Margaret Innes

New Worlds: Reading, Writing and the Imagination

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A Diary of Close Encounters of the Medical Kind

1 Diagnosis

It began with the ultrasound sonographer saying, ‘I’ll just get the radiologist.’ I had been diagnosed with breast cancer once before, ten years ago. Ever since I have had yearly mammograms and ultrasounds. I had put off last year’s due to Covid-19, thinking it had been a decade, did I really need to worry? My doctor, on the cusp of her last day before she retired, sent me a new referral marked ‘Utmost urgency.’ It was the old procedure, cold jell and the press of the transducer on my skin while I looked at shifting monochrome images on the screen thinking, this is me reduced to those sea-like waves. Before I was released to go home on that day, I had learned from the radiologist that one of those images was almost certainly cancerous, a diagnosis confirmed by the pathology results. Even before my appointment with the surgeon, I was given a barrage of referrals for other tests I had to have. I was on a medical treadmill and there was nothing to do but see it to the end.

Later when the same radiologist was preparing me for surgery, he said to the sonographer ‘This was a good pick.’ Later again, discharged from hospital and discussing the pathology reports with the oncologists, radiation and medical, I learned how good. A just in time good pick of an aggressive tumour about to get into my lymph nodes. The medical oncologist made it clear it would be foolish if I did not have chemotherapy whether I liked it or not. My partner berated me on the way home: ‘Don’t you ever let another test slip by like that again!’

I remember thinking how bright everything looked on that journey home, how vibrant the trees and the sky, how brilliantly white the feathers of the cockatoos. How sweet things immediately within your grasp become when you come face to face with understanding there is only a breath between life and death, that life is a balancing act on a tightrope, and I could easily have slipped another way altogether. I am still not sure I am securely balanced on it.

During my last bout I bought a graphic novel account of breast cancer treatment called Cancer Vixen by Marisa Acocella Marchetto. On the front cover is a woman spectacularly taking a fall. That is how it feels. So, I have decided to keep a diary and post it on my blog. Chemo this Friday and I have a pile of information on side effects to prepare me. It is a matter of charting where each step takes me from now on, who I meet there and the outcome, while still thinking there is nothing like fate to trip you up.

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Ladies in Black or What’s your subject?


The Ladies in Black in the film of the same name take their places behind the counters of Goode’s Department store in the summer of 1959 when Australia is already changing under the arrival of Europeans displaced by war and a loosening of the white Australia policy. It’s a coming of age drama, where the richness European migration is adding to the nation is contrasted against a telling critique of male-female relations at the time. Throughout the film Sydney looks wonderful, soaked in the summer sun, a harbour minus the Opera House, dominated by the Bridge.

Among the ladies is Lisa, employed for the season in her ugly black dress, having just finished her Leaving Certificate and being in that hiatus between school and some other life. At home in all its suburban dullness, Lisa is Lesley, constrained by her parents and chanting one of William Blake’s Songs of Experience, Tyger, Tyger to herself in bed. Becoming Lisa elsewhere, and especially under the wing of Magda, once a Slovenian refugee and now presiding over Goode’s enchanted realm of Model Gowns, she’s an emerging butterfly, learning who she is, what she can do, what she could wear if she had the means.

When I went to see Ladies in Black, I expected to be entertained. I didn’t expect to be moved but watching Angourie Rice play Lisa/Lesley, I was moved, for the sense of hope and possibility she brought to the role. Noni Hazlehurst, perfect as Miss Cartwright, Lisa’s supervisor, with tears in her eyes tells Lisa she’s a clever girl, the most wonderful thing in all creation. With its light touch, Ladies in Black convinces that it is possible for Lisa to do extraordinary things.

But is that touch too light? Some critics have thought so. The film pretty much stays with the book, The Women in Black (Text) by Madeleine St John, first published in 1993. Stefan, Magda’s husband, a Hungarian, says to Lisa when she comes to lunch with them one day that she should read Jane Austen’s Emma, Austen (he says) being as great a novelist as Tolstoy. And like Emma, both the novel and the film handle the bleakness of the personal lives and the marriages of the women who work at Goodes with a deceptive lightness of touch.

It’s not only about the narrowness of life in Australia at the time and its often stifling, shallow rigidity. It’s Patty William’s husband running in terror, unable to cope emotionally after unintentionally falling into good sex with his wife. There’s the tedium of Fay and her friend, Myra’s dates talking cricket to each other while they ignore both women, other than for Fay’s date to put his hand on her thigh. And Lisa’s father off to spend hours at the pub, leaving his wife and daughter behind to get his dinner. There’s no companionship here, no conversation or good humour between equals such as we see between Magda and Stefan and their friend, Rudi.

There is a darkness behind the book and its lightness. Trapped in a marriage as bleak and loveless as any in the film, subjected to shock treatment and medicated, Madeleine St John’s mother, Sylvette committed suicide when Madeleine was twelve in 1954. Her father, Edward St John’s actions in response only added to his two daughters’ trauma, a trauma which stayed with Madeleine all her life. As Lucy Sussex puts it in her review of Helen Trinca’s biography of Madeleine (also Text):

“The mores of the time dictated that a difficult woman, one who did not comply, was to be medicated into passivity. The alternatives – divorce or a reconceiving of gender relations – were simply unthinkable. Small wonder the next generation of women – the Madeleines and the Germaines – grew up furious, if not actual furies.”

