Introduction
Days before his death, Ernest Becker wrote with remarkable clarity on the human dishonesty around death. “The basic human predicament,” Becker submits, is “that we are simultaneously worms and gods.” All our symbolic constructs—the book projects, Instagram reels, religious convictions, and romantic gestures—serve the singular purpose of repudiating the fact of our own finitude.
In April 2025, I was diagnosed with advanced stage lung cancer with metastatic lesions in my brain. In the days that followed, I found resonances of Becker’s thesis in my interactions with the vagaries of modern healthcare. In this short autoethnographic reflection, I attempt to understand how the looming uncertainty around life and death intersects with advanced cancer care, occasioning unique imaginaries around the power of technological solutions.
The CyberKnife
My biopsy report comes in on a cool evening, dragging in a whirlwind of difficult conversations. The picture makes little actuarial sense. By average age of diagnosis, cancer has come knocking four decades too early.
A medical oncologist is recommended by a family friend. The first chemotherapy session is scheduled after a fifteen-minute consultation. The procedure is quick and unceremonious. The discharge summary is filed in the afternoon, and I am allowed to leave the hospital.
I have an unexpected seizure the following night. I find myself in the intensive care unit with ECG electrodes and an IV line plugged into my body. A series of practical decisions are remade quickly. The right hospital and the oncology team, the murky details in the insurance fine-print, logistics of communication and care.
What clarifies many of these decisions for my friends and family is a radiosurgery system. The CyberKnife, as it is called, is available in a private hospital in Kochi. The graphic simplicity of its name cuts through the weight of the moment; it announces itself as a simple answer to a constellation of difficult questions.
Just a day later, I am thrust back into the disarray of an oncology ward. A glossy, blue brochure finds its way into my hand. The marketing literature reassures us on the oncology department’s “state-of-the-art” radiation therapy equipment. The schedule of treatment has been organised around the CyberKnife.
For those medically untrained, a discursive regime of medical precision sculpts CyberKnife’s power. The system is characterised by its “sub-millimeter accuracy” and can deliver high energy photons from “hundreds of beam angles.”
The measured movement of its robotic arm is claimed to give the oncologist the confidence to bombard the tumour with doses of radiation that would otherwise risk healthy tissues. It features “a 6-Axis Robotic Manipulator” for precision, a “robotic couch” for containing the unpredictability of the human body, and “a linear accelerator” for radiation delivery.
Storytelling Around Machines
It is not clear what any of the words around the CyberKnife might exactly mean for a patient. Yet, glancing through them, one cannot help but feel that this radiosurgery system is devoid of the sentimental excesses of human discretion. Its economy contrasts itself against the entropy left by cancer’s fingerprints; the machine disavows the malady by slicing through the noise around life and death.
The liberatory tropes around modern technology have been of great interest to scholars who critically engage with the social life of technological systems. From conceptualisations of “cyberbole” (Woolgar 2002), “technology hypes” (Bareis, Roßmann, and Bordignon 2023), “data imaginaries” (Beer 2019), and “buzzwords” (Cairns and Krzywoszynska 2016), a rich body of literature shows us how discursive formations are central to inserting technological systems into moments of rupture. It is not surprising that the preoccupation with extending and immortalising personal identity—a project that has perennially fascinated the human mind—has been wrenched into the imaginaries around healthcare technology.[1]
A recent Netflix documentary, for instance, follows American entrepreneur, Bryan Johnson. We see a man who is presumably at war with the decay of his own body. Johnson’s “Project Blueprint” encourages his many followers to not die by lowering their “pace of aging.” For this impossible goal, the performance of the body is closely measured and calibrated. Johnson’s longevity protocol includes tracking a dizzying list of biomarkers, getting plasma transfusions, and working with laser diodes and high-frequency electromagnetic stimulators.
Johnson’s “Don’t Die” app even lets users track and gamify their longevity. At one point in the documentary, a TV show host can be heard disparaging the project– “…you’re seeking more time when you’re not even living the time you’ve been given.”
There are resonances of such Silicon Valley fantasies closer to my life. I now find it ironic that the most thoughtful purchase I made when I moved to Delhi was a portable air-purifier. Its bright OLED screen read out the Air Quality Index (AQI) in real time. Changing its HEPA filter was a ritual I undertook each winter, just before the city would be engulfed in toxic smog.
Thinking back, I realise I have always found reassurance in the words crafted around high technology. The high-precision laser sensor in my air purifier, the anti-lock braking system on my motorcycle, the BPA-free plastic in my water bottle—words mediated each act of consumption through the promise of technological certainty.
