In her new memoir, A Series of Catastrophes and Miracles, Salon.com writer Mary Elizabeth Williams documents her experience with metastatic melanoma, and her subsequent treatment in an immunotherapy clinical trial. Treated at Memorial Sloan Kettering Cancer Center by Jedd Wolchok, M.D., Ph.D., of CRI’s Scientific Advisory Council, as part of a landmark study that combined the immunotherapy drugs ipilimumab (Yervoy®) with nivolumab (Opdivo®) to treat melanoma, Williams experienced a complete response and has remained cancer-free since 2012. This combination has since been FDA-approved as a frontline treatment of advanced melanoma.
“Why me? Why not me?” is a refrain that pops up numerous times throughout the memoir. Williams acknowledges, “My horrible bad luck was my miraculous good fortune. I got cancer that was intriguing to a bunch of geniuses, and I got it at exactly the right time.” But serving as a counterpoint to Williams’s success with immunotherapy is her long-time friend Debbie’s story. Debbie is also in treatment for advanced disease; in her case, it’s ovarian cancer. There is no immunotherapy FDA-approved for ovarian cancer, and Debbie doesn’t have access to the same types of immunotherapy trials as Williams. One of the foremost issues in immunotherapy research today is understanding how to bring the successes seen in cancers like melanoma to a broader swath of diseases. As CRI’s CEO Jill O’Donnell-Tormey, Ph.D., comments in the book, “We’re in a place we’ve never been before….We don’t have all the answers yet.”
Williams also shows us that, in stage 4 cancer, as in life, the mundane, the profound, and the profane all mingle together. Poignant moments of clarity nestle right up to frank discussions of enemas and laxatives. Shortly after receiving her stage 4 diagnosis, the family discovers that they are infested with head lice. To add further insult, the lice specialist the family hires shrinks from Williams’s head because of her now-healed skin graft—a relic from the removal of her initial melanoma site. Williams turns to her husband, who had spent countless evenings tending the fragile graft, to help. (An ode to this tender relationship appeared in the New York Times’s Modern Love column.) As Williams begins treatment in the immunotherapy clinical trial, the family also begins visiting Gilda’s Club, a national group aimed at providing social support for families dealing with cancer. In recounting the shared trauma of the cancer experience, Williams shows us that cancer, not unlike head lice, is a family affair.
As Williams points out frequently, life doesn’t stop with a cancer diagnosis—there are still clothes to wash, deadlines to meet, and the aforementioned lice to eliminate. The crux of the book, for me, is about bucking the mystifyingly persistent caricatures of people with cancer that continue to pervade our culture. A cancer diagnosis doesn’t halt the mundane responsibilities, and also doesn’t morph a person into either a brave warrior or a desperate prisoner. In one scene, Williams speaks with Debbie about Debbie’s therapist:
Debbie tells me, “She keeps asking ‘Why do you come in here smiling? Why are you laughing and making jokes? I’m worried you’re not dealing with this…’”
“Don’t take this the wrong way,” I tell her, “but she sounds like a moron. She can’t handle that you don’t fit the mold of cancer patient she read about in some book.”
Williams then goes on to say, “I’m just over hearing people without cancer tell those of us who’ve experienced it how we’re supposed to do it.” With this memoir, Williams affirms that people with cancer are just that—people, above all. Profound and profane, all mingled together.
A Series of Catastrophes and Miracles
Mary Elizabeth Williams