How does a writer choose what to write about? With the darkest of tragedies in the bedrock of Madeleine St John’s emotional life, she wrote, with perfectly balanced literary skill, a book that dealt with her subject – the loneliness and harshness of empty marriages, how destructive they are – with wit, sharp humour and hope. The deftness of Madeleine’s work rests on the unseen darkness in her sensibility, much like subtle shadows in a painting give greater contrast to the representation of light. The very thing that is out of the picture, the reality not invoked in the text, the bleakness of her mother’s life and death, and Madeleine’s own grief, is its actual strength. Unspoken, it provides the underlying emotional chemistry which makes her writing, with all its apparent lightness, come alive.


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Elena Ferrante’s My Brilliant Friend

Shades of the prison-house begin to close
Upon the growing Boy
But He holds the light, and whence it flows
He sees it in his joy;

Wordsworth: Intimations of Immortality.

Set in Naples, the novel My Brilliant Friend is told in the adult voice of Lenù Greco, now living in Turin, looking back on her close friendship with a girl she had known since both were tiny, Lila Cerullo. The novel has such a large cast that thankfully there is an index to the characters at the front of the book. Ferrante handles this Neapolitan community of porters, railway workers, tradesmen (Lila’s father, Fernando Cerullo is a shoemaker) and small shopkeepers, (including those among them who have connections to the criminal underworld) with great skill and assurance. The neighbourhood is alive on the page in all its complexity of person and place. In this poor and disadvantaged community each individual is forced to deal with the poverty and lack of opportunity governing their lives in their own way. As a consequence, deep tensions exist within the neighbourhood; attachment and love are pitted against frustration and violence and loyalty to the family and the values of the community often results in the betrayal of the self.

Lila is an exceptionally gifted child from a poor family. Her mother is illiterate but despite this, Lila is able to teach herself how to read and write. There is nothing gentle about relationships in the Cerullo family or indeed many families within the neighbourhood. During an argument, Lila’s father, Fernando is sufficiently enraged with his daughter to throw her out of the window of their apartment. Lenù, who is standing outside in the courtyard, is witness to the whole incident.

“We were ten, soon we would be eleven. I was filling out, Lila remained small and thin, she was light and delicate. Suddenly the shouting stopped and a few seconds later my friend flew out of the window, passed over my head, and landed on the asphalt behind me.
I was stunned. Fernando looked out, still screaming horrible threats at his daughter. He had thrown her like a thing.
I looked at her terrified while she tried to get up and said, with an almost amused grimace, ‘I haven’t hurt myself.’
But she was bleeding; she had broken her arm.”

The complex relationship between Lenù and Lila is at the heart of the book. It seems throughout that Lila is the leading individual, the one who decides what the two of them will do. There is a scene in the section titled Childhood where Lila says she wants to see the sea. She and Lenù then take the day off school and walk for hours through unknown neighbourhoods but never in the end reach the sea. For some unstated reason, Lila cuts short the expedition; then on the way home the weather turns bad and they’re soaked to the skin. In the aftermath, Lenù gets into terrible trouble with both of her parents beating her. Lenù meets Lila in the public gardens later where Lila sees from Lenù’s bruises that she has been beaten.

“‘All they did was beat you?’
‘What else should they have done?’
‘They’re still sending you to study Latin?’
I looked at her in bewilderment. She had taken me with her hoping that as a punishment my parents would not send me to middle school? Or had she brought me back in such a hurry so that I would avoid that punishment? Or – I wonder today – did she want at different moments both things.”

Lenù is able to stay at school, a privilege denied to Lila largely due to her family and sometimes as the result her own actions. Yet she still has multiple tickets to the local library, where she takes out books out under the names of her family as well as her own, teaching herself Greek and helping Lenù with her studies. It seems that their friendship is symbiotic: Lenù’s success at school depends on her connection to Lila and her abilities. But then close to the end of the book, there is a scene which turns this dynamic on its head. Preparing for her wedding at sixteen, Lila tells Lenù, ‘You’re my brilliant friend, you have to be the best of all, boys and girls.’

But it seems to Lenù that this will not happen. In the final scenes at Lila’s wedding, Lenù is told that a piece of writing she did for a small magazine has not been accepted. ‘I swallowed my tears. I thought: maybe they’ll publish my piece in the next issue, maybe Nino didn’t insist enough, maybe I should have taken care of it myself. But I said nothing, I kept smiling …

Looking around at the wedding feast, she thinks: The plebs were us. The plebs were that fight for food and wine, that quarrel over who should be served first and better, that dirty floor on which the waiters clattered back and forth, those increasingly vulgar toasts. The plebs were my mother, who had drunk wine and who was now leaning against my father’s shoulder, while he, serious, laughed, his mouth gaping, at the sexual allusions of the metal dealer. They were all laughing, even Lila, with the expression of one who has a role and will play it to the utmost.

There is no way out for Lenù from this world or so she comes to believe. The book finishes with a scene which makes clear how Lila has been bound into a life which has no use for whatever gifts or abilities she might have and even wishes to snuff them out. This is the prison-house: a place where your own family can be your gaoler. A place where the entire fabric of society contains and confines not only Lenù and Lila but all of their companions and where each incident of childhood and adolescence builds this enclosure day by day until there really seems no way out. While the book hints that Lenù does escape, it seems clear that Lila doesn’t. Unlike Lenù, Lila never leaves Naples. For her it seems the only way out of the prison house is as a middle aged woman to roam the city alone, with her own thoughts, wherever they might take her.

My Brilliant Friend a powerful book, seeming to contain a complete world between its covers, representing the complexity of life with extraordinary skill.