The Iceberg

Artwork gives voice to the emotional intensity of care during cancer.

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Conceived and developed as an artwork, Marion Coutts’ The Iceberg (winner of the Wellcome Book Prize 2015) speaks to the emotional intensity of the lived experience of those who care for cancer sufferers, and gives agency and voice to the dying.

The book grew out of notes made during the illness and death of Coutts’ husband, the art critic Tom Lubbock, between September 2007 and January 2011.

The writer had little interest in conventional ideas around memoir, and none at all in the genre of grief memoir. The Iceberg is formed of chains of text on intuitive, non-chronological lines, allowing shifts in perspective from micro to macro. It shows rather than tells, through a highly visual language, with artworks cited, encountered, and used as proxies through which to think. Coutts makes extensive use of blank or cut scenes. In an innovative approach to time and narration, some sections cover incidents lasting five minutes, and others, six months.

The originality of writing about cancer as a form of writing against unspeakability led to Coutts being invited to contribute at multi-disciplinary medical humanities conferences and other events. The Iceberg has been cited by clinicians and specialists in medical journals; in books on bereavement and the impact of cancer; and on the websites of professional medical organisations; social care council archives; and on websites that support physical and mental health clinicians.

The Iceberg has made a widespread, significant and innovative contribution to a greater understanding of the experience of cancer patients and their families. It has been used extensively by a broad range of medical professionals to improve their understanding of the experience of caring for a patient, as well as understand the way the ability to use language is affected by brain cancer.

The book was shortlisted for the Samuel Johnson Prize and the Costa Biography Award, and was longlisted for the Guardian First Book Award. In awarding The Wellcome Book Prize, Wellcome’s Simon Chaplin said that it “is an immensely powerful book, written with astonishing candour and pulsing with raw emotion”.

This research was submitted for REF 2021.