Swimming in a Sea of Death: A Son's Memoir (Hardcover)

by David Rieff (Author)
Key Phrases: uterine sarcoma, Stephen Nimer, Memorial Sloan-Kettering, New York (more...)

Editorial Reviews

From Publishers Weekly
At age 70, Susan Sontag was diagnosed with a virulent form of blood cancer, her third bout with cancer over the course of 30 years and one she would not win. Her son, journalist Rieff (At the Point of a Gun), accompanied her through her final illness and death, and offers an extraordinarily open, moving account of the trial and journey. Sontag's avidity for life had prompted her to beat the advanced breast cancer that devastated her in 1975; she now resolved to fight the statistical odds of dying from myelodysplastic syndrome (MDS), despite the pessimistic prognosis from doctors. Rieff, who admits he was not close to his mother over the preceding decade, is silenced by Sontag's refusal to reconcile herself to dying and unable to console her. Both mother and son are by turns angered by doctors' infantilizing treatment of terminally ill patients and by their squelching of hope. Anxious, chronically unhappy and obsessed with gathering information about her disease, Sontag was unable to be alone, and Rieff becomes one in a circle of devotees who rotate staying with her at her New York City apartment. A doctor is found who does not believe her case is hopeless, and in Seattle she undergoes a bone-marrow transplant. In this sea of death, Sontag took her son with her—conflicted, wracked, but wrenchingly candid, Rieff attempts to swim out. (Jan.)
Copyright © Reed Business Information, a division of Reed Elsevier Inc. All rights reserved.

From The Washington Post

Reviewed by Reeve Lindbergh

The title of David Rieff's new book is grim but apt. Three years after his mother, Susan Sontag, died, Rieff remains deeply immersed in her last illness: its momentum, its personalities, even its language. In 2004, Sontag was diagnosed with myelodysplastic syndrome, a deadly form of leukemia. She chose to fight the disease with radical treatment, having successfully battled earlier bouts of breast cancer and uterine sarcoma. It became the task of her son and her friends, and to some degree of her doctors, to offer hope all along the way that there was a chance, however small, to bring the disease into remission.

Rieff describes with piercing accuracy how loved ones of the terminally ill pick their way unsteadily between realistic prognosis and meaningful support, between truth and hope. To maintain one's emotional balance while a dying parent fights for her life is an excruciatingly painful and exhausting exercise. One has to accept the probability of death and the authenticity of the struggle for life -- both at the same time. For a very small percentage of terminal cancer patients in even the worst cases, remission can occur. Somebody, after all, gets to be part of that lucky group.

While his mother was sick, Rieff, a contributing writer for the New York Times and author of seven previous books, chose not to write about her illness, not even to take notes or write in a journal. To do so seemed to him both distancing and futile. "What my mother and I shared were words," he writes, "and yet now they felt all but valueless -- like Confederate dollars or Soviet roubles."

Instead, he became a companion, a confidant, an adviser and a research assistant. He helped his mother to investigate every aspect of the disease, to work with a series of doctors whose medical conclusions and interpersonal skills varied widely, and to explore any potentially helpful treatment, however minuscule its chance of effectiveness. He offered her the reassurance she desperately craved, telling her what she wanted to hear and what he did not believe: that against all the odds, she could survive.

Rieff describes with admiration the ability of skillful physicians to convey the medical reality and give encouragement simultaneously. With the advantages of experience, objectivity and access to promising new treatments, they are able to envision not only the worst but also the best of possible outcomes, so that a Parisian oncologist could write honestly to Sontag after viewing her slides, "I do not think your case is hopeless."

For Rieff, though, his mother's situation was catastrophic, and the choice "boiled down to hope or truth." By choosing to give her hope, he wonders now whether he "might not have made things worse for her." He raises an impossible question, one to which there can be no answer.

A fast-moving cancer is a vortex of tremendous force, drawing everyone around the sick person into a dark spin of diagnostics, drugs, doctors, hospitals, "procedures" and treatments, with little room left for emotional exploration. It is only after the inevitable death that the burden of feelings that survivors have carried can be examined. The most tenacious of these is often guilt, not so much the guilt of survivorship as the guilt of helplessness, the feeling that one should have done something more.

