To be clear, there is nothing private about having cancer. A diagnosis requires referrals and a bewildering number of scans and tests. There are ultrasounds, MRIs, PET scans; colonoscopies, bronchoscopies, endoscopies. There are needle biopsies, razor biopsies, or liquid biopsies. Most of the tests require getting naked, or mostly naked, beneath a robe, sometimes waiting in a large room full of other terrified strangers also in robes, before presenting oneself to strangers who push, jab, thread and insert tools into or onto body parts that are not normally explored. Frequently, these tests have to be repeated, or different tests ordered, to rule something out.

說白了，患癌並不是什麼隱私的事。確診癌症需要轉診，還需要做大量的掃描和檢查。有超聲波檢查、核磁共振成像、正電子掃描；結腸鏡檢查、支氣管鏡檢查、內窺鏡檢查。有針刺活檢、刮取活檢或液體活檢。大多數檢查都需要病人赤身裸體或裸露大部分身體，只穿一件長袍，有時還需要在一個大房間裡等待，那裡擠滿了同樣穿著長袍、惶惶不安的陌生人，然後再接受陌生人對你的推動、戳刺、穿線，並將工具插入通常不會觸碰到的身體部位。這些檢查往往需要重複多次，或者要求進行不同的檢查，以排除某些可能性。

“I’ve been naked in front of so many people in my life at this point. You sort of lose some of that sense of, ‘My body is private,’” said Isabel Blumberg, who is my gynecologist. When I was diagnosed with breast cancer in 2019, Blumberg was the first person to call me. She told me that she’d had cancer, too.

「到現在，我已經在很多人面前裸體過了。這會讓人失去一些『我的身體是隱私的』這種感覺，」我的婦科醫生伊莎貝爾·布倫貝格說。當我在2019年被診斷出患有乳腺癌時，布倫貝格是第一個給我打電話的人。她告訴我，她也得過癌症。

In the video Kensington Palace released on Friday, Catherine, Princess of Wales, revealed her cancer status after more than six weeks of silence and pleaded for privacy. “We hope that you will understand that, as a family, we now need some time, space and privacy while I complete my treatment,” she said while wringing her thin hands. A princess no doubt bypasses the waiting rooms and receives a level of medical care inaccessible to most. But she cannot evade the intrusions and indignities of cancer — the anxious waiting for pathology reports, the shock of the news, the series of treatment decisions that no young, healthy person has ever imagined having to make. The treatment can feel like a grueling, interminable invasion.

在肯辛頓宮上週五發布的影片中，威爾斯王妃凱瑟琳在沉默了六個多星期後透露了自己患上癌症的消息，並懇求隱私。「我們希望你們能夠理解，作為一個家庭，在我完成治療期間，我們現在需要一些時間、空間和隱私，」她搓著瘦弱的雙手說。作為王妃，毫無疑問她可以不用候診，可以得到大多數人無法企及的醫療服務。但她無法迴避癌症的侵擾和侮辱——焦急地等待病理報告、得知消息後的震驚、一系列任何一個健康的年輕人都從未想像過的治療決定。治療過程就像一場苦不堪言的、無休止的入侵。

And because Catherine is a princess, the violations went further: the wild and incessant speculation about what had gone wrong with her body, the alleged unauthorized infiltrations of her medical files, which the London Clinic, where she underwent “major abdominal surgery,” is investigating. “There is no place at our hospital for those who intentionally breach the trust of any of our patients or colleagues,” Al Russell, the clinic’s CEO, said in a statement.

因為凱瑟琳是一位王妃，對她的侵犯還不止於此。人們瘋狂地無休止猜測她的身體出了什麼問題，有人被指未經授權地試圖獲取她的醫療檔案，她接受「腹部大手術」的倫敦診所正在對此進行調查。該診所的首席執行官艾爾·拉塞爾在一份聲明中說：「對於那些蓄意破壞病人或同事對我們的信任的人，我們醫院絕不容忍。」

Even in health, privacy is difficult for a public figure to attain, and since she married Prince William in 2011, Kate Middleton has lived under a microscope. Her physical body — her legs, her hair, her behind, her clothing — has been scrutinized in the way of every female celebrity but also because of her royal function and role.

