A Family History of Fear

I got a D in math and my sister got cancer. These aren’t causalities, only things that happened one right after the other.

Translated from  the German by Jane Marchant.

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Statistics is the science of probability. The discipline connects theory with historical experience to predict likely futures. An auxiliary science, statistics is used extensively in medical practice. Statistics does not make predictions concerning individual human cases but, rather, analyzes empirical data to show broad connections.

I read phrases and passages again and again, reorganize them in my head, but I cannot make sense of them. Or rather: I know what is on the page but I cannot accept it. Maybe that’s it.

Broad connections. For three weeks this phrase doesn’t leave my mind. When I wake up in the morning it rests under my eyelids. When I try to fall asleep at night it’s still there, as cryptic and secretive as a sealed clam shell.

Avoid: Lead, nickel, ozone. Formaldehyde, oxazepam. Benzoyl, cobalt chloride. Plutonium, vinyl chloride. Dimethyl phosphate, arsenic. Acrylamide, malathion. Diazione and busulfan. Carbazone and benzofuran. Acetaldehyde and treosulfan. Parathion and auramine. Cocamide diethanolamine, radon, phenacetin, and chromium. Isopropanol and azathioprine. Polychlorinated biphenyl. Beryllium and myleran. Cadmium and cyclosporine. Chlorpromazine and butadiene. Erionite and ethylene oxide. Cristolite and tamoxifen.

Statistics does not make predictions concerning individual human cases.

Here’s one case: My father’s mother died of cancer when he was fifteen. I’ve never asked him about it. He’s never brought it up. We have a photo of her and some tableware—two small clay cups, one crystal decanter—that’s all. Shortly after her death he started smoking almost two packs a day. He grew up in Chernihiv, a city in Ukraine near Chernobyl, the city that became infamous on April 26, 1986. My father was seventeen when it happened, wearing his hair long and listening with his friends to the music of Mashina Vremeni, Nautilus Pompilius, and Kino. When Viktor Tsoi, the singer from Kino, released “Хочу перемен” (“I Want Changes”), he simultaneously became the Russian version of Prince and announced the approaching fall of the Soviet Union.

My mother was born on April 26, 1967, in Luhansk, near Donetsk. When it happened, she was nineteen years old.

My father studied at a technical college in Lviv, where my mother studied psychology for a couple of semesters. When my parents met there in 1990, my mother had already had a child—my sister—and a failed marriage, which wasn’t unusual in Ukraine at the time. It was spring and they drove my father’s car through the blossoming city. My mother often wore a long turquoise dress that flowed around her. My father says that despite everything, it was a carefree time in his life. The air around them filled with nervous tension. The country became dominated by an intuitive, claustrophobic sense of shrinking resources, as if everyone could hear the clanking of cell doors locking all around them. If you were skilled or lucky, you could earn a lot of money quick. My father was skilled or lucky. My parents bought a large brick house in the center of Kyiv.

The risk of developing lung cancer is significantly higher among tobacco users. One’s risk of developing lung cancer is heightened if one lives in a smoking household or a home heated by coal, so it is therefore inadvisable for smokers to heat their homes with coal. It is also inadvisable to smoke. Cases of lung cancer among coal miners are extraordinarily high. Automobile exhaust can be carcinogenic. Increased rates of lung cancer are found in inhabitants of houses built between 1960 and the 1970s because the possibility is higher that asbestos is concealed within the houses’ walls.

Then everything went fast. In 1991, the Minsk Agreement was signed and the entire country awoke from a coma. Salaries paid one day were no longer paid the next. The already-ailing political system collapsed. Hyperinflation set in, and a loaf of bread cost one million hryvnia. All there was to eat was what contacts “obtained” from somewhere. An entire generation of young men, traumatized from the weapon-heavy war in Afghanistan, returned all at once to a home without work or purpose. Regional authorities divvied up the country like a packet of crackers and gangs held shoot-outs in open streets—the police, in function, another gang themselves. My thin, clever father slept with a gun underneath his pillow (something he continued to do for years on, even when we no longer lived in Kyiv). Then my mother birthed me and my father stopped smoking overnight. I was his first child. He and his friends sold everything they could get a hold of on the black market. Copy machines, soap, shoes. Once a week they drove to Poland and Belarus and loaded their cars with anything that looked valuable. My sister started school. I learned to walk and speak and read. My parents decided we had to leave. Ukraine was sinking. They sold our house and my father’s car for prices so low we could have laughed. And then we moved to Berlin, where my mother’s parents had been living for several years. Like so many Ukrainians before us. We were one story among many.

