Cancer imposes innumerable indignities on its victims.  In addition to possible death, the disease, its complications, and its treatment also force patients through the most inhumane gauntlet of our health-care system.  When you’re not giving a blood sample, you’re likely hooked up to an IV full of toxins or being zapped with near-lethal doses of radiation.  Cancer treatments consume your days with both their application and the subsequent recovery period.  But unlike other illnesses and medical procedures, we rarely remark on one epidemic indignity: the inordinate amount of time wasted in the waiting rooms of doctors’ offices and hospitals.  Sitting with other cancer patients in sterile surroundings while waiting one’s turn to see the doctor only further deadens the spirit and stifles the will to survive.  Sartre never spoke truer words than when he described Hell as “other people.”  One recent wait at my physical therapist’s office did more than just hammer Sartre’s point into my head yet again; in my paranoid, cancer-addled state, the incident gave me even more reasons to fear for the American Republic.

I have been attending physical therapy twice a week since my chemotherapy and radiation treatments ended in June.  Through a combination of exercises and stretches, my therapist teaches me how to compensate for my lack of balance and diminished manual dexterity produced by neuropathy.  This ailment, which produces a loss of feeling in one’s hands and feet, arises as a common side effect of everyone’s favorite chemotherapy drug, Cisplatin.  While my therapist always sees me on time, I usually arrive 15 minutes early at New York University’s Rusk Institute in order to gather my thoughts and make notes on my condition.  The Rusk waiting room, an unlikely respite from the midtown Manhattan frenzy 16 floors below, remains quiet in the early morning hours.

Before a recent visit I sat in the hushed waiting room across from another patient as I read my book.  Since everything is about identity politics in this modern day “Era of Maximum Sexual Confusion,” I will add that she was white, in her late 60’s, and blue-collar.  She had no visible physical handicap.  I could not help but glance up occasionally as we both waited.  She was eating sunflower seeds, chomping like a barnyard animal with her mouth open.  Before long I noticed she regurgitated every mouthful of shells back into her hand before depositing the waste in an empty plastic pamphlet holder.  My look transformed from an annoyed sneer at her audible munching to a rictus of horror at her use of the improvised garbage can.  After she had eaten all her sunflower seeds she decided not to empty the pamphlet holder in the nearby garbage can.  Instead, she disdainfully slid the pamphlet holder across the end table next to her chair and then pulled out her hairbrush.  After a few quick strokes through her 9:30 a.m. bedhead, she ran her fingers through the brush to remove the hair stuck in its bristles before dumping it all on the floor.  I grimaced yet again, right before she started to apply her eyeliner and lip gloss now that her coiffure had been completed and her nutritional needs met.  I decided to avoid looking in her direction anymore lest I vomit, something I was happy not to have done since my last chemotherapy session back in June.

My attempt to secure some peace and sanity ended abruptly, roughly two minutes later, when Miss Sunflower belched at top volume.  At that point I figured I would just stare at her until my appointment began, a one-man Panopticon monitoring the downfall of Western Civilization.  Our eyes quickly met.  Embarrassment finally set in.  Or maybe it was just her realization that someone else had witnessed her series of vile behaviors.  She loudly said, “I’m sorry,” which I assumed was just for the burp, not the hair clump on the carpet or the sunflower shells befouling the end table.  I silently accepted my minor victory for speaking up in support of proper etiquette and returned to my book.

But before I had even gotten back to locating the page in my text where I had left off, identity politics reared its idiotic head again.  Get out your intersectionality meter if you’re keeping score at home.  This time a morbidly obese, wheelchair-bound, African-American, middle-class woman decided to inject her “truth” into the ongoing manners melee.  She turned to Miss Sunflower.  “Why did you say you’re sorry?  Burping is natural.  You don’t need to apologize to him.”  Miss Sunflower mumbled a nonresponse.  I opted for a strategy of “Do Not Engage” since a privileged, “cishet,” white male who was neither death-defy ingly overweight nor a racial or “gender” minority would lose any subsequent shouting match in a world where custom, tradition, and manners now count for nothing.  So I stewed in silence and entertained myself by trying to calculate how much horsepower would be needed for the wheelchair to transport the land whale around Rusk’s enormous floors.

Then fate intervened.  Miss Sunflower’s therapist came out to bring her into the appointment room.  As they exchanged pleasantries the therapist suddenly noticed the sunflower shells in the empty “Cancer and You” pamphlet holder.  She shrieked, “Oh my God, what is that!”

Miss Sunflower knew exactly why the therapist was so upset.

