‘Eating Pomegranates’ by Sarah Gabriel

The human experience is defined by inheritance: We live in the shadows cast by those who came before. For English journalist Sarah Gabriel, those shadows are long and dark, cast by her mother, who died of ovarian cancer when Gabriel was in college. The disease and her mother’s suffering were kept shrouded in secrecy until death was just hours away.

Whatever blissful ignorance Gabriel might have enjoyed disappeared in that moment; her life became a struggle to process her rage and grief over her mother’s death and her father’s emotional withdrawal.

And there was another constant, a gnawing, terrible question Gabriel attempted to ignore throughout her tumultuous young adulthood. Was she fated to suffer as her mother had?

In “Eating Pomegranates: A Memoir of Mothers, Daughters and the BRCA Gene,” Gabriel offers a series of answers, beginning with the moment, in a doctor’s office in London, when she learns she has tested positive for a “deleterious mutation” on the BRCA-1 gene -- an inherited defect that exponentially increases the chances of developing breast and ovarian cancer.

For people with the BRCA-1 mutation, the lifetime risk of developing breast cancer is about 85% as opposed to 13% in the general population. The numbers for ovarian cancer are even starker: about 50% versus 3%. Attempting to defy genetics, Gabriel has her ovaries removed.

Several years later, she finds a cancerous lump in her breast, and she and her husband plunge headfirst into the world of hospital gowns and surgeries and calibrated survival rates, as her other world -- the world before cancer -- crumbles.

Gabriel is a gifted and sensitive writer, with an ability to wring meaning, even humor, from nearly everything, even the blithely insensitive comments of her friends, who are frantic to identify (and separate themselves from) the cause of her cancer.

“Eating Pomegranates” is not a saintly meditation on illness and redemption; Gabriel is plenty angry about her bad luck and especially about her motherless state.

Her obsession with the latter is the book’s only weakness. Gabriel seems to assume that her peers all enjoy relationships with mothers who cheerfully provide child care and home-cooked meals and that she alone is facing life without maternal guidance.

Otherwise, Gabriel doesn’t allow herself much self-pity; she understands, even when she can’t quite acknowledge it, that things could be worse. Her fellow patients’ stories, tragic and wry, are a constant reminder of what might have been -- and what could be.

Although the science of hereditary disease -- illnesses mapped with precision along the pathways of our DNA -- is relatively new, the knowledge that we leave parts of ourselves to our children and their children is as old as life itself.

As the mother of two young daughters, Gabriel wrestles with this awareness, knowing she may well have passed the mutation to one or both of her children. She watches the girls grapple, often angrily, with their mother’s illness and her transformation, courtesy of chemotherapy, from a familiar, comforting presence into something terrifying -- a creature she calls “Beast.”

“At about this time,” Gabriel writes, “the Beast is born. He appears one morning after the children have gone to school. I catch sight of it in the mirror. Brown eyes. Ashen skin. Grizzled head. Bald, or almost. Hard to tell its age. As for the sex, you wouldn’t say it has one. It has a repulsive kind of androgyny.”

For Gabriel, battling an aggressive form of breast cancer, that knowledge is woven into every part of the daily routine, from the school run to the dinner table, creating an excruciatingly heightened state of awareness.

While her family history and its cruel implications form the backbone of her memoir, she recognizes another inheritance: the long history of cancer itself. She interweaves her medical experiences with clear-eyed tributes to those who went before her, delving deeply into the lives of oncology’s pioneers, tracing the brutal paths taken by some of cancer’s earliest known physicians, and their patients.

Gabriel is a lyrical and precise writer; she fuses clinical exactitude with exceptional warmth and harrowing honesty.

This is the ultimate gift bestowed by her remarkable book: the knowledge that Gabriel has entered the darkest place in human life, struggled with unthinkable thoughts -- of death, disease, violence, rage, grief -- and emerged, savaged but alive, on the other side.

Reaves is a journalist in Chicago.