1. Debulking a life: anger and the fear of death

Across the eight chapters of her memoir, Susan Gubar moves from the moment of diagnosis and her lucid recognition of impending death, through the bodily and psychological devastation of debulking surgery and chemotherapy, into a state of life-in-death existence marked by remission and recurrence. Memoir of a Debulked Woman functions both as a critique of the inadequate and often harmful medical treatments imposed on thousands of women and as a reflection on the sustaining power of love, companionship, art, and literature in the face of illness. As Gubar herself explains, ovarian cancer has been called “breast cancer’s poor neglected cousin” in part because breast cancer is “imagined as a disease that can be overcome,” whereas ovarian cancer remains “intractable, unimaginable, unspeakable.” It lacks the public presence created by armies of activists, and mortality rates are so high because most patients whose disease is discovered at stage three or four “relapse after treatment and die.” And, unlike the symptoms of breast cancer, for which early detection is possible, those of ovarian cancer-bloating, fatigue, indigestion, constipation- are difficult to distinguish from “the general noise of the midlife or aging body.”Footnote ⁸ Like many women with ovarian cancer, Susan Gubar initially ignored early warning signs, then heard them dismissed by doctors, until it was too late. Finally, her concern took her to a Bloomington hospital for tests in 2008:

This is the chronological departure of Gubar’s autopathography, a book that is at once the memoir of her incurable illness, but whose autobiographical voice is mixed with that of the retrospective educator on ovarian cancer, and that of the literary scholar. In fact, her book contains no less than 393 footnotes, a works cited list of over 200 entries, innumerable quotes from thinkers, poets and writers from Homer or Freud to Anne Sexton, Susan Sontag, Virginia Woolf, Alice Walker, or Salman Rushdie, to name but a few, and, of course, Susan Edson’s play Wit, which she and Sandra Gilbert included in their 2007 Norton Anthology of Literature by Women. Footnote ¹⁰ Gubar also incorporates quotes from feminist scholars and other illness narrative writers, and references to painters, particularly Frida Kahlo, as sources of inspiration.

Wit, the title of Margaret Edson’s play, links up with its protagonist’s profession. Like the real Susan Gubar, fictional Vivian Bearing is a highly successful scholar, an expert on seventeenth-century English poetry, particularly John Donne’s Holy Sonnets. She is brilliant, rigorous, and unyielding. But unlike Susan Gubar, who appears in her text as deeply involved with her family and community, Vivian is completely cut off from human connection. The play traces Vivian’s trajectory from the initial diagnosis through aggressive treatment, aplasia, and sepsis, culminating in her death during a chaotic attempt at cardiopulmonary resuscitation. Along the way, the action is interwoven with flashbacks to her childhood and her academic career. Much of the dialogue unfolds between Vivian and various health-care professionals within the environment of “the all-too-familiar setting of the University Comprehensive Cancer Center.”Footnote ¹¹ But she also speaks directly to the audience, thereby breaking the fourth wall, which creates a sense of intimacy and makes the audience feel personally addressed.

The opening of Wit immediately establishes dark irony as the play’s central mode and introduces Vivian Bearing as both subject and commentator on her own illness. Her appearance on stage, bald, barefoot, and pushing an intravenous (IV) pole, immediately shows the physical effects of her illness and treatment, yet she speaks with the authority and precision of a literature professor. When she greets the audience with “Hi. How are you feeling today?” she is ironically repeating the routine question doctors and nurses constantly ask her, even when she is clearly suffering.Footnote ¹² Some lines after, she states: “It is not my intention to give away the plot; but I think I die at the end,” a line that somehow removes any suspense about the outcome and makes clear from the start that this is a story about dying, not about recovery.Footnote ¹³

As Susanna Egan has said, terminal illness, the process of dying, and the facts of death have taken on a new life. Remarkable numbers of people living in the shadow of death have begun to speak out on issues that have, for a long time, been considered entirely private if not actually shameful, and to insist on being heard. So, “dying has become a significant point of departure for life writing,” giving rise to what has come to be termed autothanatography. Footnote ¹⁴ The term is applied to autobiographical texts that confront illness and death by performing a life at a limit of its own undoing. If death has been a taboo subject in the Western world for many generations, the postmodern reaction of pathographers today is to “deromaticize their expected ending” and to become (auto)thanatographers.Footnote ¹⁵

