They buried a giant of literature and human rights yesterday in Russia. Alexander Solzhenitsyn

Solzhenitsyn was a witness to the horrors of communism, writing about the Gulag in such detail that after his trilogy was published, no longer could the elites of the west pretend that communism was a benign system of government whose successes outweighed the blood spilt by it’s perpetrators.

But it’s in his other books that the name “writer” may be better remembered. A true author tells tells us the truth by way of story rather than dry data AKA “facts” that may obscure the truth in the details.

As a physician, the novel that impressed me the most is Sozhenitsyn’s novel “Cancer Ward”. Many critics see this as an allegory to a “sick” socialist society in Russia, but to a doctor it is pure realism.

The novel chronicles the story of patients in a provincial cancer hospital. The patient suffering of the rural ethnic boy; the bossiness of the bureaucrat who finds he can terrorize his doctors but all his political pull cannot stop his cancer; the young girl facing mutilating surgery and seeking a night of love to mourn her lost  womanhood. Then there are the doctors, the young one seeking to make a life in a world where the men of her age have died in the war, and the older teacher who faces her own mortality when she herself is diagnosed with cancer.

In the midst comes the prisoner: arriving at death’s door, he comes to life when radiation therapy unexpectedly causes a remission.  Each day of life now becomes meaningful, and wonderful…

The cancer that Solzhenitsyn (and his alter ego in the book) suffered from was originally felt to be a form of lymphoma, but with better pathological diagnosis was discovered to be a seminoma, a cancer of the testicle that is found in young men.

Most are discovered when a lump is found; often the lump is diagnosed as an infection (epididymitis) or is hidden by a sac of water (hydrocoel). And this cancer if more common in those whose testicles did not descend into the scrotum, even if surgery later place them in the correct place (cryptorchidism). Sometimes these cancers are found when they metastasize: The only case I diagnosed in 35 years of medicine was  in a man with terrible back pain from metastases. But most cases are found earlier, and even advanced cases will respond to radiation or chemotherapy.

So luckily for the world, Solzhenitsyn’s cancer responded to the basic radiation available in his provincial town, and as a result the world is a little bit better than it would have been.


Nancy Reyes is a retired physician living in the rural Philippines. Her website is Finest Kind Clinic and Fishmarket. 

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