Why I had to lie to my dying mother

American writer Susan Sontag was terrified of death. She beat cancer in the 1970s, and again in the 1990s, but third time around she wasn't so lucky. In a tender account of her final illness, her son David Rieff recalls how he colluded with his mother's fantasy that she wasn't dying - and what this ultimately cost him after she had gone

Sunday May 18, 2008. The Observer

America, 1967: David Rieff and mother Susan Sontag. Photograph: Everett Collection/Rex Features

When my mother Susan Sontag was diagnosed in 2004 with myelodysplastic syndrome, a precursor to a rapidly progressive leukaemia, she had already survived stage IV breast cancer in 1975 that had spread into the lymph system, despite her doctors having held out little hope of her doing so, and a uterine sarcoma in 1998. 'There are some survivors, even in the worst cancers,' she would often say during the nearly two years she received what even for the time was an extremely harsh regime of chemotherapy for the breast cancer.

'Why shouldn't I be one of them?'After that first cancer, mutilated but alive (the operation she underwent not only removed one of her breasts but the muscles of the chest wall and part of an armpit), she wrote her defiant book Illness as Metaphor. Part literary study, part polemic, it was a fervent plea to treat illness as illness, the luck of the genetic draw, and not the result of sexual inhibition, the repression of feeling, and the rest - that torrid brew of low-rent Wilhelm Reich and that mix of masochism and hubris that says that somehow people who got ill had brought it on themselves.

In the book, my mother contrasted the perennial stigma attached to cancer with the romanticising of tuberculosis in 19th-century literature (La bohème and all that). In the notebooks for the book that I found after her death, I discovered one entry that stopped me cold. 'Leukaemia,' it read, 'the only "clean" cancer.' Clean illness, indeed. My poor mother: to think of what awaited her... [Article continues]

Susan Sontag and son

Born 13 January 1933 in New York City. Her father, Jack Rosenblatt, died when she was five, and her mother, Mildred Jacobsen, married Nathan Sontag. They move to Los Angeles.

1949 Admitted to the University of Chicago. Continues graduate study at Harvard, St Anne's College, Oxford and the Sorbonne.

1950 Sontag marries Philip Rieff, a young teacher at Chicago, after a 10-day courtship. They divorce in 1958.

1952 David Rieff is born in Boston, Massachusetts, the only son of Susan and Philip.

1978-89 David Rieff works as a senior editor at Farrar, Straus and Giroux with authors including Joseph Brodsky, Philip Roth - and Susan Sontag.

Sontag's books include four novels; a collection of short stories, I, etcetera (1977); several plays, and eight works of non-fiction, including On Photography (1976) and Regarding the Pain of Others (2003).

Rieff's books include Slaughterhouse: Bosnia and the Failure of the West (1995) and At the Point of a Gun: Democratic Dreams and Armed Intervention (2005).

· Swimming in a Sea of Death: A Son's Memoir is published by Granta, £12.99.