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CANCERLAND a Mammogram Leads to a Cult of Pink Kitsch by Barbara Ehrenreich

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CANCERLAND a Mammogram Leads to a Cult of Pink Kitsch by Barbara Ehrenreich R E P O R T WELCOME TO CANCERLAND A mammogram leads to a cult of pink kitsch By Barbara Ehrenreich I was thinking of it as one of those drive-by doesn’t work, and I get squished into position to mammograms, one stop in a series of mundane no purpose at all. More often, the X ray is suc- missions including post office, supermarket, and cessful but apparently alarming to the invisible ra- gym, but I began to lose my nerve in the chang- diologist, off in some remote office, who calls the ing room, and not only because of the kinky ne- shots and never has the courtesy to show her face cessity of baring my breasts and affixing tiny X- with an apology or an explanation. I try pleading ray opaque stars to the tip of each nipple. I had with the technician: I have no known risk factors, been in this place only four months earlier, but no breast cancer in the family, had my babies rel- that visit was just part of the routine cancer sur- atively young and nursed them both. I eat right, veillance all good citizens of HMOs or health drink sparingly, work out, and doesn’t that count plans are expected to submit to once they reach for something? But she just gets this tight little pro- the age of fifty, and I hadn’t really been paying at- fessional smile on her face, either out of guilt for tention then. The results of that earlier session the torture she’s inflicting or because she already had aroused some “concern” on the part of the ra- knows something that I am going to be sorry to diologist and her confederate, the gynecologist, find out for myself. For an hour and a half the so I am back now in the role of a suspect, eager procedure is repeated: the squishing, the snap- to clear my name, alert to medical missteps and shot, the technician bustling off to consult the ra- unfair allegations. But the changing room, real- diologist and returning with a demand for new an- ly just a closet off the stark windowless space that gles and more definitive images. In the intervals houses the mammogram machine, contains some- while she’s off with the doctor I read the New thing far worse, I notice for the first time now— York Times right down to the personally irrelevant an assumption about who I am, where I am go- sections like theater and real estate, eschewing the ing, and what I will need when I get there. Almost stack of women’s magazines provided for me, much all of the eye-level space has been filled with as I ordinarily enjoy a quick read about sweat- photocopied bits of cuteness and sentimentality: proof eyeliners and “fabulous sex tonight,” be- pink ribbons, a cartoon about a woman with iat- cause I have picked up this warning vibe in the rogenically flattened breasts, an “Ode to a Mam- changing room, which, in my increasingly anxious mogram,” a list of the “Top Ten Things Only state, translates into: femininity is death. Finally Women Understand” (“Fat Clothes” and “Eyelash there is nothing left to read but one of the free lo- Curlers” among them), and, inescapably, right cal weekly newspapers, where I find, buried deep next to the door, the poem “I Said a Prayer for in the classifieds, something even more unset- You Today,” illustrated with pink roses. tling than the growing prospect of major disease— It goes on and on, this mother of all mammo- a classified ad for a “breast cancer teddy bear” grams, cutting into gym time, dinnertime, and with a pink ribbon stitched to its chest. lifetime generally. Sometimes the machine Yes, atheists pray in their foxholes—in this Barbara Ehrenreich is a contributing editor to Harper’s Magazine. Her last two essays for the magazine were the basis for her best-selling book, Nickel and Dimed: On (Not) Getting By in America, published by Henry Holt. REPORT 43 case, with a yearning new to me and sharp as of me, has no further chance of normal repro- lust, for a clean and honorable death by shark bite, duction in the postmenopausal body we share, so lightning strike, sniper fire, car crash. Let me be why not just start multiplying like bunnies and hacked to death by a madman, is my silent sup- hope for a chance to break out? plication—anything but suffocation by the pink It has happened, after all; some genomes have sticky sentiment embodied in that bear and ooz- achieved immortality through cancer. When I ing from the walls of the changing room. was a graduate student, I once asked about