Book review: 'Milkshakes and Morphine' is a compelling and intimate portrayal of an excruciating illness

The cancer memoir is penned with an endearing dose of empathy

A medical committee will decide whether hospitals have to pay for treatment deemed unnecesary. . Getty
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Genevieve Fox is an accomplished journalist with a full life – a doting husband, two sons and a thriving career, not to mention her army of devoted friends. She refers to herself as “Gwyneth Paltrow’s worst nightmare” because she doesn’t “wear Lycra in public, drink liquidised kale or shy away from sugar as from something diabolic”.

So when she discovers a lump in her neck, her aggravating anxiety about it takes her by surprise. Her life is too enriched for her to afford a terminal illness, so when neck and head cancer are diagnosed, in quick succession, she is devastated.

What follows is a double narrative about how she grapples with the terrifying reality of the disease while keeping her humour, and sanity, intact. She chronicles the progression of her cancer, interspersing it with glimpses of her strange and lonely life growing up as an orphan.

Cancer memoirs have garnered a niche audience for themselves in the past couple of years, with Paul Kalanithi's When Breath Becomes Air and Jenny Diski's In Gratitude becoming recent bestsellers.

This genre seems to have struck a chord with readers because it is as unsparing as it is enlightening. Human beings have always been preoccupied with the subject of death and books like these offer a visceral insight into the complex relationship between life and mortality.

Fox narrates with infectious vivacity so, while the book can be occasionally hard to read, the writing is tinged with the irrepressible zest. Fox had an unconventional childhood, which seems to be adapted straight out of a Victorian novel. We discover that when she was 9, cancer killed her mother. This was only a few years after her father suffered a fatal heart attack, which forced the family to return from the United States to England.

Faced with strict adults and a terrible boarding school, Fox still considers America her home at some level and cannot let go of the image of her American life as a picture-perfect postcard of her brief but golden nuclear family.

Her experience with cancer propels her into remembering her childhood – she distinctly recalls being marred by her mother’s brush.

“My sister and I quickly became a two-girl get-well industry,” she writes.

Her fear is that her boys might be feeling the same level of trepidation and constant fear of loss that held her down in her childhood. The death of Fox's mother marks the long, treacherous beginning of a precarious life as an orphan. This realisation first strikes her when her grandmother takes her clammy hand after breaking the news to the family.

“That was my first taste of my new state: being hostage to the whims of adults,” she writes.

Her mother entrusted the care of Fox and her siblings to her 27-year-old stepson, a travelling journalist who means well but makes some questionable choices. One of those was placing an ad in a magazine for someone to look after "Three Recently Orphaned Children".

His decisions set the siblings off on a carousel of bizarre childcare arrangements, including a brief stay at their father’s first wife’s home – a Sussex vicarage.

Fox takes us on an intimate journey through what she calls “Planet Cancer”, from diagnosis to recovery.

She is put through the wringer with her roster of treatment that includes an enervating round of chemotherapy and radiotherapy.

She lives on a liquid diet of milkshakes and morphine after her treatment, which her son recommended would make a great title for the book.What really stands out is her charming candour, laced with dazzling wit, even when she is crippled with self-doubt and pain.

Literature also serves as an anchor through some of the more challenging times of her illness.

She finds her grief and loss reflected in poetry, which she tries to pass on to her children. She also reflects on how orphans, from Harry Potter to Oliver Twist and Batman, are portrayed in literature.

She shrewdly notes how writers have been using orphans as a literary device, who are either portending ill or portraying perfect agents of change with a neat character trajectory.

While she tries to keep the overall tone light-hearted, some of her reflections are profound and heart rending.

When she tells one of her first few friends about her diagnosis, she describes “the heart’s hollow that being motherless creates, how the grief lodges beneath your skin, how the loneliness and the longing are the air that you breathe and that sometimes, when the longing is so intense that you want to say, please, no, I’ve had enough, just bring her back, you feel as though you are suffocating”.

One of her greatest fears is her boys growing up motherless. Having experienced the emotional and mental havoc as a child growing up parentless, her fears for her own children have a lucid poignancy.

An engaging storyteller, Fox never misses a moment to interject details of her illness with well-timed, wry commentary, like when she ponders whether she should go the cheery Miranda Hart way or the Round Robin to break the news of her cancer to friends.

When she is asked to consider her treatment plan by specialists, she weighs up her options. She can either opt for the risky “send in the chemical and radiation hit squads” as recommended, or search for an alternative regime consisting of “mistletoe injections, biodynamic carrot juice, fever therapy ... organic enemas and pins for sticking into a voodoo doll made of sugar. And then I die”.

While she occasionally derides alternative therapies, she also notes how cancer makes you so needy you crave positive thinking, and even the most cynical among us will resort to alternative healers so as to leave no stone unturned.

Cancer is an epidemic of our era, and this endearing, ­life-affirming book is the perfect handbook on how to cope with the illness.

Most cancer memoirs are about the profundity and philosophical epiphanies that people have been struck by after having cancer diagnosed. This book avoids all that as Fox regularly reprimands herself for being self-pitying or egocentric.

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Hilarious lists are one way she gives herself a reality check. She tries to list the things she has taught her boys, and makes another one about how to behave at parties when you have cancer, including the handy “give the terminally dull short shrift”.

She regularly reminds herself that having cancer does not mean becoming a more enlightened and nicer version of herself.

While this book is never downright depressing, the only time it gets gruelling is when her trouble with eating and talking begins. She unflinchingly divulges the difficulties that eating and talking pose.

Milkshakes and Morphine is a compelling and intimate portrayal of an excruciating illness. What we can learn from Fox is that when life throws you a curveball, all you need is a buoyant attitude for life and a sense of humour to combat it.