Within this framework, both Memoir of a Debulked Woman and Wit can be read as forms of thanatography because they narrate the self under the shadow of terminal illness and anticipated death. Gubar’s memoir exemplifies autothanatography, as she writes from within the ongoing experience of ovarian cancer, documenting the progressive destruction of bodily integrity, autonomy, and hope in the future while reflecting on what it means to live toward death. Similarly, Wit, though fictional, stages Vivian Bearing’s confrontation with mortality and her gradual relinquishment of physical and intellectual control until the play ends at the threshold of death itself. Reflecting on her prognosis, Susan Gubar writes: “Especially because ‘I am going to die’ is a sentence not everyone wants to hear, it makes its way into passages in the following pages about graphic and sometimes gross physical incidents that not everyone will want to read, but that cannot be excised from reflections on the current treatment of ovarian cancer.”Footnote ¹⁶ Gubar goes on to quote Marie de Hennezel, a French psychologist who works with the terminally ill, who argues that the person able to say “I am going to die” becomes not the victim but the protagonist of their own dying. Gubar recalls silently rehearsing these words on a hospital gurney, finding in them a moment of release upon receiving her diagnosis of advanced ovarian cancer.

Turning to Wit, after being diagnosed with late-stage ovarian cancer, Vivian Bearing agrees to undergo the most aggressive experimental treatment offered to her by Dr. Kelekian, including brutal chemotherapy cycles administered throughout 8 months. According to her oncologist, “This treatment is the strongest thing we have to offer you. And, as research, it will make a significant contribution to our knowledge,” but Vivian suspects it will all be in vain.Footnote ¹⁷ Through her confrontation with death, Vivian achieves an understanding of herself that she did not possess, and resorts to John Donne’s poetry in order to find assurance and consolation:

And so, John Donne’s sonnets will serve as a recurring motif in Vivian’s mind throughout her particular Inferno, most especially the victory of life over death in the sonnet “Death, be not proud”:

Death be not proud, though some have called thee

Mighty and dreadfull, for, thou art not soe,

For, those, whom thou think’st, thou dost overthrow,

Die not, poore death, nor yet canst thou kill mee …

And death shall be no more—comma—Death thou shalt die.Footnote ¹⁹

Through Donne’s poem, Vivian recalls how Professor Ashford, her poetry instructor of 20 years before, taught her that death is not an absolute ending but a transition, a brief pause rather than a final barrier. By emphasizing the comma in “death shall be no more, comma, death thou shalt die,” she suggests that death separates two forms of existence but does not destroy life itself. The comma becomes a metaphor for continuity rather than rupture. Vivian tries to cling to that slender pause as a site of hope, yet cancer asserts itself with a force that no punctuation can defer. At the same time, Vivian’s recollections of her university teaching unfold directly before the audience, as Donne’s lines seem to emerge out of the darkness, and she carefully guides us through their meaning. The richness of the poetry is revealed gradually, until a powerful dramatic effect becomes clear: Donne’s verses mirror Vivian’s own experience of illness. The audience begins to realize that when she interprets the Holy Sonnets, she is also, in effect, interpreting the reality of her own approaching death. As Ann Henley has put it, “Vivian works out the onerous philosophical puzzle, not of a poem, but of her own life and death.”Footnote ²⁰

References to thanatography often evoke Kübler-Ross’s classic On Death and Dying (first published in 1969), where she outlines what became known as the five stages of grief: denial, anger, bargaining, depression, and acceptance. I will first focus on the second stage: anger, or the “Why me?” phase, when, once denial fades, feelings of anger, resentment, and injustice emerge.Footnote ²¹ Interestingly, the fictional Vivian Bearing openly gives voice to this stage, whereas the real, scholarly Susan Gubar intellectually distances herself from it. Vivian recites on stage Donne’s Holy Sonnet Five while the text is projected on the screen behind her:

If poysonous mineralls, and if that tree,

Whose fruit threw death on else immortall us,

If lecherous goats, if serpents envious

Cannot be damn’d; Alas; why should I bee?

