The South Carolina Modern Language Review
Volume 2, Number 1
“Exorcising
my pain”: An interview
with
Evelyne Accad
by Elizabeth A. Zahnd
Francis Marion University
The Lebanese-born novelist, poet, playwright, and literary critic Evelyne Accad was no stranger to pain before she was diagnosed with Stage III infiltrating lobular carcinoma (breast cancer) in 1994. A quest for liberation from suffering is a major thematical preoccupation in all of her works, dating back to her first book on Arab women, Veil of Shame: The Role of Women in the Modern Fiction of North Africa and the Arab World (1978). Born and raised in Beirut, Lebanon, Accad witnessed the physical and emotional horrors of war in her homeland, which she wrote about in her novel, Coquelicot du massacre (1988), and in her two literary studies, Sexuality, War and Literature in the Middle East (1989) and Des femmes, des hommes, et la guerre: Fiction et Réalite au Proche-Orient (1993). The theme of psychic pain dominates her other two novels, L’Excisée (1982), and Blessures des Mots: Journal de Tunisie (1993). In L’Excisée, Accad relates personal experiences with pain in the context of familial relationships to the violent practice of female genital mutilation taking place in traditional Arab societies. Blessures des Mots treats the concept of pain in the context of female relationships during a women’s movement in Tunisia.[1]
In her latest work, The Wounded Breast: Intimate Journeys Through Cancer (2001, with its French version Voyages en cancer, 2000), Accad explores suffering in terms of her personal experience with cancer. Though autobiographical in nature, Accad’s narrative includes scientific data and essays about cancer from a variety of sources. Her unique background allows her to study the illness through a cross-cultural perspective, with an emphasis on societal taboos, gender-based attitudes, and modern versus traditional ways of thinking about the disease. Through this multi-dimensional approach, the phenomenon of cancer reaches beyond physical suffering to become a metaphor for the ills of modern-day society.
Q: The Wounded Breast opens with a quote from Elie Weisel[2] about the holocaust, and at various points in your narrative you draw the comparison between cancer treatments and torturous practices in the concentration camps, borrowing Jeanne Hyvrard’s metaphor, “the yellow star of the sick” in reference to cancer victims (Hyvrard, qtd. in TWB 31). In your journal, you anticipate negative reactions to this comparison. What kind of response have you in fact received to this association?
EA:
I was correct in thinking it would get reactions. Some of my Jewish acquaintances got quite
upset with it and told me I had written a book of “propaganda,” while others
hailed it as a courageous association and one much needed…. I am glad to have made this association and
to have pushed it quite far in the first opening chapter. I meant it to come across as shock arguments
that would draw readers in rather than out.
Q: Though you present your book mainly as an autobiography, you include the “voices” of your friends and colleagues who react, at times critically, to your text. What led you to include these “comments in the margins” even when they offer points of view that differ from your own?
EA: During the treatment of my illness I was keeping a journal. I used it later to write my book (this is often how I operate with the writing of many of my fiction books). When I received letters from friends as well as comments from readers of the first drafts of my manuscript, I felt that their comments were interesting and deserved to be incorporated within my text even if sometimes they were in contradiction with my arguments. I wanted to show the diversity of opinions on this painful topic of cancer. I also wanted to incorporate them as coming from them and not through my own voice in order to give them proper credit. This is why I have them almost as “comments in the margins” as you well expressed it. Editors are not used to this kind of writing, except Feminist ones (notice the Feminist journal Les Cahiers du Grif for example which is a good example of the use of margins) therefore they do not know how to format a book with such comments. If you see the original of my manuscript, I used different format for different voices and I would have liked to even print them with different fonts and in various places of the page. It is a post-modern way of writing. Students in my class on “L’Ecriture Feministe” would remember that Feminist writers like such “deconstructions” in their writing. I like to claim myself within that movement.
