Josh Russell

Interviewed by Earnest Buck

I was hoping to do a shorter interview that focused on some of the themes in “Grownups” that resonated with me. I hope this isn’t too much to share, but I was caretaker to my wife when she was receiving treatment for breast cancer and I found this story mirrored (strangely) some of my experiences. So, if you’ll bear with me, here are a few questions (I may have some follow-ups if that is amenable). 

What was the impetus for this story?

I’ve been trying to write a doppelgänger story for a long time—like twenty-odd years—but I’ve never been satisfied with how my attempts have played with the light/dark aspect of the form, the aspect that makes the form more interesting than Hey, that guy looks just like that other guy! Good doppelgänger stories are Gothic; the doppelgänger is an evil twin, not just a body double. There’s something uncanny about two people looking alike, something that leads to questions about authenticity of identity. Illness is also uncanny, and also leads to questions about authenticity of identity: I thought I was this person, but maybe I just look like him on the outside while inside something’s broken, and so I’m not the person I thought I was. When I got sick, I suddenly saw this connection between the doppelgänger and illness, and figured out this was how to write the story I’d been struggling with for many, many years.

I thought your depiction of the jadedness/callousness of some of the medical professionals in the story was particularly well rendered and made for a realistic interaction in an unlikely scenario. What made you decide to depict them in this way rather than, say, as benevolent/kindly/thoughtful?

I was diagnosed with colon cancer in April 2016, and over the past couple of years I’ve met a lot of nurses and PAs and phlebotomists and colorectal surgeons and oncologists. If you don’t die, you love your surgeon, even if he’s an asshole. I love my surgeon. Luckily, my surgeon isn’t an asshole; in fact, none of the medical professionals I’ve met are assholes. Some of them are more patient and sweet, some less, but I can report that they’re all much more matter-of-fact about illness than the medical professionals on TV shows. The gastroenterologist who found my tumor during a colonoscopy said to me, “This isn’t a death sentence.” I wasn’t fully out of anesthesia when he said it, and after I got over being terrified, it pissed me off that he’d offered a cliché from a script he’d obviously memorized. Later I forgave him. I mean, sure it was a cliché, but at least he had a script, right? Back to your question: I decided to depict medical professionals in this way in the story because I wanted to do my best to show doctors and nurses as I know them: trying their best, but obviously overwhelmed by what they see day after day. The doctor who said that to me had been surprised to find the tumor, and I’m sure it bummed him out.

One of the main characters in the story gets a cancer diagnosis, but I would be reluctant to call this a “cancer” story. Cancer often seems, at least to me, to have an overwhelming presence when introduced to a story; it often dominates and seeps between the lines, metastasizes across the page (so to speak), but this story doesn’t get buried by a cancer diagnosis. I guess my question is how did you manage this?

Turns out a lot of people have cancer, have had cancer, or know someone who has or had cancer. I didn’t fully recognize this until my diagnosis, even though I’ve lost three good friends to colon, brain, and lung cancer. I thought I was special, and then it seemed everyone had a cancer story. First this was disappointing—I wasn’t special after all—then it was kind of calming to know I wasn’t alone, and then it was creepy: I’m not kidding, it seems like every single person I know has a connection to cancer. “Cancer stories” often appear to exist in a world where no one close to the characters has ever been sick. Here again I wanted to show the world as I find it: people have cancer, dementia, addictions. They’re looking for work and dealing with their kid’s teachers and eating lunch and drinking coffee. Kim’s world is complicated and messy, so though she knows Tom has cancer, it’s not possible for her to focus on just that. I also chose to have Tom, not Kim, be the one with cancer. He may think he’s special because he’s sick, but Kim’s most interested in the fact that he looks like her dead husband, which makes him at once special and not special.

If you were in Tom’s shoes and had recently come to after a medical procedure, and a stranger had convinced medical professionals that she was your wife, how would you respond to the situation?

Dude, if she were taking to me to breakfast and paying, I might be okay with that.

Editor’s note: After the interview was completed, Josh and Earnest continued to write to each other. Their correspondence is given below.

Josh: In my haste to respond, I forgot two things. First, I’d intended to begin my last message to you with the hope that your wife’s okay. I know now that my disquiet during the time between my diagnosis and surgery (six weeks) made things hard for my wife and kid. That time was probably the scariest for us all. After the tumor was gone, things got less scary, but I was out of commission for longer than I thought I would be: the magical six weeks (an echo) it supposedly takes one to recover from anything—lower anterior re-sectioning, open-heart surgery, childbirth, hip replacement—is a mean lie. It took me more like nine months to get used to my edited body, two years to get to the point where I would go for an entire day without thinking about how I used to feel, before. I hope all’s well with you and yours, and that the tests are coming back negative. Does she write? If so, has she tried to write about being sick? Have you? I’m still working on ways to explore what happened. Here’s an essay (“For Borges“) and a story (“The Ship with Three Decks“) that are attempts to articulate how I feel.

Second, I missed this question:

When I read a compelling story I’m often left with a feeling that the story continues to the right of the page (and I get to conjecture about where it goes). Do you have any notion of what happens with Kim or Tom after this story?

