A number of people have asked me about this story, a contemporary short story about cancer. Why did I write it as a hybrid of narrative prose and play script, and why did I choose such grim material, namely cancer and the Stalinist terror?

The story was motivated by the conversations I had with an older gentleman with whom I had a brief friendship a few years ago. He told me that despite his long career as an actor and theater director he had never written a play and, at the time of our meeting, he was in the process of finally doing so. It was a play he’d always wanted to write: a play about two great Russian poets of the C20th, Anna Akhmatova and Osip Mandelstam, who were two of Stalin’s victims. Akhmatova survived but Mandelstam did not. I say ‘brief friendship’ because when I met my friend he was terminally ill with cancer and had just stopped his treatment. He did finish his play but, sadly, died a few months later.

Our meeting, its context, and the ideas we talked about represented a remarkable confluence of my own interests at the time. I had been reading a lot of C20th Russian history: a period over which Stalin cast a long and very dark shadow—a shadow that extends to this day. At the same time, I had also become interested in writing (or should I say, trying to write) plays. When I heard my friend’s tale I immediately knew what my next story would be: it would be a contemporary short story about a playwright who learns that he has cancer while writing a play about the Stalinist terror. The fear and torture experienced by the central character in the playwright’s script provides a metaphor for his (the playwright’s) own anxieties and the medical “torture” he experiences as a cancer patient. And neither the playwright nor his character knows if they will survive.

The other question I am asked is why choose to write a short story involving multiple myeloma rather than better known cancers such as colon cancer, prostate cancer, pancreatic cancer, etc.? Multiple myeloma, which can strike both men and women, is a hematological malignancy, i.e. a cancer of the blood. It is considered to be incurable but can usually be managed with a variety of treatments. The typical life expectancy is usually measured in years but some patients can survive much longer. For example, the distinguished broadcast journalist Tom Brokaw (perhaps best remembered now for his book The Greatest Generation) was diagnosed with the disease in 2013 and continues to do well to this day. Former Secretary of State General Colin Powell, who died in 2021, had been treated for multiple myeloma for a few years but died of complications from Covid19, complications that resulted from a weakening of his immune system caused by the cancer.

The most drastic form of treatment for this disease is a bone marrow transplant that involves the use of the patient’s hematopoietic stem cells (the stem cells from which all blood cells originate) that are found in the bone marrow. On rare occasions the stem cells will be taken from a perfectly matched donor. The underlying biomedical mechanisms involved in the transplant are as complex as the procedure is grueling. It usually takes about a year or so for the patient to fully recover from the procedure. My interest in all of this came from the fact that in my previous life as an applied mathematician I attempted to develop a mathematical model for the production of the stem cells needed for the procedure. But that’s another story, and quite a long one!

PS. For those interested in learning more about multiple myeloma good places to start are the American Cancer Society, https://www.cancer.org and the Multiple Myeloma Research Foundation, https://themmrf.org

PPS. For those interested in learning more about the Stalinist terror there are many sources. The memoir, Hope against Hope, by Nadezhda Mandelstam (Osip’s widow) and Into the Whirlwind, by Evgenia Ginzburg (whose husband was another of Stalin’s victims) are important but painful works. For a remarkable and detailed historical account there is Yuri Slezkine’s epic (it’s over 1100 pages!) The House of Government. And there are many, many other books about that period to choose from.

PPPS I have also rewritten the story as a full-length stage play. Needless to say it has never been performed!