is pernicious and enduring. In Illness as Metaphor, Susan Sontag explores this moralization of illness throughout different eras (medieval plague, nineteenth-century tuberculosis, cancer), and, examines her own experience of being made to feel guilty for having a tumor.

Should we attribute the skin cancer pandemic in Western countries to envy, or rather to the vice of sunning oneself in pursuit of a tan? And lung cancer: repressed anger, or cigarettes by the pack? And what about childhood leukemia: past-life karma, or some random genetic accident? The fact that a musical idol like José José and his influential doctor would spread this kind of theory about the psychosomatic origin of disease is highly alarming. Depression may make treatment less effective by weakening the immune system, but there is no other proof that mood has any causal relationship to cancer.

As Sontag describes, in every generation an incomprehensible illness becomes the moral repository of our social ills. But genetic mutations aren’t here to remind us of our sins. We’re determined to find a message in cancer, as if a tumor were a carrier pigeon bearing a list of our crimes; as if it were a parrot squawking our psychological weaknesses (African grays are the smartest—I would have liked to be one of those); as if a melanoma were a crow proclaiming that death is nigh (“Nevermore”); as if cells were truly malignant and not simply hyperactive and defective; as if they were a person, and not just a jumble of cells.

To tame the word cancer we must strip it of its subjective, moral attributes. It is a thing that happens, not a concept that conveys meaning. Abnormal tissue has no mission or destiny, and is not evil. We must overcome our fear and our silence.

*

Until the last day of his life, when he weighed less than ninety pounds and was drowning in the liquid that filled his lungs, my father’s brother still said, “Tomorrow I’ll get up and go to work.” My father considered his obstinate denial an ideal strategy for facing death. Ever since I was little, it seemed to me that he had been cowardly, approaching the void eyes closed, rather than peering into it—I’m dying—to examine his life: forty years of orphanhood, financial prosperity, luxury travel, horses, and bigamy. Were I to die at my uncle’s age, I would now have less than a decade left. It would seem like far too little. Is that how my father feels, as he approaches the limit of male life expectancy in Mexico?  (Yet another reason to be a parrot: of all birds, they live the longest.)

Compared to the age of the planets, stars, and galaxies, human existence is trifling. In astronomical terms, we live only an instant. What difference does it make if we have one, six, or ten years left to live? If we don’t pay attention, ten years of routine can slip by as quickly as an hour’s impatience. “I’m dying” is an honest statement at any age, from the cradle to the hospital bed (though it makes you a bit of a killjoy). Entropy grinds away at us right from the start, eroding our DNA until the edge is completely worn off. “I’m dying” is only ever a slight exaggeration. It doesn’t matter if the glass is half full or half empty, its contents will continue to evaporate (and if it’s a glass of tequila, they will evaporate even more quickly). We have invented hells, heavens, and reincarnations to escape those words that tie us to death. “I’m dying” is the ultimate human truth, the coldest, the most cut-and-dried. The world has its causes, and these are alien to our desires.

Saying “I’m dying” is a way to distance ourselves, to abandon the limited perspective of our days and view the brief sum of our lives from afar. The statement “I’m dying” becomes truer and truer by the minute, and it’s also a great excuse to skip baptisms and book launches. It should be possible to send a greeting card with the message, “Sorry I can’t make it. I’m dying,” next to a picture of some circling vultures.

Hannah Arendt writes in The Human Condition that humans, “though they must die, are not born in order to die but in order to begin.” Though we may not have been born to die, knowing that we will provides a much-needed incentive not to postpone our beginning. (Joan Margarit, in the poem “Sin remitente,” describes the certainty of death as a “fierce stimulant.” )

Often, when people dare to accept they are dying, they rush to confess secrets, make peace, and ask for forgiveness. I’m sorry, I forgive you, I’m scared, don’t let me go—these are the phrases frequently uttered by the dying. Why wait so long to say them? If we don’t have the courage to admit that we are mortal, we’ll end up saying on our death beds, drunk with denial, “Tomorrow I’ll get up and go to work.”

*

Witnessing the ravages of several strokes up close has led me to the gym each morning to keep my blood pressure down; fear of cancer drove me to write a novel about the illness whose name was forbidden in my home. I made it a tragicomedy, since humor is the only way I know to fight pain and loss without resorting to psychoactive drugs. The best defense mechanism I have is to laugh at myself. Ever since my mother died, I’ve cracked jokes about orphanhood, but people rarely find my misfortune as funny as I do (least of all, Lacanian psychoanalysts). When The Mutations was published in Mexico, I was afraid it might make some readers—cancer patients or their relatives—uncomfortable with its irreverent approach to illness. I didn’t mean to cause them pain but to invite them to see the humor in the harmless absurdities that fill our daily lives, even during treatment for a rhabdomyosarcoma. Luckily, it was the opposite: according to the messages and comments I’ve received, those who’d lost loved ones or survived a serious illness found the book funnier than anyone else (apart from the teenagers amused by the obscenity-squawking parrot).

I’m convinced the best way to assuage our fear is to voice it. We have to name things to know them, and be able to act accordingly. Denying our fear of illness can prevent us from taking precautions, like giving up smoking, wearing sunscreen, or not sucking on bars of uranium. But no matter how careful we are, the accidents of fate that wound us can always win. We must learn to live with this uncertainty. Those of us who would rather not accept it can pray to Saint Peregrino, the patron saint of cancer patients, eat five pounds of blueberries and papaya a day, not be overly successful (to ward off envy and betrayal), or commit suicide in our prime to avoid things getting worse (it might be a good idea to kill ourselves at the age of Christ). And if none of these preventive measures work, and the doctor still says, in a sterile voice, that we have cancer, it’s best to keep calm and remember that nowadays, cancer is less and less fatal thanks to science, which has brought us miracles like vaccination, antibiotics, and Viagra. And if we’re already used to the idea of dying, maybe the news of a bleak oncological prognosis won’t seem so bad. When the time comes, we’ll have fewer unresolved conflicts and pending trips, and will have wasted fewer precious hours of our lives at baptisms and book launches. When my time comes, I hope to be ready. At least, in fiction, I have been a singer, a parrot, a spy, and a doctor. That’s enough for me. I want to enjoy the time I have left without fear. And for there to always be room for laughter, even when I’m about to leave.

— Translated by Charlotte Whittle

Jorge Comensal was born in Mexico City in 1987. He has received grants from the Fundación para las Letras Mexicanas and the Fondo Nacional para la Cultura y las Artes. His work has appeared in Letras Libres, Este Pais, Nexos, Revista de la Universidad de México, VICE, and The Literary Review. His first novel, The Mutations, is forthcoming from Farrar, Straus and Giroux in November.

Charlotte Whittle is a literary translator, writer, and editor. Her translations, essays, and reviews have appeared in publications such as Guernica, BOMB, Electric Literature, the Los Angeles Times, and elsewhere. Her translation of Norah Lange’s novel People in the Room was published in 2018 and longlisted for the Best Translated Book Award. Originally from England and Utah, she has lived in Mexico, Peru, and Chile, and is now based in New York.