即使在身體健康的時候，公眾人物也很難獲得隱私。自2011年嫁給威廉王子以來，凱特·米德爾頓一直生活在公眾的顯微鏡下。她的身體——她的腿、頭髮、臀部、衣著——受到了所有女性名人都會經受的審視，但這也是因為她的王室職能和角色。

Long ago, she traded her independence for rank, and her most important job has been to perpetuate the monarchy by bearing its heirs. In a very real way, her body is under inspection because it belongs to her nation, and to its future.

很久以前，她用自己的獨立換來了地位，而她最重要的職責就是為王室生兒育女，使君主製得以延續。可以非常真實地說，她的身體接受著檢查，因為它屬於她的國家，屬於國家的未來。

In becoming royal, a person secures a lifetime of luxury and comfort. But also, “you become a public body, the site of enormous projection, everything from longing to disdain. People pick you apart,” Susie Orbach, a psychoanalyst in London and New York who treated Princess Diana, said in an interview. “There are so many different aspects of what it means to be a royal body — which obviously no one understands when they start going out with a prince.”

成為王室成員後，一個人將終生享受奢華和舒適。但同時，「你也成為了一個公眾人物，一個巨大的投射點，投射從渴望到蔑視的種種情感。人們會把你挑得體無完膚，」在倫敦和紐約執業的心理分析師蘇西·奧爾巴赫在採訪中說，她曾為戴安娜王妃提供過治療。「成為王室的身體意味著許多不同的方面——顯然，開始和王子約會時，沒有人會理解這一點。」

Guarding against incursions into privacy — controlling who has an interest in and access to the female royal body (for certainly no one is as obsessed with King Charles III’s health as they are with Catherine’s) — is at least four centuries old. Elizabeth I “spent an enormous amount of time authorizing images of her body,” strategically projecting an image of potent virginity to avoid marriage in order to amass and preserve power, explained Jean Howard, a Renaissance scholar at Columbia University. “She had to produce a body that people would accept,” Howard said.

防止隱私受到侵犯——控制對王室女性的身體利益相關並能接觸到她們身體的人（因為顯然沒有人像關心凱瑟琳那樣關心國王查理三世的健康狀況）——至少有四個世紀的歷史了。伊麗莎白一世「花了大量的時間批准她的畫像」，戰略性地塑造了一個貞潔的形象，以逃避婚姻，從而積累和維護權力。」哥倫比亞大學的文藝復興歷史學者讓·霍華德解釋說。「她必須塑造一個人們能夠接受的身體。」

Working with court painters, the image makers of the time, Elizabeth I created “a virginity that everyone fetishized,” both sexual and unattainable. “She adorned herself with pearls of purity. She was painted in dresses that had a pearl right where the clitoris would be,” Howard said. When she passed childbearing age and could no longer wear virginity as armor, Elizabeth I instructed her portrait makers to render her as godlike — in Howard’s words, “the bride of Christ, married to her job, and married to the country.”

伊麗莎白一世與當時的形象塑造者——宮廷畫家——合作，創造出了「人人迷戀的貞潔形象」，既有性吸引力，又高不可攀。「她用純潔的珍珠裝飾自己。在她的肖像畫裡，她的裙子上有一顆珍珠就綉在陰蒂的位置，」霍華德說。當她過了生育年齡，不能再把貞潔作為盔甲武裝自己時，伊麗莎白一世指示她的畫師把她畫得像神一樣——用霍華德的話說，「基督的新娘，嫁給了她的職責，嫁給了這個國家。」

But the monarchy has undergone the same cultural shift as everyone else — from bright lines between public and private selves to blurred ones, “from believing in privacy to believing you share everything,” Orbach said. When Queen Elizabeth II was pregnant in 1948 and 1950, with Prince Charles and Princess Anne, respectively, “the Queen was merely said to be in ‘an interesting condition’ and all photographs of that ‘condition’ were prohibited,” wrote Tina Brown in “The Diana Chronicles.” And in 1966, when the queen’s mother, Elizabeth, was admitted to the hospital, the communications team at Clarence House referenced “abdominal surgery,” and nothing further. More than 40 years passed before the Queen Mother’s biographer, William Shawcross, revealed that a cancerous tumor had been removed from her colon.

