My collaboration with Nathan Hyland Walker focuses on how poetry can help the cancer patient undergoing chemotherapy find themselves inside the medical discourse. To become a cancer patient is not just to take up residence in a foreign kingdom, but to be immersed in a foreign language called oncology which differs from standard English in both vocabulary and syntax. In her essay, Illness as Metaphor, Susan Sontag wrote that “Illness is the night side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom of the well and in the kingdom of the sick.”[1] It is essential to learn the language of the kingdom of the sick in order to feel at home.
Nathan Hyland Walker generously lent his practical and technical culinary expertise to my poetry. Our collaboration began serendipitously on a phone call, when I said Perjeta, he heard bruschetta. Perjeta was first approved in combination with Herceptin and it is not given without Herceptin. Perjeta complements and enhances the action of Herceptin on HER2+ breast cancer. The bipartite nature of bruschetta as toasted bread and topping mirrored its desired effect on metastatic breast cancer cells. I suggested that we should write a poem about this mishearing and how it illuminates Perjeta’s mechanism of action. Nathan and I decided to collaborate on a series of poems exploring the Velvet Clinical Trial which combined Perjeta, Herceptin, and Navelbine in cancer treatment.[2]
The Velvet Protocol refers to the use of Perjeta, Herceptin, and Navelbine as a first-line treatment of HER2+ Metastatic Breast Cancer. Metastatic, otherwise known as terminal, stage IV, or incurable breast cancer has spread beyond the breast tissue and adjacent lymph nodes. HER2+ means that the tumors over express the Human Epidermal Growth Factor Receptor 2 on their cell walls. Nate and I wrote a poem for each component of The Velvet Protocol. We translated the names of the medications into recipes, because food is a kind of chemical therapy that is familiar and trusted, even pleasurable. It is something that we gladly take inside ourselves. Nathan’s culinary expertise was essential for creating the recipes in our poetry collection, The Velvet Protocol.
Ironically, our writing about Herceptin hit a rough patch, because I don’t eat meat. Nathan had to describe not only the preparation, but the flavors and textures of hare to me in great detail. He had to answer many follow up questions, not unlike an oncologist explaining a new treatment to a patient. I was relentlessly irritating, because I associated the consumption of meat with a negative experience. I did not want to add the experience of consuming hare, ceps, and wine to my life history. It is important to note that the issue was one of aesthetics and not ethics for me. Nathan was extraordinarily patient. He debated the merits of using the generic name for Herceptin, Trastuzumab, with me repeatedly. I was quite excited by Thai Yuzu crab, but felt that inconsistency in the nomenclature used for the chemotherapy drugs would introduce confusion to our project. It was Nathan’s commitment to employing his culinary knowledge to help cancer patients that sustained our collaboration.
Nathan and I tend to describe The Velvet Protocol as a transdisciplinary collaboration. We used our respective disciplinary training and longstanding friendship to enter into a bidirectional exchange. Nathan is a Culinary Institute of America trained chef with an extensive knowledge of culinary theory and practice. He has worked in kitchens including The Fog Island Cafe, The Fog Island Grille, Vescio’s, Pizza Boys, and The Tap Room. He now works as head chef for the residents of a memory care facility in New York. His practice includes working with residents and medical professionals to design menus that meet the care home populations’ unique dietary, culinary, and safety needs.
My practice is similarly interdisciplinary. I hold a doctorate in Creative and Critical Writing from Cardiff University for the dissertation Against Originality: what is lost without discourse between poetry and philosophy of science? I drew on my Creative Writing MFA from Kingston University and my bachelors degree in Biology and Chemistry from Bryn Mawr College to develop a transdisciplinary poetics. Nathan and I put together our training and mutual respect to transcend disciplinary boundaries in The Velvet Protocol. We would like to thank our publisher Alec Newman for transforming our manuscript into a book that mirrors our ambitions. Knives Forks and Spoons Press published The Velvet Protocol in 2022.[3] The complementary relationship between a book and its content is not to be underestimated.
Our process for the writing the book evolved as we worked. My collaboration with Nathan began as an experiment in translating chemotherapy medicines into culinary and literary contexts. The chemotherapy protocol that was tested in the Velvet Clinical Trial became our source text for the collaboration. Nathan took the names of chemotherapy drugs, created a homophonic translation of their brand names, and then created a recipe for the named dish. I used Nathan’s recipes as source texts for poems about the chemotherapy and the associated dishes. We were interested in drawing parallels between the way synthetic organic chemists use recipes to produce medication as well as the mechanism of action of the medications on the body of the patient.
The Velvet Protocol is a recipe for an experience by the patient. It quickly became obvious that we were not representing the entire experience without including the premedications and antiemetics given to help the patient tolerate the chemotherapy. In the practice oncology, the patient is often given a cocktail of chemotherapy drugs and premedications and antiemetics. All of these drugs interact inside the body of the patient. Every patient is different, with different bodily needs, pain tolerance, allergies, and preexisting conditions. We employed my mother and Nathan’s friend’s treatment sheet to copy the exact drugs and amounts that she was given. Her treatment cycles occurred over a six week period. The goal of our collaboration moved from characterizing one line of chemotherapy to characterizing the experience of being diagnosed with terminal breast cancer and beginning to come to terms with that knowledge. The Velvet Protocol is a recipe for a very specific experience. Nathan and I have already begun working on a sequel, so stay tuned…
(Excerpted from a talk given at the London Book Fair 2022)
Works Cited
1. Susan Sontag, Illness as Metaphor, (London: Picador, 2001)
2. Michael Andersson, José M. López‐Vega, Thierry Petit, Claudio Zamagni, Valerie Easton, Julia Kamber, Eleonora Restuccia, Edith A. Perez, 'Efficacy and Safety of Pertuzumab and Trastuzumab Administered in a Single Infusion Bag, Followed by Vinorelbine: VELVET Cohort 2 Final Results', The Oncologist, vol 22.10, October 2017, <https://doi.org/10.1634/theoncologist.2017-0079> pp. 1160–1168.
3. Julia Rose Lewis and Nathan Hyland Walker, The Velvet Protocol, (Newton-le-Willows: Knives Forks and Spoons Press, 2022) <https://www.knivesforksandspoonspress.co.uk/product-page/the-velvet-protocol-by-julia-rose-lewis-nathan-hyland-walker-84-pages>