Swimming in a Sea of Death

Memoirs written after the death of a loved one can either be elegies radiant with poetic inspiration or they can be self-serving eulogies. David Rieff, a thoughtful and intelligent writer, happens to be the son of Susan Sontag, one of America's most brilliant authors and essayists, a woman of great courage with the gift of exploring concepts of our society that she found in need of our attention while at the same time a being novelist able to spin meaningful tales about the indomitable human spirit. SWIMMING IN A SEA OF DEATH: A SON'S MEMOIR is far more than a rehash of an artist's life and exit from life: this book is a work of sensitive evaluation of not only a great woman but also of the myriad aspects of our healthcare system, both good and bad, and the delicate yet coarsely bumpy path that begins with the diagnosis of a terminal disease and ends with the sigh that completes mortality. From this book we learn not only the trials of Susan Sontag's battle with three attacks of cancer (breast cancer in 1975 with radical surgery and chemotherapy, uterine sarcoma in 1998, and Myelodysplastic Syndrome in 2004), but we also learn about the relationship of a son and mother and the challenges to each in coping with threatening diseases and ultimately death. What makes this 'memoir' so different is the frank honesty of the author David Rieff. He reflects on the avid love for living that ruled Sontag's life, her refusal to give in when she felt that fighting the odds was better than the alternative of doing nothing. Rieff took on the role of supporting his mother's belief that all of the chemotherapy, mutilating surgery, radiation, bone marrow transplantation - all accompanied by severe physical and psychological pain - was worth the effort if the methods of attacking the disease process held any degree of hope of remission. It is a lesson for all of us who have dealt or are dealing with being there for loved ones who face medical decisions, times when the patient needs the support of those who care and are willing to accept the fact that the patient is very much alive - until life is no longer an option. The reader comes away from this book with a profound respect for the spirit of Susan Sontag, the courage of her various physicians who respected her participation in her decisions, and the quiet and gentle love of a son who can now see the giant who was his mother as he passes her grave in Paris. Toward the end of this book Rieff quotes form Sontag's journals: '"I write the way I live and my life is full of quotations." Then she adds: "Change it." But she never did.' This memoir is an Elegy. Highly recommended reading. Grady Harp, February 08

So David Rieff describes his mother Susan Sontag's relationship with her own mortality. A two-time cancer survivor (she was first stricken in her early 40s, and went through brutal therapy), Sontag never lost her deep repugnance at the thought of her own extinction nor her equally deep conviction that the only reasonable response to death was to resist it to the final breath. Rieff's memoir of his mother's last and losing struggle against an especially aggressive form of leukemia is a touching and at times profound reflection on the fragility of life which. It reveals much more than Sontag's own struggle with mortality. It is equally revelatory when it comes to her son's own discomfort with death. It ponders on whether some ways of entering into dying are better--for oneself as well as one's family and friends--than others. Finally, it invites readers to reflect on our culture's obsession with beating death, or at least holding it at arm's length. Rieff reiterates throughout the book that Sontag resisted death as mightily as she did because she so loved life. "She reveled in being...No one I have ever known loved life so unambivalently" (p. 143). But Rieff's descriptions of Sontag's mental anguish, her strategies of denial, and her demands for comfort and company and false hope during her last months inevitably raise the question of where a love of life that resists death ends and a desperate terror of death which clings to life any any cost begins. Might it be that a genuinely celebratory love of life is one that recognizes that transience is part and parcel of its bittersweet appeal? Could it be argued that a desperate struggle to live when it's clear that the time to die has come bespeaks something less than love of life? Could it be that there's something profoundly important to be said for going gently into that dark night? Such a possibility is hinted at, perhaps unintentionally, by Rieff. Another issue raised by his memoir is the responsibility of physicians to their dying patients. In an especially interesting chapter, Rieff discusses the attitudes of two of the oncologists who treated his mother. One took the conventional approach that the physician's primary responsibility is to keep the patient alive so long as even a shred of medical hope remains. The other deplored the "surreal minuet" of medical "denial, the kind of winking that goes on, where, yeah, we all know the patient's going to die but we're all going to pretend like there's hope" (p. 114). The surreal minuet implicates more than just patient and physician. It can force family and friends into the dance of denial as well. One of the more poignant themes in Rieff's memoir is his on-going guilt over the role his mother forced him to play during her dying: continuously lying to her about her condition. He asks himself--and will always ask himself--if this was the proper thing for him to do. Did his "winking" encourage false hope in Sontag, thereby prolongi