Rieff's book is suffused, almost tainted, with self-questionings, but he writes so well that instead of muddying the narrative with these, he offers a clear and rare perspective on the dilemma of the loving witness -- spouse, partner, sibling, child. On the one hand, he must absorb the full enormity of the disease in its every detail and implication. On the other, he must give his sick mother what she needs most, even if what she needs most is a lie that seems to contradict everything in her character, and in his.

To be in such a position means being divided against oneself during one of the most intense events a life can hold. To describe this position so unflinchingly, and with such eloquence, means that David Rieff is his mother's son.

Copyright 2008, The Washington Post. All Rights Reserved.

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Product Details

• Hardcover: 192 pages
• Publisher: Simon & Schuster; 1 edition (January 8, 2008)
• Language: English
• ISBN-10: 0743299469
• ISBN-13: 978-0743299466
• Product Dimensions: 8.6 x 6.1 x 0.8 inches
• Shipping Weight: 10.4 ounces (View shipping rates and policies)
• Average Customer Review: 3.6 out of 5 stars See all reviews (13 customer reviews)
• Amazon.com Sales Rank: #493,643 in Books (See Bestsellers in Books)

Customer Reviews

Most Helpful Customer Reviews

51 of 51 people found the following review helpful:

5.0 out of 5 stars 'She was entitled to die her own death.', February 27, 2008

By	Grady Harp (Los Angeles, CA United States) - See all my reviews (TOP 10 REVIEWER)    (REAL NAME)

Memoirs written after the death of a loved one can either be elegies radiant with poetic inspiration or they can be self-serving eulogies. David Rieff, a thoughtful and intelligent writer, happens to be the son of Susan Sontag, one of America's most brilliant authors and essayists, a woman of great courage with the gift of exploring concepts of our society that she found in need of our attention while at the same time a being novelist able to spin meaningful tales about the indomitable human spirit. SWIMMING IN A SEA OF DEATH: A SON'S MEMOIR is far more than a rehash of an artist's life and exit from life: this book is a work of sensitive evaluation of not only a great woman but also of the myriad aspects of our healthcare system, both good and bad, and the delicate yet coarsely bumpy path that begins with the diagnosis of a terminal disease and ends with the sigh that completes mortality. From this book we learn not only the trials of Susan Sontag's battle with three attacks of cancer (breast cancer in 1975 with radical surgery and chemotherapy, uterine sarcoma in 1998, and Myelodysplastic Syndrome in 2004), but we also learn about the relationship of a son and mother and the challenges to each in coping with threatening diseases and ultimately death.

What makes this 'memoir' so different is the frank honesty of the author David Rieff. He reflects on the avid love for living that ruled Sontag's life, her refusal to give in when she felt that fighting the odds was better than the alternative of doing nothing. Rieff took on the role of supporting his mother's belief that all of the chemotherapy, mutilating surgery, radiation, bone marrow transplantation - all accompanied by severe physical and psychological pain - was worth the effort if the methods of attacking the disease process held any degree of hope of remission. It is a lesson for all of us who have dealt or are dealing with being there for loved ones who face medical decisions, times when the patient needs the support of those who care and are willing to accept the fact that the patient is very much alive - until life is no longer an option.

The reader comes away from this book with a profound respect for the spirit of Susan Sontag, the courage of her various physicians who respected her participation in her decisions, and the quiet and gentle love of a son who can now see the giant who was his mother as he passes her grave in Paris. Toward the end of this book Rieff quotes form Sontag's journals: '"I write the way I live and my life is full of quotations." Then she adds: "Change it." But she never did.' This memoir is an Elegy. Highly recommended reading. Grady Harp, February 08

25 of 26 people found the following review helpful:

5.0 out of 5 stars For Sontag, death was not an option., January 20, 2008

By	Robert Schmidt (Honolulu, HI & Logan, UT USA) - See all my reviews (TOP 500 REVIEWER)    (REAL NAME)

How does a son respond when told that his mother is dying? Is there a difference when this is not the first time? What does it mean to the soul when the cure itself kills?

American writer Susan Sontag died in 2004 of a form of cancer brought on by her earlier aggressive treatments for advanced breast cancer. She was told of her fatal condition as she was accompanied by her son, David Rieff. Nine months later she was dead.

Is there any difference between fighting for life and fighting against death? In Sontag's case, it seems that her goal was to survive and to live life to the fullest. She was a believer in a "take no prisoners" approach to her cancer treatments... a serious disease required an equally serious treatment, and a dedication to this treatment. For her, according to Rieff, death was not an option.

