Thanks for the clarification, and apologies for my perhaps hasty
response to your earlier post.

Steve

I hope your father has a wonderful Christmas J.

In her world, it *would* have come back if he'd lived longer.

moo

~~~~~~~~~~~~~~~~~~~~~~~~~~

The statements I have posted are supportive of the interests of the
breast cancer patient. They are however, against your interests and
those of the rest of the cancer industry.

Welcome to Cancerland: A Mammogram Leads to a Cult of Pink Kitsch
by Barbara Ehrenreich

Reprinted with the gracious permission of Harper's Magazine

http://www.bcaction.org/Pages/LearnAboutUs/WelcomeToCancerland.html

I was thinking of it as one of those drive-by mammograms, one stop in a
series of mundane missions including post office, supermarket, and gym,
but I began to lose my nerve in the changing room, and not only because
of the kinky necessity of baring my breasts and affixing tiny Xray
opaque stars to the tip of each nipple. I had been in this place only
four months earlier, but that visit was just part of the routine cancer
surveillance all good citizens of HMOs or health plans are expected to
submit to once they reach the age of fifty, and I hadn't really been
paying attention then. The results of that earlier session had aroused
some "concern" on the part of the radiologist and her confederate, the
gynecologist, so I am back now in the role of a suspect, eager to clear
my name, alert to medical missteps and unfair allegations. But the
changing room, really just a closet off the stark windowless space that
houses the mammogram machine, contains something far worse, I notice
for the first time now an assumption about who I am, where I am going,
and what I will need when I get there. Almost all of the eye-level
space has been filled with photocopied bits of cuteness and
sentimentality: pink ribbons, a cartoon about a woman with
iatrogenically flattened breasts, an "Ode to a Mammogram," a list of
the 'lop Ten Things Only Women Understand" ('Fat Clothes" and 'Eyelash
Curlers" among them), and, inescapably, right next to the door, the
poem "I Said a Prayer for You Today," illustrated with pink roses.

It goes on and on, this mother of all mammograms, cutting into gym
time, dinnertime, and lifetime generally. Sometimes the machine doesn't
work, and I get squished into position to no purpose at all. More
often, the X ray is successful but apparently alarming to the invisible
radiologist, off in some remote office, who calls the shots and never
has the courtesy to show her face with an apology or an explanation. I
try pleading with the technician: I have no known risk factors, no
breast cancer in the family, had my babies relatively young and nursed
them both. I eat right, drink sparingly, work out, and doesn't that
count for something'! But she just gets this tight little professional
smile on her face, either out of guilt for the torture she's inflicting
or because she already knows something that I am going to be sorry to
find out for myself. For an hour and a half the procedure is repeated:
the squishing, the snapshot, the technician bustling off to consult the
radiologist and returning with a demand for new angles and more
definitive images. In the intervals while she's off with the doctor I
read the New York Times right down to the personally irrelevant
sections like theater and real estate, eschewing the stack of women's
magazines provided for me, much as I ordinarily enjoy a quick read
about sweatproof eyeliners and "fabulous sex tonight," because I have
picked up this warning vibe in the changing room, which, in my
increasingly anxious state, translates into: femininity is death.
Finally there is nothing left to read but one of the free local weekly
newspapers, where I find, buried deep in the classifieds, something
even more unsettling than the growing prospect of major disease a
classified ad for a "breast cancer teddy bear" with a pink ribbon
stitched to its chest.

Yes, atheists pray in their foxholes-in this case, with a yearning new
to me and sharp as lust, for a clean and honorable death by shark bite,
lightning strike, sniper fire, car crash. Let me be hacked to death by
a madman, is my silent supplication-anything but suffocation by the
pink sticky sentiment embodied in that bear and oozing from the walls
of the changing room.

My official induction into breast cancer comes about ten days later
with the biopsy, which, for reasons I cannot ferret out of the surgeon,
has to be a surgical one, performed on an outpatient basis but under
general anesthesia, from which 1 awake to find him standing
perpendicular to me, at the far end of the gurney, down near my feet,
stating gravely, "Unfortunately, there is a cancer." It takes me all
the rest of that drug-addled day to decide that the most heinous thing
about that sentence is not the presence of cancer but the absence of
me-for I, Barbara, do not enter into it even as a location, a
geographical reference point. Where 1 once was-not a commanding
presence perhaps but nonetheless a standard assemblage of flesh and
words and gesture-"there is a cancer." I have been replaced by it, is
the surgeon's implication. This is what I am now, medically speaking.

In my last act of dignified self-assertion, I request to see the
pathology slides myself. This is not difficult to arrange in our
small-town hospital, where the pathologist turns out to be a friend of
a friend, and my rusty Ph.D. in cell biology (Rockefeller University,
1968) probably helps. He's a jolly fellow, the pathologist, who calls
me "hon" and sits me down at one end of the dual-head microscope while
he mans the other and moves a pointer through the field. These are the
cancer cells, he says, showing up blue because of their overactive DNA.
