The journalist David Carr was a master of his craft and a mentor to many aspiring journalists, including Ta-Nehisi Coates, who Carr hired as an intern when he was the editor of the Washington City Paper.
A new book, “Final Draft: The Collected Work of David Carr,” includes more than 50 of his stories, from his early days as a freelancer in Minneapolis to his writing about the media at The New York Times.
Here & Now’s Jeremy Hobson talks to Jill Rooney Carr, David Carr’s widow, who edited the book.
Book Excerpt From ‘Final Draft: The Collected Work Of David Carr’
By David Carr
Still Life with Alien
How the Monster from Inner Space Took Over My Life
Appeared in Twin Cities Reader
August 24–30, 1994
From the time I was little, I loved watching movies about aliens.
Years after I saw The Day the Earth Stood Still, my dreams were filled with steel-noggined guys who spoke in detached, tinny voices as they ordered the world to submit. Their invasion was relentless but seductively ordered and controlled. Those aliens of my childhood seemed very far away — just so many dots on my parents’ crappy black-and-white TV.
They didn’t scare me, and if they did come, well, I’d know what to do.
The aliens became more menacing with the passage of nights. They arrived in the longest part of sleep, when consciousness steps back and reveals a darkness within. In that nightmarish reverie the invaders seemed more explicitly interested in me than in world domination.
They didn’t wear helmets or live on TV. In these dreams they appeared as a part of me I couldn’t quite recognize, with an intimacy that made them infinitely more confounding.
When the alien of my dreams made its presence known in my waking life on December 10, 1992, I stepped aside immediately, regarding myself and the alien with inexplicable detachment. I couldn’t bear sharing space — even for a second — with something that was after me . . . in me.
During the time of occupation, I answered my phone with excessive cheerfulness, wrote reassuring notes to old girlfriends, and smiled knowingly whenever someone in a white coat revealed something sharp in their hands. I put my fingers in my ears and hummed tunelessly until someone told me it was gone. I acted as if I had been merely interrupted.
I can remember the day cancer came to me in the mirror. I am not one to study myself, at least not in mirrors, but a distortion in my reflection caught my eye one cold December morning. It looked as if, overnight, someone had inserted a large sausage underneath the skin on the left side of my neck — part of me was clearly under invasion. The next morning, I was absolutely certain the incubus was bigger. I called a clinic.
From the instant the doctor entered the room and stared at my neck, the firm line between nightmare and reality dissolved. I remained inert, waiting for a cue to panic, but each technician, nurse, and doctor I encountered riveted me with their devotion to routine. From the outset, I mimicked the detachment surrounding me, even when someone mentioned a lymphatic cancer called Hodgkin’s disease.
I remained awake while they surgically removed a piece of the mass in my neck for biopsy, and in spite of myself I asked for a look at it.
The small but ominous specimen bobbed in a vial filled with iridescent, greenish fluid. I swore under my breath when its ugliness came into view.
Four days later I got a call from the surgeon, Dr. John Delaney, telling me my neck sausage was cancerous. I thanked him for the call, if not the information, and went to my bathroom mirror. The tumor was there, no different, just as alien as when it first arrived. My eyes were another matter, offering a sober flicker of recognition that I was sharing space with my nightmares. As I watched, I saw myself going away.
In the first five months of 1992 I underwent radiation therapy for the treatment of Hodgkin’s disease, a “good” cancer with a high cure rate.
The regimen was unpleasant but manageable. I hung on to my job, my kids, and my equilibrium by concocting enough denial to get from one day to the next. But my pretense that nothing horrible was underway left me with a persistent feeling that all of it was happening to someone else.
This summer, more than two years after being treated at the University of Minnesota Hospital and Clinic, I felt compelled to review my medical records — to revisit a part of my life during which I’d made a point of not paying attention.
There was nothing significant or noble about my treatment for cancer: the four inches of files depict a routine case with a successful outcome. The records are mostly indecipherable, full of hard and fast data that betrayed no hint of the unreality gripping me during those months when I felt as though I was being forced out of my body.
I continued to pretend it never existed even after it was gone. The treatment, the rhetoric, and the pity engendered by diagnosis left me feeling abashed, as if I had woken up and found someone I did not know touching me. It set off a deep, inexplicable sense of embarrassment that took years to dissipate.
Even now, the word cancer sounds dreadful to me. It’s still the big C, with an eponymous power that makes it difficult to insinuate into polite conversation. Cancer sounds horrible and it is, an inexorable mutation of the flesh that leaves the host beleaguered and friends speechless.
