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

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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

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.

I can understand very well that Mr Rieff felt the need to write about his mother's death. That such a writing should take the form of a published book is a totally different matter.
With all due respect, and I have no doubt that David Rieff went through a terrible ordeal, his book adds nothing to what those who really care about their loved ones already know. Well, it is true that he elaborates
more cleverly than most of us would be able to but all the clichés are there: the guilt, I wish it had been me, was there somethong else I could have done...
Here I am obviously talking about the psychological side of being close to someone who is dying. One is very lucky if the practical difficulties which arise can be dealt with smoothly and for that you basically need money.
When I say that Mr Rieff's book is no contribution of great value I also want to say that it is not his fault (he could however chosen not to publish). In my opinion there is nothing to minimize the suffering caused by death. Especially if it takes place after a long period of time, which is usually the case with cancer. The fact that Ms Sontag was a very intelligent and intelectually rich person must have made things even more difficult.
To sum it up, there are no easy deaths (the expression is borrowed from the reply given to Simone de Beauvoir by a french nurse: "But, madam, it was a very easy death." about the death of the former's mother. It was sarcastically used by SB as the title of an account of her mother's death.)
You never forget, that is my experience. You just go on trying to learn how to live with absence.

PS Mr Rieff comments disapprovingly on the publication of some pictures of his dead mother by Annie Leibovitz. I compliment him on that.

The New York Times review of this book concluded that Susan Sontag's death was the kind of death most people would want to avoid--a hard death. Yes, but that aside, this book by her son offers readers little other than the chronicle of one unreflective perspective on a series of difficult events.

To begin, the book is poorly edited, which is a great shame. (One brief example: "Remembering how my mother had behaved during her previous cancers, her close friends also began to search online, and were soon e-mailing to Anne the most informative or promising materials or links that they had found online.")

Also, it is highly repetitive in content. One entire chapter is almost exclusively focused on maligning a brochure put out by the Leukemia & Lymphoma Society. Rieff devotes page after page to berating it for essentially adopting his own attitude toward his mother during her illness: "a refusal to write as if bad news were bad news and despair were despair." Additionally, he revisits in almost every chapter the main theme of the book--that he does not know whether giving her the answers that he thought she wanted to hear (that is, lying to her about her chances for survival) was what he should have done. Once, or maybe twice, would have been poignant. But one can surmise that a briefer treatment would not have given this volume the length to justify publication.

In addition, the narrative portrays Rieff's experiences in detail but with little insight. He attempts to present his mother's thoughts about death, but since he did not know her well, he could only do this through a conjectured reading of her diaries. Interestingly, he does write that during her illness she talked with others about her approaching death but not with him, which calls into even greater question his ability to generalize from the perspective of his admittedly strained relationship with her. He writes that he is still angry about her death, but he does not attribute this to the process of grief. For him, grief does not seem to be a process at all but rather an onslaught of emotions which he would much rather suppress. Why then did he write a book about grieving?

And, finally, Rieff insists that both his and his mother's reactions to her experience were universally applicable. He belabors the other choices they both could have made. He describes other paths his mother could have taken. But in the end, he presents the past as inevitable and his mother's decisions as largely correct. (Reacting other than with despair upon being given a terminal diagnosis would be "insane," according to Rieff.) In doing so, he does a severe injustice to the myriad of experiences possible under similar circumstances, and in the process he runs the risk of alienating readers whose choices were or will be different, whose reactions do not mirror his or his mother's own.

Susan Sontag was a justly famous person. This book sheds light on an aspect of her life that her writings may not have revealed: her myopic failure to accept an important part of her own humanity. Had her son been able to look beyond her limited perspective, this would have been a far better book.

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.

This book takes 180 pages to repeat the same theme over and over:his mother was dying of a blood cancer,and she was in denial about it being incurable.There is little in the way of inspiration or insight since almost the entire book consists of the author's thoughts as he trys to decide whether to foster his mothers unrealistic expectations.Since the book is essentially about the author's thoughts(we hear almost nothing from his mother),we feel more sympathy for him.To make matters worse,the sentences are long and complex,forcing the reader to read and reread them.This book would have been better as a nice short story in a magazine.

So David Rieff describes his mother Susan Sontag's relationship with her own mortality. A two-time cancer survivor (she was first stricken in her early 40s, and went through brutal therapy), Sontag never lost her deep repugnance at the thought of her own extinction nor her equally deep conviction that the only reasonable response to death was to resist it to the final breath.