Why should intent or reason, borne in mee,

Make sinnes, else equall, in mee, more heinous?Footnote ²²

Absorbed in a soliloquy on its meaning, she concludes: “Why would God choose to do what is hard, to condemn, rather than what is easy, and also glorious—to show mercy?”Footnote ²³ And, again, Donne’s sonnet articulates Vivian’s anguished questioning, closely paralleling the “Why me?” phase (“Why should I bee?”) described by Kübler-Ross. In the poem, the speaker challenges the apparent injustice of divine judgment, asking why he should be condemned when other destructive elements in nature remain unpunished. Similarly, Vivian confronts and gives voice to the perceived injustice of her own suffering and impending death, perhaps recognizing her fate as arbitrary and utterly undeserved.

Gubar, by contrast, rationalizes her condition, reframing the conventional “Why me?” as a more sober acknowledgment that, given the high incidence of cancer in contemporary society, she could hardly consider herself an exception. Having witnessed cancer affect “young and old people” alike, she concludes that, in a world where the disease can strike “anyone, anywhere, any time,” the more predictable question might well be “why not me?”Footnote ²⁴ So, instead of torturing herself in the anger stage, she advances to the fifth stage; that of acceptance, reframing her cancer not as an exceptional injustice but as a shared human condition, as she puts it:

2. Body politics and medical politics: a critical medical humanities approach

In a feminist study of women’s cancer theatre, Mary DeShazer explores the diverse representations of “body politics” and “medical politics” in various cancer plays.Footnote ²⁶ Applying her method to our own purposes, we could argue that an analysis of body politics demonstrates how our two protagonists view their ovaries; how they cope with their disease and the accompanying fear, loss, and anger; and how they prepare for their deaths. An exploration of medical politics reveals how the authors interrogate the behavior and discourse of medical practitioners and the complex problem of debilitating cancer treatments.Footnote ²⁷ This exploration of medical politics would align our analysis with the aims of the critical medical humanities.

As Anne Whitehead, Angela Woods, and Julia Kristeva observe, early medical humanities scholarship largely revolved around three “Es”: ethics, particularly bioethics; education, especially the training of healthcare professionals; and experience, understood as the lived reality of illness.Footnote ²⁸ The critical medical humanities expand this framework by introducing a fourth E: that of entanglement.Footnote ²⁹ This concept foregrounds the unequal interrelations between individual illness and the institutional, political, technological, and socio-economic structures in which it is embedded. As William Viney and colleagues further argue, “‘race’ and ethnicity, sexuality and gender, disability (and madness), technology and media, economics, and social and environmental inequalities” are not peripheral but central to the production of medical knowledge and to the experience of health and illness.Footnote ³⁰ In sum, the critical medical humanities turns a critical lens on the authority and assumptions of medicine. From this perspective, we may conclude that both Gubar’s and Edson’s texts may be read within this critical mode, revealing illness as inseparable from broader social forces, as will be discussed below.

The standard treatment for advanced ovarian cancer, which gives Gubar’s memoir its title, is debulking, a procedure that seeks to remove as much cancerous tissue as possible, including organs to which the disease has spread. In what Gubar calls “the mother of all surgeries,” an operation that can last 6–8 hours, the body is cut open from the navel to the pubic bone:

In her case, as in most cases, the debulking was “suboptimal,” which means that visible lesions (“dirty margins”) remained, increasing the chances of recurrence. Although the operation extends life, it rarely cures, and it carries a high risk of complications, as Gubar discovered. But “debulking” also becomes a metaphor that threads through the book. Gubar must “bulk up” before chemotherapy begins, and learn to live “with a multitude of attachments to the bulky world.”Footnote ³² Later, struggling through treatment, she feels “bulking up indoors” while wearing layers of socks and sweaters, while the freezing cold keeps seeping into her heart.Footnote ³³ In fact, her book constitutes an account of how the post-debulking “got negotiated by a 63-year-old who had bulked up her earlier life by means of an insatiable appetite for reading and writing books, making friends, teaching literature, quilting, knitting, cooking, partnering, collaborating, and mothering.” In short, bulk is mass, presence, life; debulked is “an ugly adjective,” and an ugly reality.Footnote ³⁴

