Cancer, Depression, and T.S. Eliot’s “The Wasteland” 

Depression is more than being gloomy on a rainy day or agitated when weekend plans fall through. Depression is a disease. Like cancer, it is an illness that is often misunderstood, stigmatized, and assumed to be the result of a lack of willpower.

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As I have discussed in depth in a previous article, a cancer diagnosis is not a moral failing. One’s ability to survive the disease has far more to do with random gene and cell mutations than with positivity or determination. While determination, resilience, and a positive outlook can play a role in disease management, they cannot guarantee survival. Cancer is an erratic and often untamable biological beast.

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We, as a technologically advancing society in the twenty-first century, struggle to admit when we lack control—especially when that lack of control is in response to an inanimate force, and even more so when it involves parts of ourselves. Fearful of this reality, we approach uncertainty with broad assumptions and bold “battle” language to give ourselves and our loved ones a false sense of omnipotence.

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For example, when we refer to cancer as a battle that must be beaten, we set patients up for failure. Cancer, like war, is brutal and traumatic. It often incurs lifelong or lethal injury to both body and mind, much like war does to soldiers, civilians, and their families. Yet patients do not enlist. We do not pledge our lives willingly. We are thrown into an arena against our will, facing an opponent far beyond our weight class—one that breaks every rule we thought governed the body.

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For many of us—especially those with ultra-rare cancer subtypes and limited research-backed treatment options—entering the arena comes with the real possibility that we may never exit, despite relentless efforts to survive “victoriously.” Despite being told to think positive thoughts, eat a plant-based diet, and never give up the fight, we eventually realize that these external commentaries reflect a deeply distorted view of disease: one that assumes illness can be neatly boxed up and eradicated if we simply try hard enough.

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These unsolicited prescriptions do more harm than good, particularly when we live with the looming reality that this class of disease often progresses regardless of our optimism, discipline, or desire to live.

The successful treatment of depression emphasizes patient willpower more than cancer treatment often does, as mental health care traditionally relies on a combination of medication, cognitive behavioral therapy, and lifestyle-based interventions for long-term maintenance. However, the stigma surrounding depression (and mental illness as a whole) often parallels cancer stigma, especially for patients navigating both simultaneously.

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The assumption that one can “think their way out of depression” through positivity alone undermines legitimate medical and therapeutic treatment. It places blame on patients when symptoms persist despite their effort, and it encourages dismissal rather than support. When society does not understand something, it reaches for blame. For cancer patients with concurrent mental health diagnoses, this can feel like evidence that we have done everything wrong.

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While many cancers have unknown origins, we still hear comments such as, “You caused this through your choices—smoking, diet, stress.” Similarly, despite the well-established biological, genetic, and environmental factors involved in depressive disorders, we are left listening to echoes of: “You caused this with your mindset or lifestyle.”

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In a world where blame is humanity’s first response to miseducation and powerlessness, patients face moral judgment for illnesses that rage beyond the limits of our control. The result is isolation and the invalidation of our fear, grief, and distress. The “positive attitude” we are told will save us sits only at the surface of a vast, complex network of physical, psychological, and emotional realities that accompany chronic illness.

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II. The Underground (and some dude named T.S. Elliot) 

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The underground is a place where only those touched by the mortal hands of disease receive entry. It is not an exclusive nightclub with a bouncer, strobe lights, and overpriced cocktails—though depending on your treatment plan, you may encounter some of those. Instead, it is cold, with gray concrete walls, ceilings, and floors.

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There are many people here, yet the space feels empty. One or two figures pass by every few hours like ships in the night, solemn and hazy-eyed. The underground has no official name; each member calls it something different depending on the phase of their stay. At this moment—though I hope not for long—I call it “The Wasteland,” borrowing from T.S. Eliot’s 1922 poem of the same name.

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My college friends are probably laughing. We spent weeks dissecting this poem for an exam in our “Development of Western Civilizations” course and graduated years later still unsure of what Eliot was doing. Yet as I now traverse the narrow tunnels of this underground—with terminal cancer like a noose around my neck and treatment-resistant depression like ankle irons slowing my gait—I understand his modernist cynicism more deeply than I ever expected.

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I won’t attempt to fully unpack the cumbersome poem, but its opening lines make a point worth examining. In these lines, Eliot deliberately reverses our expectations. Spring, typically associated with rebirth and hope, becomes cruel. Winter, usually linked to death and stagnation, becomes merciful.