Rieff's memoir of his mother's last and losing struggle against an especially aggressive form of leukemia is a touching and at times profound reflection on the fragility of life which. It reveals much more than Sontag's own struggle with mortality. It is equally revelatory when it comes to her son's own discomfort with death. It ponders on whether some ways of entering into dying are better--for oneself as well as one's family and friends--than others. Finally, it invites readers to reflect on our culture's obsession with beating death, or at least holding it at arm's length.

Rieff reiterates throughout the book that Sontag resisted death as mightily as she did because she so loved life. "She reveled in being...No one I have ever known loved life so unambivalently" (p. 143). But Rieff's descriptions of Sontag's mental anguish, her strategies of denial, and her demands for comfort and company and false hope during her last months inevitably raise the question of where a love of life that resists death ends and a desperate terror of death which clings to life any any cost begins. Might it be that a genuinely celebratory love of life is one that recognizes that transience is part and parcel of its bittersweet appeal? Could it be argued that a desperate struggle to live when it's clear that the time to die has come bespeaks something less than love of life? Could it be that there's something profoundly important to be said for going gently into that dark night? Such a possibility is hinted at, perhaps unintentionally, by Rieff.

Another issue raised by his memoir is the responsibility of physicians to their dying patients. In an especially interesting chapter, Rieff discusses the attitudes of two of the oncologists who treated his mother. One took the conventional approach that the physician's primary responsibility is to keep the patient alive so long as even a shred of medical hope remains. The other deplored the "surreal minuet" of medical "denial, the kind of winking that goes on, where, yeah, we all know the patient's going to die but we're all going to pretend like there's hope" (p. 114).

The surreal minuet implicates more than just patient and physician. It can force family and friends into the dance of denial as well. One of the more poignant themes in Rieff's memoir is his on-going guilt over the role his mother forced him to play during her dying: continuously lying to her about her condition. He asks himself--and will always ask himself--if this was the proper thing for him to do. Did his "winking" encourage false hope in Sontag, thereby prolonging the futile and agonizing struggle to survive? Did it reinforce Sontag's "deep refusal of death" at a time when both her own dying and its impact on others could've been tempered by acceptance? And does our culture's general deep refusal of death, surely born more of fear than love of life, make dying all the more difficult? In order to die better, ought we to rethink what it means to live well?

Ultimately, these sorts of questions, all raised by Rieff's reflections on his mother's dying, are what makes the book such a profoundly important read. In a very fitting way, Swimming in a Sea of Death complements Sontag's own insightful books on illness and pain.

Susan Sontag had battled breast and uterine cancer before in her life. But there was hope for treatment and survival for those cancers. In 2004, she was diagnosed for the third time with a blood cancer with no treatment and no hope offered by the doctor. Thus begins this memoir by David Rieff, Susan Sontag's son. This short little book is about the author's attempt to "report" on his famous mother and, I suspect, the distance between them. He doesn't go into graphic detail about the effects of the illness or about their relationship. He muses about his mother's drive for life and the book is a tribute to her will to live.

This lovely and heartwrenching book takes the reader not only through the mind of Susan Sontag as she struggles with her last illness. It also reveals the humanity of the author and how he himself struggles with the aftermath, in wondering if he did enough, in questioning his own behavior throughout. I know from personal experience in losing parents and very close friends, no matter how much you do, you will always feel that there was one more thing you could have done to ease their pain, either their physical or psychic pain. Although in this thoughtful account, the author appears to be second guessing what he and others did, I believe he is reflecting honestly on what it means to confront death--your own or that of a loved one. I'm reminded of one of Scott Peck's quotations which roughly said, "only when you confront the reality of your own death are you freed to live your life." Susan Sontag did not go gentle into that good night. Both she and her son are an inspiration for all of us as we face our ultimate outcome.

I love morbid, psychologically minded books, but was not a fan of this one. I did not like his writing style, which felt much too fragmented and the sentences did not flow well at all. Someone else mentioned rereading sentences and I found myself doing the same thing. Also this book was lacking insight and was very repetitive. I felt like I did not come away with anything after reading this, except a bunch of good quotes. That was one plus in this book: its collection of marvelous quotes, perhaps to make up for the author's lack of insight.

Also I was curious to learn more about his mother. I think that's where the book could have had substance, if he was better able to translate what she was going through. But he didn't seem to know her well enough to do so. Maybe after longer time passes and he is able to process some of his guilt, he will be able to write a more insightful memoir.