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Authors: Nancy G. Brinker

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BOOK: Promise Me
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On the nights the theaters were dark, we watched risqué film noirs in stuffy art houses, where cigarettes glowed like fireflies, appearing and disappearing here and there throughout the audience. Suzy and I made no attempt to flag down viable dates, and if any were eyeing us, they didn’t let on.

“All the hair on these men here in Beatle Land,” Suzy said on our way home from Madame Tussauds. “I can’t tell if they’re mods or rockers. Very confusing.”

“I don’t have anything to wear on a date anyway. Our clothes look like they’ve been dragged through three wars.”

“I know, but we can’t give them up for two days to be cleaned. We’ll just keep dousing ourselves with French perfume to disguise any musky aroma. Mommy would do the same in our situation. It would be silly to miss any opportunity.”

“Agreed.”

Suzy rested her head on my shoulder, and we swayed with the subway.

“I’m glad we came, Nan. This trip will forever be the highlight of my life. Other than getting married and having children, I mean.” She stuck her feet out in front of her. “Are my legs smaller?”

“No, your shoes are bigger.”

“I’ll bet I’m down to a size two. My hose have to be rolled three times at the top. And I’ve been eating like I’m getting shot in the morning.”

“We must have walked another six miles today. That would do it,” I said, wondering why that wasn’t doing it for me.

Our excitement about laying hands on an American newspaper faded when we saw the front page. Escalating bloodshed and casualties in Vietnam. Thirty-four people dead after five days of race riots in Los Angeles. Close to home in Illinois, a plane had crashed into Lake Michigan, killing the crew and twenty-four passengers. That night, while I stared at the ceiling, despairing over the state of the world, Suzy thrashed and moaned until I shook her awake and crawled in bed with her.

“Are you okay?” I whispered. “You were having a nightmare.”

“That plane crash … oh, Nan …” She hugged her arms around me,
trembling. “I want to go home, but I feel sick when I think about getting on that airplane.”

“We’ll dose you with Dramamine. You’ll see. No more shpilkes.” I used Aunt Rose’s word for nervous jitters. “If we’re going to be world travelers for the next fifty years, you can’t be afraid to get on an airplane.”

“I hear they have fabulous parties on ships. Dancing every single night.”

“Oh. Well, if you’d be more comfortable on the boat, I don’t mind.”

I miss the days of sprinting into the airport to catch a plane. No barriers, no fear, no standing in line with one’s shoes in one’s hand. We pride ourselves on our streamlined connectivity, but in some ways we’re more segregated than ever, conferencing via video instead of face-to-face, thumb typing a quick text instead of making the call. Dashing down the concourse in those God-awful square-toed shoes, we felt like we were flying already. Every gate invited us on another adventure. Suzy charmed her way out of the extra luggage fees and fortified herself with root beer and Dramamine.

“I’m ready to get home,” she said. “I’m going to take a long, hot bubble bath.”

“I’m going to eat a slab of roast beef two inches thick.”

“Nothing compares with good old America.”

“My favorite place in the whole world.”

“My favorite place is
everywhere.
” She closed her eyes and gripped my hand as we took off over the Atlantic. “I don’t want it to be over, Nanny. I can’t believe how fast life flies by.”

Forever Blonde

Judy Holliday, whose portrayal of a junk dealer’s doxy in
Born Yesterday
created a new kind of beautiful-but-dumb blonde, died of cancer yesterday. She was 43 years old.

T
HE OBITUARY
had appeared in the
New York Times
the same week Suzy and I left for Spain in the late spring of 1965. Suzy probably saw the item or something similar that went out on the wire, but she wouldn’t have known that Judy Holliday died of breast cancer. The
Times
obit mentioned something about “cancer surgery” but spared readers the specifics, sharing instead the more comforting detail that “She died in her sleep.”