The therapist then picked up the pamphlet holder and stomped over to the reception desk.  In the most demanding of tones she yelled at the two receptionists: “What is this!  What is this!  Who did this?  Tell me right now who left this here!”  After a period of dumbfounded silence from the two receptionists on duty, the therapist screamed, “Are you listening to me???!!!”  It sounded to me like a long-running feud between the therapist and the receptionists was about to end with the therapist submitting the final piece of evidence—the holder full of shells—as grounds for their firing.

At that point I decided to wreak vengeance on Miss Sunflower.  I yelled to the therapist, “Excuse me, those shells are from your patient who sat there and spit them into that container.  The receptionists have no idea what’s going on.”  Miss Sunflower glared at me as I finished tattling on her, even though I didn’t point out the hair clump on the carpet or imitate the deafening belch.  Needless to say, she and her therapist likely now have a new client/patient relationship.

My victory lap was short-lived.  Instead of satisfaction from my feeble attempt to improve my corner of the world and teach an uncaring slob the most basic of behavioral lessons, I quickly descended into a deep depression.  Maybe we Stage 4 cancer patients think crazy thoughts when facing our mortality.  In any event, my brain raced.  My drug-addled mind’s eye pictured Ben Franklin, who warned us that the government he and his cohort had conjured up—a republic—would last only as long as we could keep it.  I worried to myself: What kind of republican citizen is Miss Sunflower?  Would you want her on your jury?  Would someone so self-absorbed volunteer for the local fire department, first-aid squad, or youth sports coaching?  Our tax system functions on the honor system; audits happen only rarely.  Do you think someone like Miss Sunflower, who refused to own up to her therapist’s queries and accusations, can be trusted when she fills out her Form 1040?

How informed can the vote of someone who behaves as atrociously as Miss Sunflower be?  Don’t forget: Her vote counts just as much as yours.  At moments like this we should thank the Founders.  Even though identity-politics fanatics will remind us the evil Founders were all white males, we owe our patriotic ancestors a debt of gratitude for instituting every check and balance they imposed as a brake on pure democracy.  They should now take a victory lap as they look down on Miss Sunflower and every other solipsistic American who votes with her heart and rarely engages her brain.

And what about the two-legged amorphous heap of adipose tissue in the wheelchair?  Yes, Ms. Moby Dick, burping is natural.  Defecating and coughing are both natural, too.  But in public we don’t openly defecate, and we don’t cough without covering our mouths out of our shared practice of etiquette.  At their most fundamental level, manners amount to an acknowledgement that other humans exist.  We don’t cut in line; others are waiting, too.  We don’t let doors slam on those behind us.  And we don’t speak when others are taking their turn.  To burp or cough in another’s face, or to defecate on his living-room floor, is to deny his existence.  So stick a cork in your blowhole next time you want to assure your fellow republican citizen that the exercise of her “natural” bodily function doesn’t require an apology.  There is nothing natural about denying the humanity of those around us.  I will concede that those of us who take umbrage at your uncivilized ways are a shrinking minority.  Your “anything goes” relative morality and aggressive nihilism have driven us far into the weeds Franklin warned us about.  We have come to learn, thanks to your post-1968 re-education crusade, that no sexual behavior is “unnatural,” just as we have learned common manners and etiquette are impositions from patriarchal, capitalist, Western, or whatever nasty forces.  And your strategy of silencing the voices of the so-called privileged as you destroy polite society only succeeds when applied to the weaker members of our side.

Nineteenth-century U.K. Prime Minister Benjamin Disraeli coincidentally foresaw something akin to our current cultural and political polarization in his 1845 novel Sybil, or The Two Nations.  Today, our rift goes far deeper than the labels Democrat and Republican.  An all-out war has broken out between male and female, white and nonwhite, handicapped and normal (yes, I wrote “normal”), and those who recognize the existence of others versus those who deny their opponents’ humanity.  Tribal wars ruin societies.  Sadly, as Disraeli wrote, Ms. Moby Dick and I have cleaved into

two nations; between whom there is no intercourse and no sympathy; who are as ignorant of each other’s habits, thoughts, and feelings, as if they were dwellers in different zones, or inhabitants of different planets; who are formed by a different breeding . . . are ordered by different manners, and are not governed by the same laws.

While Disraeli directed his remarks at the yawning chasm between his era’s rich and poor, the two tribes of modern America’s cultural poles boil down to Franklin’s responsible republican citizens and the narcissistic savages in our midst.  Had T.S. Eliot been waiting with me on the morning I collided with Miss Sunflower and Ms. Moby Dick, he might have rephrased the oft-cited line from his 1925 poem “The Hollow Men”: “This is the way the world ends, not with a whimper but with a belch.”