Lieke Marsman’s The Following Scan Will Last Five Minutes (Pavilion Poetry/Liverpool University Press, 2019) is an unlikely little gem of a book about cancer, language, poetry, Dutch politics, philosophy, the environment, the art of translation and friendship – all bound together by a burning desire (in both original author and her translator, Sophie Collins) to advocate the virtues of empathy. The PBS have chosen it as their Summer 2019 Recommended Translation.

It’s Audre Lorde who is the presiding spirit here, the woman with whom Marsman is in most frequent conversation. Lorde’s The Cancer Journals (1985) recorded her response to the disease: a sharpened realisation – an underlining – of life’s transience and, consequently, a more acute sense of “act[ing] out of it”. She also refused to allow her response to the disease to “fossilise into yet another silence, nor to rob me of whatever strength can lie at the core of this experience”. Marsman (and her translator Sophie Collins) takes up this challenging baton to produce a busy, intelligent, funny, chatty and touching sequence of poems, an autobiographical essay and 10 concluding letters from Collins, the whole text responding to Marsman’s own diagnosis of chondrosarcoma at the age of 27.

The sort of silence Lorde fears is evoked in the monitory opening poem. Its unusual, impersonal narration is acutely aware of the lure of sinking away into the “morphinesweet unreality of the everyday”, of the allure of self-imposed isolation (“unplugg[ing] your router”) in the face of the diagnosis of disease. What the voice advises is the recognition that freedom consists not in denial, in being free of pain or need, but in being able to recognise our needs and satisfy them: “to be able to get up and go outside”. It’s this continuing self-awareness and the drive to try to achieve it that Marsman hopes for and (happily) comes to embody. But it was never going to be easy and towards the end of the poem sequence, these needs are honed to the bone:

There is nothing I need to see

Except, again and again,

A new day with you

Marsman’s poems are usually very free in form, sparsely punctuated and (unlike the opening poem) give the impression of an intimate address by a sensitive, self-aware, curious and well-educated woman. This makes the moments of frank disclosure even more powerful: “I am just so scared of disappearing [. . .] I desperately need to hear / from other sufferers”. The vitality in the poems belies the exhaustion of the ill person who lacks the energy even to sort her recycling, who watches “Eurosport replays / of alpine skiing” all afternoon and for whom tying her own shoelaces becomes “the stuff of poetry!” Such rapid shifts of tone are important in conveying the resilience of the patient – more than that they suggest the true nature of the individual who is (this is Marsman’s point) more than a mere patient.

It’s this restless interest in the world that accumulates slowly to portray the individual and – against all the odds – makes this book such a pleasurable read. The poems are only partly about cancer or rather cancer is only part of what the poems are interested in. We hear fragments of conversations (‘Identity Politics Are a Fad, You Say’), then meditations on irrationality and evolution and luck. ‘Treats’ ends with thoughts about Wittgenstein’s ideas concerning language games (“Whereof one cannot speak, thereof one must be silent”) but ends with Marsman’s characteristic blend of intelligence, self-awareness, humour and pathos:

Whereof one cannot speak,

Thereof one forms silent gestures

Or bursts into tears.

Elsewhere, the individual’s interest is swept up into gender politics, multiculturalism, reality TV shows, upscale housing developments and the political hypocrisy of the Dutch state. In the autobiographical essay that follows the poems, Marsman explains: “I had to write about politics in order not to be totally subsumed by the cancer”. This also meant she was continuing to preoccupy herself with things that interested her before the diagnosis. It also had the effect of taking her out of herself (cancer, she says, “hurls you into yourself”). Such an interest in the multiplicity and variousness of the Other proves a beneficial way out of “a very lonely experience”.

