On Cancer, Scanxiety, HR 40, and Curative Care

“Fear is incomplete knowledge.” – Agatha Christie

In searching for an appropriately evil, accessible corollary for systemic racism in America, I’ve got to be honest with you: I never really got past cancer.

“Our bodies are made up of trillions of cells grouped to form tissues and organs,” begins How cancer starts, grows, and spreads on the Canadian Cancer Society website.

“Genes inside the nucleus of each cell tell it when to grow, work, divide and die. But when there is a change in our DNA or damage to it, a gene can mutate. Mutated genes don’t work properly because the instructions get mixed up. This can cause cells to divide and grow out of control, which can lead to cancer.” *

I will defer to medical experts if there is a richer analogy, but something about a disease where fundamentally sick cells divide and replicate uncontrollably before spreading unchecked through a body while actively co-opting and perverting preexisting channels and functions to further entrench and defend themselves…yeah, I think cancer fits.

Like many of you, I have lost family, friends, and other people I love to this horrific disease. I have also studied enough to know a few early warning signs.

So, in an attempt to arm my friends and professional network with some leading indicators, you may be suffering from cancer (or systemic racism) if you (or your society) have any of the following symptoms: 

·      A nagging, persistent rasp [1]

·      Open sores

·      Inexplicable losses [2]

·      Persistent pain

·      Unusual bleeding [3]

·      Loss of appetite

·      Thickened lumps [4]

·      Fatigue

·      Shortness of breath [5]

·      Night sweats

·      A noticeable change in the color of your skin [6]

Establishing, then, that if systemic racism were cancer, America would be en route to the Mayo Clinic, let’s talk about scanxiety.

Scanxiety refers to the very normal, potentially very dangerous anxiety patients feel before, during, or after a diagnostic exam. Now while it is completely natural to feel a bit uneasy in the liminal phase between recognizing symptoms and confirming a diagnosis, it is also entirely irrational to hold off on seeing a specialist because you are concerned about what she might say. If the diagnosis of systemic racism in America is obvious, a comprehensive examination of root causes and prospective solutions to it are not. Which brings me, in turn, to HR 40.

 If you asked me twenty-two days ago what I thought about HR 40 – the bill calling for the study of reparations in America – I would have politely demurred, pivoted the conversation to some of the obvious structural inequities in this country as it relates to education, housing, healthcare, and the penal system, and – if pressed – I may have even pithily riposted that I’d rather focus on some broad-based policy solutions.

“Yes, I have read Ta-Nehisi Coates’ evocative article on The Case for Reparations,” I could have easily said, “but I am just not sure it is in our country’s best interest to pursue a forensic accounting that could well find our first black President with more marks on the debtor’s side of the ledger.” **

Then, twenty-two days ago, the world changed. And so did I.

In re-reading Mr. Coates and in reexamining my own scanxiety, I think what I’ve come to is the realization that questions do not necessarily have to presuppose answers. Publicly grappling with and painstakingly unpacking our history – both before and after 1865 – can and will be therapeutic if not restorative for our nation. To that end, I will say that one of my biggest critiques of the bill as written is the presumption that we can precontemplate and/or neatly outline the buckets that a to-be-formed bipartisan commission will ultimately recommend we fill. ***

A commission’s findings, however, are not legislation and without doing the work, how will we ever move past diagnosis to treatment? We needn’t see the finish line on this one to begin our race for a cure and I have no idea what recommendations ultimately come out of an ad hoc commission’s comprehensive review. 

But once we do the work – once we have our diagnosis and our action plan in hand – I propose we fundamentally shift as a society from palliative to curative care. 

I propose we get aggressive in pursuit of systemic solutions, cut out whatever rotten, anachronistic growths we find within ourselves, and – working together – drive this national sickness once and for all into remission.

Mr. Fishel overuses run-on sentences in a juvenile attempt to create urgency in his writing, chronically batches statements into three sections, and correspondingly finds ample opportunities to deploy the Oxford comma.

[1] *cough* See Cooper, Amy and Alexander, Lisa for two recent examples. *cough*

[2] Of body weight or of a body’s weight.

[3] See Brooks, Rashard.

[4] In the throat or elsewhere.

[5] See Garner, Eric and Floyd, George.

[6] For white people particularly, be sure to check for black moles and blackface.

* Condensed and reformatted for clarity from: https://www.cancer.ca/en/cancer-information/cancer-101/what-is-cancer/how-cancer-starts-grows-and-spreads

** https://www.theatlantic.com/magazine/archive/2014/06/the-case-for-reparations/361631/ and https://www.nytimes.com/2007/03/03/us/politics/03obama.html, respectively.

 *** https://www.congress.gov/bill/116th-congress/house-bill/40/text