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Book
ReviewInside
Hidden LivesProstate tales: men's experiences with prostate cancer. Ross Gray,
2003. Harriman, TN: Men' s Studies Press Paper; ISBN 193132008 Paper, 195
pp., £8.00 paper
SAGE Publications, Inc.2004DOI: 10.1177/09675507040120010602
DavidJackson
The European Men's Health Development Foundation
Prostate
cancer is a secret killer in the hidden lives of men. Prostate cancer not
only affects one in eight men in the western world but is surrounded by a
shadowy aura of confusion, uncertainty and lack of easily available information.
Many men know very little about their own prostates. According to a Mori poll
published in the UK in 2001 only 12% of men knew what the prostate gland does
and 20% wrongly believed that it is located in the testes.1 But even more
importantly a corrosive culture of shame, silence and humiliation is often
associated with prostate cancer and its main side effects arising from treatmen~
incontinence and impotence.
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This
dominant culture of isolated fear and shame is turned upside down by Ross
Gray in his book, Prostate tales. It is an `in-depth study of prostate cancer
and masculinity', revealing the complex chal- lenges facing men with prostate
cancer. He does not do this through an academic report that is aimed at a
narrow circle of other aca- demics, but through the adventurous innovation
of experimenting with nonstandard, written forms and mainly through a blend
of fic- tion with social science observations. The result is a fresh, surprising,
energizing read, in a book that combines fictional, narrative accounts based
on transcribed interviews, with more reflective commentaries on the emerging
links between prostate cancer and a gendered aware- ness of masculinities'
viewpoint, and detailed information and refer- ences to some of the medical
issues involved in prostate cancer. Part of the engagement and challenges
of reading these stories comes from the ambivalent positioning of the reader,
straddling dif- ferent genre expectations, of moving, sometimes uneasily,
between social documentary and literary fiction. There are a few unanswered
questions that remain about the precise processes of narrative compo- sition:
how did the author reassemble and shape spoken fragments into the significant,
narrative form of a story? How is significant form in a story different from
that of a social documentary? And how are symbolic patterning devices used
by the author to focus meaning and purpose in terms of the wider intentions
of his social project? The author's broader sense of possible audiences for
these stories involves reaching out to a range of `cancer educators, health
profes- sionals and policy makers, researchers and community organizations'
as well as other men who are struggling with prostate cancer, their spouses
and other family members and friends. Ross Gray is a social scientist working
in a cancer programme in Toronto. In the book' s prologue he talks about his
motivation for writing the book. He says he wanted to `understand what men
go through when they have pros- tate cancer'. All the narrative accounts and
one dramatic script in the book are based on interviews that his research
team carried out with men with prostate cancer. Each man was interviewed 4
or 5 times. We asked the men about their experiences with prostate cancer
and, beyond that, about their entire lives. In discussion with these men,
we considered the full impact of prostate cancer. The life situations described
in the narrative accounts ... were inspired by these interviews. Many of the
words spoken by characters in the accounts were drawn directly from what men
actually said in interviews. One part of my task in writing has been to honor
the perspectives and expressions of the men we interviewed. Another part
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has
been to protect their individual identities by fictionalizing their accounts,
combining bits provided by various men and disguising iden- tifying details.
The strength of Prostate tales is the unique emotional sharing of men's experiences.
In a dominant culture of repression and denial, it is so unusual to listen
to men tentatively exploring forbidden terri- tories, like depression, incontinence,
grief, loss, sexual problems and joyful alternatives, unemployment, fear of
death and marital conflict. It is the narrative power of the stories themselves
that pulls the reader in to entering some of the emotional realities of older
men's lives with prostate cancer. The reader is offered a compassionate understanding
of these men's lives from the inside, not just facts about the disease but
emotional experiences to engage with. To give you something of the flavour
of the 13 stories and the one drama script, here are a few memorable lines
selected from the book: `If I would sneeze I would wet myself.' `Now the Playmate-of-the-month
could walk in here without a stitch on and I'd just yawn.' And `I'd rather
die than lose my potency.' The stories use the concrete detail of the original
interview tran- scripts but also work on the creative imagination of the reader
through a process of careful crafting and shaping. For example, the imaginative
tension in one story, `Frederick tries for a job', is fash- ioned through
the clash in a 62-year-old, gay man's life between his dreams of status and
self-respect through a new work identity and the bleak, present reality of
a man who has considerable anxiety and some despair about his `severe urinary
incontinence' . At the very end of the story, Frederick visibly pees himself
just before the job interview. He knows that he can not go for the interview
in that state but the reader is persuaded to feel some kind of emotional connection
for Frederick' s predicament through a carefully worked, metaphor- ical contrast
in the last paragraph. Here are the last few sentences of the story: `For
a few moments he [Frederick] stands quietly in the foyer, looking around him
at the displays in the windows. A cou- ple of them strike his fancy, very
much like the kind of work he would do. Then he steps back through the revolving
door, out onto the snowy street.' Frederick's dreams of creating fashionable,
window displays (almost like a longed for self-presentation as well), like
he did in the Warsaw of his youth, are savagely punctured at the point where
he has to confront the grim, icy reality of his collapsed hopes and fantasies
in the `snowy street'. So, in the collection as a whole, the effectiveness
of the story's shape (fictional artifice/ symbolic pattern- ing) can deepen
the force of the social science argument.
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The
other key point about the stories is their social range and diversity. In
this collection, gay men rub shoulders with heterosexual men, black with white,
unemployed, working-class men with other men who are more financially secure
with jobs. This social breadth seems to be achieved effortlessly without any
forced contrivance. Indeed, it is probably one of the richest, most culturally
diverse books that I have read within the men and masculinities' field. There
is no empty rhetoric or tokenism here. Instead there is a multiplicity of
dif- ferent experiences and social perspectives with their own biographical
variety embedded into the collection. I was very moved, disturbed and excited
by the stories. I was moved by the way Ross Gray makes the hidden, often shamed
worlds of men with prostate cancer more visible through the stories. I was
also excited by the author's personal and political commitment to reconstructing
traditional masculinities and gendered identities. As he says, prostate cancer
profoundly disrupts a conventional, masculine biography. Prostate cancer is
a `huge blow to a man's sense of being a man' as well as being a serious health
issue. The severe trauma of prostate cancer threatens the stability and bodily
coher- ence of conventional masculine identities. It is this threat that,
ironically, often provokes a difficult process of remaking social relations
(men trusting and helping other men as well as women); re-embodiment (men
becoming more aware of and looking after their own bodies); and provokes a
movement towards taking up non- competitive and nonhierarchical masculine
identities. As a result, positive well-being for men with prostate cancer
is closely tied into these masculinity shifts where, traditionally, homophobic
fears of being seen as `weak' or `soft' can often block a man's journey towards
closer intimacy, friendship and mutual understanding. In short, then, Prostate
tales is a courageous book that I can enthusiastically recommend to all Auto/
Biography readers. It is an exciting but unsettling read. What disturbed me
about these stories are the examples of men struggling to keep alive within
a dominant culture that squanders men' s resources and, ultimately, men' s
lives. Some men' s capacities to share themselves more fully, to live more
fully, to love more fully and intimately, even to have longer and more fulfilled
lives are all so strictly contained through social/cultural regu- lation and
self-surveillance. As one of the story characters remarks: `Do men have to
be sick or on the brink of death before they wake up to their common humanity?'
(p. 47). It is hoped that these stories will play a part in opening up men's
silences about the hidden pain and loss in their lives.
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NOTE
1 From The Men's Health Forum
2002: Getting it sorted: a new policy for men's health: The Men' s Health
Forum. London