In my critical analysis of these two pathographies, I shall partly follow Hunsaker Hawkins’ anatomy of these texts, evaluating them as “didactic” and “angry” pathographies. Firstly, “didactic pathographies,” Hunsaker Hawkins argues, are motivated by an explicit desire to help others. They often mix practical information with a personal account of the experience of the disease and treatment, grounded on the assumption that the author’s experience can serve as a mirror or model (either positive or negative) for potential readers.Footnote ³⁵ Susan Gubar’s pathography clearly falls under this categorization. In the “Foreword” to her memoir, the author warns her potential readership that, even though she does not wish to disabuse the hopeful of their hopefulness, or to promote pessimism, writing this book in de midst of her treatment, has a clear, didactic motive: to convey a fierce belief that something must be done to rectify the miserable inadequacies of current medical responses to ovarian cancer.Footnote ³⁶ Memoir of a Debulked Woman is her attempt to share and make sense of her experience, “delivered in a voice that is intelligent, feminist and devastatingly honest.”Footnote ³⁷ Never omitting scientific terminology, the reader learns, and even “sees”—so vivid are her descriptions—what, for example, is an ileostomy and its quite distinct abjections: “bringing a loop of the small intestine up through the skin, folding it back like the turtleneck of a sweater or the top cuff of a sock, and stitching it in place on the abdomen.”Footnote ³⁸ There is no need to dwell on the very specific minutiae that Gubar gives of her “stoma,” but this ironic and metaphoric description will suffice for any reader:

A stoma is a surgically created opening on the outside of your body that connects to an organ on the inside. The operation to create this opening and connection is called an ostomy.Footnote ⁴⁰

“Illness is about learning to live with lost control,” Arthur Frank states in his landmark study The Wounded Storyteller, where he further defines contingency as “the body’s condition of being subject to forces that cannot be controlled.”Footnote ⁴¹ And this contingency is what Gubar exactly describes throughout her cancer odyssey. For instance, at one point she recalls having to undergo a third abdominal surgery—after one recurrence and two cycles of chemotherapy—to repair the abscess caused by the debulking operation. After a few days of incapacitating misery, Gubar feels that “a gush of bloody pus spurts out of the center of the right cheek of my bottom … it is at this moment that I think: call me putrefaction, a misbegotten abomination.Footnote ⁴² Inevitably drawing on her scholarly wit, Gubar turns to Kristeva’s theory of the abject and adds: “no need to consult Julia Kristeva on the psychic power of my horror, but the truth of Freud’s insight—‘dirt is matter in the wrong place’—comes home to me. I am perpetually dirty, defecating incessantly from my belly.”Footnote ⁴³

To an interviewer’s remark that such frank and graphic descriptions are often missing from illness narratives, Gubar replied, quoting one of her literary foremothers:

Her scholarly reflection further suggests that while, historically, men have been associated with transcendence and spirituality, women have been linked to the body and physicality; “so it may be that women are fearful of writing honestly about embodiment during illness, fearful of being identified as less than human or nothing but a body.”Footnote ⁴⁵

While Gubar reflects on cultural anxieties surrounding women’s embodiment, Arthur Frank provides a broader framework for understanding how the ill body is narrated. He distinguishes four configurations: the disciplined, mirroring, dominating, and communicative body. Gubar’s self-presentation aligns most closely with Frank’s “communicative body,” which defines itself through relationality, reflects on its experience, and accepts uncertainty through dialogue rather than control.Footnote ⁴⁶ In this line of thought, as a didactic pathography, Gubar wishes to share her own experience with what Albert Schweitzer has called the “brotherhood (I should add ‘sisterhood’) of those who bear the mark of pain,” speaking not only for herself but for other women with cancer.Footnote ⁴⁷ In doing so, her didactic impulse often turns to anger. As Hunsaker Hawkins notes, such “angry pathographies” often arise from a personal need to expose failures in patient care: they reveal how patients may be both beneficiaries and victims of a healthcare system whose technological excellence can also be dehumanizing.Footnote ⁴⁸

In this sense, in the Foreword, Gubar acknowledges that “at least at times,” she adopts an activist stance. Committed to “telling the truth about the experiences of the female body,” she records in unsparing detail its degradation: dry mouth and tingling extremities, the numbing routines of treatment, hair loss, persistent cold, cognitive fog, and the effects of debulking surgery, culminating in what she calls a “posthumous existence” (title of chapter six).Footnote ⁴⁹ Yet her purpose is not simply to chronicle private suffering. She insists:

