The train winds through lush countryside and crowded cities, like a finger tracing a vein, clogged with bleak tenements and abandoned factories and neighborhoods long out of control. If this land is our shared body, the cities are the vital organs, and they are largely uncared for, plagued by the waste and tension of modern life, unloved.

We speak of dialogue as being authentic, but we seldom know if it is. When Mark Twain claimed to have used four modified varieties of the “Pike County” dialect, or John O’Hara to have duplicated the speech patterns of eastern Pennsylvanians, or Ring Lardner to have caught the exact flavor of conversation around a ballpark, there weren’t many readers who could have checked up on them, and thirty years later nobody cared anyway. What we ask of dialogue is not that it be authentic but that it seem so, and that it be lively, colorful, and interesting. Good dialogue does not reproduce speech, but imitates it, especially its rhythms, in a kind of shorthand. When a beginning writer with a sharp memory tries to reproduce speech, it is inevitably windy, lifeless, and dull.

This was one of the most important and thoughtful talks given at Cancer Dialogue ’80. Stephanie Matthews-Simonton is a psychotherapist and the director of counseling at the Cancer Counseling and Research Center in Fort Worth, Texas. What she has to say — about how we make ourselves sick, and how we can become well — applies to us all.