Get Access to Print and Digital for $23.99 per year.
Subscribe for Full Access

Christopher Hitchens’s Very Personal Handbook on Cancer Etiquette


It is strangely humbling to read the last writings of a dying atheist whose opinions seemed of near-stratospheric condescension, and who stood among a group of modern anticlerics who consider empiricism a virtue, disparage religion without consulting theological texts, and in general exercise the same merciless rigidity they despise in their opponents. Humbling because these are the words of a man who was dying. To gripe with his ideas seems petty, irreverent even. And there is, after all, a difference between a man and his beliefs.

Christopher Hitchens, who died on December 11, 2011, is the author of the posthumous book Mortality, in which he muses on senescence, erects and then demolishes straw-man arguments for theism, exhaustively describes his days of radiation and chemotherapy, and basically illustrates how much this kind of medical predicament sucks for a steadfast materialist whose mantra is “I don’t have a body, I am a body.” The book itself is a pamphlet of reflections and anecdotes, most of which were originally published in Vanity Fair, that Hitchens began writing shortly after being diagnosed with stage-IV esophageal cancer in June 2010. It began, in his mind, as “a short handbook of cancer etiquette,” and with the exception of some of the truly morbid stuff, this is how much of Mortality reads.

Though Hitchens’s politics inverted sometime around the second war in Iraq, his religious orientation was intractable for as long as he wrote. In 1982 he authored an essay for Harper’s Magazine, “The Lord and the Intellectuals,” that foreshadowed the rhetorical tactics of many of his fellow New Atheists: confront those religious skeptics who are nevertheless accepting of religious worldviews, and present the spiritually conflicted with the ultimatum they dread—believe or don’t. In 2001, with A Letter to a Young Contrarian, Hitchens adopted the term “antitheist,” which he preferred to “atheist” because of its more precise and exclusive definition.

Safe to say that religious tolerance was never his deal. And if you are hoping to find that Christopher Hitchens in Mortality—the crusader who hurls denouncements at religious institutions, who takes the odd potshot at Calvinists, who spells “God” with a defiantly lowercase g, and who scoffs at being the subject of your prayers unless it “makes you feel better” . . . if that’s the Hitch you want, rest assured, he’s here.

Understandably, news of his diagnosis prompted some self-righteous invective from the religious crowd he’d provoked all his life. His prognosis was bleak, but he would still have time—albeit time marked by pain, nausea, and delirium—to reconsider his various blasphemies and materialistic dogmas. This had to be one hell of a way to go. As if his terminal struggle wasn’t enough, he knew that people were betting on his deathbed conversion, and worse, that some Christians were watching the spectacle of his death with satisfaction, believing it divine punishment. Hitchens provides an example:

Who else feels Christopher Hitchens getting terminal throat cancer [sic] was God’s revenge for him using his voice to blaspheme him? Atheists like to ignore FACTS. They like to act like everything is a “coincidence.” Really? It’s just a “coincidence” [that] out of any part of his body, Christopher Hitchens got cancer in the one part of his body he used for blasphemy? Yea, keep believing that Atheists. He’s going to writhe in agony and pain and wither away to nothing and then die a horrible agonizing death, and THEN comes the real fun, when he’s sent to HELLFIRE forever to be tortured and set afire.

You’ve got to hand it to Hitch: To face down all of this malice at such a time displayed immense courage. Though, predictably, he proceeds to dismantle this tirade as if all Christians were so belligerent, stupid, and cruel: “Why not a thunderbolt for yours truly, or something similarly awe-inspiring?” he writes. “The vengeful deity has a sadly depleted arsenal if all he can think of is exactly the cancer that my age and former ‘lifestyle’ would suggest that I got.”

That Hitchens developed a malignant tumor on his esophagus (not his throat), then, was the natural result of too much alcohol, too many cigarettes, and unrestrained mitotic division. It didn’t signify anything, least of all a deity’s vengeance.