And she goes on to describe “gutting, draining, bagging, and poisoning” as standard protocols undertaken “not to eradicate but to retard metastases,” treatments that “damage the lives of many ovarian cancer patients.”Footnote ⁵¹ Here, the “communicative body” becomes explicitly sociopolitical: Gubar presents her suffering not as individual misfortune but as evidence of systemic failures affecting other women with ovarian cancer. She also shows how poor medical communication deepened her vulnerability. Reflecting on her debulking surgery, she writes that the operation “created the abscess and perforation that ominously ruled my existence,” and that she must live with the consequences of “the drains, the ileostomy, and the chemotherapy,” treatments that extended her life but “shocked” her “either because I was not given sufficient information or because I had not been able to assimilate whatever information I had been given.”Footnote ⁵² The episode clearly reveals how the gap between medical expertise and patient understanding can itself become a source of suffering, a central concern of the critical medical humanities.

Edson’s theatrical narrative, for its part, can also be considered an “angry pathography,” since a comparable critique emerges in Wit, where Vivian Bearing gives voice to the same sense of anger and betrayal in response to the dehumanizing logic of medical approaches to ovarian cancer:

Both works angrily denounce the dehumanizing tendencies of modern medicine, particularly when patients are treated as “guinea pigs” in the name of research, a critique Gubar makes explicit.Footnote ⁵⁴ In fact, beyond functioning as a pathography, Memoir of a Debulked Woman also engages critically with Margaret Edson’s Wit, which Gubar references several times. Drawing on her expertise as a literary scholar, she compares Vivian Bearing’s ordeal with her own and evaluates the play’s portrayal of ovarian cancer treatment: “Margaret Edson’s play encapsulates what most people intuit: a succession of poisons are hurled at the ovarian cancer patient in a series of therapies that may kill the patient before the disease does.” Such practices, she argues, are so harsh that “fifty years hence doctors will look back at the treatment of ovarian cancer today and judge it medieval.”Footnote ⁵⁵

As said, Margaret Edson draws on her experience as an aide in an oncology ward to trace Vivian Bearing’s decline, from diagnosis through an experimental treatment for ovarian cancer led by Dr. Kelekian and his fellow, Dr. Jason Posner—who happens to be Vivian’s former student— to her death. This former classroom hierarchy is sharply inverted, since the once authoritative professor becomes the object of her student’s clinical gaze. The play repeatedly stages the medical encounter as a ritualized performance in which the patient is reduced to a case study. In one scene, resident physicians gather around Vivian’s bed and subject her to a standardized interrogation, invariably beginning with the formulaic “Hi. How are you feeling today,?” a greeting that grows increasingly hollow through repetition.Footnote ⁵⁶ Eager to impress their superior, they recite her symptoms: anemia, nausea, and vomiting, without truly looking at her. Vivian listens to this medical litany as her face turns from one side of the bed to the other “as if she were a judge in a tennis game,” visually capturing her marginalization.Footnote ⁵⁷ And, in a moving aside to the audience, she openly denounces her objectification as material fit for an indexed medical journal:

Any reading of Wit must remember that Vivian Bearing is, above all, a philologist—an expert in the complexities of seventeenth-century language. Her identity rests on intellectual precision and lexical mastery, as she tells the audience:

She, therefore, arrives in the hospital thinking she is the best. But cancer and the medical jargon will impose their law. And, as the play develops, Edson reveals unexpected parallels between the literary scholar and the medical professionals who treat her. Wit shows that, despite disparities, “both disciplines use language to inhibit rather than promote communication, both avoid meaningful personal interaction, and both reduce the subject of research to object.”Footnote ⁶⁰ This is Vivian’s ironic reaction to the incomprehensible medical jargon she is subjected to:

Steven Wilson argues that serious illness produces a “fall of language”: the patient’s vocabulary collapses under the dominance of medical discourse.Footnote ⁶² This concept illuminates the linguistic dynamics of Wit. For Professor Bearing, language once signified intellectual mastery. After her diagnosis, however, she admits that medicine commands a “more potent arsenal of terminology,” and that her own arsenal “has fallen.” Although she jokingly suggests she will simply learn more words, she is, in fact, linguistically belittled and spiritually disarmed. Edson thus exposes the structural affinities between literary scholarship and medical practice: as Henley observes, both disciplines can “use language to inhibit rather than promote communication” and “reduce the subject of research to object.”Footnote ⁶³ In a metatheatrical moment, Vivian does not simply criticize Dr. Jason; she places herself on trial:

