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The heartbreaking children's book on cancer that every adult should read
23:54 GMT, 8 September 2012
Insight: Patrick Ness has been praised for the honesty of his book A Monster Calls
A few months ago, the respected medical journal The Lancet published a review of a children’s book. This may seem a little surprising, but in fact it was an appropriate and enlightened choice.
The reviewer believed the novel – which tells the story of a 13-year-old boy whose mother is terminally ill – was remarkable for the unique way it tackles the difficult yet universal subject of a terminal illness within a family and all those terrifying, conflicting emotions that such a situation throws up.
A Monster Calls, by Patrick Ness, was written for readers aged nine and over, but before it was first published last year I was asked to check it for medical accuracy.
It is now being repackaged for adult readers after a groundswell of support from grown-ups who have found it totally compelling. Although the story is unchanged, the new edition doesn’t feature the original harrowing but striking black-and-white illustrations.
Since coming across this book I have recommended it to many patients and their families, health professionals and teachers, and, of course, my friends. Universally, they have been pleased to have read it, even if at times they have found the content upsetting.
The story is told entirely from the perspective of 13-year-old Conor O’Malley. His mother has cancer, although the word is never used – she loses her hair and is clearly undergoing chemotherapy treatment.
The failure of anyone to address the reality of the situation exacerbates Conor’s bewilderment, anger, frustration guilt and internal loneliness.
From time to time his father, grandmother or one of his teachers take him aside ‘for a little talk’, but despite their best intentions they always fall short of telling him the painful truth – that his mother is going to die.
Even Conor’s friends are unable to understand and cannot communicate with him. They taunt him brutally at school about his bald mother.
At the start of the book, Conor wakes from a recurrent nightmare and is visited by a terrifying monster – a yew tree in his garden that takes on a human form.
The story is told from the perspective of a boy whose mother has cancer
Over the ensuing nights the monster repeatedly wakes Conor and recounts three vivid stories which unearth his emotions about his mother’s illness. Eventually, the boy confides in the monster and says he wants all the pain and worry to end – even though he realises that this would result in his mother’s death.
Of course, the monster is a fantastically astute metaphor for all Conor’s confusing, frightening and bewildering feelings. The monster’s stories help Conor to understand the conflicting emotions of loving someone but also wishing them dead to stop the pain their illness is causing.
The magical exchanges in Ness’s novel are an incredibly effective way of addressing the difficult emotions that everyone feels in these situations, whatever age they are.
Despite being aimed at a young audience, it is completely honest, never patronising nor remotely sentimental.
It tackles this heartbreaking scenario with an incredibly accurate insight.
Doctors like myself, who specialise in looking after patients with cancer, have to develop some emotional coping strategies. Despite this, while reading A Monster Calls in my professional capacity for the second time, there were at least three occasions when I felt tears in my eyes.
But perhaps this book is best summed up in the words of its author Patrick Ness, who has justifiably won many awards for his singular work.
He says this is a story ‘about loss, but also the fear of loss and there’s not a person in the world – young or old – who hasn’t experienced that’.
Kate Wheeler is a consultant paediatric oncologist at the John Radcliffe Hospital, Oxford.
INSIGHT: Patrick Ness, above, has been praised for the honesty of his book A Monster Calls, left