Most of them are arranged in staid semicircular arrays, like suburban
houses squeezed into a cul-de-sac, but I also see what I know enough to
know I do not want to see: the characteristic "Indian files" of cells
on the march. The "enemy," I am supposed to think-an image to save up
for future exercises in "visualization" of their violent deaths at the
hands of the body's killer cells, the lymphocytes and macrophages. But
I am impressed, against all rational self-interest, by the energy of
these cellular conga lines, their determination to move on out from the
backwater of the breast to colonize lymph nodes, bone marrow, lungs,
and brain. These are, after all, the fanatics of Barbaraness, the rebel
cells that have realized that the genome they carry, the genetic
essence of me, has no further chance of normal reproduction in the
postmenopausal body we share, so why not just start multiplying like
bunnies and hope for a chance to break out?

It has happened, after all; some genomes have achieved immortality
through cancer. When I was a graduate student, I once asked about the
strain of tissue-culture cells labeled "HeLa" in the heavy-doored room
maintained at body temperature. "HeLa," it turns out, refers to one
Henrietta Lacks, whose tumor was the progenitor of all HeLa cells. She
died; they live, and will go on living until someone gets tired of them
or forgets to change their tissue-culture medium and leaves them to
starve. Maybe this is what my rebel cells have in mind, and I try
beaming them a solemn warning: The chances of your surviving me in
tissue culture are nil. Keep up this selfish rampage and you go down,
every last one of you, along with the entire Barbara enterprise. But
what kind of a role model am I, or are multicellular human organisms
generally, for putting the common good above mad anarchistic individual
ambition? There is a reason, it occurs to me, why cancer is our
metaphor for so many runaway social processes, like corruption and
"moral decay": we are no less out of control ourselves.

After the visit to the pathologist, my biological curiosity drops to a
lifetime nadir. I know women who followed up their diagnoses with weeks
or months of self-study, mastering their options, interviewing doctor
after doctor, assessing the damage to be expected from the available
treatments. But I can tell from a few hours of investigation that the
career of a breast-cancer patient has been pretty well mapped out in
advance for me: You may get to negotiate the choice between lumpectomy
and mastectomy, but lumpectomy is commonly followed by weeks of
radiation, and in either case if the lymph nodes turn out, upon
dissection, to be invaded-or "involved," as it's less threateningly
put-you're doomed to chemotherapy, meaning baldness, nausea, mouth
sores, immunosuppression, and possible anemia. These interventions do
not constitute a "cure" or anything close, which is why the death rate
from breast cancer has changed very little since the 1930s, when
mastectomy was the only treatment available. Chemotherapy, which became
a routine part of breast-cancer treatment in the eighties, does not
confer anywhere near as decisive an advantage as patients are often led
to believe, especially in postmenopausal women like myself-a two or
three percentage point difference in ten year survival rates,1
according to America's best-known breast-cancer surgeon, Dr. Susan
Love. I know these bleak facts, or sort of know them, but in the fog of
anesthesia that hangs over those first few weeks, I seem to lose my
capacity for self-defense. The pressure is on, from doctors and loved
ones, to do something right away-kill it, get it out now. The endless
exams, the bone scan to check for metastases, the high-tech heart test
to see if I'm strong enough to withstand chemotherapy-all these blur
the line between selfhood and thing-hood anyway, organic and inorganic,
me and it. As my cancer career unfolds, I will, the helpful pamphlets
explain, become a composite of the living and the dead-an implant to
replace the breast, a wig to replace the hair. And then what will I
mean when I use the word "I"? I fall into a state of unreasoning
passive aggressivity: They diagnosed this, so it's their baby. They
found it, let them fix it.

I could take my chances with "alternative" treatments, of course, like
punk novelist Kathy Acker, who succumbed to breast cancer in 1997 after
a course of alternative therapies in Mexico, or actress and ThighMaster
promoter Suzanne Somers, who made tabloid headlines last spring by
injecting herself with mistletoe brew. Or I could choose to do nothing
at all beyond mentally exhorting my immune system to exterminate the
traitorous cellular faction. But I have never admired the "natural" or
believed in the "wisdom of the body." Death is as "natural" as anything
gets, and the body has always seemed to me like a retarded Siamese twin
dragging along behind me, an hysteric really, dangerously overreacting,
in my case, to everyday allergens and minute ingestions of sugar. I
will put my faith in science, even if this means that the dumb old body
is about to be transmogrified into an evil clown-puking, trembling,
swelling, surrendering significant parts, and oozing postsurgical
fluids. The surgeon-a more genial and forthcoming one this time-can fit
me in; the oncologist will see me. Welcome to Cancerland.

