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Jeffrey Scales/HSP Archive

One can’t say Susan Sontag died a particularly private death. She once declared she wouldn’t tell her readers “what it is really like to emigrate to the kingdom of the ill and live there,” but it seems other people were determined to do it for her. The latest glimpse we have of her sickbed is “Swimming in a Sea of Death,” David Rieff’s intelligent, disordered account of his mother’s final illness.

It is perhaps surprising that Rieff objects violently to the frank and controversial photographs that Annie Leibovitz took of his mother as she was dying. He writes that Sontag was “humiliated posthumously” by Leibovitz’s “carnival images of celebrity death.”

TRieff himself seems to have made a compromise with the business of intimate revelation; in his indirection one feels the tastefulness, the reserve of the reluctant or ambivalent memoirist. His images of his mother are vague, a figure weeping in another room; if they were sketches, they would be rendered in a charcoal smudge. We see her underlining a pamphlet put out by the Leukemia and Lymphoma Society, but we do not see her illness itself in any detail. Rieff tells us he is not taking notes during her final months (which echoes Leibovitz’s assertion that she stopped taking pictures during that same time). He tells us, in one elliptical passage, that “she might be covered in sores, incontinent and half delirious,” but he does not want to write straightforwardly that she is.

What is shocking about the memoir is how ordinary Sontag seems. The reactions of this strong, singular woman to her illness, as Rieff reports them, are oddly generic. In a car returning from receiving the terrible diagnosis, he writes, she looks out the window, and “‘Wow’ she said, ‘Wow.’” It tells us something important, surely, that one of the most articulate women of the last century should say, in the face of her cancer, “Wow.”

In fact, Sontag’s confrontation with her own ordinariness is the most intriguing element of Rieff’s story. For a woman who had always believed in her own exceptionality, who had defined herself by her will to be different, to rise above, the terrifying democracy of illness is one of its most painful aspects. Throughout her final illness, she tells Rieff, “This time, for the first time in my life, I don’t feel special.” In the most profound and affecting passages of the book, Rieff questions whether, on some level, his mother thought that she was too special to die. He investigates the line between hubris and bravery, grandiosity and vitality. Do we ever truly accept that we will die? Is there a part of the mind, especially for someone as ambitious, as avid, as Sontag, that refuses to believe in its own extinction? Rieff enumerates the qualities that enabled her to transcend her unhappy girlhood in Arizona and her early unhappy marriage to become one of the country’s most formidable intellectuals. “Her sense that whatever she could will in life she could probably accomplish ... had served her so well for so long that, empirically, it would have been madness on her part not to have made it her organizing principle, her true north,” he writes. That same belief in the power of her own desire, that spectacular ambition, that intellectual bravado, made it impossible to accept that fatal illness was not another circumstance she could master.

Of course, Sontag’s belief in her exceptionality had a history. In her first bout with breast cancer in her early 40s, she survived. In early interviews after her recovery, she seemed intoxicated by her brush with death. She claimed she had acquired a “fierce intensity” that she would bring to her work; and she incorporated the idea of radical illness into the drama of her intellect, the dark glamour of her writer’s pose. Sontag had written in her diary during her treatment that she needed to learn “how to turn it into a liberation.” And it was that determination, that stubbornness, that constant act of self-transcendence that she thought she could reproduce at 71, when cancer was diagnosed for a third time. But this time it didn’t work. “She had the death that somewhere she must have come to believe that other people had from cancer,” Rieff writes, “the death where knowledge meant nothing, the will to fight meant nothing, the skill of the doctors meant nothing.”

For a writer who voluntarily embarks on a memoir about his mother, Rieff is curiously silent on the subject of their relationship, but the contrast in styles speaks for itself. If Sontag was incomparable in her confidence, grand-scale in her ambition, constitutionally incapable of self-irony, her son is the opposite. He is disarming in his tentativeness, his modesty, his self-doubt. “I am not even remotely smart enough to resolve any of this, even in my own mind,” he writes.

The book is haunted by Rieff’s anxiety that Sontag may have undergone an arduous treatment that was almost certain to fail, and in doing so put herself through an unnecessary ordeal. One of the doctors Rieff consults suggests a “folie à deux” between some cancer patients and their doctors, where physicians offer elaborate treatments, holding out hope when there is essentially none, in order to honor their patients’ last wishes to battle their disease. Did Sontag undergo a painful and doomed bone marrow transplant because she refused to accept the basic medical facts of her case? Rieff suggests that she might have. She struggled past the moment it was rational to struggle. Rieff seems to wish she had died a more peaceful death.

One of the fascinations of this memoir is watching Sontag’s thoughts play themselves out in the medium of life. In her elegant polemic, “Illness as Metaphor,” she argues against the various fantasies that surround disease. Instead of poetry and emotionally charged beliefs, she argues, patients need to see clearly, think rationally, arm themselves with medical information to prepare themselves for the hard work of the cure. When Sontag was sick, she wrote in her journals that “I have become afraid of my own imagination.” It was this fear she so brilliantly investigated and rejected in “Illness as Metaphor.” The imagination, the romantic overlay we give disease, becomes the patient’s worst enemy.

The purity and charisma of the ideas Sontag laid out in “Illness as Metaphor” are irresistible, and yet this time around, for Sontag, seeing clearly and absorbing information would lead only to the certain knowledge that she would die. In her final confrontation with cancer, she needed consolation; she needed fantasy; she needed not to think clearly. This was the dilemma for Rieff: Should he act according to what he felt his mother wanted as she lay in her hospital bed, nurturing false hopes and offering comforting lies? Or should he follow the dictates of her rigorous, uncompromising work, and tell her the truth? Rieff returns again and again to his guilt over whether he should have been more honest. The book’s very structure mimics the restlessness of a family member in a hospital room: pacing, circling, hovering. In the end, Sontag couldn’t live her illness without metaphor; she needed the idea of a fight even after the fight was lost.

Ultimately, Sontag’s strength is hard to disconnect from her folly. Her way of dying seems impossible, arrogant, heroic. Her conclusions, so hard won, so beautifully wrought, in “Illness as Metaphor” seem a luxury here. In the introduction to that book, Sontag wrote about the kingdom of the ill, but in the real kingdom of the ill, as Rieff reminds us, there is no place to ruminate on metaphors: there is only death. From her bed at Memorial Sloan-Kettering, when she was recovering from breast cancer, Sontag wrote in her journal, “In the valley of sorrow, spread your wings.” Rieff, his mother’s son, unwilling to mystify, to romanticize, adds that “this was not the way she died.” But it is, of course, the way she lived.

Katie Roiphe teaches in the Cultural Reporting and Criticism program at New York University and is the author of “Uncommon Arrangements: Seven Marriages.”