The questions of our path, our choices, and our identity are bound up, in large part, with those of memory and transmission. We are the heirs of the past and of the history we issue from, which continue to work upon us, to shape us, down to the smallest aspects of our lives. I have sought to understand how this history has influenced my professional choices, and how certain aspects of my work help me to approach it more intensely, more intimately. It is thus that we become more fully aware of our identity and of our living bonds to the past.
For fourteen years I have worked as a psychiatrist and psychoanalyst in the Department of Pediatrics of the Institut Gustave Roussy, at Villejuif, with children being treated for cancer, with their parents, and with their caregivers. Chance had much to do with it, but the chance that orients our choices is never wholly irresponsible and arbitrary. It is well to inquire into the relation between chance and the demand that then reveals itself to us, a demand that sometimes existed within us for a long time, unbeknownst to us. More than the role the name of the place, “Villejuif” [literally “Jew-town”], may have played, I have sought to understand the interest I felt for these children, and the relation between that interest and my own history.
The limit-experience.
Extreme situations, limit-experiences — those in which we stand at the limits of what we can bear and at the possibility of our own death — drive us to cast a glance back over our life, our origins, our history. Then questions, sometimes old, forgotten, repressed, encysted, frozen, resurface, set themselves once more in motion, receive a new light, weave unsuspected links with other questions.
A child’s cancer is, for the child, for the parents, for the siblings, such an event, such a limit-experience — even if today, with the present therapeutic means, most children are cured. The Shoah represented, and still represents for the Jews of Europe, such a limit-experience: the limit of the imaginable, of the thinkable, of the sayable, the limit of the feeling of belonging to the human species.
A child’s cancer and the Shoah have nothing in common, and it would be false, stupid, and odious to want to compare or associate them. But parents of children treated for cancer have cried out: “Here [the hospital ward], it is the ghetto.” The hospital ward is open, and the caregivers work there under the attentive and competent gaze of the parents, but cancer shuts caregivers and cared-for alike within its closed universe, beyond the gaze of others who are untouched by it and who wish to see in it only the therapeutic feats, present or to come, that it occasions — and not the daily constraints it imposes, nor the upheavals of the body that it works.
Other parents have said: “What was the use of my father surviving the camps if it was only to come to this?” They thus pose for themselves, in a way that is comprehensible and legitimate, the question of the meaning of the cancer — not of its cause — within the history of their life and that of their family. Even if, in itself, cancer has no meaning: it simply is. But for want of furnishing a sufficient answer to the question “why?” (not a precise answer, of course, but a movement of thought), cancer risks being nonsense, pure destructiveness.
But, like the children and the parents, those who have voluntarily agreed to work in this universe of childhood cancer must reflect on the reasons for that choice. The general answers — an interest in children, the unacceptableness of their suffering and their possible death — do not suffice. One must push much further the succession of “why?”s and interrogate this interest and this revolt. The meticulous description, in its smallest details, of the experience traversed by these children and their families, together with reflection on its psychopathological, ethical, and existential aspects, have helped me to understand the reasons for my attachment to this work. How could I have known them before I had begun to work at it? Ever since, the questioning about these children’s experience and the questioning about my own interest in them never cease to speak to one another, enriching each other mutually.
The child’s experience of cancer.
Cancer can make the child die. It is a blind, inhuman force, totalitarian in its aim. Nothing gave reason to foresee it, since there is no known cause for this biological cellular dysfunction: neither psychological, nor toxic (tobacco, diet), nor environmental (pollution) — apart from cancers of the thyroid due to radiation and a few rare cases of genetic origin.
Cancer has no meaning, no logic. Its onset is an event that sets in motion the questioning about the meaning of a history, of a life: “Why him/her, why us, why now? What does it mean?” This is why the parents (and the children) seek explanations, a cause in spite of everything, someone responsible — most often themselves: “We made bad choices — we should not have married, lived in that place, eaten those foods, separated, scolded him/her, etc.” Sometimes they blame fate, which pursues them and their family. Sometimes they turn against God: how can one go on believing in Him if He lets innocent children die, even babies? Others rebel against society: “Why did our society not give itself every means to prevent children from dying?”
Without this questioning, they would risk remaining psychically passive in the face of the senselessness and the violence of cancer — the experience of the illness reduced to medical and nursing care — discharging all responsibility onto the caregivers or onto their own parents. The child would then be alone, despite their physical presence, without their being the privileged interlocutors that the child’s own questioning requires. If the child is cured, how will he be able to lean on them to integrate, into the continuity of his life and his history, this period so important, in which they were neither able nor willing to take part; how will he be able to share with them its outcome and its effects? A testimony — factual, objective, like the medical file, completing it — is necessary, but does not answer his demand and his need to know what he has lived through (and besides, he well knows that he will not be able to obtain an exact, precise, exhaustive memory of it, and that does not interest him). The parental function of witness — a party to the experience, having undergone and continuing to undergo its effects — is irreplaceable. Otherwise, the bond between them risks being altered, despite all the kindness and affection.