"But with the greatest respect [for her oncologists], the brute fact of mortality means that there are limits on how much better we can realistically expect to do" (p. 166).

This is a book of two viewpoints: what Rieff as a son saw of his mother and himself as the MDS progressed, and how Sontag approached life and death during this period.

Both were brave, and reflective.

"During the months I watched my mother die, I was increasingly at a loss as to how I could behave toward her in ways that actually would be helpful. Mostly, I felt at sea" (p. 103).

"She told me at one point that she was tormented by the amount of time she had wasted during her life on what she called her 'Girl Scout-ish' obsession with doing 'worthy' things" (p. 106).

"And in the end, those of us who loved her failed her as the living always fail the dying, for we could not actually do the only thing she really wanted, which was to stave off extinction for just some time longer, let alone give her what I'm afraid is all too accurately called a new lease on life. Only her doctors could do that" (p. 136-137).

Sontag's philosophy toward treatment was simple in its complexity:

Search for every treatment option.
Take every chance.
Survive.

She watched friends die because they did not heed this advice. But as the sand inexorably runs through the hourglass, the options disappear, the menu of treatments is taken away, and the final endpoint appears.

Rieff collects his thoughts from his observations and reflections, and from both his pre-death conversations with his mother and his post-death review of her journals. This is not a biography of Susan Sontag. It is a mourning of a son for his mother.

"Mostly, I felt at sea."

It is a tough decision, financially, emotionally, and practically, to be aggressive in fighting disease. Sontag was always a fighter, and her experiences fighting breast cancer shaped her to the end. For Rieff, his mother was... his mother. There is no expectation of a reunion in the afterlife, or a reincarnation and reinvention. You live your life, and then you die.

Sontag refused to be passive in life, and in her approach to the prospect of death.

And she is missed by her son.

13 of 15 people found the following review helpful:

2.0 out of 5 stars Rieff should get out of the water, April 14, 2008

By	N. King (Washington, DC) - See all my reviews (REAL NAME)

This book is one of the most depressing and pessimistic books I have ever had the misfortune to read. Fortunately, I borrowed it from the library - having finished it, I wouldn't have it in my house.

This is not to say that, purely from the perspective of language and construction, it is not largely well-written, although the numerous rather self-conscious attributions to largely obscure personalities (intellectuals all, no doubt) interrupt the flow at times. Rather, it is the lack of insight into character - Rieff's and his mother's - that leaves me cold.

I have to emphasize that I am not a disciple of Susan Sontag - I think that is the appropriate word. In general, I tend to distrust people who claim, by dint of superior intelligence, education, or reasoning power, to have some special avenue to "the truth", particularly when they broadcast it as widely as she did. All she really provided was (usually) well-reasoned opinion.

I prefer evidence of wisdom. And I do not believe that she was wise.

She loved life? Well - in truth - most of us do. No. She was PASSIONATE about life. Well - many of us are, though we may express that passion differently than she did. We all fear death? Well - no, we don't. Not in the way she did. I don't accept that her overwhelming fear of death - and apparently her son's, for that matter - sprang solely from her putative passion for life.

The living always fail the dying? Well - no, they don't. Sometimes, the dying fail the living.

Where is the personal responsibility in all this rending of cloth?

Rieff maintains that to have told his mother that she was terminally ill would have sent her spiraling into an abyss of despair and madness. But where has she sent him? Most of us of a certain age have lost one or both parents and other loved ones, sometimes to protracted and painful illnesses. But almost four years after the event, Rieff is obviously still in his own pit of despair (if not madness). Is this an appropriate legacy for a mother to leave a son?

What I find most ironic about this book is that, although Rieff makes reference on a number of occasions to Jerome Groopman, M.D., calling him a family friend, he seems to be peculiarly ignorant of Groopman's own views. Groopman, himself a deeply religious man, has written several books based on his personal experience with illness, and experiences with patients who know themselves to be terminally ill. He has a unique idea of what constitutes "hope", and how "hopeful" dying patients can be - not about cure, or even remission, but about whatever they themselves define as hope when given the opportunity. Rieff should remember the source of the title of Groopman's first book, The Measure of Our Days: "So teach us the measure of our days, that we may apply our hearts unto wisdom" (Psalm 90). Even better - he should read it.