Cancer Ward by Aleksandr Solzhenitsyn

The title and subject matter are sure to put off many people from this novel and they would be right as there are quite a few grim moments in it. Despite that it is an immensely rewarding read that left me feeling quite humble.
Cancer Ward is set in a hospital in Uzbekistan in the 1950s which was a Soviet Republic at the time.
It is told from the point of view of various narrators - patients, doctors and nurses - but mainly from the perspective of Kostoglotov, a fictional version of Solzhenitsyn. Like the author Kostoglotov is a former soldier who was sent to a gulag and then on his release in to exile where he developed cancer.
The other patients in the hospital form a cross-section of society in the far-flung outreaches of the USSR. A party apparatchik (Rusanov), an idealistic young communist and various ethnicities are all laid low by various forms of cancer and thrust together in the same ward.
The novel can of course be read at a symbolic level, with the hospital seen as a microcosm the USSR and the cancer that runs through the patients a manifestation of the sickness of society. It is just after the Stalanist era and there has been a relaxation of the harsh laws that saw dissidents like Kostoglotov imprisoned and exiled.
Rusanov, carries a guilty secret that he has only ever spoken of to his wife (he is suffering from a tumor in his throat. Twenty years earlier he had denounced a man and his wife who had shared an apartment with him and his wife because of a minor domestic dispute that resulted in his neighbour being sent into exile. Rusanov feels no guilt for what he has done but is alarmed with the new liberalisation that is taking place that will allow exiles to return.
Despite his illness and the fears of death that it brings he feels little empathy for his fellow sufferers and resents sharing a ward with them.
As a party member he fared well in the Soviet Union and lived a life of privilege. In a society that is supposed to be classless he looks down on the peasants and ordinary workers around him.
Kostoglotov challenges the communism that has been allowed to develop and says that under a true communist system the woman who cleans the hospital ward would be paid the same as the doctors who treat the patients. A statement that outrages the party member Rusanov.
Solzhenitsyn prose ranges from the pure unrelenting description of cancer in its various forms and how it eats away at the limbs and organs of the body to the poetic as gets inside the deepest fears of those who have been striken by the disease. The treatment in the 1950 often entailed bombarding tumors with x-rays with little thought for the collateral damage being caused to adjoining healthy parts of the body. Surgery was also often used, cutting out piece of the body and affected limbs.
There is great sense of time and place for those who lived in the sprawling USSR at that time.
Cancer Ward is as much a history lesson (with excellent but never distracting translator's notes) that helps the reader contextualise what is happening and explain some of the more obscure references.
Solzhenitsyn is superb on how the disease totally redefines the lives of those who are suffering from it, how they move from a before (they were diagnosed) with cancer to after it. How the disease defines their lives and how what they took for granted before suddenly assumes an almost magical and precious quality, that even the banal experiences of everyday life (even for a prisoner and political exile)are suddenly worth savouring.
This is not an easy novel to read but that is not an excuse not to read it.