After the end of treatment.
This questioning must remain open, evolving, and there is no answer to the questions posed. By freezing, it risks shutting the child, his siblings, his parents, within the false reassurance of a crushing certainty, whatever its terms may be: our family is cursed, we are guilty, others are guilty (of not having undergone what we have undergone, of not having been able, known, or willing to help us, to understand our suffering), we are victims, etc.: shut within a bitter, even hateful solitude.
Children treated for cancer, and their siblings, sometimes say: “When I grow up, I’ll be a pediatrician, or a researcher, or a veterinarian.” A refusal of the suffering and death of children lies at the origin of many a pediatrician’s vocation. The siblings of children who have died may say: “Later, I won’t have children: I saw my parents’ suffering, and I would not want to undergo such an ordeal. I would not want, like them, to transmit death along with life.” Others say: “I’ll have a child, to replace the one my parents lost.” The particularities of personal and family histories are added to the experience of cancer to induce these attitudes, these choices, these vocations. It is desirable that each person have a sufficient idea of the various elements at work in his choices and attitudes, so as to avoid illusions and disappointments (reality has its own autonomy and is not reducible to ideal images), and so as to be able to pursue the course of his life between reality and ideal, realism and utopia, past and present.
On the right use of analogy and memory
Some parents express clearly, allusively, confusedly, the idea that their child’s cancer lies within the inevitable continuity of the Shoah, that it illustrates the Jewish destiny. Memory, unconscious or conscious, and the traces left by recollections — personal, familial, or collective, as much as by historical knowledge — can have points in common, resemblances, with the present reality in which we live, and we may have an intuition of the bridges that link these two fields of our path. This intuition is fruitful and stimulating if it helps us to understand better the logic of our lives, to pursue our course more surely. But it would be a pity were it to sterilize itself by alienating itself to a superficial and simplistic analogy.
The experience of cancer can have traits in common with that of the extermination: the alteration of bodies can sometimes evoke the extermination camps. But the subjective experience that the patients live is radically different. There is no common measure with that of the deportees: it is the cancer that is destructive, and the caregivers seek ardently for the patients to be cured and to live, or at least for the end of their life to unfold as humanely as possible.
But the bodily sensations may be close: when, for example, intractable pain makes one lose confidence in one’s body, the feeling that this body is indeed one’s own and that one inhabits it; when the child, wasted, exhausted, bald, no longer recognizes himself in the mirror, and hears his parents say: “He has changed so much, he’s no longer the same, we don’t recognize him anymore.” But these sensations, these situations, are partial, provisional. Does this mean that there is no point in common whatsoever between the two experiences? No, of course not. The experience of the extermination, in the villages, the ghettos, the camps, was also one of hunger and cold, of the intolerable suffering of bodies, and of the fear of dying, under terrifying conditions. The experience of the one helps to understand more intensely, more intimately, the experience of the other, and reciprocally — on condition of knowing and accepting the limits of such an exercise, and of not yielding, driven by the fascination of the unsurpassable experience, to the temptation of finding artificial analogies.
What is at stake is to move forward, not to keep returning toward the past, in alienation and obsession. To move forward at the price of forgetting, of shame, of an exasperated rupture with a past become unbearable by dint of having been too often, too heavily evoked? No, of course not! The present illuminates the past intensely, on condition of considering it for what it is, neither more nor less, and not as the present proof, one more, of a destiny written long ago, which every moment of our life, tirelessly, would confirm and incarnate. And memory is not preserved in formaldehyde, in the museum, in the reification and idealization of the past, but in the invention and discovery of the present, in the risk of forgetting.
To save the children from death. To save the dead from oblivion.
The children must be saved! When children die, the “natural” course of history is reversed, and death triumphs, far beyond the one whom it has touched directly. When parents and grandparents die, prematurely, massively, the children receive as their inheritance death itself and its ravaging effects upon the living. A terrible transmission: to be born of death as much as of the living, to be born within the space of death. Parents in mourning have said: “When I buried my father, I buried my past. When I lost my daughter, I buried my future.” And others: “The most terrible thing was to tell myself that my daughter, my only daughter, will never wear a wedding dress, that I will never be a grandmother.” Others: “And I, my only son dead, who will carry on my name?”