Once you’re diagnosed, people loop around the word so often you begin to think you have a disease called it. “So how is it?” they say. Every once in a while I wanted to interrupt the séance of avoidance and say, “Oh, you mean this large cancerous mass on my neck?” But that would have scared people and me even more. Instead, I’d tell them that it was fine and so was I, even though the cancer was still there, strengthened by its ineffability.
I was unable to wrap my lips around the word until my second day at the hospital, when I was sent over to the Masonic Cancer Center. The people who work there call it the Masonic Day Hospital, which sounds infinitely more comforting and less chronic. I stopped and read the writing on the sign, trying on the sound and reality of cancer. It made me feel sick.
- • •
In my experience, even medical people don’t like talking about cancer unless they have to. It’s too dreadful, too unfathomable — even to them.
Its persistence is an affront to their belief system, a whisper of unadmitted mortalness and mortality. Doctors respond to cancer by becoming monster-movie heroes — those plucky guys who make it to the end of the story. When something goes wrong and the alien takes out another hapless victim, they shake their heads, then get back to fighting that damn alien.
In order to maintain their equilibrium and your sanity, there are doctors who act as if they can kick the shit out of cancer, but even they know it’s a crapshoot. While medicine has made enormous strides — many of which personally benefited me — doctors are clearly at a loss to explain why certain parts of people’s bodies metastasize into killing fields.
When someone is completely overtaken by cancer, the patient’s caregivers offer spoken homage to the good fight. I know from sitting in a lot of waiting rooms that many people with uncontrollable cancer don’t fight the good fight. They fight a miserable fight, full of unspeakable pain and physical abasement — and then they die.
There aren’t a lot of ways to avoid this blind spot in American medical brilliance if it’s your turn. Alternative medicine seems a little speculative and freeform in the context of something as beguilingly poisonous as cancer. In allying with mainstream medical doctors, I found a gauzy assurance that somebody was doing something about the monster from inner space.
For most of my life, my operating principle was blind aggression. If I thought someone was coming after me, I contemplated poking their eyes out as a defensive strategy. If I didn’t like the way the game was going, I’d tip over the board and walk away. But cancer shrugs off belligerence with its implacability. Once I became a patient, I became a model of compliance — my records duly note my persistent acquiescence. I made friends with my doctors because I found their uniforms and presumption of expertise comforting. I was impressed and nourished by their hubris. I let them shower me with radiation, excise my spleen, and dissect my neck whenever they asked. Given a medical directive, I became Forrest Gump in hospital pajamas. Patient is as patient does.
I remember my initial consultation with Dr. Greg Vercellotti, a hematologist eminent in his field who possesses social skills not normally associated with medical professionals. After I was diagnosed, Greg and I acted as though we were auditioning for roles in a made-for-TV movie. He’d say things like, “We’re going to beat this thing, buddy,” and I would respond with a determined nod. I often felt a very shameful urge to giggle.
During that first visit, Greg was upbeat, saying that the scans and blood tests seemed to indicate that I had Hodgkin’s 1A, which is the disease’s earliest and most treatable form. The cancer likely was located only in the lymph nodes of my neck and probably had not spread, even though the tumor was expanding in size into cantaloupe range.
He went on to say that “just to be sure,” they were going to perform a staging laparotomy, which involved making a ten-inch cut in my abdomen, biopsying all of my major organs, and even taking my spleen out. I noted the organ I’d be losing was elemental to my disposition, but Greg said they wanted to take it and squeeze it to make sure that the Hodgkin’s disease was not on the march through my lymphatic system. I was stunned that major abdominal surgery could qualify as diagnostic work, but Greg told me it was the most conservative approach.
Even in medical parlance, which is the most euphemistically infected language in the world, “conservative” seemed like a reach. Conservative is a doctor code word for patent aggression in the name of survival.
Cancer produces the same reaction as the monster who pops up in the midst of a well-armed landing party: everybody starts blasting away with everything they’ve got. I found solace in the trips from clinic to clinic at the U, submitting my problem to the serial expertise of a big hospital, but there were moments when I felt that they were taking my life in order to save it.
Half an hour before the staging laparotomy, a doctor — whom I had not met — came into the room and introduced himself as an oral surgeon. He and his “team” had determined that my mouth was in for a lot of radiation because the cancerous node in my neck was high. His team had decided to take out twelve of my grinding teeth as a preventive measure against radiation cavities and ensuing necrosis of the jaw. Sitting in just my surgical gown, I was loath to make a major life decision without my pants on. I gathered my thoughts enough to tell the doctor, whose name I never knew, that his timing was poor and that I was only willing to donate my spleen on that particular day. He used cryptic jargon to indicate I was going to dearly regret my decision. I don’t. I think of him every time I order steak.
