Next day, Siddhartha Mukherjee, then in the early months of a two-year immersive fellowship in oncology, met Carla to explain her diagnosis of acute lymphoblastic leukaemia, from which her chances of recovery were about one in three. Appalled by a ‘rehearsed and robotic’ quality in his sympathy, yet unable to draw back from his patients’  ‘lives and fates … played out in colour-saturated detail’, Mukherjee, compelled to understand his enemy, intensified his study of ‘the larger story of cancer’. The result is a brilliant and encyclopedic exploration of the nature – for he soon realises it is a personality he is studying – not only of cancer, but also of medical research, human resilience, metaphor, and language.

The Emperor of All Maladies creates a biography of cancer from its conception, to pursue the metaphor. Mukherjee discusses the work of Imhotep, an Egyptian physician whose observations of breast cancer in about 2500 bce were transcribed onto papyrus by a hasty and erratic plagiarist in the seventeenth century and later bought by an English antique forger, Edwin Smith. They were then translated into English in the 1930s. This serendipitous journey, with its multiple layers of forgery and discovery, is suggestive of the twists and turns both of Mukherjee’s antagonist and subject, and of this wild and adventurous book.

Mukherjee’s language is descriptive and exuberant in ways contemporary life writing often eschews. In his author’s note, Mukherjee talks about his subject as a ‘lethal, shape-shifting entity imbued with … penetrating metaphorical, medical, scientific and political potency’. In borrowing the biographer’s mantle, Mukherjee professes faith in the idea of an ending, since investing the disease with a personality implies its mortality. Yet the guise of biography does not occlude the book’s most pressing question, about the possibility – or not – of cancer’s eventual demise. The account of a passionate young oncologist, whose attitude toward his patients is respectful and generous, and whose respect extends to the disease itself as he unravels its mysteries, makes for compelling reading. In charting his ‘coming of age as an oncologist’, Mukherjee implies his own reliance on the disease, and the deeply embedded paradoxes of investment and opposition that this necessitates.

Carla’s story and those of other patients are threaded through the work, along with stories of cancer’s antagonists, including numerous doctors and researchers. Many of these were considered maverick and chastised in various ways for the intuitions that, in some cases, led to breakthroughs in the treatment and understanding of the disease. Carla’s story is one of victory over the disease, but it is a victory hollowed by the vulnerability she retains. Mukherjee’s sensitivity to this, and his refusal to minimise the injuries she and other patients sustain, gives the book a compassion and complexity at odds with a more conventional medical calculation of success and failure. Most resonant in this extraordinary and multifarious work is perhaps one of its humblest aspects. Mukherjee’s scrutiny of what it is to be a doctor, and to administer treatments that may succeed but may also damage a person, exemplifies a courageous interrogation of the application of the Hippocratic Oath’s primum non nocere. Beyond this, patients’ courage is the work’s overarching theme. From the image of the Persian Queen Atossa, whose decision to cut off her diseased breast proved remarkably prophetic, to the patients who clamoured for or resisted various treatments, Mukherjee highlights the way that resilience, too, has its metastases.

My sense of resilience as metastasising through Mukherjee’s account reminded me of the metaphor Paul Celan makes with the word ‘metastases’ in his love poem ‘Largo’. The poem starts with gentle whimsy (‘You of the same mind, moor-wandering near one’) and ends with clouds – ‘our whitely drifting / companions up there’ imagined as ‘our / meta / stases’. The word is broken as metaphor is skewed to refract easy or conventional comparison. Mukherjee does something similar. Aware of Susan Sontag’s Illness as Metaphor (1978) and its argument that metaphor and myth have the capacity to increase the suffering of patients, Mukherjee works to demystify cancer, but also to probe language; to find new ways of expressing its history and effects. This brings him again and again to the two-faced nature of metaphor with its capacity both to express and occlude. His conundrum resonates with Celan’s, and recalls Adorno’s prohibition ‘after Auschwitz, no poetry’, in understanding the ways that aestheticising atrocity might endanger bearing witness to it.

