No Cure for Being Human: And Other Truths I Need to Hear

Kate Bowler, a professor of history at Duke University, explores what it means to live without the promise of a future after receiving a Stage Four colon cancer diagnosis. She describes her life with her husband, Toban, and her young son, Zach, and frames the book's central question: As years dwindle into months and days, how should she spend them?

In the surgical wing of Duke University Hospital, a young doctor read Bowler's scan results aloud: multiple tumors across her liver, a large mass in her colon, and lymph nodes suggesting the cancer had begun to spread. She learned that Stage Four was the highest stage and that the median survival rate was 14 percent, with survival defined as two years. She grabbed the doctor's hand and began counting: 730 days, two Christmases, 104 Thursdays. When Toban arrived, she withheld the specifics, unsure how to tell him she was now a clock ticking loudly.

Friends and colleagues, mostly pastors, filled her hospital room with prayers and hymns. She felt momentarily whole, but devastation returned when they left. Determined to be discharged, she pushed herself to walk the halls and discovered the hospital gift shop selling prosperity gospel books, which promise that God rewards the faithful with health, wealth, and success. She confronted the manager, arguing that books like Joel Osteen's Your Best Life Now blame sick people for their own diseases. Bowler reflects on American culture's broader obsession with self-optimization, from megachurch theology to the wellness industry, and insists that no formula, spiritual or secular, will exempt anyone from the pain of being human.

Back home, her house filled with family channeling despair into frantic service. Her mother did laundry, her father-in-law repaired the fence, and her sister-in-law, a nurse, managed medications while Zach raced between them. In a quiet moment with her father, a fellow historian, Bowler compared her situation to a siege: Cancer was the enemy willing to wait while those inside took inventory of dwindling resources.

At Duke Cancer Center, her oncologist, Dr. Cartwright, explained that chemotherapy would attempt to destroy the cancer within roughly 10 months. Blood tests revealed she fell into a rare three percent of patients whose genetic profile responded to immunotherapy. Dr. Cartwright arranged for her to receive the drug Keytruda through a clinical trial in Atlanta, Georgia. Each Wednesday she left home at 3:45 A.M., flew six hours south for treatment, and returned after midnight. Her parents and siblings took out loans and deferred retirement to cover costs insurance denied.

She began seeing a psychologist named Peter, who compared her situation to Appalachian Trail hikers learning to set down weight they could not carry. Bowler applied the lesson literally, purging her closet of anything that could not be stretched, bleached, or removed with one hand and throwing her maternity clothes down the stairs. She bought an at-home Last Will and Testament, arranged a family portrait, and met with Linda at Duke Human Resources to assemble financial information for Toban.

The clinical trial was brutal. After six months, her feet and fingers were numb, and every 60 days a CT scan determined whether she could stay in the study. Mental health counselors at the cancer clinic suggested she make a bucket list. Bowler traces the history of the concept from the Seven Wonders of the ancient world through medieval pilgrimages to the modern experiential-capitalism version, and critiques bucket lists for approximating infinity rather than helping people face finitude. She had wanted two children, world travel, and to hold her mother's hand at the end. She concludes that a person dies to a thousand possible futures in a single life.

After nine months, Dr. Cartwright arranged for the immunotherapy drug to be available at Duke, eliminating the Atlanta flights. But Bowler discovered that he had secured the drug for another patient months earlier and could have spared her the grueling travel long ago. The wasted months left her stunned.

Frustrated by Cartwright's reluctance to consult other experts, Bowler enlisted historian friends, all named Kate, to create a research database they called "No Kate Left Behind." Leading oncologists recommended aggressive surgery, but a world-class surgeon warned that the most dangerous tumor, buried near the inferior vena cava, a major blood vessel, could not be safely removed without leaving too little liver to sustain her. The path to cure could itself be fatal.

At a conference at Regent University, friends T.J. and Doug pressed her about her stalled academic research. She confessed her fear that spending her remaining time writing a book no one would read was a waste when she should be with Zach. Doug countered that if the worst happened, Zach could still find her in her work. She returned to writing, producing 500 words a day for 183 days to finish her manuscript before the tenure deadline. She dedicated the book to her father, whose decades-long struggle as an underpaid adjunct professor mirrored her understanding of how vocation can cost everything.

Bowler decided on a partial liver resection to remove the larger tumors, with radiation planned for the inoperable one near the inferior vena cava. Bishop Will, her friend and colleague, arrived at 4:00 A.M. to bless her before surgery. After recovery, a radiation oncologist reported astonishing news: The remaining tumor had compressed flat and no longer required treatment. Dr. Cartwright confirmed it was gone.

Most of her family and friends accepted the news as though they had already believed it. Bowler entered a second wave of loneliness, recognizing that chronic suffering exhausts those around it. Then, at a routine follow-up, a surgeon showed her what appeared to be an aggressive new tumor. She had come alone. For weeks she lived with dread until her doctor friend Max helped her comb through the medical reports and discovered that a technical glitch called "signal dropout" had been misread as cancer. The supposed tumor was a fat deposit. When Bowler confronted Dr. Cartwright about the error, he deflected.

In therapy, Peter told her she could not remain in a state of extreme vigilance and asked what she had to lose by moving forward. "Everything!" she exclaimed. She resolved to let herself look forward to turning forty and had her chemotherapy port surgically removed, a painfully optimistic leap into an uncertain future.

She turned forty just as the COVID-19 pandemic shut down the world, canceling her planned trip to Holland, a high school reunion, and a charity race. Days before her birthday, she received results from the clinical trial: Most of the other participants were dead. Her research revealed that trial participants are treated not as patients with personal doctors but as study subjects, with protocols designed to serve the study rather than the individual.

Bowler closes with a memory of visiting the Batalha Monastery in Portugal with her family. Inside an ornate octagonal chapel, she looked up and saw open sky where the ceiling should have been. Seven kings had overseen its construction, and none lived to finish it. An elderly tourist told her the unfinished chapel was a perfect expression of life: "We're never done, dear. Even when we're done, we're never done." Bowler embraces this incompleteness, affirming that lives are not problems to be solved. Meaning and beauty are possible, but never resolution.