That’s the mark of a successful story, don’t you think? That resonance? Because of how I’ve set things up, there are a lot of short-term things that will happen: Doris will release Kim from the hug; Tom will have to find a way back to his neighborhood from the neighborhood he finds himself in when he flees the house to which Kim’s taken him; Kim will have to pick up Ella; etc. And then there are the questions about what happens next: How’s Tom going to afford cancer surgery? Will Kim get that job? How will Kim’s relationship with her mother-in-law change after what happens in the story? Hopefully introducing, and then leaving unanswered those questions causes the kinds of resonance that you describe: the story continuing to the right of the page.

Earnest: Part of the reason I find myself interested in stories revolving around cancer (and part of the reason your story resonated) is that I am a widower. My wife was diagnosed on my 31st birthday—two and a half years ago—with stage 3 triple negative breast cancer. After seven months of treatment (chemo, surgery, and radiation) she was given a No Evidence of Disease diagnosis; she died three months later, after her cancer had reappeared in her lungs, roughly two weeks before what would have been our ninth anniversary. It was a year of peaks and valleys. I was initially terrified, then cautiously optimistic, then relieved, and then suddenly devastated. I had initially deferred David Leavitt’s offer to study fiction at UF after my wife’s diagnosis, but decided to pursue the MFA last fall.

I mean to write about my experience. I’m not sure what will become of it, a series of essays, something memoirish perhaps. I’m not sure, but I do feel compelled to write about it (I don’t think I will be able to write other things until I do). I read your two short pieces. I liked them both; “For Borges” was moving and pretty and I appreciate your sending the links.

I feel like you might not be giving yourself enough credit when you say, “‘Cancer stories’ often appear to exist in a world where no one close to the characters has ever been sick.” I think you are right in that most people have a “cancer story,” but I think most people find it too devastating, or too overwhelming to write compellingly or interestingly about it (maybe most of us lack the perspective necessary). Subtropics had more than one-thousand submissions for this issue and many stories that could be classified as “cancer stories.” Yours was the only one seriously considered. I submit that part of the brilliance of “Grownups” is that you’ve told a story with a cancer diagnosis that is still compelling and interesting, a story that acknowledges life does not stop because of a diagnosis. Upsettingly, frustratingly, and unsurprisingly, the world continues on.

Josh: I’m sorry to hear about your wife. I can only imagine the whiplash that sick-well-sick timeline caused both of you, and how baffling losing her must have been. My wife and I have muddled through a handful of heath scares over the years, and even just a scare can make one feel uneasy for a long time—and you’re spot on re the world and its frustrating, upsetting, unsurprising continuing.

Do you think this is why there are so few successful 9/11 stories, as well as so few good stories about cancer? When trauma that overwhelming is shared by a lot of people, and the trauma is caused by something that makes that cohort feel helpless, it’s hard to explore it through art—or to explore it at all. In both cases, don’t you think the trick is to focus on the hyper-local? When I talk to people about my recovery, and they ask for details, which I don’t offer as casual conversation, the thing that freaks them out the most is that my bowel movements are different than they were before. That detail makes the experience very real—and external, and shared (everybody poops)—rather than internal (literally) and unique to only those who’ve had a lower anterior resectioning.

I’m glad we’re having this conversation.


Hello Josh,

I think any story that asks the writer to grapple with trauma and immortality (especially on a mass scale like 9/11) is a big task. Most humans, and writers are often part of this classification, aren’t good at having the sort of internal conversations these ideas require. I suspect it is worse in the U.S., what with our grand notions of individualism and our culture’s general avoidance of anything painful. I found I was largely unequipped to deal with trauma of any seriousness when I was 31 and my wife died. Of course, there is room to disagree, and there are many stories of difficult American childhoods, but some of us are raised in near-idyllic households (I think I experienced a version of this), which is sort of lovely, but also doesn’t prepare us for the inevitable pain and trauma that comes with being human.

I think your notion of the hyper-local is correct (If I understand it correctly). A difficult moment for me during my wife’s treatment was when she asked me for help cutting her hair. She had long curly hair, and it had been coming out in locks after her second chemo treatment, and there is a video of me, face dripping, as I cut her hair off. I could probably think of a dozen other experiences that were hyper-local like this. But part of cutting her hair being difficult was that it was a defining feature of her—I remember the way it looked pinned up, loose strands falling and having to be placed behind her ear, and the way her hair framed her face and how it looked as she slept in the moonlight from the window of the apartment we had shortly after college. Is some of the above what you mean by hyper-local? Personal experience that most readers could identify with? Not that the hyper-local necessarily has to register as sad, but grounded and relatable in a situation that is largely foreign (to the reader that is).


I think I understand what you’re saying. Because so many of us, especially those of us who end up in college classrooms are indeed raised in ways that can be defined as idyllic, my undergraduate students are often puzzled when we discuss the rules that underpin the traditional Bildungsroman: a young person moves from the familial home in the country to the solitary home (or streets) in the big city, suffers humiliation at the hands of someone who specializes in taking advantage of bumpkins (pickpockets, con men, prostitutes), has an epiphany brought about by suffering, and then manages to create a home that echoes in some ways the one he left behind (virtuous woman, trustworthy parental figures, warm hearth). That model simply doesn’t describe the lives of many of us. Instead, for a lot of us trauma triggers the epiphany that the world is more complicated than we knew, and that shift doesn’t necessarily happen when we’re teenagers. Some of us are 31 when it happens, some are teenagers, some maybe never suffer that kind of epiphany (good for them, I guess—though I get the feeling that the cruelty that drives a lot of US politics might have it’s source in a lack of such epiphanies . . .).

The hyper-local is also hyper-specific. It defamiliarizes.