the My official induction into breast cancer comes strain of tissue-culture cells labeled “HeLa” in the about ten days later with the biopsy, which, for rea- heavy-doored room maintained at body temper- sons I cannot ferret out of the surgeon, has to be ature. “HeLa,” it turns out, refers to one Henrietta a surgical one, performed on an outpatient basis Lacks, whose tumor was the progenitor of all HeLa but under general anesthesia, from which I awake cells. She died; they live, and will go on living un- to find him standing perpendicular to me, at the til someone gets tired of them or forgets to change far end of the gurney, down near my feet, stating their tissue-culture medium and leaves them to gravely, “Unfortunately, there is a cancer.” It starve. Maybe this is what my rebel cells have in takes me all the rest of that drug-addled day to de- mind, and I try beaming them a solemn warning: cide that the most heinous thing about that sen- The chances of your surviving me in tissue culture tence is not the presence of cancer but the absence are nil. Keep up this selfish rampage and you go of me—for I, Barbara, do not enter into it even as down, every last one of you, along with the entire a location, a geographical reference point. Where Barbara enterprise. But what kind of a role mod- I once was—not a commanding presence perhaps el am I, or are multicellular human organisms but nonetheless a standard assemblage of flesh generally, for putting the common good above and words and gesture—“there is a cancer.” I have mad anarchistic individual ambition? There is a been replaced by it, is the surgeon’s implication. reason, it occurs to me, why cancer is our metaphor This is what I am now, medically speaking. for so many runaway social processes, like cor- ruption and “moral decay”: we are no less out of control ourselves. LET ME DIE OF ANYTHING BUT After the visit to the pathologist, my biologi- cal curiosity drops to a lifetime nadir. I know SUFFOCATION BY THE PINK STICKY SENTIMENT women who followed up their diagnoses with EMBODIED IN THAT TEDDY BEAR weeks or months of self-study, mastering their op- tions, interviewing doctor after doctor, assessing the damage to be expected from the available In my last act of dignified self-assertion, I request treatments. But I can tell from a few hours of in- to see the pathology slides myself. This is not dif- vestigation that the career of a breast-cancer pa- ficult to arrange in our small-town hospital, where tient has been pretty well mapped out in advance the pathologist turns out to be a friend of a friend, for me: You may get to negotiate the choice be- and my rusty Ph.D. in cell biology (Rockefeller tween lumpectomy and mastectomy, but lumpec- University, 1968) probably helps. He’s a jolly fel- tomy is commonly followed by weeks of radia- low, the pathologist, who calls me “hon” and sits tion, and in either case if the lymph nodes turn out, me down at one end of the dual-head microscope upon dissection, to be invaded—or “involved,” as while he mans the other and moves a pointer it’s less threateningly put—you’re doomed to through the field. These are the cancer cells, he chemotherapy, meaning baldness, nausea, mouth says, showing up blue because of their overactive sores, immunosuppression, and possible anemia. DNA. Most of them are arranged in staid semi- These interventions do not constitute a “cure” circular arrays, like suburban houses squeezed in- or anything close, which is why the death rate from to a cul-de-sac, but I also see what I know enough breast cancer has changed very little since the to know I do not want to see: the characteristic 1930s, when mastectomy was the only treatment “Indian files” of cells on the march. The “ene- available. Chemotherapy, which became a routine my,” I am supposed to think—an image to save up part of breast-cancer treatment in the eighties, for future exercises in “visualization” of their vi- does not confer anywhere near as decisive an ad- olent deaths at the hands of the body’s killer cells, vantage as patients are often led to believe, espe- the lymphocytes and macrophages. But I am im- cially in postmenopausal women like myself—a pressed, against all rational self-interest, by the en- two or three percentage point difference in ten- ergy of these cellular conga lines, their determi- year survival rates,1 according to America’s best- nation to move on out from the backwater of the breast to colonize lymph nodes, bone marrow, 1 In the United States, one in eight women will be diagnosed with breast cancer at some point.
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