I now look at myself every morning, every evening, naked, in the mirror, equanimously, as I always did, and what I see is not a maimed body. Some might call this denial. Yet – I look at this flat expanse of my chest and I do not find it ugly, or repellent. My face, somehow, “goes” with this chest, there is a harmonious continuity from my face all the way down my body. There is, in all human beings, when they are bare-chested, a touching symmetry between the eyes and the nipples, and this symmetry, of course, in my case, is gone. Yet, and this may sound scandalous, absurd, or even mad: this breast-less body is not devoid, in my eyes, of a certain pure and abstracted beauty. If it is indeed monstrous, it is so in the manner of some magical, not quite human creature – a fairy, a mermaid – an Amazon. Anne-Marie de Grazia
Likely you know the fairy tale of The Princess and the Pea. A prince is looking for a bride. A woman appears at the gate of his castle who claims to be the real deal but she looks, well, pretty disheveled. Old ma knows how to tell the difference, and so places a pea under the pretending princess’ twenty mattress bed. When the parvenu wakes up she whines incessantly about having slept so poorly because there was something amiss with the bed and BINGO everyone knows she’s the real deal. The prince marries his newly authenticated bride. The pea is put in a museum.
As a child, I felt deeply ambivalent about this story. The fetishization, in women, of useless knowledge seems to me epitomized by the positive spin placed on the princess’ ability to find the pea. And when the possession of that useless knowledge is the litmus test for jubilant heterosexuality, well, then its existence, let alone cultivation, is most assuredly far from innocent.
How then, to feel about the fact that it is now my task, imposed by the medical establishment, to effect local control of a breast cancer recurrence by finding the pea. “When it comes back” my surgeon explained patiently, the other day, “it almost always feels like a pea.” Keeping track of the pea is not a new job for me. My family tree is chock-a-block with breast cancer, which is why I have been dutifully going for yearly mammograms since the age of 42.
Little did I know that mammograms are a very unreliable method for tracking early breast cancer in women under the age of 50, and that this lack of accuracy is even more pronounced for women with what are known as “dense breasts” – small, prone to cysts… After all, I had a “good” mammogram just ten months before my cancer was diagnosed. It had been missed the time before. It is also the case that I did not know that MRI’s are considered by some to be a much more reliable tool for detecting early breast cancer in women under 50.
I wonder about how my chances of finding that pea would be affected by reconstruction. There is a lot of pressure on women to undergo reconstruction after a mastectomy. Audre Lorde talks about this phenomenon in her Cancer Journal. When I went to visit my GP about a week prior to my double mastectomy, she asked me which surgeon was going to do my reconstruction. She guffawed when I told her that I had decided against reconstruction. “You’re in denial” she proclaimed. “I am going to sign you up. The waiting list is two years anyway. By then, you’ll be more than ready.”
Oncological research appears to indicate no impact of reconstruction on detection of recurrence. But there is a clear set of normative assumptions at work in this research, which go something like this: (1) breasts constitute a vital marker of femininity, (2) women will benefit from the restoration, post-mastectomy, of their “spoiled identity” (E. Goffman) and therefore (3) reconstruction should be made widely available to all women undergoing mastectomy.
This is what the official story regarding reconstruction and mastectomy sounds like:
“Deciding on Mastectomy Making the decision to have a mastectomy can be very difficult. It can be hard to imagine living without your breast, and you may feel like your identity or femininity is being threatened. The procedure can often be made easier by having breast reconstruction after mastectomy. This helps to reshape your breast and reduce any disfigurement, and may help you to feel more comfortable choosing mastectomy. Ask you health care provider for more information about this option.”
No where in all of this research are the side effects and complications of reconstruction clearly delineated. Reconstruction surgery involves an initial long and very painful operation followed by several additional surgical procedures. The impression of breasts is created either by means of implants or the use of a woman’s own tissue (abdominal) which is relocated to the chest area.