This parallel underscores one of Wit’s central ethical concerns: when intellectual mastery becomes an end in itself, it risks undermining the human connection that gives meaning to both teaching and healing. That is why Ann Henley contends that Wit challenges teachers of literature and medical professionals alike to assess their efficacy in conveying to students and patients the simple human truths that dignify life and death.Footnote ⁶⁵ In fact, one could argue that Dr. Kelekian treats Vivian much as she once treated her students: for both, the encounter becomes a display of authority, “turning each encounter into an exercise in wit.”Footnote ⁶⁶ In her flashbacks to her days of academic glory, Vivian retreats into intellectual detachment and remembers herself, for instance, refusing extensions for late papers to students, and dismissing personal circumstances with irony: “‘Don’t tell me. Your grandmother died … the paper is due when it is due’.”Footnote ⁶⁷ As Gubar contends, in the end, Vivian confronts the irony that she had “ruthlessly denied” her students: “the touch of human kindness she now seeks.”Footnote ⁶⁸ And she eventually realizes that the intellectual rigor she prized cannot shield her from doctors who now read her as a text to be interpreted and managed.

Ethical dilemmas such as assisted dying are central to both texts. In Wit, this issue emerges through Susie Monahan, the ward nurse. In contrast to the doctors’ detachment, Susie alone treats Vivian with warmth and genuine concern. As Vivian’s pain becomes increasingly unbearable, Susie is the one who suggests signing a do not resuscitate (DNR) order to prevent any attempts at revival when her heart stops. She is too well aware that the physicians, driven by research, will prolong life at any cost:

When Vivian’s heart finally stops, Dr. Jason calls a Code Blue team despite Susie’s reminder that she has signed the DNR order. For him, who “always wants to know more things,” Vivian is, simply and bluntly, “research.”Footnote ⁷⁰ Ironically, it is the nurse who “saves Vivian’s life” by letting her die.

Gubar also dwells on such ethical dilemmas and criticizes what she calls the “American antipathy to discussions of mortality,” arguing that cultural denial of death has obstructed meaningful reform of end-of-life care. She notes how proposals for patient-centered consultations have been distorted into fears of “death panels,” and how doctors, wary of litigation, often feel compelled to pursue aggressive treatments rather than humane alternatives. Reflecting on her own situation, she questions the charged term “assisted suicide” and suggests “assisted death” as a more accurate expression of care aimed at relieving suffering, defending practices such as palliative sedation even when they may hasten death.Footnote ⁷¹

Two final aspects that can be examined from the perspective of the critical medical humanities are employment and institutional protection, on the one hand, and gender bias in medical practice, on the other. During her aggressive chemotherapy, Professor Gubar also found herself anxious about her salary. She notes that “a combination of chairs and deans has determined to keep me on the English Department’s payroll throughout the spring semester,” describing this decision as “an act of generosity for which I am unprepared.”Footnote ⁷² The fact that institutional support is framed as generosity rather than a right reflects a broader feature of the U.S. system, where continued salary during serious illness may depend on goodwill or negotiated arrangements. Beyond the suffering caused by the disease itself, patients may also fear losing the salary needed to sustain daily life and to cover treatment costs, especially when their insurance does not fully reimburse them. I must admit I was shocked when I read this passage. As a scholar in an English Department myself, but working within a different national framework, I cannot avoid comparing systems. In Spain, paid medical leave is a legal right guaranteed by labor law and social security, not an act of personal or institutional generosity. From a critical medical humanities perspective, this contrast underscores how illness is shaped not only by medical treatment but also by labor policies and welfare structures, which profoundly affect a patient’s sense of security and vulnerability.

