When I Die: Lessons from the Death Zone

How do you review a book by someone who has described in detail his oesophageal cancer and his preparations for death, a man who in the later stages of his illness says he is enjoying his death and allows himself to be photographed on the site of his grave in Highgate cemetery? Is "review" in fact the right word for what I am doing? Am I under an obligation not to offend? I find myself racked with doubt. This is unquestionably a moving and extraordinary book, bold and almost unbearably frank. It tracks the course of Gould's diagnosis in 2008, the treatment in London, New York and Newcastle, the consultations, the operations, the small victories, the optimism – followed by setbacks, more operations, utter desolation and then a dawning and ultimately sublime acceptance, accompanied at times by ecstasy. In addition to Gould's most intimate thoughts, there are pieces by his wife, Gail Rebuck, his two children, Grace and Georgia, a tribute from Alastair Campbell, which was read at Gould's memorial, and a short expert description of oesophageal cancer. Most of the material has been published in the Times; as I write this I have beside me a very affecting piece by his daughter Georgia. This is the second time I have read it and I am again moved to tears. While this book is an account of Gould's preparations for his own death, it is also a festschrift for a remarkable man. But I feel uneasy. It would be offensive to speculate on what drove Gould to write it, beyond the reasons he gives – trying to make sense of his death and to help others – but it bears the fingerprints of a congenital political strategist, a man obsessed with commanding and channelling the reaction to important issues. As Gould writes: "Everything I thought about the battle with cancer was strategic, as if I was fighting an election campaign." But a political strategist is neither a scientist nor a philosopher, and Gould's account of his approaching death has elements of New Labour's romantic values – essentially the sense that individual feeling is the touchstone of politics, that the individual consciousness is the only reliable vessel for a personal truth. You could argue that understanding this, with the encouragement of Gould, was Tony Blair's most successful contribution to the art winning of elections. And, as it happens, two extraordinary moments in Gould's account involve Blair: "I had dinner with Tony Blair; I was not so much low as lost. I could see no way through. Why had it happened? The first diagnosis I understood: I got cancer as others did and I fought it with as much determination as I could muster… Why had it come back? He [Blair] paused for a second and said slowly: 'Because the cancer is not finished; it is simply not done with you, it wanted more. You may have changed, but not by enough, now you have to go on to a higher spiritual level still. You have to use this recurrence to find your real purpose in life.' "Tony was right. I had to find meaning in this recurrence, had finally to come to terms with the purpose of the cancer." At the second meeting, when things are manifestly not going well, Blair gives Gould one of his most cherished possessions, a 6th-century ring from Sinai: "He gave it to me to give me luck." Should I, in reviewing the book, avoid questioning these mawkish absurdities when Gould has himself mentioned them? For instance, should I avoid asking what spiritual content the ring from Sinai could have contained? Two years and four months after his original diagnosis, and after an operation in New York, his cancer returned. Treatment at the Marsden in London was followed by another operation in Newcastle, and finally back to the Marsden for his last weeks. Through all these setbacks, Gould tried to find meaning. His last days, supported by his family, are heartbreaking. But the fact is that, for all the frankness and despite the unflinching courage of this book, its logic is essentially meaningless: I may not be able to beat death but death is not able to beat me. What does this actually mean? Does it mean that he is not going to go quietly into that dark night, or does it mean that he believes he will in some way outlive his death, which of course is a religious view? We will never know: it remains true that death is not an experience in life. But, for all my mean-spirited reservations, I urge you to read the book for what it also is: a brave and unique account of facing death by looking it squarely in the face. Whether it will serve as a lesson, I don't know; I would guess that, just like lives, all deaths are different.