Exactly the same thing might be said of breast cancer these days — but not in the same circles. Rather, it is the social scientists who get to contemplate the full panorama of human reaction to disease by studying the fallout from a single one: all the shades of anguish and anger, the posturing, the politics and the cartloads of wishful thinking, all wrapped up in a big pink ribbon.
Less than 50 years ago, breast cancer was hardly discussed in polite company. Now it is the most visible disease around, especially in October, when beribboned pink products flood the market in honor of Breast Cancer Awareness Month (now in its 25th year).
Millions suit up in pink and run or walk for the cause. Others find the display repellent: After her own breast cancer diagnosis, the social critic Barbara Ehrenreich wrote a widely applauded article for Harper's in 2001 rejecting all the pink symbolism as infantilizing and saccharine, the badge of a forced sisterhood created for purely commercial ends.
In "Pink Ribbon Blues," Gayle A. Sulik, a sociologist and an expert in women's studies, now makes similar points in a critique that is far more comprehensive than Ms. Ehrenreich's, if somewhat less engaging. Her book treads an interesting middle ground between the academic and the journalistic as she analyzes giant hunks of information and opinion, and also interviews patients to illustrate her points.
Like Ms. Ehrenreich, Ms. Sulik takes issue with the "she-ro" of the breast cancer movement — an idealized patient who is assertive and boundlessly optimistic, and remains feminine and sexy despite the depredations of disease and treatment. This paragon often uses a diagnosis of breast cancer as a catalyst for a personal transformation; she begins to "take time for me," discovers "what's important in life" and comes out of the experience a changed and better person.
The movement has turned "the shoulds and should nots of survivorship" into a tyranny, Ms. Sulik argues, leaving many women with breast cancer as depressed by their failure to be uplifted and transformed as by any other facet of the experience. "This is not the breast cancer story people want to hear," one said sadly, after telling her own.
Meanwhile, the multiplying scientific uncertainties of the disease are often at odds with the consumer movement's talking points. Mammograms early and often? In truth, mammography is a mediocre screening tool, while the best treatment for the early-stage disease it often uncovers remains extremely controversial. For all the money raised by pink projects, improvement in breast cancer survival rates has been relatively modest.
Further, the disease now constitutes such a huge profit center for so many industries that the conspiracy-minded are beginning to conclude there is an actual cabal against finding a cure.
Throughout Ms. Sulik's comprehensive summary of the giant "cancer marketplace," the names that recur are Susan G. Komen and Nancy G. Brinker, the sisters who made the pink ribbon what it is today. Shortly after Ms. Komen died of breast cancer in 1980, Ms. Brinker began a fund-raising effort that has grown into a multimillion-dollar operation, encompassing races all over the world, hundreds of corporate sponsorships and that inevitable pink ribbon.
Or, actually, two ribbons. The first, modeled on the red ribbon that denotes AIDS, remains in the public domain, but in 2007 Ms. Brinker introduced ribbon No. 2, this one copyrighted, presumably to cement her market share.
It is no surprise that this consummate strategist has herself produced a memoir of her career in the breast cancer biz. The surprise is that her book is almost impossible to put down. The woman is clearly breathtakingly good at public relations, both in deed and, with some help from a co-author, in word.
Two pretty little girls, Suzy and Nanny, live happily in 1950s Illinois with Mommy and Daddy (now in her 60s, Ms. Brinker refers to her parents in just this way). Were they really the iconic postwar American family, or is Ms. Brinker just blowing stardust in our eyes? After a while, immersed in the story, you don't really care. Suzy Komen is painted in sure, fond strokes as one of those magnetic young women who own every room they enter. At age 34 she finds a breast lump. A surgeon removes it, sews her up, assures her he "got it all." Three years later she's dead.
Ms. Brinker details every step she has taken in the intervening years to fulfill her promise to the dying Suzy to "make things better." The book wanders through personal setbacks (like her own mastectomy for early-stage cancer) and corporate triumphs (like "Pinking the Pyramids" with Egypt's first breast cancer race). She also tells the stories of many breast cancer she-ros, most of them young and very heroic.
At the end comes a scene of cinematic impact: Ms. Brinker takes Ms. Komen's two young granddaughters to tea at (where else?) the American Girl store in Manhattan, and tells Suzy's little namesake to "take care of your sister."
There isn't a dry eye in the house. This is surely how illness should read: triumphant, assertive, can-do. Ms. Sulik's complicated uncertainties are a real downer by comparison. The inspirational and the actual, the wish-it-were and the how-it-is: don't read one of these books without the other.
