CORNELIUS RYAN was the author of those best-selling histories of World War II, The Longest Day, the Last battle, and A BRIDGE TOO FAR. He finished the last book only just before he died of cancer at the early age 54, on November 23, 1974. This book is an account of his battle against death. Part is written by his wife; but the bulk of the book takes origin from tapes which, unbeknown to anyone, Ryan himself dictated throughout the 4 1/2 years of his fatal illness.
Ryan was not only a courageous man, but a persistent, inquisitive reporter who wanted the truth. He therefore read everything he could about cancer of the prostate gland, the form of the disease which killed him: sought out the best professional adivce: refused to be put off by medical equivocation: studied the laboratory reports on his own condition: and became more knowledge about his complaint than any but the most highly trained specialists.
Ryan was clearly what some doctors call a "difficult" patient. That is, he was not prepared to accept advice without obtaining second, third, or fourth opinions. No doctor whom Ryan consulted could afford to be other than detailed and precise in his prognosis, or pretend to knowledge which he did not possess; for Ryan would be sure to see through any attempted at cover-up or hopeful reassurance which was not based on accurate information. In the event, after much searching, he found doctors, acknowledged as world experts, who were both intelligent enough and secure enough to cope with this rather formidable patient; and Ryan and his wife pay tribute to their skill and devotion.
Cancer, in Ryan's case, has already spread beyond the prostate gland by the time that treatment was instituted. The tapes give us a blow-by-blow account of Ryan's initial horror at the diagnosis of cancer; of his determination to fight the disease; of his gradual recognition that his life was going to end prematurely; of the ups and downs of irrational hope and despair.
As a doctor reading this detailed account, I became from time to time impatient. We all have to die, and many of us will die of cancer. Only a tiny proportion of suffers have the money to fly all over the world to seek the best advice and then to pay out thousands of dollars for hospital bills. Ryan was a gifted journalist and a historian whose books will be remembered; but was he so different from those millions whose approach to death is unsung and unrecorded?
Then I realized that may reaction was churlish. Although tragedies like Ryan's death happen every day, and although every doctor could record tales of equal courage, this book is a unique document. Our culture still tries hard to sweep death under the carpet; to pretend that it doesn't exist; to treat it with the delicate abhorrence with which Victorian middle-class ladies treated sex. Drawing veil over this aspect of reality is harmful, because it means that neither those who are dying nor those who care for them approach the inevitable end with the right attitudes. As the Ryans found, Nurses and doctors are sometimes insensitive to the emotional needs of the dying and their relatives; and i think this partly due to our civilization's conspiracy of silence.
I salute Kathryn Ryan's fortitude in compiling what is not only a tribute to her husband, but an honest, compelling account of what death from cancer is actually like. In spite of modren medical resource, death is all too often painful, undignified and squalid. It is not the odor of sanctity but the odor of incontinence which pervaded the bedroom of the dying.
I hope that doctors and nurses will be among the many people who will read this book. They will learn a good deal about basic human emotions which are seldom made explicit but which, if they are to practice their professions with proper skill and compassion, are vital for them to understand.