In April 2014, author and family court judge Manjusha Pawagi was diagnosed with an acute form of leukemia. Her candid and often funny new memoir covers the period from her diagnosis to her meeting, two and a half years later, with the donor whose stem cells ultimately saved her life.
The first six months following the diagnosis take up most of the book. After the initial shock and mental recalibration, there are emergency room ordeals and encounters with often cantankerous hospital roommates as Pawagi endures a first round of induction chemotherapy. When that is not successful, she must find a suitable stem-cell donor – no easy task for a Canadian woman of South Asian descent – and undergo more intensive chemotherapy before an extremely risky stem-cell transplant.
Nostalgic chapters about life before cancer punctuate tense meetings in which biopsy results are revealed. This tension is a testament to Pawagi’s storytelling, given that the book’s very existence precludes any mystery regarding her prognosis. She does not gloss over her own occasional petulance and stubbornness in the face of infantilizing medical professionals whose tone can pivot sharply from ingratiating to terse.
Thanks to Pawagi’s unadorned, conversational prose, the whole book can be read in a few hours, though the author has an unfortunate tendency to disrupt the narrative for a meta-analysis of how the story is progressing. At one point, her husband, Simon, interjects to criticize the author’s “cancer cells as terrorists” metaphor, only to turn around and claim he made no such criticism. Pawagi follows this by writing, “He’s objecting to his first objection, which, I have to admit, I did sort of make up.”
Pawagi’s inexhaustible sense of humour does not neutralize so much as complicate her terror and despair. A chapter in which she nearly dies of septic shock includes an imagined press conference on the grounds of the Canadian National Exhibition, a reminder that medical emergencies are sometimes perceived quite differently in the delirious, opiate-addled consciousness of someone experiencing them first-hand. The author’s fixation, at one point, with acquiring a banana Popsicle illustrates how a person trapped in a hospital bed can use small, concrete goals to regain some measure of control.
Love and Laughter in the Time of Chemotherapy is full of such revelations, which emerge from among minute details as is often the case with memoirs, but their frequency and richness here is due largely to the author’s honesty.