“It almost always begins in darkness, my memory’s trip back to China where Terrence and I meet.” So begins Amanda Bennett’s moving new memoir, The Cost of Hope, the story of an intensely devoted marriage, cruelly shortened by the cancer that killed her husband. The word “darkness” in Ms. Bennett’s opening sentence implicitly foreshadows her husband’s death. After all, cancer is not only a disease, but also a very personalized destination, sometimes to a dark and isolated place. However, it is the words in the title, cost and hope, that immediately resonate with the oncology community at large—patients with cancer hang on the hope of a cure, and doctors increasingly worry about how the rising cost of care might hamper their ability to treat patients.
Roller Coaster Ride of a Marriage
Ms. Bennett, a Pulitzer Prize–winning journalist, uses the short, punchy syntax of her trade to propel the story along. The memoir opens in Peking (it was still Peking in those days), China, in 1983. Ms. Bennett, then a foreign correspondent for the Wall Street Journal, meets her future husband, one Terrence B. Foley, at a raucous, late-night cocktail party. Foley, working as envoy for the American Soybean Association, is a bow tie–wearing, multilingual, polymath, curmudgeon—he knows how to say ‘artificial insemination’ and ‘ribonucleic acid’ in Chinese—who both dazzles and infuriates Ms. Bennett all the way to the alter and beyond.
During their peripatetic marriage they have two children, as Ms. Bennett slugs away at her writing career and her husband “reinvents himself once, twice, three times.” It’s an interesting roller coaster ride of a marriage that, despite constant friction, never seems in peril of collapsing.
Then it happens: Acute intestinal pain drives Foley to an emergency room visit during which he is diagnosed with severe ulcerative colitis; the attending doctor mentions, almost as an aside, that on the scan a “shadow” appeared on Foley’s kidney, which turns out to be cancer. Remarkably, the couple views the cancer as “a nuisance, a distraction from another more demanding illness and everything else going on in our lives.” After weeks of unremitting pain, Foley has a total colectomy.
Battleground of Illness
Shortly after, the shadow on Foley’s kidney assumes a leading role in the narrative as Ms. Bennett and her husband are summoned by a phone call to Dr. Turner’s office, where he uses the words “very concerning” and “worrisome” to describe the lesion. Dr. Turner recommends that the kidney be removed. It is just 3 weeks since Foley’s colectomy, and from this point, the reader is pulled into the battleground of illness.
Three days after the operation, Ms. Bennett and her husband see Dr. Turner, who tells them that the kidney cancer is an odd type, “of unknown origin,” (later referred to as “collecting duct” by one doctor, and “papillary” by another, though ultimately the type of kidney cancer was not confirmed), reassuring them that he’ll call as soon as he knows more. Her husband tears up and thanks the doctor for saving his life. They shake hands. Foley never sees the doctor again.
At this point in the book, Ms. Bennett weaves back and forth in time, using her husband’s illness and subsequent death as the fulcrum. Some of the more interesting sections deal with Ms. Bennett’s transformation from wife to that of caregiver/advocate. “What makes me think curing Terrence’s cancer is my responsibility?” she asks, at the opening of chapter 12. In search of an answer, she states, “I become part of a cancer community.” She investigates cancer on the Internet, keeps voluminous notes, and barrages the doctors with questions, as the couple navigates a maze of diagnoses and treatments. Anyone who has been a caregiver will embrace these sections, as Ms. Bennett champions her husband’s battle with cancer.
Through it all, her husband serves as an inspiration for anyone facing serious illness. “Terrence never does stop doing what he loves. Even during his treatment, even on the hardest days, Terrence’s life is full,” she writes as they carry on with their life together, despite his declining health and imminent death.
Most patients with cancer want therapy, even if it only gives them limited time. Ms. Bennett says, “The medicine buys him time with our children. Time with me. It buys him music and study and Sunday afternoons with his friends.” This is an important observation. Ms. Bennett understands that small parcels of time have immeasurable rewards for patients staring mortality in the face, and for their loved ones.
The Cost of Hope is a personal and insightful glimpse into how high-priced medicines and expensive technologies burden this nation’s health-care system but at the same time afford patients and their families precious added time together. ■