On Close Examination, Gloria Chinyere Okwu, 2026; Cognix, pp 324
“Everyone who is born holds dual citizenship in the kingdom of the well and in the kingdom of the sick.” So begins Susan Sontag’s seminal essay, Illness As Metaphor. “Although we all prefer to use only the good passport,” it goes on to say, “sooner or later each of us is obliged, at least for a spell, to identify ourselves as citizens of that other place.”
For first-time author Gloria Chinyere Okwu who received a breast cancer diagnosis in 2017, the publication of her memoir, On Close Examination, makes her not just a citizen of the storied kingdom of the sick, but an ambassador.
Shelfmates with books like Jean-Dominique Bauby’s The Diving Bell and the Butterfly and Paul Kalanithi’s When Breath Becomes Air, Okwu’s memoir is part of a growing subgenre of literature whose authors detail their personal experiences with disease, disability, or mental health challenges. These illness narratives, as they are called, help to bridge the gap between medical jargon and lived human experience. Okwu’s account, in particular, provides valuable insight on the state of Nigerian healthcare and the peculiarities of navigating life as a cancer patient within such a system.
But there is more to Okwu’s identity than her medical condition. Long before her biopsy and mastectomy scars, there were less visible ones.
Growing up first in Jos, then Abuja with occasional stints in Ukpor, her early years are marked by financial precarity and psychological trauma from growing up in environments where domestic violence and emotional abuse are considered norms. On top of this, there is the pressure of being the Ada — the firstborn daughter in an Igbo family — and the obligations attached. Parentified at an early age, she is corralled into serving as a bonus parent to her siblings and confidant to her mother well before she is emotionally ready for such roles. Such is the responsibility that when her parents’ rocky marriage permanently ruptures, she shoulders a needless burden of guilt.
Add to that foundation, hailing from a community that prizes ‘early’ marriage without preparing one for the reality of the marital institution, and in the teenaged Okwu’s mind, wedlock begins to look like an escape route out of dysfunction. Luckier than many in similar circumstances, she ends up marrying her choice of suitor, but contrary to her expectations of love and stability, she finds herself trapped in the same cycle of abuse and poverty she originally sought to escape. Her aspiration to pursue higher education proves to be her anchor in the storm of her turbulent marriage, but after a hard-won battle to realise this goal, a shock cancer diagnosis threatens to undo everything she has worked so hard for.
Some cancer survivors, the American author Suleika Jaouad for example, bristle at the use of the word ‘warrior’, however, I find it to be the best descriptor for people like Okwu who have to not only confront their mortality in a society where people have been conditioned to view sickness either as manifestations of spiritual attacks or evidence of wrongdoing, but also contend with faulty equipment and indifferent medical personnel in a public healthcare system that is both inefficient and cost-prohibitive. Little wonder then, why many cloak their medical histories in obtuse euphemisms and seek alternative treatment from quacks. Nigerian health authorities would do well to incorporate this text into their educational outreaches; better still, use it as a prognosis to overhaul public health infrastructure.
While Okwu’s fight extends outside the arena of ill health to a patriarchal culture that encourages women to cede their autonomy to male guardians who do not always act in their best interest, her greatest battle is her mindset, and she works hard at freeing herself from learned helplessness, poor decision-making and superstitious beliefs.
Recommending On Close Examination to readers of Service95, the lifestyle publication founded by the pop icon Dua Lipa, Okwu’s publisher, Lola Shoneyin, describes the book as “an intimate and searing account of self-discovery” and praises the author for reclaiming her agency. Without that paradigm shift, Okwu would likely never have been as unflinchingly honest about her own missteps and moral failings as she has been in this book, a measure of accountability that ensures the tone of her memoir is rueful, but never woeful.
Today, Gloria Chinyere Okwu calls her bout with cancer her “greatest challenge and unlikely ally,” and she has made cancer advocacy a crusade. This memoir is both a testament to her resilience and an invaluable resource for cancer patients and their caregivers.
***Akumbu Uche is a writer and storyteller from Nigeria. Her works have been published by thelagosreview.ng, Aké Review, Brittle Paper, Canthius, The Cincinnati Review, and elsewhere.