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facing of hard facts, thanks. Don’t you be doing it too. And yet I had absolutely invited the question. Telling someone else, with deliberate realism, that once I’d had a few more scans and treatments I might be told by the doctors that things from now on could be mainly a matter of “management,” I again had the wind knocked out of me when she said, “Yes, I suppose a time comes when you have to consider letting go.” How true, and how crisp a summary of what I had just said myself. But again there was the unreasonable urge to have a kind of monopoly on, or a sort of veto over, what was actually sayable. Cancer victimhood contains a permanent temptation to be self–centered and even solipsistic.

    So my proposed etiquette handbook would impose duties on me as well as upon those who say too much, or too little, in an attempt to cover the inevitable awkwardness in diplomatic relations between Tumortown and its neighbors. If you want an instance of exactly how not to be an envoy from the former, I would offer you both the book and the video of The Last Lecture . It would be in bad taste to say that this— a pre-recorded farewell by the late professor Randy Pausch— had “gone viral” on the Internet, but so it has. It should bear its own health warning: so sugary that you may need an insulin shot to withstand it. Pausch used to work for Disney and it shows. He includes a whole section in defense of cliché, not omitting, “Other than that, Mrs. Lincoln, how was the play?” The words “kid” or “childhood” and “dream” are employed as if for the very first time. (“Anyone who uses ‘childhood’ and ‘dream’ in the same sentence usually gets my attention.”) Pausch taught at Carnegie Mellon, but it’s the Dale Carnegie note that he likes to strike. (“Brick walls are there for a reason . . . to give us a chance to show how badly we want something.”) Of course, you don’t have to read Pausch’s book, but many students and colleagues did have to attend the lecture, at which Pausch did push-ups, showed home videos, mugged for the camera, and generally joshed his head off. It ought to be an offense to be excruciating and unfunny in circumstances where your audience is almost morally obliged to enthuse.This was as much an intrusion, in its way, as that of the relentless motherly persecutor with whom I began. As the populations of Tumortown and Wellville continue to swell and to “interact,” there’s a growing need for ground rules that prevent us from inflicting ourselves upon one another.

V
    I have seen the moment of my greatness flicker,
    And I have seen the eternal Footman hold my coat, and
        snicker,
    And in short, I was afraid.
    —T. S. Eliot, “The Love Song of
    J. Alfred Prufrock”
    L IKE SO MANY OF LIFE ’S VARIETIES OF EXPERIENCE, the novelty of a diagnosis of malignant cancer has a tendency to wear off. The thing begins to pall, even to become banal. One can become quite used to the specter of the eternal Footman, like some lethal old bore lurking in the hallway at the end of the evening, hoping for the chance to have a word. And I don’t so much object to his holding my coat in that marked manner, as if mutely reminding me that it’s time to be on my way. No, it’s the snickering that gets me down.
    On a much too regular basis, the disease serves me up with a teasing special of the day, or a flavor of the month. It might be random sores and ulcers, on the tongue or in the mouth. Or why not a touch of peripheral neuropathy, involving numb and chilly feet? Daily existence becomes a babyish thing, measured out not in Prufrock’s coffee spoons but in tiny doses of nourishment, accompanied by heartening noises from onlookers, or solemn discussions of the operations of the digestive system, conducted with motherly strangers. On the less good days, I feel like that wooden–legged piglet belonging to a sadistically sentimental family that could bear to eat him only a chunk at