During the last war, a good part of the Jewish resistance was devoted to saving the children. We understand it well: the transmission of the values and the bearings of the past, of what the life of those who are going to die once was, takes place only toward the living. Living people are needed to protect the memory of the dead and of what their life and its worth once were.
The cancer-event.
The cancer-event, which confronts the parents with the possible death of the child, is, inevitably, chronologically, the culmination of a long history. But it would be a pity if, placed in the position of the unsurpassable, of the ultimate term, it were to halt this history, to freeze it. It illuminates this history with its raw, violent light, sometimes far further back in the past than the parents had ever cast their gaze. But it must escape the grip of this past, must not become its prisoner, its hostage. Otherwise the death-dealing cancer would have won, whatever the outcome of the treatment might have been. It must integrate itself into this history, and, with time, become an event — an element among others, more important perhaps, more intense, but not so different; for otherwise it would isolate itself, a desert island, a deserted one, within the continuity of a life.
The cancer-event (its discovery as much as its treatment) belongs, like every event, to the past as much as to the present. It can make a link and continuity between these two times, just as it can make a rupture. The parents of children treated for cancer say: “Nothing will ever be as it was before,” “It’s as if the world had collapsed.” And the children, after the end of the treatment, sometimes say: “I’ll never again be the one I was, the one I could have been,” “I’ve changed so much that I no longer recognize myself.” But they also say: “I discovered in myself, in my parents, in my friends, qualities I never suspected, that they never suspected,” “I opened myself to others, to the world,” “I didn’t seek it, and I paid dearly for it, but I don’t regret this experience, this period.” Later, others say: “It was the most intense period of my life. It’s funny — sometimes I miss it.”
This experience illuminates the past, for the one as for the other. To the parents’ questioning about the choices of their life there answers the child’s questioning about their history and about the characteristics of the bond that unites them: “Did you yourselves face, at my age, in childhood, a situation as difficult, a serious illness, or ordeals of another nature? And how did you react? And your parents? Could you count on them? How did it transform you? What did you make of it afterward? Did this experience have consequences for your desire and your attitude toward me, for the way you raised me, for the rules and the outlook on the world you transmitted to me, for the lines of strength and of weakness I have perceived in you, more or less clearly and accurately?”
The Jewish child and his parents, confronted with cancer, are driven, more than others, to think about the possible link, whatever it may be, between the History of the Jews of Europe and the cancer that strikes them. And the one who, being Jewish, cares for these children no doubt poses for himself a similar question, with no simple or definitive answer: what link is there between this history and his vocation, his daily work?
The afterwardsness of the cancer.
The effects of the cancer-event are, of course, very diverse. The child (and/or his parents, his siblings) may have the feeling of having traversed a difficult ordeal, of having risen to it, without for all that considering himself a hero, an exceptional being; he may, throughout this ordeal of truth, have discovered himself in the complexity of his qualities and his faults. Others consider themselves victims, decide never to be so again, give themselves every means to a superior position, with relations of force become the rule of their dealings with others. Misanthropic and phobic solitude may be another consequence of it. The child may think that he has “paid” enough with cancer, and that from now on he will pay no more, that it is the others’ turn to pay.
Others have discovered the fragility of all life, the possibility of death at any moment, at any age, with no respect for logical chronologies, and decide to live as though they might die the day after each day; they abandon all ambition, all projects, live in the present instant, reduce to the maximum the discomforts and constraints that weigh upon them, the efforts they would have to make to succeed. Some keep from this experience the feeling of their fragility, fear that what happened once will happen again, and live a timorous, minimal life, never very far from the medical protection to which they repeatedly appeal, for all the problems of their life, medical, relational, affective, social, familial (and parental, when they have children), with cancer become the unsurpassable model of every difficulty. Others embark on a medical career, so as never to leave this protective milieu, so as to place themselves on the side of those who, all-powerful, saved them — having become like them.
Some, inversely, consider that they have vanquished cancer — they themselves far more than the caregivers and their treatments — and that they have given proof of their strength, even of their indestructibility, and that, from now on, nothing can reach them anymore. Risk-taking conduct, the placing of one’s body in danger, can follow from such a position, not always a conscious one, of course.
