When NPR’s executive producer Madhulika Sikka was diagnosed in 2010 with breast cancer after a routine mammogram, she found herself reaching out to others who had already spent time in the place she calls Cancerland. “I had excellent doctors and fabulous friends and colleagues who knew the latest treatment information. But I also knew people who’d been through breast cancer treatment themselves. Sadly, there was more than one person I could call about it. I was lucky to have this circle of women who knew right away what I was facing and could tell me, ‘Listen, sometimes you’ll feel like crap. Sometimes you can’t stop crying. It happens.’ ”
Her impulse to offer that same lifeline to others led her to create A Breast Cancer Alphabet, which Kirkus says provides the “perfect combination of practical advice and personal musings to help any woman, her family and her friends handle the complicated road through Cancerland.”
As a journalist, the habit of note-taking came naturally to Sikka—but the idea of writing a book was far from her mind. “I wrote during the whole process—that’s what I do. There were things I knew I would want to remember about what I was going through; it was just force of habit, and helpful for me as I was going through it, to process it.” Though she never thought she’d write a book (“and certainly not this book”), Sikka knew if she was going to do something, she wanted it to be “useful.”
“It’s a funny thing to say when I wrote a book mostly about my experience, but I didn’t want to write something that was too self-indulgent,” she admits. “I knew I didn’t have a cancer memoir in me. I knew I didn’t have lots to say about lots of things. I just wanted to write little things I could dip in and out of. “
So that’s when she “set upon” the idea of an alphabet, a structure that allowed her to pick up and put down the writing project. Sikka says that writing in “bite-sized ways” gave her a sense of accomplishment. “When you take a couple of weekends to write 750 words….well, then you’ve got 750 words that stand alone, that don’t rely on something that came before it or after it. As a process that made it easier.”
Certain letters posed greater challenges. “For example, I was hard.” Sikka settled on “I is for Indiginties.”
“I wrote about all the things you have to go through, the poking, the prodding, the endless pictures. ‘Oh, wait, you’re gonna do that to me?’ Then came those letters—X and Z—the letters you’d expect to be hard. I know I cheated a little with ‘X is for X-haustion,’ but I thought that what I had to write was more pertinent than X-ray.”
That’s because Exhaustion is a pervasive feature of Cancerland and one that influenced not just the way she approached writing her book but also how she pictured her audience reading it. “You can’t focus. You don’t want to be carrying a big fat medical book around; you can’t read a hundred pages at a time.”
Sikka’s compact book of 26 essays is small enough to tuck into a purse and doesn’t need to be read in any particular order. A reader might want to start with “W Is for Warrior,” where she challenges society’s need to assign cancer victims a role as brave combatants. Or “J Is for Journey,” where Sikka takes issue with the concept of cancer as a mystical journey, rather than a terrible disease, questioning everyone’s need to wrap the disease up in a neat pink ribbon. “P Is for Pillows,” but it’s also for permission, which Sikka gives her readers plenty of: to wear makeup, to consider Drugs an ally, to feel like Quitting some days, to reject the label of Warrior if they so choose.
“I wanted to point out that there’s more than one way of dealing with this disease. There is a sense somehow that it’s your failure if you don’t conform. Look, I’m in a situation where my doctors found it. I’ve gone through treatment—I’m on drugs, but that’s ok—I know people who have had a much tougher time of it. Let us not forget some 45,000 women die from this disease each year. They’re not failures, they’re not people who didn’t fight hard enough. As I say, in ‘O Is for Odds’—it’s an odds game.”
Sikka hopes that this book she never intended to write nevertheless has a long life. “It’s not a generalist scientific book precisely because I wanted something that wouldn’t need to be updated,” she says, “something that doesn’t change because the science or knowledge of this disease changes. I would hope this book is still meaningful to people who are dealing with breast cancer…in five years from now as much as it is in five months from now.”
Jessie C. Grearson is a freelance writer and writing teacher living in Falmouth, Maine. She is a graduate of the Iowa Writers’ Workshop.