Q: Along the same line, why did you decide to insert commentaries of your own, written two years later, to your original journal, rather than add these commentaries as a chronological sequel to your manuscript?
EA: For the same reasons as what I said before: a different way of writing, showing the evolution, or lack of it, of my thinking process, to express different times, different ways of thinking and of writing.
Q: Did you do most of your journaling for this work in French or in English? It seems your choice of words in the English text often led to interesting “slip-ups” or plays on words that your American colleagues pointed out (such as seminar/seminary,
bold head/bald head, and historectomy/hysterectomy).
EA: I first wrote my journal in French (as I always do, since it is my maternal tongue and the one that comes most easily to me), then translated it into English to first write my book in English, then translated it back into French when the book was finished. The comments of my readers helped me point out to these plays on word which I did not find as easy to make in French… does the English language lend itself more easily to such slips and play on words?
Q: At one point in the narrative, you admit you considered writing The Wounded Breast as a work of fiction, and you actually include an excerpt from the alternative text. Why did you ultimately choose autobiography as a more appropriate genre?
EA: You are right, I did consider the two alternatives at first. I don’t consider my work to be an “autobiography” per se… but rather a mixture of many genres: autobiography, anthropology of the disease, fiction, poetry/prose, etc. If I chose to speak in the first voice with real names as well as made-up ones, it is because I wanted to give to the text a sense of urgency and authenticity I felt would be more appropriate for a book where I want to be “sounding the alarm system” of our world falling apart on all sides.
Q: One of the main points in your book seems to be that cancer patients, especially women, are “paying the price” for what the poet Damas called “ci-vi-li-sa-tion”, or modernity gone awry. Following your mastectomy, you write, “my breast has been offered to the gods of modern civilisation” (TWB 175). Could you expand on this point for our readers?
EA: Most women hit with breast cancer ask the question “Why me?”, an association aimed at helping women with breast cancer, has even been named after this question. Other women ask: “Why not me?” And still others say: “If it had to be someone, it had to be me.” I belonged to the first category. I did ask “why me?” Later, I tried to answer this question and found out that I belonged to the category of people paying the price for “our civilization or modernity gone awry,” by that I mean that our way or handling nature and the environment as well as dealing with politics, always aggressively and violently, leads to inevitable destruction, oppression and victimization rather than harmony and the respect of others. Yes, I did feel that my breast had been offered in sacrifice to the gods of modern civilization, that I had been mutilated against my will, made a victim of all the pollutants, harmful chemicals, destruction and depletion of nature we are witnessing in this day and age. It is not a sacrifice leading to redemption though, and I am certainly not happy to be a victim.
Q: There’s an obvious parallel between the traditional practice of female genital mutilation described in your novel The Excised and what you describe in The Wounded Breast as a routine mutilation of cancer patients (through unnecessary hysterectomies and mastectomies). You discuss modern medicine in terms of mysogyny, quoting Hyvrard’s notion that “cancer treatment provides the surgeon with all the necessary alibis” for mutilating women (Hyvrard, qtd. in TWB 156). Why would modern medical practitioners deliberately harm their female patients? Why do you think many women experience cancer as a castration?
EA: I read that the radical “Halsted” mastectomy type of operation (I, myself, underwent a “modified radical Halsted mastectomy”) was designed by a certain doctor Halsted who was not very concerned about women’ welfare, except to get rid of the disease by excising the breast as widely as possible, even if it had debilitating effects on women. He not only removed the breast, but also all the muscles around it, as well as the lymph nodes, leaving women maimed for life. He was even considered misogynistic, had a lousy personal life and was on hallucinogenic drugs. Reading his life story, I felt that I would not have trusted him at all, yet he was praised by the medical establishment and mastectomies are still named after him!! I am sure that many medical practitioners are not like that and have their patient’s welfare as a real priority, yet why have not less mutilating forms of treatment been found?…. I made the connection with the Excised in my first novel because mastectomy, like excision, is a mutilation one receives in ones body with huge sexual consequences (most of the time hidden and not talked about by the medical establishment or by patients who have gone through it, hence another reason for writing my book). You are led into the mutilation of mastectomy unconsciously and uninformed just as young girls are led into excision unconsciously and without their consent with huge repercussions for their future life. If you look at the titles of my books, there is continuity with an obsession to women’s suffering and wounds… This last work on cancer is more universal and touches women all over the world. I feel that it has given my commitment to women’s issues a wider scale.
