I was 13 when my best friend died of brain cancer. That was also the year my grandmother developed the first of the ovarian tumors that would eventually kill her. And the year her daughter, my aunt, was diagnosed with late-stage breast cancer—maybe a product of the lymphoma that had afflicted her decades earlier, at 17, or of the experimental isotopes that had saved her life, but maybe just a freak coincidence. In any case, as I soon learned, cancer has a way of rendering the “why” largely irrelevant; a tumor is always, in some sense, a non sequitur. And so, that time of encroaching illness would come to feel less like a sequence of discrete events, of causes and effects, than like a lightless singularity, a kind of narrative black hole.
I thought of this again recently as I read The Mutations, the promising, frustrating, and ultimately moving debut of the young Mexican writer Jorge Comensal. It’s a novel brightly alert to the conflict between the storyteller’s imperatives and the raw facts of disease. (An epigraph comes from Susan Sontag: “The most truthful way of regarding illness … is one most purified of, most resistant to, metaphoric thinking.”) That The Mutations nonetheless takes cancer as its central subject seems, at first, an act of kamikaze daring. Yet for all the obvious risks the novel runs—and sometimes can’t outrun—it also taps a hidden power.
Cancer has a way of rendering the “why” largely irrelevant; a tumor is always a non sequitur.
Take, for example, the opening chapter. A middle-aged lawyer, Ramón Martinez, is out to eat at a favorite watering hole when he feels a “searing and exquisite” pain at the back of his throat. Almost immediately, he is in a doctor’s office, at the business end of a tongue depressor that might as well be “a cattle prod, or perhaps an ice pick.” Then comes “a painful biopsy in which several millimeters of his tongue were extracted with a thick needle.”
For all their clinical objectivity and glancing comedy, these scenes are impressively hard to read. Some of their horror surely stems from the nightmarish particulars of Ramón’s tumor: his cancer sits at the base of his tongue, the source of his language, livelihood, and sense of self; the surgery he faces, a “total glossectomy,” threatens all three. But for me—and, statistically, for you and everyone else who picks up this book—the painfulness of Ramón’s story derives from its intersection with lived experience, whether at first or second hand. For centuries, from the chancery courts of Bleak House to the serial killings of 2666, novelists have sought the topos that might span the whole of modern life. In The Mutations, Comensal suggests it’s been hiding just out of sight: the Emperor of All Maladies, at most one degree of separation from any one of us.
This universality licenses the novel to pursue its large ambitions with bracing efficiency. For one thing, little time need be wasted on set dressing; we are in Mexico City, yes, but apart from the chorizo sopes Ramón can no longer choke down, plus a few images of “San Peregrino, the patron saint of cancer patients,” little about his disease hangs on local specificity. For another thing, the plot of any cancer, insofar as it exists, is a voyage through archetypes: treatment, remission, recurrence… Authorial contrivance, or even shading, are beside the point.
Instead, Comensal builds his book around the lateral creep of Ramón’s cancer into the lives that surround him. Braided chapters introduce us to his loyal wife, Consuela, and teenage children, Mateo and Paulina; to his devout housekeeper, Elodia; to his oncologist, Dr. Aldama; and to Teresa, his Lacanian therapist, herself a former cancer patient. Even before a shit-talking parrot named Benito makes the scene, it’s a colorful menagerie, and the varying perspectives lend Ramón’s struggles a cumulative weight. He might seem vain, tired, petulant, paranoid—“whereas before the cancer Ramón had been unpleasant,” thinks Mateo, “now he was insufferable”—yet his life has real meaning for those around him.
The painfulness of Ramón’s story derives from its intersection with lived experience.
That said, Comensal’s panoramic structure sits oddly against the coolness of his humor, the nail-paring quality of his omniscience. In the impacted space of a short novel, major characters can ill afford to linger in the shallows. Yet Comensal, born in 1987, struggles to imagine his way into the depths of his middle-aged professionals. Ramón’s life as a lawyer feels too notional to register as much of a loss. Conversely (perhaps compensatorily), the minds of the doctor characters are overstuffed with vocational jargon, faithfully translated by Charlotte Whittle. The oncologist remains one-dimensionally oncological: “Late had he known the thrill of hunting down founder mutations.” And at least for a while, the Lacanian seems implausibly Lacanian—all “libidinal spectrum” and “metonymies of impossible desire.”
More perplexing still is Comensal’s handling of the younger characters. He grants Mateo and Paulina, amusingly, the “respective hobbies of masturbation and karaoke,” but not much else. In the face of their father’s illness, they display “an apathy typical of nihilist philosophers or provincial museum guards,” and we see little to contradict the assessment. Where it manages to balance its competing urges—toward longitude and latitude, concision and incision—The Mutations is caustically funny, like a subtropical Noah Baumbach. But where it tips into broad satire, it reads like warmed-over Houellebecq.
Still, as Ramón’s family members and medical team make increasingly deluded attempts to save him, the book’s comedy of failed connections starts to click, and its excessive dispassion reveals an even deeper passion—a productive fury at the language of “battles” and “survivors” and “victims.” Shorn of these sanctifying tropes, what cancer exposes, in The Mutations, is a gulf not only between the living and the dying but also between the living and the living. Loneliness, in other words.
At one point late in the book, Teresa, the therapist, drills down to what might be Comensal’s view of the human condition: “Everyone had an immutable core, a kind of soul in the secular sense—a piece of hardware, like the aluminum soul of a polyethylene pipe … impervious to mutation.” The image here, of hollowness and artificiality, points to some of the soft spots that plague this novel, but also to an adamantine resolve. Jorge Comensal will not be wooed by sentiment or easy reconciliation, and if his characters’ souls remain walled off from each other, and betimes from their author, they also have a weird integrity. In life, such souls might be as untouchable as, in death, they are irreplaceable, but it is the achievement of this sparky novel to make them seem, however flickeringly, only just beyond our reach.
Garth Risk Hallberg is the author of City on Fire