Nellie Bly was chained, starved, medicated against her will and isolated at a mental asylum for women in New York in 1887. She wasn’t a patient. Her real name was Elizabeth Jane. She was one of the first women writers to pioneer investigative writing, even before it had a name. She spent ten days in what she called a ‘mad house,’ uncovering the abuse those patients endured, in the name of healthcare. She is not writing today, but readers are still more interested in what happens inside a mental health institute, instead of, say, a breast cancer ward.

There is an eerie silence on breast cancer. Affliction and literature have long been partners. Many great writers have suffered physically. An account of their ailments became a part of their legacies; Proust, Kafka, and George Orwell used disease as a metaphor for societal flaws. Who knows how many women writers have lived with the disease without knowing why? The pain brought on by breast cancer has largely been limited to memoirs and self-help books. It’s understood as a deeply intimate disease. While literature is about essential human experience, the publishing industry has not been able to incorporate literary activism with diseases like AIDS and depression.

Writers in South Asia have shown little interest in addressing an ailment that affects more than two million women each year, a number of whom don’t get a second chance. The disease is visible in public life through awareness campaigns and celebrity endorsements, especially in South Asia. There’s little visible effort to engage with breast cancer as a visceral experience. This isn’t to say that women alone can write about breast cancer. (It’s not women alone who treat it). The question is why did breast cancer not become as popular a subject as mental health?

South Asian writers have mostly concerned themselves with the political and the social, to the extent that these issues dominate the narrative. The growing body of writing from this region is seen as activism, disease only a side note to real social and political issues. This geographical and thematic conjunction is problematic: Palestinian writers must talk about atrocities against their people, South Africans must address racism, Chinese writers have to address the Party. Who, then, can write about breast cancer – a disease that’s common and entails the most unique personal reactions? Simply saying “women writers” might not be the answer. We don’t classify literature under disease, as if it doesn’t exist. We know it isn’t the job of a writer to address medicinal enterprise, unless she wishes to. Even within the social and the political, breast cancer remains obscure as a theme. We’re back in the who-gets-to-write-what rabbit hole.

Breast cancer deserves a place right next to Kafka and Orwell. Women must write about it because no one else will.

Virginia Woolf was asking the same question in 1930. In her essay, On Being Ill she goes “Considering how common illness is, how tremendous the spiritual change that it brings… it becomes strange indeed that illness has not taken its place with love and battle and jealousy among the prime themes of literature.” When it comes to illnesses that are gender defined, like breast cancer, we see little interest. Strange indeed.

Not that there isn’t noise. There is a lot. Most of that noise, however, comes from popular culture, where, every time, the conversation dies a slow death. South Asian film celebrities have only recently used social media to document their experiences, playing around the notions of beauty with or without hair. Bald women with make-up is seen as courageous. What’s lost is the raw experience and excruciating pain. Both saturated with social media clicks and comments. “Beauty is truth, truth beauty,” John Keats said, and if literature is about truth, it must be more meaningful. Unlike the instant gratification of social media, literature helps create a more solid basis for dialogue. That dialogue, when organically developed, includes uncomfortable discussions but long-lasting outcomes.

Nietzsche thought that great literature can’t be produced without great suffering. Knowing that much of the world’s literature has indeed been produced without great physical suffering, women writers can’t be made to feel the burden to vocalise the pain of breast cancer as a singular experience. It’s a multiplicity of voices that will get this disease into our classrooms. The sufferings caused by cancer are impossible to canonise, but must be documented beyond memoirs and self-help.

When Nellie Bly was rescued out of the asylum after ten days, she felt “intensely selfish to leave them to their suffering.” Breast cancer deserves a place right next to Kafka and Orwell. Women must write about it because no one else will.

The writer is a   freelance writer based in the US. She can be reached at sikandar.sarah@gmail.com