Q: One aspect of cancer that you refer to several times in your journal is the “silencing” of the victims. You compare a Middle Eastern phrase for cancer, “Al-marad illi ma btitssamma”--which translates as “the disease not to be named”--with French euphemisms for the disease such as “protracted illness” and with a tendency on the part of American doctors to deny the realities of the disease in favor of “soothing words” (TWB 28-29). This silencing process—embedded in language itself-- made me think of what Gayatri Spivak had to say about the subaltern woman, whose voice was stolen when colonizers assumed control over the “word”. Do you think cancer patients are systematically “colonized” by modern society, and by the medical establishment in particular?
EA: Very good association you are making with the colonization by modern society, the medical establishment in particular, of cancer patients. I like this association I had not thought of and which gives me ideas. It is sad to notice though that the farther you go into “third world” societies the less one is inclined to talk about this “disease” even though these are the societies that have most suffered from colonization. But I should not be surprised and go back to Fanon’s analysis which sheds light on the phenomenon by noticing that the more oppressed one is the less one is able to deal with it directly, hence all the internal struggles of oppressed people who fight amongst each others rather than against their oppressors.
Q: You mention of a “cult of consensus” (TWB 173) which keeps doctors from speaking out against the bureaucracy, particularly when it comes to dangerous practices such as the over-prescription of hormones and the routine release of toxins into our environment. Do you think it will ever be possible to mobilize health care workers, much less ordinary citizens, to take action against such a system?
EA: This is a good question and one I ask over and over again throughout my book, so I am very glad you picked it up. If you remember, there is a scene where, right after my mastectomy, two nurses from the mid-west meet at my house and I try to make them aware of these problems, without any results… Unfortunately I do not see any way out of this attitude by mainstream medical workers, especially in the US, even when they themselves are victims of the system. The only hope I see comes from non-mainstream, marginal medical workers, those prescribing herbs and non-traditional medicine. I also see more questioning in other countries such as France, Lebanon, Tunisia (the countries I visit) from even the mainstream medical establishment. I believe this comes from their being less tied to economic gains, big money donors, and the connection between the pharmaceutical companies and mainstream medicine. It also comes from the warrior spirit of US politicians, the medical establishment and society as a whole which deals with the body as it deals with politics, very aggressively and with radical “solutions” rather than more “though-out” long term examination of problems.
Q: You refer to a “zone of illness” (TWB 30) that consists mainly of powerlessness in the face of the medical establishment. How did feelings of helplessness affect your own experience with cancer?
EA: I did feel powerless at first with a disease, completely unexpected that hit me and I felt thrusted into a system that denied me and deprived me of my freedom and independence. I was unaware of this dark side of life and taken completely by surprise. I did receive some advice about going to doctors accompanied, etc. and would like to pass this information on to other people who will have to face such trauma. I speak about it in the book but would like to reemphasize here some of those points: Go to the doctor with friends, people you trust who will take notes for you while you ask questions and who will also ask questions. One often feels so hopeless, intimidated, overwhelmed and helpless in such situations that one is incapable of taking notes or asking questions. Accept what people offer you, take charge of your life and your illness. Read about it, take notes, join support groups, don’t stop your activities if you can, share your condition with people willing to listen to you. Change your eating habits to include health foods and things that please you. And above all, don’t give up and don’t despair.
