Grave Condition, but not Hopeless

The Author: Alexander Solzhenitsyn

He  was born in December 1918;  known as a Russian novelist, historian, and short story writer. Solzhenitsyn fought in World War II as a commander in Russia’s Red Army and was decorated twice. He was arrested in 1945 for making derogatory comments about Stalin in a letter to a friend. He was subsequently sentenced to eight years imprisonment to be followed by permanent internal exile.

He was an outspoken critic of the Soviet Union and communism and helped to raise global awareness of its Gulag forced labor camp system. He was allowed to publish only one work in the Soviet Union, One Day in the Life of Ivan Denisovich (1962), in the periodical Novy Mir. After this he had to publish in the West.   He is a stomach cancer survivor and his experiences serve as the basis for Cancer Ward (1968).  He also published The First Circle (1968), August 1914 (1971), and The Gulag Archipelago (1973). He was awarded the Nobel Prize in Literature in 1970 “for the ethical force with which he has pursued the indispensable traditions of Russian literature”. Solzhenitsyn was afraid to go to Stockholm to receive his award for fear that he would not be allowed to reenter. He was eventually expelled from the Soviet Union in 1974, but returned to Russia in 1994 after the state's dissolution.  He died in 2008. 



The Novel:   Cancer Ward 

“What is an optimist? The man who says, "It's worse everywhere else. We're better off than the rest of the world. We've been lucky." He is happy with things as they are and he doesn't torment himself.

What is a pessimist? The man who says, "Things are fine everywhere but here. Everyone else is better off than we are. We're the only ones who've had a bad break." He torments himself continually.”   ― Aleksandr Solzhenitsyn, Cancer Ward


The story takes place in the men's cancer ward of a hospital in a city in Soviet Central Asia. The patients in Ward 13 all suffer from cancer, but differ in age, personality, nationality, and social class (as if such a thing could be possible in the Soviet "classless" society!). We are first introduced to Pavel Rusanov, a Communist Party functionary, who enters the hospital because of a rapidly-growing neck tumor.
"The hard lump of his tumor--unexpected, meaningless and quite without use--had dragged him in like a fish on a hook and flung him onto this iron bed--a narrow, mean bed, with creaking springs and an apology for a mattress."(p 10)

Solzhenitzyn himself was released from a labor camp in early 1953, just before Stalin's death, and was exiled to a village in Kazakhstan. While incarcerated, he had been operated on for a tumor, but was not told the diagnosis. He subsequently developed a recurrence, received radiotherapy in Tashkent, and recovered.

The narrative places its focus on the central character of Oleg Kostoglotov, a young man who has recently been discharged from a penal camp and is now "eternally" exiled to this particular province. Only two weeks earlier, he was admitted to the ward in grave condition from an unspecified tumor, but he has responded rapidly to radiation therapy. Among the doctors are Zoya, a medical student; Vera Gangart, a young radiologist; and Lyudmila Dontsova, the chief of radiation therapy.

Rusanov and Kostoglotov respond to therapy and are eventually discharged; other patients remain in the ward, get worse, or are sent home to die. In the end Kostoglotov boards a train to the site of his "eternal" exile: "The long awaited happy life had come, it had come! But Oleg somehow did not recognize it."

In The Cancer Ward Solzhenitzyn transforms his own experiences into a multifaceted tale about Soviet society during the period of hope and liberalization after Stalin's death. While Cancer, of course, is an obvious metaphor for the totalitarian state there is also a penetrating look at mid-century Soviet medicine and medical ethics. 
“But substantial X-ray treatment is impossible without transfusion!” “Then don’t give it! Why do you assume you have the right to decide for someone else? Don’t you agree it’s a terrifying right, one that rarely leads to good? You should be careful. No one’s entitled to it, not even doctors.” “But doctors are entitled to that right—doctors above all,” exclaimed Dontsova with deep conviction. By now she was really angry. “Without that right there’d be no such thing as medicine!” 
Of course, the paternalism evident here (e.g. lack of truth-telling and informed consent) was also characteristic of medicine in other countries in the 1950's and remains an important concern in professional ethics.

The novel also explores the personal qualities and motivation of physicians, and the issue of intimate relationships between doctors and patients. The most incisive aspects of the book are its insight into human nature and the realism of its characters.