Others keep from this experience the feeling of an irreducible difference that time will never abolish. The child may keep, lastingly, the impression that the stigmata of cancer — including when the illness and the treatment have left in him no aftereffect — will remain long inscribed within him, and that, even buried in the very depths of his body, of his being, some people will discover them, and that he will not know how to explain himself about what remains the shame and the fear of his life. This is why he prefers to avoid relations too close, too lasting, too intimate, so as to preserve his secret. Another “solution” confines him within a small group, sometimes the group of those who were, like him, treated for cancer, in the effort to abolish, within this homogeneous milieu, the unbearable feeling that follows from the exceptional identity of which he cannot rid himself, from which he cannot detach himself — at the price of accentuating still further what separates him from all the others. An inverse temptation incites him to try to abolish this difference and this gap so as to become like the others, like anyone at all, to blend into common banality, to efface every distinctive sign.
But many other attitudes express his suffering and his distress, for cancer certainly imposes a framework and constraints common to all those it touches, but they are not identical for all, and each receives and undergoes them according to his personality, his history, his capacities, his entourage, and preserves, more or less, his freedom to make of them what he can and wants.
To preserve the freedom of one’s destiny despite the experience traversed
All these attitudes must be considered as a few models for finding one’s bearings better within the so rich diversity of situations that the experience of cancer induces. This is why the gaze of the interlocutor or of the fellow citizen of these children, of these parents, must likewise preserve its freedom, and theirs, must avoid pity, fascination, horror, unhealthy curiosity, and voyeurism, and so many other relations that would freeze them within an identity reduced to this single dimension: “having been treated for cancer,” or “having survived a cancer,” or “parent of a dead child, or of a survivor.” It matters that they be able to say, and be heard, understood, accepted also in this speech: “Yes, I lived an extraordinary experience, but it was not such that it did not belong to the field of our common experiences, nor such that it was wholly incomprehensible to you, separating me radically from you.” To banalize this experience would be to deny it; to see in it only an incomparable exception would do so just as much. A narrow but necessary path for whoever wishes to avoid the idealization and the reification of the experience traversed, and the temptation of its oblivion and effacement. He might perhaps find his place among the others, but at the price of the travesty or the effacement of what was lived. They would accept him, but without any longer knowing who he was, who he is, losing the chance to integrate his experience authentically into the common experience.
The afterwardsness of the experience of the Jews of Europe.
The Jews of Europe have lived through major events, in History: antisemitism and the pogroms at certain periods and in certain places; the Shoah everywhere. After 1945, like anyone, they were able to live through events, small and great, personal, familial, historical. Some took them as the logical sequel, the continuity of the Shoah, the originary event. Others drowned, with a bitter, exhausting, sterile pleasure, in the uninterrupted flood of these little worries, of these derisory dramas of daily life, in the ever-disappointed hope of dissolving in them the crushing massiveness of the effects of the extermination. Others sought to attenuate its weight in the ritualized exercise of a repetitive narrative or of the duty of memory, but the Shoah infiltrated every aspect of their lives, very often unbeknownst to them.
Those who were caught up in the Shoah have a threefold belonging: to the history of Judaism, to the History of the twentieth century, and to their family history, made up of the relations of the couple their parents formed, of those of their parents to their own parents, to their brothers and sisters, of fraternal jealousies, and so on. It is not always easy for their children and grandchildren, who seek to restore to their parents and grandparents an identity more complete, more complex than that of victim and/or survivor of the Shoah, to distinguish these three belongings. Their intellectual, affective, and social formation, the choices of their life, issued in large part from this threefold history, and from what their parents and grandparents made of it. But it is no easier for them to find their bearings when they want to understand the history they issue from, their identity, and the origin of their ways of being, of thinking, of loving.
The one who became a pediatrician, or a gynecologist — is it in memory of the dead children, of those who should have been born, who were never born, or out of fear that adults might no longer be able to have children, or even to desire to have them? The one who became a psychologist — is it in order finally to understand the origin and nature of the madness of his parents and grandparents, to find the means of protecting himself from it, of not transmitting it to his own children? What destroyed world does the architect or the mason never cease seeking to rebuild, to build? And the professor, the teacher who instructs — is it because he received no teaching, no sufficient transmission? The language is lost and the faces have left no images, the ways of living are unknown, just imaginable, but so distant, so opaque: this vanished world is another world.
The one who made wealth the objective of his life — is it in order to amass the money that would permit flight in case of mortal danger? The one who sought to integrate at any cost, to efface every distinctive sign — is it in order to blend into the protected, protective mass, out of fear of drawing dangerous attention upon himself? And the one who feels at ease, and reassured, only at the margin; or who lives close to borders easy to cross? The one who needs the group, and the solitary, who believes he can count only on himself? The one who feels himself a victim, of society or of his parents, who were unable to free themselves from what their own parents had undergone and made them undergo? And the one who feels himself invested with a mission as avenger, which he never ceases to carry out, in his social, professional, or affective relations? The persecuted and the persecutor, the one who can only be on the side of the oppressed, and the one who feels secure only on the side of the powerful?