Q: Drawing heavily from your own work, Sexuality and War, as well as common war metaphors such as “the battle against cancer,” you establish in The Wounded Breast a link between cancer and violence. Following your radiation treatments, you write, “My body’s like a battlefield being prepared for bombardment by rays: a dismembered body…. In this cruel civilization, I’m being poisoned as the earth’s being poisoned; we’re both subjected to death and destruction” (TWB 201). At the same time, you declare yourself a pacifist. Can one fight cancer and remain a pacifist?
EA: Very good question and one that I raise in my book on Sexuality and War, as well as in others. How can one struggle in this world of violence without becoming violent oneself? Some of the answers I give to this central question can be found in Active Non-Violence or Passive Resistance, the roots of which can be found in the theories and practice of people like Martin Luther King, Gandhi or even Christ. As I say in my book, I wish softer cures for cancer had been developed because right now they are brutal, maiming and totally unacceptable. Cancer patients are heroes of our time. Subjected to the most cruel forms of mutilations and debilitating treatments, they struggle with courage and fortitude. They silently accept what they are faced with because they are told there are no other alternatives.
Q: In Sexuality and War, you also refer to the concept of “femihumanism”— men and women working together to bring about change. In what way is The Wounded Breast a “femihumanist” work?
EA: Good question. If you notice, the first part of The Wounded Breast deals with my cancer and the second one with that of my companion. Prostate cancer is much less talked about than breast cancer. Men are more reluctant than women to deal with this topic. Yet my companion encouraged me to tackle it in the book and even helped me ask important questions about it. As I noticed in my journal, it was ironic that I was getting in remission as he was being diagnosed with the disease. He was at my side and helped me considerably as I was going through the ordeal and I did the same with him. The experience reinforced our love and got us closer. Hence the good example of femi-humanism which I am happy you picked up on because it is so central to what I am trying to say in my works.
Q: One theme that seems to permeate your fictional work is that of exile. How does that concept fit into The Wounded Breast? Was some of the anxiety you described in your journal uniquely tied to suffering in a foreign country? How did your travels across three different continents affect your perspectives on cancer?
EA: If you noticed, the question of “would that have happened to me had I stayed in Lebanon?” keeps coming back. It was such a shock to be diagnosed with cancer and such a surprise also, since I could not remember a single member of my close family or far away relatives diagnosed with it, that I kept asking it. The question probably also reflects my feeling far away from “home” at a time when I was most vulnerable and dependant, missing the familiar and the warmth of Mediterranean countries and of its people. It is true, looking back, I feel that it was the US and its civilization that gave me the disease: the stress of academia, chlorine in the water, pesticides on fruits and vegetables, etc, and the more I read, the more those convictions increased. My readings reinforced all my fears about what exile can cause. Traveling across so many countries as I was convalescing made me ask more questions and compare how the various people I met in those countries, from doctors to patients, to writers, researchers, neighbors, were dealing with cancer. It allowed me to compare and contrast their reactions and writings. I feel this is one of the strengths of this book: its multi-cultural, multi-dimensional voices.
Q: Often you compare cancer treatments in France, which tend to be conservative, to more aggressive practices in the United States. To what cultural or historical factors do you attribute these differences?
EA: I am not sure what makes this difference between France and the United States, but it is indeed one of its main differences. Could it be the pioneering spirit of the Americans, their military strength, their puritanical values, their obsession with competition and success? I am not sure. I read a book that I quote at great length which describes the differences in medical practices between the Americans, the French, the Germans, the British. It is a fact that the French, along with the Italians, have developed the more conservative treatment for breast cancer: removing only the tumor or lump and giving radiation to the infected area, which is just as effective as radical mastectomies.
Q: You write of a group of women in Tunisia who would rather die than undergo cancer treatment. Is this a continuation of the suffering you describe in Wounding Words: A Woman’s Journal in Tunisia? Does your narrative offer these women any hope?