The likelihood of developing leukemia, thyroid cancer, or lymphoma is very high if one lives within a radioactive zone near the site of a nuclear disaster. One’s likelihood of developing cancer is exponentially higher if one ingests fruits and/or vegetables contaminated with radiation. The probability of developing cancer is extremely high in individuals who touch uranium. Those exposed to elevated doses of ionizing radiation have a higher likelihood of developing acute radiation syndrome than those unexposed. Electromagnetic radiation such as radio waves, microwaves, infrared waves, X-rays, and gamma rays, in effective doses, are likely to cause cancer.

So we learned German. My sister and I rode the bus to school. My mother studied art history and my father found a job as an engineer at a good firm. The euro replaced the deutsche mark. My sister and I learned to ride bicycles. We visited a Christmas market and a shopping mall for the first time. We fought often then forgave each other, as sisters do. We spent our afternoons in courtyards between cheap prefab apartments built after the second World War and summer holidays with relatives in Poland. At my German friends’ houses, I ate potato salad and sausages and drank cola; at home we ate bland, ribbon-like noodles with canned meat and tinned fish and sipped Russian black tea. We took it all with humor. My parents settled into their new life. Then I got a D in math and my sister got cancer.

One’s likelihood of developing cancer is substantially higher when a family member has had cancer. The probability that someone in one’s family has had cancer increases the larger one’s family is. In many cases, cancer will skip a generation, although sometimes it passes directly from parent to child. One’s chance of developing cancer grows with age. Certain cancers are found almost exclusively in children and teens.

I entered high school, my sister the hospital. I lost my house key—my sister, her hair. These aren’t causalities, only things that happened one right after the other. When two things lie side by side, it can seem like they have something to do with each other. Our days were filled with things lying side by side. And when two things are placed next to each other often enough, someone, somewhere, is bound to create a statistic.

It was a gray phase of life. We held our breath. I wasn’t allowed to visit my sister in the hospital—I spent afternoons with my grandparents, I stayed with them entire weeks. Perhaps my parents thought it shouldn’t be expected of me. Then one day they let me go. And I asked myself, Why all of a sudden? My grandmother and I rode the U-Bahn into the city. She cried the whole journey but stopped before we entered the hospital doors. My sister had a fever and was hallucinating, dreaming with half-closed eyes and lashless lids. She told me everything she saw that I couldn’t. She spoke of a dark horse that brought her sweet, ripe plums. Or: The sun shines like a pink rose in the middle of the night.

May no one tell me it makes sense that she became sick and I stayed well. That it could have been predicted, avoided, prevented.

The chances of developing cancer are higher if you are a cisgender man. Colon cancer affects cisgender men at much higher rates than cisgender women. The likelihood of developing breast cancer is significantly higher if you are a cisgender woman. In rare cases, breast cancer can also affect cisgender men. Your probability of developing breast cancer doubles if someone in your family has been diagnosed with breast cancer. You are unlikely to develop testicular or prostate cancer if you are a cisgender woman. You probably will not develop cervical or ovarian cancer if you do not have a cervix or ovaries.

My sister clenched her teeth together and fought harder than I had ever seen before or since. Her fever broke and her hair grew back fine and soft like the down of a chick. She finished school and moved away for college. Three times a year she had follow-up appointments; three times a week I went to my job after school. She lost her humor and I my innocence. Like all parents, mine blamed themselves for everything, thinking a single moment of past neglect caused all of it to happen. Our grandmother blamed Chernobyl and couldn’t be persuaded otherwise. My mother left the house less and less often and avoided her friends. My father stayed at the office later and later and became skinnier than ever. I missed my sister.

Merkel replaced Schröder; Obama replaced Bush. We moved into a smaller apartment. I got my first dog, my mother her first diagnosis. We thought, This time, we are ready. But this time it was more complicated and our experience was useless. I looked for a job near the hospital. My father and I met at the train station or between half-packed moving boxes in our dark kitchen late at night. For over half a year, the only light in the room was a small reading lamp illuminating the stove. I fried potatoes and eggs and my father and I ate in silence. While he chewed and chewed I sat across from him and studied his paper-thin violet eyelids, thinking that mine too would age like his. My mother returned home without cancer, but the side effects of her therapies were formidable, irreversible. It was a gray phase of life. Everything seemed too surreal to be true. I was offered a vaccine against the type of cancer my mother had, but I chose not to get it. I don’t remember why. It wasn’t out of protest. It was idiotic. I felt guilty but indestructible. Unbreakable. As if death had skipped me. It was so unlikely to happen a third time.