Fortunately, no one has to go through this alone. Thirty years ago,
before Betty Ford, Rose Kushner, Betty Rollin, and other pioneer
patients spoke out, breast cancer was a dread secret, endured in
silence and euphemized in obituaries as a "long illness." Something
about the conjuncture of "breast," signifying sexuality and nurturance,
and that other word, suggesting the claws of a devouring crustacean,
spooked almost everyone. Today however, it's the biggest disease on the
cultural map, bigger than AIDS, cystic fibrosis, or spinal injury,
bigger even than those more prolific killers of women-heart disease,
lung cancer, and stroke. There are roughly hundreds of websites devoted
to it, not to mention newsletters, support groups, a whole genre of
first-person breast-cancer books; even a glossy, upper-middle-brow,
monthly magazine, Mamm. There are four major national breast-cancer
organizations, of which the mightiest, in financial terms, is The Susan
G. Komen Foundation, headed by breast-cancer veteran and Bush's nominee
for ambassador to Hungary Nancy Brinker. Komen organizes the annual
Race for the Cure©, which attracts about a million people-mostly
survivors, friends, and family members. Its website provides a
microcosm of the new breast-cancer culture, offering news of the races,
message boards for accounts of individuals' struggles with the disease,
and a "marketplace" of breast-cancer-related products to buy.

More so than in the case of any other disease, breast-cancer
organizations and events feed on a generous flow of corporate support.
Nancy Brinker relates how her early attempts to attract corporate
interest in promoting breast cancer "awareness" were met with rebuff. A
bra manufacturer, importuned to affix a mammogram-reminder tag to his
product, more or less wrinkled his nose. Now breast cancer has
blossomed from wallflower to the most popular girl at the corporate
charity prom. While AIDS goes begging and low-rent diseases like
tuberculosis have no friends at all, breast cancer has been able to
count on Revlon, Avon, Ford, Tiffany, Pier 1, Estee Lauder, Ralph
Lauren, Lee Jeans, Saks Fifth Avenue, JC Penney, Boston Market, Wilson
athletic gear-and I apologize to those I've omitted. You can "shop for
the cure" during the week when Saks donates 2 percent of sales to a
breast-cancer fund; "wear denim for the cure" during Lee National Denim
Day, when for a $5 donation you get to wear blue jeans to work. You can
even "invest for the cure," in the Kinetics Assets Management's new
no-load Medical Fund, which specializes entirely in businesses involved
in cancer research.

If you can't run, bike, or climb a mountain for the cure-all of which
endeavors are routine beneficiaries of corporate sponsorship-you can
always purchase one of the many products with a breast cancer theme.
There are 2.2 million American women in various stages of their
breast-cancer careers, who, along with anxious relatives, make up a
significant market for all things breast-cancer-related. Bears, for
example: I have identified four distinct lines, or species, of these
creatures, including "Carol," the Remembrance Bear; '}lope," the Breast
Cancer Research Bear, which wears a pink turban as if to conceal
chemotherapy-induced baldness; the "Susan Bear," named
for Nancy Brinker's deceased sister, Susan; and the new Nick & Nora
Wish Upon a Star Bear, available, along with the Susan Bear, at the
Komen Foundation website's "marketplace."

And bears are only the tip, so to speak, of the cornucopia of
pink-ribbon-themed breast-cancer products. You can dress in
pink-beribboned sweatshirts, denim shirts, pajamas, lingerie, aprons,
loungewear, shoelaces, and socks; accessorize with pink rhinestone
brooches, angel pins, scarves, caps, earrings, and bracelets; brighten
up your home with breast-cancer candles, stained-glass pink-ribbon
candleholders, coffee mugs, pendants, wind chimes, and night-lights;
pay your bills with special BreastChecks or a separate line of Checks
for the Cure. "Awareness" beats secrecy and stigma of course, but I
can't help noticing that the existential space in which a friend has
earnestly advised me to "confront [my] mortality" bears a striking
resemblance to the mall.

This is not, I should point out, a case of cynical merchants exploiting
the sick. Some of the breast-cancer tchotchkes and accessories are made
by breast-cancer survivors themselves, such as "Janice," creator of the
"Daisy Awareness Necklace," among other things, and in most cases a
portion of the sales goes to breast-cancer research. Virginia Davis of
Aurora, Colorado, was inspired to create the "Remembrance Bear" by a
friend's double mastectomy and sees her work as more of a "crusade"
than a business. This year she expects to ship 10,000 of these teddies,
which are manufactured in China, and send part of the money to the Race
for the Cure. If the bears are infantilizing-as I try ever so tactfully
to suggest is how they may, in rare cases, be perceived-so far no one
has complained. "I just get love letters," she tells me, "from people
who say, 'God bless you for thinking of us."

The ultrafeminine theme of the breast-cancer "marketplace"-the
prominence, for example, of cosmetics and jewelry-could be understood
as a response to the treatments' disastrous effects on one's looks. But
the infantilizing trope is a little harder to account for, and teddy
bears are not its only manifestation. A tote bag distributed to breast
cancer patients by the Libby Ross Foundation (through places such as
the Columbia Presbyterian Medical Center) contains, among other items,
a tube of Estee Lauder Perfumed Body Crème, a hot-pink satin
pillowcase, an audiotape "Meditation to Help You with Chemotherapy," a
small tin of peppermint pastilles, a set of three small inexpensive