EA: A woman psychiatrist I met in Paris told me of women she had treated in Tunisia who would rather die than be mutilated because they felt life was too hard and dying would give them rest. I never met the patients this woman was treating. In Tunisia, I dealt with women involved in the Feminist movement at its peak, a specific group of women who met regularly at the Club Taher Haddad for consciousness raising meetings, conferences and cultural activities they organized as well as a journal they founded. Some of the women within that second group might have identified with the pain of the first one but I was not aware of it at the time. Remember that Wounding Words: A Woman’s Journal in Tunisia was written ten years before The Wounded Breast.
Q: Cooking oils, vessels filled with oil, and anointments of the head with oil are repeating images throughout your text, in the dream sequences as well as in conversations and interactions with loved ones. Could you comment on the meaning of the oil?
EA: Oil, especially olive oil, is often used in my country of origins, Lebanon, as a healing ointment. It is also used in religious practices and rites for benediction, sanctity and purification. It is also supposed to get the evil spirits out. I do not believe myself in such superstitions even if I do believe in the good healthy effects of olive oil, but people around me, some members of my family as well as some acquaintances, thinking it might helpe me, used the oil to bring about my healing and protection, hence the recurring images of these symbols in my dreams as well as stories within the text.
Q: Several times in your text, you attribute your cancer to mega doses of hormones, which your doctor prescribed, prior to your falling ill. What did you mean when you called this a “postmodern way of treating the body” (TWB 67)?
EA: Yes, I am definitely convinced that the hormones prescribed to me when my doctor found out the level of hormones in my blood was low, even though I did not have any of the symptoms of menopause yet, brought about my cancer. If you remember correctly, I asked my doctor to give me low doses of it, but she replied it would not be effective in preventing osteoporosis that my mother was suffering from and that I should take the mega doses. I have since found out that the particular hormone I was given to is no longer used in France because it is too strong and made from the urine of mazes. A new study in the US came out last summer associating these hormones with increases in breast cancer, which even led to a stop of the study!! What I mean by a post-modern way of dealing with the body is that until this century, menopause and its symptoms were considered a normal part of aging, a process the body had to go through, but now the body is manipulated through hormones, plastic surgery and the like, women are made to believe they can push away the specter of wrinkles, sagging skin, diminished libido, and all the signs of aging under this post-modern way of treating the body. It can have devastating consequences just like some new ways of processing food has led to new diseases. Technological advances are not always positive and beneficial and researchers as well as doctors are often not cautious enough in prescribing medicine.
Q: You end the book with the following quote from Jackie Stacey: “Narration makes it possible to exit from pain but also ensures that it will not be forgotten. Perhaps it is a kind of memory that heals. Restorative writing” (Stacey, qtd. in TWB 528). How did the writing process help you heal?
EA: Writing has always been cathartic for me. It helped me dig into myself and find out the disturbing, upsetting elements of my past and present life, and project new hopes for the future. It is the same with this book, even much more so! It was vital for me to write it. It helped restore my sanity as I was going through the shock of finding out about the disease and going through the debilitating treatments. I try to take my readers through the hollow coaster I am going through. I share my anxieties and pain and it helps me move forward. I feel that if I am able to help some people go through such an ordeal, I will have achieved a lot and my pain will not have been in vain.
Q: What led to your decision to include your post-mastectomy photographs both on the cover and in the interior of the text?
(Photo by Eva Enderlein, copyright Spinifex Press. Used with permission.)
EA: I was glad that my English publishers accepted to include those pictures which my other publishers (French, Lebanese and Tunisian) did not… When my friend Eva came to visit me during the radiation treatment and asked if she could take pictures of me and of my scars, I hesitated… I did not especially want to exhibit my “ugly” scars, but I knew Eva was a very sensitive person and a creative artist who knew how to express major, important aspects of our world problems, which she does in her photography. So I accepted and the sessions with her were extremely helpful and cathartic. Thanks to her friendly eye behind the camera and through the artistic results of the pictures she took, I was able to express visually what I was going through. It was as if I was able to tell the world: look at me, I am mutilated, I have a big scar on my chest with horrible tattoos for the radiation treatment, I am bald from chemotherapy, I have only one breast left, and yet I am beautiful and able to assert that in front of you, I am able to tell the world: this is what happens to women more and more and will continue to do so unless we have drastic changes in the way we handle nature and the environment.