Elevated cancer rates are observed in workers processing industrial chemicals such as aniline, tar, nickel, cobalt, and chromium, and likewise for farmers working with engineered fertilizers. There is sound evidence that the agricultural pesticide glyphosate induces cancer. Winemakers, carpenters, and copper and tin foundry workers are at high risk of cancer. Your likelihood of developing cancer increases when you eat processed meats preserved with sodium nitrate. Evidence suggests that red meat encourages the growth of cancer. Without exception, you should avoid ethanol in alcoholic beverages. In large quantities, caffeine will feed cancer’s growth. Abstain from fruits and vegetables treated with pesticides. The carcinogenic fungus aspergillus flavus often infects corn, pistachio, and cereal crops. Do not eat it. Avoid contact with toxic fabric dyes, children’s toys, and packaging material. You are strongly advised against licking yogurt lids, as this can lead to cancer.

Then someone gave me a prognosis: I belong to a risk group. They call it a genetic predisposition. I thought a third time was improbable. Turns out the opposite is true: Statistically, it is improbable that I do not get cancer. Another prediction: Today, it will rain. But instead the sun shone. It wasn’t a lie, but it wasn’t the truth. It was probable. But when does something go from being prediction to probable to true?

I felt nothing. I was, all things considered, an exceptionally healthy child. A doctor advised me to get blood tests twice yearly. Someone advised my mother to drink lemon water twice daily. Someone else advised us all to be more optimistic. Soon colorful notes hung throughout our apartment: I will stay healthy! I’m doing good! I feel great! I developed a fierce animosity toward Post-its. My mother goes to follow-up appointments twice a year. I used to go with her. Now I wait for her call every six months. My father has started smoking again.

Your likelihood of developing skin cancer increases when you sunbathe unprotected under ultraviolet radiation. Your chance of developing skin cancer is higher the lighter your skin is. The highest rates of skin cancer are in Australia, where the ozone layer’s protection is thinnest. Sunscreens can contain carcinogenic chemicals.

I read that the International Agency for Research on Cancer divides chemicals into five groups: “carcinogenic to humans,” “probably carcinogenic to humans,” “possibly carcinogenic to humans,” “not classifiable as to its carcinogenicity to humans,” and “probably not carcinogenic to humans.” When writing this, I read that the last group contains a single substance: caprolactam. But I bet the fifth group will be empty soon. If you look long enough, you can collect data for anything. A prognosis is not a prophecy—it’s an expectation. When I order a coffee, I don’t expect a Fanta. When you develop lung cancer though you’ve never smoked, the news is unexpected. What more is there to say? You’re just an exception.

Autoimmune diseases can increase the risk of cancer. Some viruses can be cancer inducing, such as HIV or mononucleosis. Your likelihood of developing cancer is higher if you already have cancer.

All of this is an isolated case. Everywhere are isolated cases. Here is another: My friend Holly lost her father in a train accident. He was seventy-seven. Her mother is sixty-five and competing in an upcoming Iron Man competition. The worst thing Holly’s ever had was a stomach flu, but she’s sure she’ll get cancer if her modem is too close to her bed. Here’s another: One friend only uses self-made shampoo out of fear she’ll get cancer from parabens. She stirs her coconut oil as if nothing can happen to her now. I’ve begun to avoid her. Maybe I envy her peaceful sleep. I’m a terrible consumer and I don’t read labels. Consider it denial. Last week I discovered a new mole. All of a sudden it was on my left thigh: a small dark dot. For three days, I held my breath. But one can’t hold back the entire atmosphere.

There is a probability of developing cancer. There is a possibility of dying of cancer. Statistics show that every third European will develop cancer in their lifetime.

Am I the first, second, or third European? Probability, truth. When two things lie side by side often enough . . . The truth is: It is June. My mother waters her hydrangeas. My sister owns a dog. I feel normal. My grandmother sometimes says that death is the last banal thing to happen in life. That’s a trite statement. Pacifying yourself is an art. When my father coughs three times, we all think the same thing. At every doctor’s visit I receive prognoses that will knock me into terror or lull me into safety—whether I ask for them or not (and I never ask), they will be there until they’re not. It will happen a third time or it will not. No one can predict it. Nothing can prevent it. Statistics offer nothing more than the illusion of control. I try to breathe, not to scrutinize, not to frighten myself. I see things lying side by side in a potential order and I try to observe them separately. Here is a book. There is an orange. That is all that is there.

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Originally published in German by BELLA triste.