The stakes are certainly not different today. The imaginaries around the CyberKnife, too, constantly slip between the aesthetics of persuasion and the euphemisms of risk management. An assorted network of communicative devices—brochures, user manuals, video testimonials, websites—become critical in the storytelling around this technology.
Inserted into the social world of cancer medicine, the precise function of the CyberKnife becomes obscured by the iconography of an impending miracle. If cancer delivers impermanence as a fact of life, the CyberKnife stiches together the strands of sanity that have begun coming apart around it.
A discursive formation is mobilised to conjure fantasies of salvation from the terror of death. Matters of fact and fiction blend seamlessly, and technological wizardry is wielded to resolve the fundamental crisis of human existence.
The Everyday Life of the CyberKnife
The insurance company approves the procedure. The night before the encounter, I am rolled into an MRI machine that would generate “thin slice” images of my brain. To exorcise the malignancy, the machine needs to see my body in its own terms. A radiograph of my brain is digitally constructed from various angles and transferred into the CyberKnife software. This would be combined with other image guidance systems installed in the facility, allowing the software’s tracking algorithms to track my skull and spine in real time.
My first encounter with the CyberKnife takes place on a Thursday. The facility that houses the Cyberknife stands in stark contrast to the rest of the oncology department. The chemotherapy unit in the hospital, for instance, is space compressed to accommodate the volume of sick bodies. Rows of beds stand close together, IV lines and brightly coloured injection trays strewn over dull, white sheets.
The image is oddly reminiscent of a “nerve splicing” scene from a William Gibson novel. Despite the levity in the movement of the nursing staff, there is uncertainty writ large in the atmosphere. Even with the best of human efforts, this urban microcosm cannot conceal the vulgarities entrenched in the healthcare system. Even in this large private hospital, care is slow and regimented for the cancerous masses.
The CyberKnife does not seem to belong in the same world. Hidden away from the chaos of the medical oncology ward, it announces its presence as a spectacle par excellence. The corridors no longer have the punitive force of counters or queues. The appointment was set on email, and the facility has been blocked for several slots before the Easter weekend. The only paper trail, for now, is a pink slip with ‘CyberKnife’ encircled.
In the morning, I am wheeled through a central atrium, past a series of doors with bright cautionary stickers. The signs on the doors are mostly directed at women who are or may be pregnant. Those suspected of carrying life are strictly required to keep away from these doors. In these warnings, you encounter a familiar metaphor. Cancer is the opposite of life. The CyberKnife is part of a vast arsenal of medical technology that is designed to identify and eliminate malignant cells that have invaded the perimeter of the body. The allegories of the war room are bound to find their way.
It is here that the CyberKnife first reveals its infrastructural life. In many ways, it is the material embodiment of the present moment of technological solutionism. Even when it appears larger than life, a human-machine assemblage emerges from the penumbra.
The night before, a gauze mask has been tailored for my face. The bench is sanitised and a fresh paper towel is rolled over the soft cushion. A laundered blanket is brought in to make sure that I am comfortable. The backroom has the feel of aeronautic control room—rows of white monitors, revolving chairs, and other assorted equipment are neatly laid out around the room. No grandeur of automaticity can conceal the labour through which the charisma of the CyberKnife is manufactured.
Even with the preparations, life presents obstacles. During the therapy, the liveliness of the human body makes itself felt. A patient breathes and coughs, muscles remain vital, tumours move. In the backroom, two technicians wait to ensure that I remain submissive to the regularities of the machine. The robotic arm must constantly stay on target—it must compensate for the excessive dynamism of human life.
Around 9:30 am, I am pushed up an elevated corridor. The CyberKnife emerges into my view. It is smooth and polished, stylised logo printed with the makings of a high-precision weapon. It sits in a thermally controlled chamber, a mechanical coolness you feel as soon as you enter the room. I step out of the wheelchair and onto the bench. My family is allowed in for a moment to witness the beginning of the spectacle.
Immersed in a long emergency, the words around the machine have already begun producing an effect on how I imagine the limits and possibilities of care. As I feel the warmth of gauze mask, my vision is obscured. The spectators have already left the room, but gaze of the machine lays me bare. It is almost as if I am a theatrical subject in William Halsted’s operation room. I hear the dull whir of the machine. Quietly and mechanically, an immortality project is set abuzz.
Acknowledgement:
This piece owes a great deal to Jaya Mathur, who generously curated a health anthropology reading list for me and shared thoughtful, incisive feedback.
[1] Abou Farman’s ethnographic exploration of secular immortality projects, On Not Dying, portrays many such capital-fuelled attempts at immortality.
Bibliography
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