Other procedures were just to be gone through, part of an endurance contest that left me progressively desensitized over the course of the five months. At the beginning of my treatment I submitted to a bone marrow biopsy to determine the extent of the Hodgkin’s. Bone doesn’t anesthetize well but has a surprising amount of nerves, which is an unfortunate combination. The doctor who was after the marrow in my pelvic bone was furtive and clumsy. “You might experience a little sharpness here,” he said, just before the needle penetrated some whitehot place. Sharpness.
Doctors are wrenches, biological mechanics who head into the shop looking to solve problems. On the whole, I liked my doctors. My surgeon found out I had cancer, my hematologist decided what to do about it, and my radiation doctor used one of her machines to make it go away. They cured my cancer, and while I hated what they did to me, I appreciated what they did for me.
Treatment regimens for cancer are full of painful realities and powerful ironies: Radiation can cause cancer or wipe it out. Toxins in the body can create an opening for cancer or be used to shut the door. In order to fight cancer, I had to sit very still. Being a cancer patient required spending much time alone in rooms of white that hosted shiny medical appliances. In those hours, I often wished I could leave while my neck was being treated, that I could dissemble into a form in which the tumor — and what it represented — wasn’t part of me.
Many of the machines I encountered had a peculiar ability to see what I could not. The CAT scanner would rotate around me, a huge whirling doughnut of metal that seemed as if it was preparing to take off. I was conveyed into the device’s tube and listened to the mechanical voice repeating instructions from the small speaker. Hold your breath.
Relax. I came out of the tube smiling beneficently, lulled by the Zen rhythm of diagnostic hardware.
I never came close to dying from cancer, but the first month of my treatment made it look as though I might. In those thirty days I had a neck biopsy, a bone marrow biopsy, major abdominal surgery including a splenectomy, and thousands of rads of radiation. I went from a fat, self-involved creep to a skinny, almost beatific soul who could only handle a bite or two of white rice. My gaze averted every time I caught a reflection.
Bystanders react in different ways to having cancer in their midst.
Some of it was predictable. My parents and siblings were perfectly pitched throughout, relentlessly optimistic when things were tough and indignant when things went wrong. Many good friends were unconditionally available for the length of my illness. Other reactions were understandable but less foreseeable. There were good friends who went away because they truly didn’t know what to say. And there were men and women whom I had viewed as near-mortal enemies who showed up with hot dishes and wan smiles while I was ill. I was gratified by their interest but mortified by my own vulnerability.
The compassion of others can be a tremendous burden. When people would call or show up, they’d inevitably ask, “How are you?” Which meant they wanted to talk about it until I told them I was fine, even though some days that was not the case. I stopped telling the truth about how I really was for purely practical reasons. When some of my strength returned, I began pushing people out of my life. I ended a long relationship with a woman, in part because I couldn’t bear to have someone looking at me from an intimate distance while I was in a state of contamination.
When I was alone, I spent time speculating about why the alien chose
- I was certainly a juicy, deserving target — the big-chested blonde in the monster movie who is a little too slow to outrun the beast. There was a long and glorious history with cigarettes and a romance with alcohol and class A narcotics that had cooled not long before the beast came after me. But Hodgkin’s isn’t like lung cancer, a swift and sure punishment for ignoring both your mother and your doctor. It’s a kind of malignant opportunistic invasion — an uncontrolled proliferation — that lays siege to otherwise healthy middle-aged people. My doctors were loath to speak of causality, preferring to focus the discussion on making the cancer go away.
My speculation came to rest on an old microwave, a fixture in my home for many years. It was ancient, an appliance of doubtful structural integrity that throbbed and buzzed with radiant energy when I used it to warm a bowl of frozen corn. Maybe, I thought, my microwave leaked cancer into my life.
Once I had cancer, my prescribed cure involved being led into a room by chirpy technicians who positioned a couple of tons of radiation-issuing machinery over me, then ran away behind lead doors. Other than the hum and throb of the machine — which reminded me of the microwave — it was pretty quiet in there. I passed the time by staring at a tropical tableau above the machine, put there for that very purpose.
(Which might explain why I left for a vacation in the jungles of Central America eight days after my final radiation treatment.)
Dr. Chung K. Lee, a physician eminent in the therapeutic effects of highly targeted X-rays, decided that about ten million volts would be sufficient to send my cancer back where it came from. She warned me that I might lose “a little” hair on the back of my head. It was the only lie she ever told me. During the initial stages of treatment, I’d wake up with a face full of fur, as if I had been sleeping with a Saint Bernard that had a shedding problem. I was left with a small skullcap of hair that fit right in at First Avenue but looked pretty weird everywhere else. I took to wearing a Public Enemy cap one of my daughters gave me. I thought it enhanced my profile at a time when I was consummately concerned about appearances.