Poet Geoff Goodfellow, his daughter Grace Goodfellow, and photographer Randy Larcombe, in their collaborative account of Goodfellow’s cancer, start with metaphor, but quickly abandon it. The rhyming slang of the title Waltzing with Jack Dancer and the image of Goodfellow, bare-chested in pyjama bottoms and boxing gloves, suggest both humour and resilience. Yet the work that follows contains minimal evasion, barely any metaphor, and a great deal of anger. It is narrative poetry stripped back to its bones, accompanied by blunt, spare photographic portraits and, finally, by a teenage daughter’s memoir of Goodfellow’s diagnosis and treatment.

Alongside diagnosis and misdiagnosis is a stark account of where the cancer might have started – a five-year-old sneaking a cigarette, then the cocktail of ‘sixty to eighty cigarettes / a day for fifteen years / & over twenty half coronas / for another ten’, then an extensive catalogue of solvents, sealants, stains, and paints, working on building sites ‘in blinding sun’. Goodfellow’s wry catalogues continue. He numbers the many medical professionals who discuss his case with him, many of them erring in their recommendations.

While Mukherjee charts the battles between the purveyors of, and researchers into, carcinogens, Goodfellow surveys the wreckage in the Head & Neck ward, where most of the patients are ‘old Marlboro men / on Alpine white beds / now that’s Kool’. The poem’s jokes collapse, ending with the realisation that, as uninformed consumers, ‘the laugh’s / on us’. Grim accompanying portraits of Goodfellow show an accusatory stare, mingled with defiance. The photo-essay that weaves through the book is a spare and unsettling one; a cautionary tale in pictures. Grace Goodfellow’s memoir of her father’s illness and her own reactions is direct, with a similar sombre wit, leavened by references to her life as a teenager – school, dreams, music, boys.

This formula of unevasive depiction of cancer, cautionary tale, and mordant wit is also part of Dudley Bradshaw’s memoir, Cancer Four Times Removed. Mukherjee describes cancer’s history as an unspeakable disease (Grace Goodfellow alludes to this, calling her memoir The C-Word). Mukherjee’s ‘once whispered-about, clandestine’ cancer of the past saw its victims silenced and shamed. Bradshaw’s book refuses to allow euphemism and embarrassment to get in the way of communicating to men the importance of early intervention in cases of prostate cancer. Although Bradshaw’s book is a long way from Mukherjee’s encyclopedic vision, there is a similar urge in each to build understanding of the enemy, and to demystify it. Significantly, where Goodfellow’s angry cover image shows him in combat, Bradshaw’s shows a pair of boxing gloves hanging up, no longer necessary, and the book’s celebration of renewed health is central.

Dutch-born Australian auteur Paul Cox has long made films about human vulnerability and resilience, and his memoir Tales from the Cancer Ward, although as fearless as Goodfellow’s and Bradshaw’s books, has about it an exquisite sensitivity, and an extension of his films’ celebration of humility and depth. ‘We all live on borrowed time,’ he writes. ‘There is no other time.’ His is less the cautionary tale of Goodfellow’s account, nor the appeal of a survivor to other potential victims of Bradshaw’s, but a wider expression of the need to live fully and well. Although illness is at the centre of Cox’s lyrical memoir, wellness is its theme. Slivers of remembered music, dreams, moments of generosity, illumination, and love form a mnemonic that evokes the themes of his films and affirms ideas of a life lived with creativity and connection at its centre.

Cox describes a more literal experience of borrowed time as he awaits a liver transplant. His dreams are scarred with confusion and thinned by the need to remain alert for the crucial phone call. Like the other memoirists, his experiences of medical care encompass the thoughtless and wrong-headed to the profoundly generous. For Cox, cancer, despite its violence, is the occasion for a meditation on vitality and gentleness, extending the work of his films.

Each of these books captures a sense of a battle’s urgency, and each writer uses language to find ways to understand the experience of cancer. But like Celan’s broken image, each conveys a sense of an ultimate ineffability. The Emperor of All Maladies recently added to its awards the Pulitzer Prize for general non-fiction. Another kind of victory, of the kind attained by Carla Reed and each memoirist, is something larger; dependent on an accumulation of funding, knowledge, and the kinds of hope and illumination to which these four books strive to contribute.