The obituary mentioned Miss Holliday’s Oscar, Golden Globe, and Tony Awards, her genius IQ, and how she rallied friends to cook up a cabaret act while blacklisted from radio and television during the Red Scare. In 1960, she starred opposite Dean Martin in the film version of
Bells Are Ringing
, playing switchboard operator Ella Peterson, the Broadway role that won her the Tony. Ella has a second-act showstopper, “I’m Going Back,” in which she sings about returning to happier days at the “Bonjour Tristesse Bra-zeer Company.” In the movie, Holliday danced her hands across her décolletage and tossed in a sly little line about “modeling on the side.”

Judy Holliday was hilarious and charming. Like my sister, she somehow managed to be sexy and wholesome at the same time, and that’s how the mass audience liked to think about breasts back then. Torpedo bras were lifting and separating from coast to coast, but we kept it classy for
the most part, a coquettish wink-and-a-smile that offered just a hint of sexuality, the way peep-toe shoes offer a hint of red nail polish.

The unwritten media rule on breasts was “Look but don’t type”; most people probably wouldn’t have recognized the word
mastectomy
anyway. When Judy Holliday had her left breast removed in October 1960, she and her PR people put out a cover story that she was in the hospital for a “bronchial infection.”

Hoping she’d been cured by the surgery, Miss Holliday appeared on
Perry Como’s Kraft Music Hall
TV show a few months later and subsequently returned to the stage. She went on
What’s My Line?
in 1963 as part of a junket for a Broadway show called
Hot Spot
. It flopped despite her formidable star power, and the game show appearance would turn out to be Judy Holliday’s last TV gig. According to later reports, well-meaning physicians and family members thought Miss Holliday, who was prone to depression, would be better off not knowing her cancer had metastasized, so she was told the increasing pain in her right breast was “inflammation of the sternum.”

I strongly suspect that the dumb blonde with the genius IQ knew she was being lied to. The ravages of the spreading cancer quickly became undeniable. Whether or not it came up in conversation, she had to have known she was dying.

Would Judy Holliday be alive today had she known the truth about her diagnosis? Almost certainly not. Treatment options in the 1960s were few and ineffectual. At most—and it’s a stretch—chemo might have bought her enough time to make it to her son’s bar mitzvah. (Jonathan Oppenheim was twelve when he lost his mother.) Would she have died more peacefully or less peacefully had she been told up front about the terrible fate that awaited her? It’s not appropriate for those of us who didn’t know her to speculate.

The truly relevant question takes in a much bigger picture:

Is knowledge more dangerous to a woman’s health than ignorance?

Women were being “protected” from the facts about their breast cancer long before Fanny Burney’s surgeon assured her back in 1811 that a mastectomy was “but a little thing” to be carried out with the patient seated comfortably in a parlor chair. And it’s still going on today. Every
time I think we’ve come so far, gained so much ground, established open dialogue, claimed our right to make informed treatment decisions—every time I’m certain we can file this one under “No-Brainer”—we find ourselves rehashing it again.

As recently as November 2009, forty-four years after the death of Judy Holliday, the U.S. Preventive Services Task Force (which sounds like a government agency but is actually an “independent panel”) revised its recommendations regarding breast cancer screening and early treatment. Instead of getting routine annual mammograms beginning at age forty, they said, women should forgo routine screening until age fifty and then get a mammogram every other year. They went on to say women shouldn’t be taught proper breast self-exam (BSE) technique—that BSE was, in fact,
harmful
—because finding a lump in her breast causes a woman emotional distress and prompts her to take unnecessary action. The panel had based its recommendations on statistics that had been floating around for a long time, but as Mark Twain said: “People commonly use statistics the way a drunk uses a lamp post, for support rather than illumination.”

Of course, the news hit the fan, and pundits rushed in where angels fear to tread. One anchorwoman sat down with the network’s chief medical editor to ask the obvious questions. Scrimping on mammograms could at least be rationalized as a cost-cutting measure, but why discourage BSE—a no-cost, noninvasive procedure which simply encourages a woman to be aware of changes in her breasts?

“Amid the passionate response,” said the anchorwoman, “are a lot of women who say the old guidelines saved their lives. For example, we have a woman from Pennsylvania.…” She produced a letter and read from it.