While I was undergoing radiation, I went to see an old boss of mine who had bone cancer. His bones were disintegrating, and from what I had heard, his head was gradually dissolving into his shoulders. The pain was said to be beyond expression, yet there he was, sitting at his desk. We talked for a half hour, mostly about hair. Neither of us mentioned the word cancer. He died four months later.
As my treatment progressed, I began to ignore the culture at large and see myself in the context of other patients, like the wino who rolls over in the gutter hoping to see someone just a little farther down the hill. On a day when I was feeling low about the radiation-induced burns all over my ears and neck, I was seated in the waiting room next to a dairy farmer from Luverne, Minnesota, who had a metal hoop screwed into his skull. The hoop helped hold his head very still so the radiation killed the tumor in his brain and not him. “How’s it going?” he said cordially, peering up from beneath his steel halo. “Great,” I said, not mentioning that part of the reason I felt okay was that I wasn’t scheduled to have any metal components screwed into my head.
On my last day of treatment, I brought flowers to the radiation technicians and told them I would miss our daily visits.
Cancer returns often enough after its supposed demise to leave a palpable vapor trail of fear. Cancer patients are said to be in remission, not cured. Four months after finishing treatment, I returned to see Dr. Vercellotti: my neck had enlarged again. As I walked in, I noticed him eyeballing my neck as so many doctors before him had. I watched his eyes with the same intensity and noted the shine of concern. He probed my neck, then moved down to the lymph nodes in my armpits. With his hand in my armpit, he spoke quietly. “I feel a mass in here.”
The message was clear, the space between us electric. Not only was my cancer back, but it was on the move. I never made a peep during the alien’s initial visit, but a return engagement meant more than a temporary interruption. Greg’s note in the chart indicates I had a “vasovagal episode” when we talked about a recurrence. He means I fainted straightaway.
An ensuing battery of tests — neck biopsy, CAT scans, and bloodwork — revealed that my swoon was premature. My denial had been built on a belief that the alien was only visiting, and when I was confronted with the possibility that it was back to stay, along with a much more acute diagnosis, my brain shut down. Greg and I had a laugh about it after the biopsy came back negative.
Illness has ennobling effects that are difficult to adequately describe.
The waiting room for therapeutic radiology was often suffused with an undue cheeriness. I saw people with holes burned in their heads smiling and chatting like it was just another day.
I know what they were up to. To acknowledge, even for a moment, the seriousness at hand would have corroded my infrastructure of denial. I needed to pretend everything was under control so I could remain in check. In order to avoid a sudden tumble into despair, I spent an enormous amount of time pretending to be happy while I was sick.
The first expression of my cancer-free life was the return of my historical prickliness. Beneath the practiced diffidence, I was really pissed that the alien had landed on me.
But now I’m fine. Really. Friends who haven’t seen me for a while ask after my health with more than passing interest, but I pretend I don’t know what is behind their concerned perusal of my face. Because the cigarettes are back for occasional, guilty visitations, their faces darken every time I light up. Having cancer certainly spoiled my ability to truly enjoy a cigarette, but I still like them just as much as I ever did. I’ll smoke for a month every now and then before the fear and guilt overtake me.
I lived to inherit “the gifts of illness” term I swore I would never use.
My innate fatalism has not been supplanted by an enhanced lust for life, but cancer did make me a handsomer person. I arrived for treatment as a prototypically obese American male with a gut and an early onset of jowling about the cheeks and neck. The radiation made me too sick to eat, so I lost a lot of weight. Some of the pounds have returned, but the jowls are banished. The radiation that killed all of the cancerous cells in my neck took the fatty ones, too. I now have an elegant pencil neck and clearly defined jaw. It’s a pleasant reminder that cancer changed me.
- • •
Cancer narratives hew to words such as bout, battle, and fight, as if the patient is in the midst of an exceptionally long boxing match. Combative rhetoric offers the comforting illusion that a disease will somehow respond to the will of the host. But I never threw a punch. The period of occupation was a time of endless surrender — to my doctors, to the corruptive immigrant within my body, and to my fate, which turned out to be a happy one.
At thirty-seven, I have developed the mind-set of a grandfather, swallowing pills every day while squeezing and probing every lump and bump, searching for a reason to worry. In a way, I should be honored.
Maybe now that I’ve had a little touch of cancer, it will be someone else’s turn.
My doctors tell me that I am free of cancer, but that’s not really true.
When I catch an image of myself in a mirror, it is apprehension, not vanity, that is reflected. The frightful alien in my dreams is now in remission, and if he returns, he will be in a form I now recognize. He will look like me, except he will have cancer.
Excerpted from “Final Draft: The Collected Work of David Carr” by David Carr. Copyright © 2020 by Jill Rooney Carr.
This article was originally published on WBUR.org.
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