Considering the second concern mentioned above, the gendered construction of medical knowledge, we may focus on the way diagnostic categories, research priorities, and treatment protocols are shaped by biased assumptions about women’s bodies and social/gender roles. In the case of Wit, the hospital room becomes the site of invasive medical scrutiny for the cancerized woman, when male doctors and researchers are presented as cold, distant, and dehumanized technicians of the body. In the case of young Dr. Jason, the distant and arrogant resident, their doctor-patient relationship is further complicated by the fact that he was Professor Bearing’s former student. These are Vivian’s words in her direct address to the audience:

This scene of the humiliating pelvic exam at the hands of a former student serves as a miniature version of the play as a whole, as it “mixes vengeance and voyeurism into a crude kind of poetic justice.” In this scene—her feet in the stirrups—the body is more than examined: it is “penetrated,” “in a sort of porno-clinical scenario.”Footnote ⁷⁴ In Pamela Cooper’s words, “Bearing’s pelvic exam suggests itself as a rape: an ostensibly functional but effectively harsh claiming of (sexualized) knowledge; an assertion of power.”Footnote ⁷⁵

For her part, Susan Gubar, a feminist scholar, cannot divorce her critical stance from her experience of illness, and she frequently links both of them in her autopathography. In chapter two, entitled “Ovariana,” she exposes the gendered history that has shaped the understanding and treatment of ovarian cancer and recalls that, for centuries, ovarian cancer patients were implicitly told that their “aberrant sexuality” had provoked a condition they somehow deserved. From this premise, she raises a series of unsettling rhetorical questions: might long-standing prejudices about ovarian disease have contributed to the poor state of its treatments? Did culturally entrenched notions of “Ovariana” distort scientific research and influence generations of predominantly male physicians? And does the fact that the disease primarily affects older, post-menopausal women—“with little cultural capital”—help explain its relative neglect?Footnote ⁷⁶ Through these questions, Gubar articulates a distinctly feminist critique: ovarian cancer is not presented merely as a biological event but as a condition historically filtered through misogynistic assumptions about female sexuality and value. In this way, Gubar turns her memoir into a critique of the gendered biases embedded in medical history and institutional practice. And she illustrates this dynamic through her own experience: when her gynecologist advised a radical hysterectomy, she distrusted his recommendation, recalling that “I did not trust his opinion. Like many women of my generation, I doubted the popularity of an elective procedure which manifested, I suspected, the propensity of mostly male doctors to regard women’s reproductive organs as diseased or abnormal.”Footnote ⁷⁷

As I have argued, advanced ovarian cancer exposes the female academic to what Nielsen et al. call “epistemic injustice” in healthcare.Footnote ⁷⁸ Both texts expose this injustice by showing how patients’ knowledge of pain, fear, vulnerability, and bodily change is repeatedly subordinated to the authority of medical protocols and clinical expertise, while their academic identity is also destabilized. Pathography, in turn, transforms that marginalization into critique, witness, and a challenge to clinical dismissal.

3. Conclusion: toward a final redemption?

Toward the end of her narrative, Susan Gubar pointedly remarks that “all those memoirs assuring readers that cancer teaches us to appreciate the preciousness of the present moment, that treatment is a journey with a spiritual pot of gold at its end” sound hollow in terms of technologies and protocols that ravage ovarian cancer patients’ lives “by stunning, hurting, or harming us.”Footnote ⁷⁹ On the contrary, Margaret Edson has stated that Wit is “about redemption.”Footnote ⁸⁰ And this is the final idea I wish to tackle as a way of conclusion. Are they “redemptive” pathographies?

Redemption generally refers to a process through which suffering acquires meaning, leading to moral, spiritual, or existential transformation. It suggests reconciliation, insight, or a new understanding of self that emerges through crisis. By contrast, Arthur Frank’s “restitution narrative” has a basic plot: “yesterday I was healthy, today I’m sick, but tomorrow I’ll be healthy again.”Footnote ⁸¹ Obviously, in the case of Wit and Memoir of a Debulked Woman, restitution is impossible: one protagonist dies; the other lives under the shadow of recurrence. They never return to “the kingdom of the well,” as Susan Sontag expressed it.Footnote ⁸² And yet, redemption is somewhat present in both texts, even if Gubar claims not to believe in “pots of gold.”

Wit presents Vivian Bearing’s redemption, not through intellect, medical success, or scholarly superiority, but through her gradual acceptance of vulnerability and compassion. As Martha Geene Eads contends, “clearly Edson sees Vivian’s redemption as the product of her having relinquished her autonomy, her authority, and, ultimately, life itself.”Footnote ⁸³ As Gubar herself contends in her memoir, Wit concludes with the ethical and spiritual maturation of Vivian, but Gubar fiercely denounces that the doctors who treat her “remain unregenerate to the end—callous, callow, and self-congratulatory about research that issues in protocols worse than ineffective since they reduce the patient to a tortured lab animal.”Footnote ⁸⁴ Vivian’s “conversion” is made most evident in a moving scene toward the end, when Nurse Susie again comforts and consoles her by sharing conversation and a soothing popsicle. Disarmed and needy, the once solitary and self-assured Vivian now humbly begs for company and compassion:

VIVIAN: You’re still going to take care of me, aren’t you?