This is the point about empathy made more systematically in the prose section which is pointedly titled ‘How Are You Feeling?’ In the final lines, Marsman puts it plainly: “What I do know is that the suffering of others is not something to be judged, ever, and that the right question to ask someone who is going through something difficult [. . .] is not ‘What’s in this for me?’ but ‘How are you feeling?’” This might seem to have the air of obviousness about it, but the preceding pages have documented depressing numbers of counter examples. The initial prose sections provide a pretty straight account of a young successful woman who sees the only likely danger for her as stress and “burn-out”. It makes her – and many of the medical practitioners she initially sees about a painful shoulder – fail to see there is a serious problem. On re-reading, I began to see this also as a failure of empathy, a failure to listen in to one’s own body. And there are certainly signs that Marsman (and Collins in her later letters) see the medical profession’s slow up-take as partly due to a lack of true empathy: “not only your age but your gender had an impact on the way you were perceived and treated”.

Marsman tells us she read Audre Lorde and Susan Sontag’s Illness as Metaphor after her operation and discharge from hospital. It’s Sontag who draws attention to the role of language in the way patients themselves and other people respond to cancer. Marsman asks herself: “Am I experiencing this cancer as an Actual Hell [. . .] or because that is the common perception of cancer?” The implied failure to achieve truly empathetic perception of the role and nature of the disease is echoed horribly in the empathetic failures and hypocrisies of Dutch politicians (UK readers will find this stuff all too familiar in our own politics). Prime Minister, Mark Rutte, blithely allocates billions of euros to multinationals like Shell and Unilever (on no valid basis) while overseeing cuts in health services. Marsman reads this as a failure to empathise with the ill. Another politician, Klaas Dijkhoff, reduces benefits on the basis that people encountering “bad luck” need to get themselves back on their own two feet. Bad luck here includes illness, disability, being born into poverty or abusive families, being compelled to flee your own country. Marsman’s own encounter with such ‘bad luck’ makes her rage all the more incandescent.

Marsman’s texts are about 35 pages long in this Pavilion Poetry edition. The remainder of the book consists of Sophie Collins’ letters. This might look like padding but the letters not only raise interesting points (particularly about the practice of translation) but are at one with Marsman’s pleas for a social fabric that enables “mutual, consensual and willing exchange[s]” between its citizens and its power structures. The epistolary form has this sort of open, empathetic exchange at its heart. In fact, the phrase I’ve just quoted is from Collins’ discussion of translation. She argues against the idea of ‘fidelity’ in translation because of the implied power relationship in such a word: “‘fidelity’; implies the presence of a primary source of power”. Traditionally, this would be located in the source text or source author; a power to which the (secondary) translator must defer. Collins wants to propose a more equal partnership, one she wants to call ‘intimacy’: “a mutual, consensual and willing exchange between two or more subjects without referencing (an) authority at all”.

Translation as an act of intimacy seems right to me, though it might appear easier to achieve this with a living source author than a dead one. But Collins really means “developing a sincere engagement with the source text, author and culture”, a ‘getting close’, so – quoting Gayatri Chakravorty Spivak – the translator actually “speak[s] from inside”. This is a timely re-statement of a view of translation that, in these days where versioning and textual appropriation is so common, can be lost sight of. Collins goes even further here than the great Michael Hamburger, who was in the habit of saying the translator puts herself at the service of the source text. Collins sees the practical reality, that any translator herself is always going to be “fixed in a particular moment [. . .] will never, ever be a neutral entity” so however much we serve our source, the translator must always be bringing something of herself too: translation is an intimate engagement, a series of negotiations, an on-going drama of the most complex empathies.

Collins points out that this view of translation is one particularly fitting for the kind of work presented in this book. Marsman’s voice has the marvellous accessibility and liveliness of a conversation: “there is a deep intimacy in the way you seek to connect with your audience [. . .] the amount of credit you give your readers”. Her writing is both “accessible and smart”, says Collins, and this is just right. I might also add ‘uplifting’ – not only because Marsman’s personal prognosis looks good but because between them these two authors have produced a remarkable hybrid sort of book, grown from the astonishingly rich soil of empathetic response to others, expressive of a range of human intimacies as well as a variety of angers at the way individuals – and society – too easily succumb to blinkered self-interest and self-immuration.