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“April is the cruelest month, breeding
Lilacs out of the dead land…”

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Spring is cruel because it forces life to return. Lilacs blooming from dead land symbolize renewal, but renewal is painful—it requires confronting what has been lost and buried. Eliot continues:

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“mixing / Memory and desire, stirring / Dull roots with spring rain.”

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Before flowers appear, spring first awakens memory and desire. What was dormant is stirred. Eliot writes in the shadow of the First World War, describing a collective numbness and trauma, yet I find that these lines resonate deeply with my experience of physical and mental illness.

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The expectation of revival is distressing. For me, this pressure is especially heavy at the start of a new calendar year, when reflection and resolution are demanded. Our desires for the future highlight what we no longer have (or may never have). For cancer patients and those struggling with depression, the promise of a “fresh start” can feel like a reminder of loss and uncertainty rather than hope.

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Our personal “spring” might be a new year, a promising treatment, or any moment that asks us to feel hopeful when we have nothing left to give. Numbness and indifference often replace hope, not because we lack desire for positive outcomes, but because repeated setbacks put into question our trust.

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Just as illness flips our expectations, Eliot makes another paradoxical claim:

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“Winter kept us warm, covering / Earth in forgetful snow…”

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Winter is comforting. Snow dulls sensation and allows for forgetfulness. Here, emotional numbness, though bleak, can feel safer than hope. Further, Elliot’s winter asks nothing of us. Stagnation replaces growth, optimism, and emotional involvement. 

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This contrast mirrors the experience of depression, especially when layered with terminal illness. Depression resembles Eliot’s winter: a muted emotional landscape where apathy can feel safer than feeling one’s emotions fully. When life becomes unbearable, numbness can present as shelter.

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Spring-like moments, such as holidays, milestones, and new beginnings, become cruel not because they are inherently bad, but because they expose the gap between what we are expected to feel and what we are capable of feeling. A New Year is supposed to promise renewal and possibility, yet terminal illness sharpens the future into something finite.

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Instead of new beginnings, there is grief, uncertainty, and fear. Optimism becomes an accusation.

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Why aren’t you hopeful? Why aren’t you grateful? Why aren’t you happy?

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Just as spring “stirs dull roots,” these moments stir grief for milestones we may never reach, longing for futures that now seem unreachable, and fear rooted in memories of hospital rooms, adverse treatments, and the gradual loss of distinctive parts of ourselves, like hair, strength, energy, and identity.

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III. Quiet Triumph (even when life sucks)

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Eliot’s winter is a season of emotional retreat, of lowered expectations and quiet survival. It sounds pessimistic, but I find there is a gentleness to it that you don’t get from the bright, demanding energy of spring. Winter gives us the space to just exist, without pretending. It doesn’t demand our joy.

When we and our caregivers allow ourselves to be honest about how much hope can hurt, we create a collective space where we can live free of the rigid connotation of hope as a fountain of joy, identifying the contradiction that hope poses for many of us. We want life, we crave hope, but we struggle with the threat of uncertainty from a future that feels too heavy to imagine.

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Chronic illness often bruises hope by letting us down time and time again; however, spaces of community and honest reflection remind us that our changed vision of hope is not a moral failing nor a lack of willpower. It is a deeply human response to a suffering that is too vast for the simplistic narratives our society tells about strength, positivity, and renewal.

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Our contradictory outlook on hope as a stubborn, weary advance, rather than as an act of bright and bubbly optimism, represents our honest commitment to living alongside the uncertainty of illness without giving into despair. As we learn to flow with the tide of uncertainty rather than against it, we find that sometimes hope just shows up, quietly—in a laugh that surprises us, in a surge of pride for something we write or create, in the relief of being understood without having to explain ourselves.

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For those of us living with cancer, depression, or both, joy is often quiet. It is often small and fleeting: a glimmer of sunshine on an otherwise cloudy day, a conversation over coffee with someone who actually gets it, fresh sheets, a warm heating pad, a new episode of a favorite show, and cancer pain kept at bay. These moments are proof that life keeps offering us these little glimmers of connection, both with each other and with ourselves, even in the eye of the storm.

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Looking forward doesn't require certainty. In fact, it can’t. It doesn’t demand that we believe everything will be okay, because that’s something we can never know. Sometimes, looking forward just means staying open to those soft pauses and breaths of quiet. It’s trusting that telling our stories might make this underground passage feel a little less isolating for someone else who's also passing through.

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Hope continues to exist even in the underground, not in the shiny, dramatic mock-up society tries to sell to us, but through unspoken resilience. It is the kind of hope that resides in honesty, in community, and in the autonomy to define living with chronic illness on our own terms.