So what is the medical establishment’s priorities in relation to breast health, cancer, and morbidity amongst women? Clearly, millions, if not billions of dollars is going to the improvement and funding of breast reconstruction. And it is equally obvious that virtually no money is being directed to programs that would improve the reliability of cancer detection in populations at-risk of mammogram failure. Whose job is it, actually, to find that pea? How terribly convenient for medical discourse inappropriately to relocate responsibility to women to find that pea, and in so doing, exaggerate the agency possessed by individual women in determining the likelihood of survival in relation to early stage breast cancer.
What a different world it would be if we decided to spend all of the breast cancer research dollars on the (a) identification (and elimination) of the actual causes of breast cancer, (b) widespread availability of accurate methods of early detection, (c) appropriate methods to deal with post-surgical complications (e.g., lymphedema, which is very common and extraordinarily challenging), and of course, (d) a cure for cancers of all kinds. Hallelujah!
July 22, 2007 at 10:40 pm
I know what you mean, about seeing a new beauty in oneself, after mastectomy. The notion that breasts are what make a woman feel like a woman is baffling for those of us who didn’t have our vaginas removed at the time of the surgery. I’m pretty sure that’s a rather more significant marker of “woman-ness”. I mean, I’m willing to accept that there’s women who want to have reconstruction. So why can’t people accept that there’s women who…don’t?
The fact that your GP is so socially unfortunate shouldn’t come as a surprise, given my own experiences, but it still…chapped my nether regions (I’m being quasi-polite in recognition of the fact that I’m not on my own blog):
How dare she? I mean, how DARE she say you’re in DENIAL? I can’t think of a more pragmatic, no-nonsense position than to say “I don’t need these to feel okay.” Where’s the denial in that?
Excellent, excellent post. Thanks for writing it!
July 23, 2007 at 2:31 am
Can I just say that I think you are as gorgeous, beautiful, sexy, wonderful and all those other words we use to describe attractive people, with a flat chest as you were with a chest that had breasts.
Just my humbe opinion of course
*S*
July 26, 2007 at 8:49 pm
Your closing comment is absolutely correct: Find the cause to find the cure. I’m old enough to remember hearing that slogan on the TV when I was a kid…long before going to medical school.
Women need to know about and utilize breast thermography? It is an FDA approved, painless, no radiation test of your physiology. A mammogram is a xray of your anatomy and finds cancer–after it has occurred. A thermogram identifies problems years before it shows up on a mammogram giving you a chance to be proactive. And it is a great tool for young women, those with dense breasts and those who are concerned about cancer reoccurance on a remaining breast.
Women need to drive this industry and get Conventional Medical doctors to do their home work and know that the technology is new (digital) and the international research advocating its use is compelling. The technology has been available since 1982. Doctors don’t use it because they can’t write a prescription for a drug to address abnormal findings…the answer is in diet, vitamins, supplements and homeopathic detoxification.
Remember: Mammograms do not prevent cancer–they find it early.
There are many things you can do to improve breast health. Find out more here: http://drsherri.wordpress.com/
November 9, 2007 at 2:12 am
[...] I have commented upon in previous blog posts, breast reconstruction is narrated entirely un-self-consciously as the reparation of a state of [...]
October 4, 2008 at 10:59 pm
I am a female artist working on a piece that discusses the feminist ideal. I am centering the work around Breast reductions and mastectomies and the feelings associated with the loss of femininity. Regardless of the feelings of relief or even being content with the results of surgery, I felt a sense of displacement in how I related myself to other women. The overwhelming feelings of disconnectedness with the body and perceptions of the self are ideas I’m trying to explore. I know that I still perceived myself as the same woman I was before my surgery but what was reflected to me was a body I didn’t recognize or feel connected to. I’ve discussed these feelings with other women that have had both reductions and mastectomies. I have had a breast reduction myself and will be using my body in my work. I am in need of other women to model or that have photographs of themselves having either the breast reduction or mastectomy surgery. I cam across your website and thought you could help me in locating women willing to participate in this project. I appreciate anyone who is confident enough to allow me to use them in this important work. I am also receptive to any women that feel comfortable discussing these ideas even if they are not willing to provide images. In discussing this topic with other women having the same experiences it has been both beneficial to myself as well as them. If you have any information for me or have any further questions about my work please contact me via email.
aosoway@cnr.edu
Thank you, Ashlee