Yet. You start to notice in Mortality an eerie tendency for Hitchens to ascribe intent to his demise. He catches himself doing so once, after referring to his cancer as “a blind, emotionless alien,” but goes on to repeat the metaphor through the rest of the book. He says his cancer can “tease,” “want,” and “scorn.” He laments the “snickering” of T.S. Eliot’s eternal Footman. And he compares the disquieting litany of ghastly side effects he must endure—loss of nasal hairs, needled forearms, radiation rash, retching—to the now-famous experiment in which he consented to be waterboarded. Having cancer, he implies, is like being tortured by someone; he even addresses this faceless “torturer” in an imagined bedside visit:

What if, though, as I once semi-consciously thought as I lay in similar distress, [my nurse’s] voice had had just the faintest hint of a taunt in it? What if it had been saying, in the merest possible way, “This won’t hurt—much”? The whole balance of power would have been violently subverted, leaving me defenseless and petrified. I would also, instantly, have to wonder how long I could coexist with such a threat. The torturer’s intricate work would have begun.

I stress ‘intricate’ because torture isn’t really a matter of sheer brute pain and force. As I found out when I was actually a torture victim, it is above all a matter of subtle calibration. “How are we doing today? Any discomfort?

Does this seem at all personal? Surely, random suffering can be seen as purposeless, as incidental pain in a nihilistic vacuum. But not so with torture. There cannot be torture without intent. So what is the intention of Hitchens’s faceless but pervasive “torturer?”

The answer becomes apparent when Hitchens claims that without his voice—which his cancer did eventually alter and threaten to silence—and its lyrical patterns and inflections, he would not have been a writer. He continues by elucidating just how much of his identity is bound up with his voice. I’ll save you time: all of it.

At the end of Mortality, in “fragmentary jottings” that were left unfinished at the time of his death, Hitchens finally articulates what he’s been implying throughout the book. “My two assets my pen and my voice—and it had to be the esophagus. . . . this alien can’t want anything; if it kills me it dies but it seems very single-minded and set in its purpose.” Interpreting this stuff is dubious, granted, but it’s difficult to finish reading Mortality and not think that Hitchens took his cancer as an intentional attack. “I’m not fighting or battling the cancer,” he says. “It’s fighting me.” His reaction to the disease is not unlike John Milton’s to losing his sight:

When I consider how my light is spent
Ere half my days in this dark world and wide,
And that one talent which is death to hide
Lodg’d with me useless, though my soul more bent
To serve therewith my Maker, and present
My true account, lest he returning chide,
“Doth God exact day-labour, light denied?”

But where Milton can appeal to God, Hitchens has nothing, and so suspects foul play. To an ardent materialist who spent his life vehemently defending ideals—among them equality, honesty, and justice—that under his professed ideology have no metaphysical basis beyond what we invent, it must have seemed a sort of maleficent joke to realize the hollowness of those ideals at the end. And of course a joke implies intent.

Mortality is, if nothing else, a poignant account of what uncompromising materialism can become: a cynical cosmic paranoia in which the Universe is not indifferent but hostile, not impersonal but personally invested in Your suffering. Throughout the book, you sense Hitchens struggling to uphold the burden of his unbelief. Examples abound: “If I convert it’s because it’s better that a believer dies than that an atheist does.” Or, “Always prided myself on my reasoning faculty and stoic materialism . . . [y]et consciously and regularly acted as if this was not true, or as if an exception would be made in my case.” Or, “As a terrified, half-aware imbecile, I might even scream for a priest at the close of business, though I hereby state while I am still lucid that the entity thus humiliating itself would not in fact be ‘me.’ ”

I’m in no way trying to suggest that Hitchens was a closet theist. But reading Mortality makes me wonder if human beings are truly capable of denying our search for teleological meaning, for purpose. To try requires a peculiar courage that Hitchens seemed to possess. Toward the end, when he became truly infirm, he proposed to test the validity of Nietzsche’s aphorism “What doesn’t kill me makes me stronger.” He ultimately disagreed. Though Nietzsche’s writings still seem appropriate to evoke when considering Hitchens, and as I thought about the last years of his life I remembered another of Nietzsche’s maxims: “Even the bravest rarely have the courage for what they really know.” So evident in Mortality is the tension between what Hitchens said he believed and what he really knew. The unanswered question is whether only imminent death can compel someone to learn the difference between the two.


More from

“An unexpectedly excellent magazine that stands out amid a homogenized media landscape.” —the New York Times
Subscribe now