SUSIE: ‘Course, sweetheart. Don’t you worry.

When Vivian is administered morphine and dies—literally, rests in peace—at the very end of the play, the stage directions indicate that she rises from her bed and walks “naked and beautiful, reaching towards the light.”Footnote ⁸⁵ This final resurrection image, “naked and beautiful,” transforms clinical catastrophe into a moment of transcendence. The body that has been objectified, examined, and reduced to “a specimen jar” is restored to dignity and even grace. That symbolic movement toward light evokes spiritual reconciliation, which gives the ending a redemptive tone, despite the absence of a cure.

The fictional Vivian Bearing dies at the end of the play, but the real Susan Gubar is an ovarian cancer survivor at 82, 16 years after having finished writing her Memoir. Upon its conclusion in December of 2010, she realizes that “this book is what I wanted to complete before any more medical interventions, consequences, and decisions have to be confronted,” and hence, that “this is, after all, a happy ending, the happiest ending I can now imagine.”Footnote ⁸⁶ Indeed, Gubar’s ending reaches a moment of narrative closure as she frames writing itself as fulfillment. The memoir becomes an achieved task and, if her cancer has not been cured, it has been shaped into meaning through authorship. In both cases, redemption does not lie in medical recovery. It lies in dignity restored, (feminist) agency reclaimed, and suffering transformed into text, whether theatrical or narrative.

To return to the distinction between testimonial authority and dramatized experiential truth, Gubar’s memoir shows that autobiographical writing does not provide unmediated access to the real. Even when grounded in lived experience as an autobiography, it passes through the double filter of language and time: through the words that must shape suffering into narrative and through the retrospective distance that breaks experience into remembered fragments, into a “heap of broken mirrors,” in Borges’s phrase.Footnote ⁸⁷ Memoir of a Debulked Woman, therefore, offers not transparent truth but an honest reconstruction of illness, further inflected by scholarship, citation, and reflection. Wit, by contrast, makes no autobiographical claim, yet drama can stage illness with a different kind of truth. Spanish dramatist Alberto Conejero’s statement that “in order to tell what is true, one sometimes has to depart from what is real” helps clarify this point.Footnote ⁸⁸ Edson’s fictional departure from empirical reality does not weaken the play’s truth claim; rather, it enables the play to condense and intensify the experience of illness through direct address, compression, and the present tense of performance. In this way, Wit renders bodily degradation, medical violence, and emotional isolation as immediate experience. Read together, the memoir and the play do not simply oppose truth and fiction; they reveal two distinct ways of knowing illness: one reconstructive and testimonial, the other performative and experiential.

As humanities scholars confronted with advanced ovarian cancer, Gubar writes and Edson’s Vivian Bearing performs from a position doubly marked by gender and illness, traditionally associated with silence rather than authority. Their texts transform the objectified ill body into a speaking subject capable of interpreting its own condition. In this way, both works exemplify Smith’s claim that embodied narratives allow marginalized subjects to intervene in dominant discourses, making visible experiences that medicine tends to reduce to bioclinical abstraction.Footnote ⁸⁹ Of course, the dehumanization described in both texts does not originate solely in medical practice. Advanced ovarian cancer is itself physically and emotionally devastating. What Gubar and Edson expose is how clinical routines, research imperatives, and failures of communication can intensify, rather than alleviate, that prior vulnerability.

In sum, for clinicians and caregivers, the value of these texts lies not in offering medical instruction, but in sharpening attention to what patients know, fear, misunderstand, endure, and often cannot say within the time and language of the clinic. Together, Gubar’s memoir and Edson’s play give concrete form to these failures; yet the broader lesson that emerges from both works is more unsettling, a lesson Gubar states most forcefully when she writes that “the state of contemporary approaches to ovarian cancer is a scandal.”Footnote ⁹⁰