The Narrator remembers hugging a man named Bob—a man with “huge sweating tits.” Bob cries and encourages the narrator to cry, too. This, the Narrator says, is how he met Marla Singer.
The chapter, told in flashback, opens with an image of emasculation: Bob is a man, but he’s depicted as being burdened with humiliatingly large mammary glands, or, in The Narrator’s rather cruel phrase, “huge tits.” With this, Palahniuk immediately contrasts the danger, pain, and “realness” of the first chapter to what is here presented as a weak, emasculated modern culture.
The Narrator explains that he was attending support group sessions. Bob’s testicles were removed because he had cancer; he was also given hormone therapy, giving him huge breasts. Bob thinks the Narrator lost his testicles, too.
The Narrator attends support groups meant for people with serious medical problems, even though he’s perfectly healthy. The men in such groups, such as Bob, seem almost literally, biologically feminized by this: Bob loses his testicles and gains breasts.
As the Narrator hugs Bob, he notices a woman in the testicular cancer support group—as they stare into each other’s eyes, they seem to shout, “Faker!” at each other. The narrator has seen this woman in every one of the therapy groups he attends—those for leukemia, blood parasites, brain parasites. The Narrator finds himself unable to cry when the woman watches him.
The Narrator, it’s becoming clear, attends many support groups for problems he doesn’t have. The awareness of another person who does the same thing—another faker—makes the Narrator feel more self-conscious and guilty; he can no longer “lose himself in the moment” and cry.
The Narrator flashes back to explain how he began going to therapy for problems he didn’t have. Two years before, the Narrator went to a doctor about his bad insomnia. His doctor told him, “Insomnia is just the symptom of something larger. Find out what’s actually wrong.” The doctor also mentioned that if the Narrator wanted to see real pain, he should go to a cancer patient support group.
The Narrator’s insomnia, the doctor suggests, is symptomatic of a larger problem (although this is also a common misdiagnosis of insomnia). The larger problem presented here is the Narrator’s emasculation and boredom: he lives an unsatisfying life and has a dull corporate job. The Narrator’s problem, as the doctor’s comment about “real pain” might suggest, is that his life is boring: everything he does is familiar and comfortable. Pain, then, is an escape from the ordinary for the Narrator, a way to experience something truly “real.”
The Narrator went to a cancer support group, and indeed, he saw horrible pain. He met a woman named Chloe who was dying of cancer—Chloe was obsessed with having sex one more time, and spent all her time watching pornography. Chloe hugged the Narrator, who, she assumed, was also dying of cancer, and wept. But the Narrator didn’t cry—he kept going to cancer support groups, but he couldn’t cry yet.
At the cancer support group, The Narrator sees pain and death everywhere. Chloe’s behavior suggests the conflicted relationship between sex and death, or, according to the psychologist Sigmund Freud (an important influence on the novel), eros and thanatos. The Narrator is fascinated with death and pain, but can’t force himself to join in the cathartic crying; he still feels uncomfortable there, and his emotions are still dulled by his consumerist existence.
Then, the Narrator met Bob at a testicular cancer support group. Bob was a former body builder who used steroids. As a result of his steroid abuse, his testicles were amputated. Bob explains that he’s lost most of his muscle, and his children don’t return his calls. The Narrator began to cry, deeply. He found that crying at support groups cured his insomnia.
The Narrator finally finds a “friend” in the cancer support groups who is tragic enough to make him weep. Perhaps the Narrator weeps with Bob because he sees Bob’s suffering as being analogous to his own: where Bob has been literally castrated, the Narrator senses that he’s been figuratively emasculated by his society (a problem that much of novel goes on to address). By getting rid of his pent-up emotion, the Narrator seems to solve the “real problem” his doctor mentioned.
We return to where we were at the beginning of the chapter: the Narrator meeting the other “faker.” She introduces herself to the Narrator as Marla Singer. The Narrator imagines an elaborate scenario in which he angrily insists that Marla needs to get out—he can’t cry, and therefore can’t sleep, when she’s around. The Narrator then imagines Marla accusing him of being a “tourist.”
The passage is funny because Marla obviously doesn’t have testicular cancer either, but nobody is brave enough to tell her to get out. Even the Narrator is too cautious to confront Marla directly, since he’s just as big of a liar as she is. The chapter shows that the Narrator has an active imagination (he’s imagining his entire confrontation). Also, the passage suggests that the Narrator is a “tourist”—in other words, he’s just trying to experience cancer patients’ suffering to get a little thrill of reality, without actually living the life of a cancer patient.