但君主制已經和其他人一樣經歷了文化轉變。公共自我和私人自我之間的界限從明確變得模糊，「從相信隱私變成相信分享你的一切」，心理分析師奧爾巴赫說。在1948年和1950年，當女王伊麗莎白二世分別懷上查爾斯王子和安妮公主時，「人們只是說女王處於一種『讓人好奇的狀態』，所有關於這種『狀態』的照片都被禁止」，蒂娜·布朗在《戴安娜編年史》中寫道。1966年，當女王的母親伊麗莎白王太后住院時，克拉倫斯宮的通訊團隊只提到了「腹部手術」，再無下文。40多年後，王太后的傳記作者威廉·肖克羅斯才透露，她切除了結腸裡的一個惡性腫瘤。

“I hope they’re looking after you well,” Prince Charles, who was 18 at the time, wrote to his grandmother. “Mummy said that you had difficulty getting around two gi-normous policemen wedged into the corridor outside your room.” By the time Charles was expecting his first child, the tabloids were full of stories about Diana’s morning sickness.

「我希望他們好好照顧你，」當時18歲的查爾斯王子在給祖母的信中寫道。「媽媽說你很難繞過兩個大塊頭警察，他們就在你房間外面的走廊裡。」而當查爾斯的第一個孩子即將出生的時候，小報上到處都是關於戴安娜孕吐的報導。

Cancer is not just an intrusive, malignant replication of cells that “lives desperately, inventively, fiercely, territorially, casually, and defensively” in the body, as Siddhartha Mukherjee wrote in “The Emperor of All Maladies,” but it always carries with it a whiff of death. At its best, cancer is something to be vigilant about and to contain. At its worst, it destroys. In any person, a diagnosis of cancer comes with a recognition of mortality. In many people, especially young healthy people, it feels like betrayal.

癌症不僅是一種侵入性的細胞惡性複製，如悉達多•穆克吉在《眾病之王》中所寫的那樣，它在人體內「拚命地、創造性地、激烈地、領地性地、隨意地和防禦性地生活著」，而且它總是帶著死亡的氣息。在最好的情況下，癌症是需要警惕和遏制的東西。在最壞的情況下，癌症會摧毀一切。對任何人來說，得到癌症的診斷意味著必須認識到生命的有限性。對許多人，尤其是對健康的年輕人來說，這種感覺就像遭到了背叛。

“I had the easiest breast cancer I could have had,” Dr. Blumberg told me, “and it brought me up short.” She was diagnosed at 46 and is now 52. “It creates a sense of embarrassment that your body let you down at this age. I do remember feeling kind of stunned. Like, weak. Like embarrassed that my body had shown a vulnerability that I didn’t think I was going to have.” I felt the same way. We both also understood exactly how lucky we were to have small cancers, health insurance and doctors we could reach on the phone.

「我得的是最輕的乳腺癌，」布倫貝格醫生告訴我。「但它卻讓我的生活突然被打斷」。她46歲時被確診，現年52歲。她說：「身體在那個年齡讓你失望，這讓人很尷尬。我確實記得當時有種驚呆了的感覺。像是一種虛弱。好像我的身體表現出了一種我沒想過會有的脆弱性，這讓我很尷尬。」我也曾有同樣的感覺。我們也都明白，我們的癌症很小、有醫療保險，可以通過電話聯繫到的醫生，這一切是多麼幸運。

Still, for Catherine, whose royal image is one of lithe and capable athleticism, who has been photographed running, boating, mountain biking, and playing rugby, the news must be unbalancing. To process the reality of cancer — and the possibility of desiccation, weakness, and ugliness — when the public stakes in her vibrant health and beauty are so high, in the midst of the malign social media torrent, must feel outrageous.