The traumatic event provokes a radical rupture: its own violence makes it unthinkable, inaccessible, and bars the thought that seeks to recover access to the past that preceded it, with which the present, spontaneously, no longer has anything in common: do they belong to different worlds? The temptation is then strong, to the detriment of the necessary feeling of the continuity, in spite of everything, of a history, to believe that one can start again from zero, refound a new continuity, reconstruct a new origin that the event would not have contaminated.
The paths of transmission and of permanence despite the rupture
How is one to preserve, to assume, the relation to the past when the voice of transmission makes a paradoxical message heard: “Follow my path faithfully, but my path has been shattered, and its origin, destroyed, is henceforth inaccessible to you.” Exemplary fidelity, servile or pious imitation, the museum-present, seek to maintain the illusion of a continuity alienated to an idealized and frozen past, as though time had not passed, as though nothing had happened. Imitation preserves appearances, for want of higher ambitions. To content oneself with the illusion as to the efficacy of this minimal transmission — is this really without risk? But the exaggerated, frenzied rupture provoked by anger at what the past made the living undergo, continues to make them undergo, by the feeling of powerlessness — to measure up to those who are dead and to their destiny, to answer the demands of transmission, by the shame of surviving — is it a better answer? Is it enough to turn one’s eyes away from the past to make it disappear, to annul its grip on our life, and our responsibility toward it?
Knowledge is necessary, of course. To know the past sufficiently wards off fantasies, the overflowings of the imaginary, and excessive misunderstandings. But is this knowledge sufficient for the past to go on living in the present? No doubt not. It must find its place in our living present, in this life that we discover in surprise and invent in freedom, outside the preestablished programs — which a promise, sometimes tacit, made to the living as much as to the dead, or an oracular word uttered by an ancestor, long before our birth, heard in our early childhood, without our then understanding its meaning, but which has remained inscribed within us, have written; programs which, if we did not take care, would direct our life. It is the present of the living that integrates the past, and not the past that imposes its conditions upon it.
This life in the present bears permanently, in its manifold choices, those of the everyday as well as those that engage the future, near or further off (studies, profession, places of life, friendships, social networks, the upbringing given to children, etc.), the risk of divergence, of infidelity, of misunderstanding, of forgetting. It is only in the aftermath, facing ourselves, in the gaze we can cast upon the unfolding of our life and the becoming of our children, that the question resurfaces: “What, then, has my path been, the path that led me here? And who am I now? Different, no doubt, from what my grandparents, my parents, once were, from the hope they placed in me, from the one I once was, from the one I could have been, that I dreamed of being — and yet the same. Or another? At what moments, under what conditions, following what concatenations, what choices, were the ruptures made, the first ones, which I had not perceived at the moment when they were insidiously settling in?”
One must have confidence in transmission.
One must have confidence in the transmission that takes place, in depth far more than at the surface — but both are necessary: not the one without the other — and which carries the risk of its failure. What, then, do the Jews who came from Eastern Europe, before 1945 and after, those whose history unfolded, for a time, over there, also transmit? What can they bring to Europe? The active memory of their history: that which they remember — they are, without any possible renunciation, the guardians of memory — but also what they have made of it, what they continue to make of it, and what continues to shape them. Memory of dispersion and of exile, of the crossing of borders, of illegality and clandestinity, of fear, of hope in a better life, in a better world, and of disappointment; memory of the confrontation with death and with annihilation; memory of a rupture that left nothing of the past but indelible, opaque traces; memory amputated of its places and its objects and which nevertheless goes on remembering, including the pain of its lacks and its impotences. Memory of the necessity of inventing, reinventing everything, with derisory bequeathed tools, and a crushing responsibility. Issued from this history, every Jew who recognizes himself as a Jew pursues, in his own manner, with his own means and his own choices, conscious and unconscious, his path; and all of them together constitute the Jewish community, gathered and dispersed. The sequel of their history will tell what the pertinence of these choices will have been, for each and for all: will they go on existing as Jews, will Judaism go on existing, and in what form? These questions of the few will be posed for many.
The years to come, in Europe, will no doubt continue to be marked by migrations and by the upheavals of national identities. This is why the questions with which every Jew is confronted will be posed for many: how is one to preserve, despite these conditions, one’s identity-bearings, one’s communal belongings, the feeling of one’s history, the capacity to transmit them? It is also with their old and dearly paid-for experience of these questions, which continue to work upon them, that the Jews will contribute to the constitution of Europe.