Susan Sontag had battled breast and uterine cancer before in her life. But there was hope for treatment and survival for those cancers. In 2004, she was diagnosed for the third time with a blood cancer with no treatment and no hope offered by the doctor. Thus begins this memoir by David Rieff, Susan Sontag's son. This short little book is about the author's attempt to "report" on his famous mother and, I suspect, the distance between them. He doesn't go into graphic detail about the effects of the illness or about their relationship. He muses about his mother's drive for life and the book is a tribute to her will to live.

This lovely and heartwrenching book takes the reader not only through the mind of Susan Sontag as she struggles with her last illness. It also reveals the humanity of the author and how he himself struggles with the aftermath, in wondering if he did enough, in questioning his own behavior throughout. I know from personal experience in losing parents and very close friends, no matter how much you do, you will always feel that there was one more thing you could have done to ease their pain, either their physical or psychic pain. Although in this thoughtful account, the author appears to be second guessing what he and others did, I believe he is reflecting honestly on what it means to confront death--your own or that of a loved one. I'm reminded of one of Scott Peck's quotations which roughly said, "only when you confront the reality of your own death are you freed to live your life." Susan Sontag did not go gentle into that good night. Both she and her son are an inspiration for all of us as we face our ultimate outcome.

How does a son respond when told that his mother is dying? Is there a difference when this is not the first time? What does it mean to the soul when the cure itself kills? American writer Susan Sontag died in 2004 of a form of cancer brought on by her earlier aggressive treatments for advanced breast cancer. She was told of her fatal condition as she was accompanied by her son, David Rieff. Nine months later she was dead. Is there any difference between fighting for life and fighting against death? In Sontag's case, it seems that her goal was to survive and to live life to the fullest. She was a believer in a "take no prisoners" approach to her cancer treatments... a serious disease required an equally serious treatment, and a dedication to this treatment. For her, according to Rieff, death was not an option. "But with the greatest respect [for her oncologists], the brute fact of mortality means that there are limits on how much better we can realistically expect to do" (p. 166). This is a book of two viewpoints: what Rieff as a son saw of his mother and himself as the MDS progressed, and how Sontag approached life and death during this period. Both were brave, and reflective. "During the months I watched my mother die, I was increasingly at a loss as to how I could behave toward her in ways that actually would be helpful. Mostly, I felt at sea" (p. 103). "She told me at one point that she was tormented by the amount of time she had wasted during her life on what she called her 'Girl Scout-ish' obsession with doing 'worthy' things" (p. 106). "And in the end, those of us who loved her failed her as the living always fail the dying, for we could not actually do the only thing she really wanted, which was to stave off extinction for just some time longer, let alone give her what I'm afraid is all too accurately called a new lease on life. Only her doctors could do that" (p. 136-137). Sontag's philosophy toward treatment was simple in its complexity: Search for every treatment option. Take every chance. Survive. She watched friends die because they did not heed this advice. But as the sand inexorably runs through the hourglass, the options disappear, the menu of treatments is taken away, and the final endpoint appears. Rieff collects his thoughts from his observations and reflections, and from both his pre-death conversations with his mother and his post-death review of her journals. This is not a biography of Susan Sontag. It is a mourning of a son for his mother. "Mostly, I felt at sea." It is a tough decision, financially, emotionally, and practically, to be aggressive in fighting disease. Sontag was always a fighter, and her experiences fighting breast cancer shaped her to the end. For Rieff, his mother was... his mother. There is no expectation of a reunion in the afterlife, or a reincarnation and reinvention. You live your life, and then you die. Sontag refused to be passive in life, and in her approach to the