儘管如此，對於凱瑟琳來說，她的王室形象是輕盈幹練的運動愛好者，經常被拍到跑步、划船、騎山地單車和打英式橄欖球，這個消息一定會讓她驚慌失措。公眾對她的健康和美麗如此關注，在社群媒體的惡意抨擊聲中，要面對癌症的現實——以及變得乾癟、虛弱和醜陋的可能性——她一定會感到非常憤怒。

With every cancer diagnosis comes the question of whom to tell, and when. And because cancer still carries with it such a deep sense of failure and shame, this telling is freighted with fear of judgment. When Susan Sontag wrote “Illness as Metaphor” in 1978, doctors in Italy and France did not tell any but “the most mature and intelligent” patients of their cancer diagnoses, fearing “the truth will be intolerable.” And “patients who know what they have tend themselves to be extremely prudish, if not outright secretive, about their disease,” she wrote. When, 40 years later, it was suggested, in a previous job, that I tell the HR manager about my breast cancer, I recoiled. I tell my friends everything, yet felt I did not know this man well enough to admit to a sickness in my left breast.

每一次癌症診斷都會帶來一個問題：告訴誰，什麼時候說。因為癌症仍然給人們帶來深深的失敗感和羞恥感，因此告知他人的過程中充滿了對評判的恐懼。蘇珊·桑塔格在1978年寫下《作為隱喻的疾病》時，義大利和法國的醫生除了「最成熟、最聰明的」病人外，不會告訴病人他們的癌症診斷結果，因為他們擔心「真相讓人無法承受」。她寫道，「知道自己得了什麼病的病人往往對自己的疾病非常謹慎，甚至完全保密。」40年後，有人建議我把自己患乳腺癌的情況告訴我當時所在單位的人力資源經理，我退縮了。我把一切都告訴了我的朋友們，但我覺得自己還不夠了解這個人，所以不敢告訴他我左胸的病情。

The desire to disclose the details of one’s cancer varies widely, depending on the nature and severity of the diagnosis, the patient’s support systems and responsibilities, and, of course, gender. “Cancer management, like all of life, does not occur within a vacuum. It occurs within a system of relationships,” wrote the authors of a 2003 paper on cancer management. A 2009 analysis affirmed the convention that young men tend to be stoical, but it noted that women can also feel responsible for how others receive the news. “Women described trying to ‘protect’ or ‘distance’ their families from their diagnosis, and several talked explicitly about their efforts to remain upbeat,” the researchers wrote.

人們披露癌症詳情的意願差別很大，這取決於癌症的性質和嚴重程度、病人的支持系統和責任，當然還有性別。「癌症管理，就像生活裡的一切一樣，不是在真空中進行的。它發生在一個人際關係的系統中，」2003年一篇關於癌症管理的論文這樣寫道。2009年的一份分析報告肯定了年輕男性傾向於用冷靜堅毅面對疾病的傳統觀念，但也指出，女性也會覺得自己對他人如何接受這一消息負有責任。研究人員寫道：「女性試圖『保護』家人或『剝離』家人與疾病的關係，有幾位女性明確談到了她們為保持樂觀所做的努力。

Six weeks is not a long time in cancer world. Information reveals itself slowly, in stages, as do treatment options, and decisions are made accordingly. Now that Catherine has revealed her condition — broadly, without specifics — the world has another opportunity for projection. “Do we recoil?” Orbach asked. “Do we hurt? Do we identify? Do we fear?” Everyone will have some response, “including people who are anti-royalists, triumphalists.” But it’s not all negative, she pointed out. “People are fearful, but they also really care about you.”

在癌症的世界裡，六週並不算長。信息會慢慢地、分階段地顯露出來，治療方案也是如此，決定會據此做出。現在，凱瑟琳透露了她的病情——雖然只是籠統的——世界又有了一次投射的機會。「我們會退縮嗎？」奧爾巴赫問道。「我們會感到痛苦嗎？我們會認同她嗎？我們會恐懼嗎？」每個人都會有一些反應，「包括反皇主義者、勝利主義者」。但她指出，這並不全是負面的，「人們會害怕，但他們也會真正地表達關心。」

The royals, Orbach said, have lost their privacy along with everyone else — and to a higher degree because of the public’s magnified focus on them. But at the same time, their position affords them protection, and retreat. For Catherine, “I think there are enough private spaces, and one doesn’t need to worry about that.”

奧爾巴赫說，王室成員和其他人一樣失去了隱私，而且由於公眾對他們的關注被放大了，他們失去隱私的程度更高。但與此同時，他們的地位也給他們提供了保護和退路。對於凱瑟琳來說，「我認為私人空間已經足夠多了，人們不需要為此擔心。」