Q: You quote Sandra Steingraber as saying “our bodies are living scrolls” (Steingraber, qtd. in TWB 406). In what way is The Wounded Breast a testament of our times? Do you see a special relationship between the cancerous body and the pen?
EA: I never thought of it this way, but your question raises some very interesting points that I would like explore in the future. The idea of body as living scroll, the cancerous body’s relation to the pen takes me back to many of the notions expressed by writers and thinkers in L’Ecriture Feministe. How does one write the body? And how does one write the diseased body? I would like to expand on these questions sometimes in the future.
Q: How did your experience with cancer change your overall world view?
EA: One can no longer be the same after such an experience. Cancer, like any life-threatening experience has the power to change you. It gives you a sense of immediacy and vulnerability, the realization that life is short and one often slowed down or even stopped by insignificant matters.
Q: Ultimately, is The Wounded Breast a “call to action”?
EA: Definitely so, it is a call to action to change our ways if we want to see this world survive and give a future to our children. I hope you got that message while reading the book and I hope my readers felt the same and got challenged to take the warnings seriously and do something about them before it is too late.
Q: Do you have a new project in the works?
EA: I have several new projects in the works but writing takes time usually to mature and one needs time… It is sometimes difficult to do everything in academia, so I am looking forward to retirement and to more time for the long-term projects. All I am able to do right now are article and reviews writing. On the creative side, I have a collection of short stories on the condition of women all over the world, which I would like to complete. I also have a study of interviews I conducted with women all over the world particularly North Africa and the Middle East which I would also like to complete… “Du pain sur la planche”… as you can see….
Q: Do you have any additional comments?
EA: I was glad you raised all these important questions. I hope all of my readers will have the great insights you so well express and will be moved to take action and do something about the problems that were raised in this interview.
Works Cited
Accad, Evelyne. Blessures des mots: Journal de Tunisie. Paris: Côté femmes, 1993. English edition: Wounding Words: A Woman’s Journal in Tunisia. London: Heinemann, 1996.
---. Coquelicot du massacre. Paris, L’Harmattan, 1988.
---. Des femmes, des hommes, et la guerre: Fiction et Réalite au Proche-Orient. Paris: Côté femmes, 1993.
---. L’Excisée. Paris: L’Harmattan, 1982. English edition: The Excised. Trans. David K. Bruner. Colorado Springs: Three Continents, 1989.
---. Sexuality, War and Literature in the Middle East. New York: NYU Press, 1989.
---. Veil of Shame: The Role of Women in the Modern Fiction of North Africa and the Arab World. Sherbrooke: Naaman, 1978.
---. Voyages en cancer. Paris: L'Harmattan, Tunis: Aloès, and Beirut: An-Nahar, 2000. English edition: The Wounded Breast: Intimate Journeys Through Cancer. Melbourne: Spinifex, 2001.
Hottel, Ruth A. “A Poetics of Pain: Evelyne Accad’s Critical and Fictional World.” World Literature Today 71:3 (Summer 1997) 511-16.
Hyvrard, Jeanne. Le cercan. Paris: Des femmes, 1987.
Stacey, Jackie. Teratologies: A cultural Study of Cancer. London and New York: Routledge, 1997.
Steingraber, Sandra. Living Downstream: An Ecologist Looks at Cancer and the Environment. Addison Wesley, 1997.
Wiesel, Elie. Memoirs: All Rivers Run to the Sea. New York, Knopf, 1995.