I am a woman who was diagnosed with breast cancer at the age of thirty-five. It was because of me and my self-exam that I found this cancer. It was grade three, invasive, with three lymph nodes positive. It infuriates me that this study is suggesting that self-exams are useless. If I’d not done my exam, I’d be dead right now.

The anchorwoman lowered the letter and looked the medical editor in the eye. “So what are we saying to women like this one?”

“What we’re saying, with great sensitivity,” said the medical editor, “is that there are big bodies of science, where we look at the numbers across all women and all age groups who’ve been getting mammograms, and then there are anecdotes. The personal stories. We all know women who’ve found their breast cancers and were diagnosed at twenty-eight or routine screening at forty, and those stories
matter.

She really did say it with great sensitivity, too.
Great
sensitivity, I must say.

“But,” she went on, “the recommendations say that for every story like that, there were nineteen hundred other women who got unnecessary radiation, for whom screening wasn’t the issue. So cancer is always personal, but these recommendations are supposed to give us scientific guidelines.”

“But if, in fact, self-exam shows you that you have a lump,” said the anchorwoman, “even if the chance is overwhelming that you won’t find anything—but there’s a chance that you would—what does it hurt? Why not just let people self-exam?”

“If you do self-exam and you’re comfortable with that, that’s fine,” said the medical editor, “but a lot of women have been taught to do this search-and-destroy mission on their bodies every month, that our breasts are our enemies … and for the average woman, the yield is very low.”

A lot of women
. (Certainly a scientific, nonanecdotal way to quantify it.)

Do a search-and-destroy mission
.

Against their enemy breasts
.

The clumsiness, inaccuracy, and disrespect in that statement literally took my breath away. That characterization is the antithesis of what BSE is.

We take our children to the pediatrician every year for a routine checkup before the start of school; it’s never recommended that mothers should blow that off because “the yield is low” and the “average child” walks in and out as healthy as a polo pony. At regular dental exams, the hygienist never accuses us of “a search-and-destroy mission” on our gums. Driving the car into the mechanic’s bay for a routine inspection, we aren’t berated for treating the Chevy like an enemy. Yet for some reason, routine maintenance of breast health is constantly being scrutinized and blustered against. I’m just plain baffled by the assumption
that women who drive eighteen-wheelers and perform brain surgery turn into hysterical nitwits when they walk into a doctor’s office, so (as Judy Holliday’s well-meaning physician believed back in 1965):
Women are better off not knowing
.

The problem with BSE is that it works too well. When a woman finds a lump, she usually insists on knowing what it is, and when it’s a malignancy, she usually insists on getting rid of it. The vast majority of lumps are benign and even some of the malignant ones aren’t life threatening. If you completely ignore your breasts—keep your hands in your pockets, slap anyone who tries for second base, go to the movies instead of going for mammograms—odds are in your favor; you very probably won’t die as a result. That’s a statistical fact. One out of eight women will be diagnosed with breast cancer, but look at the bright side: the other seven won’t! A biopsy that rules out cancer is deemed “unnecessary”—a waste of a perfectly good panic attack. So, they conclude, why worry our pretty little heads? We’d be
healthier
not knowing, and the people who love and insure us would be happier if we weren’t so high-maintenance.

I reject the notion that blissful ignorance is healthier than an informed choice or even an educated guess, which is often as good as it gets. Shame on any doctor who subscribes to that belief, and God help any woman so easily displaced from the driver’s seat of her own life. We are the CEOs of our bodies. It’s our responsibility to gather the information we need to make the decisions with which we alone will live or die. My definition of an “unnecessary biopsy” is one in which you already know there’s a malignancy. If there’s any question, a biopsy provides a definitive answer. Obviously, I’d love to see a reduction in the number of biopsies on benign tumors. That’s one of the reasons Susan G. Komen for the Cure is convening a major national technology think tank in 2010 with the goal of developing better screening technology, including a more accurate, more predictive mammogram.

Early mammogram technology that emerged in the 1960s was a step forward from the blurry, nonspecific x-rays of yesteryear. The second-generation designs of the early 1980s reduced radiation exposure and increased accuracy with better film and the first motorized compression device. In the early 1990s, the introduction of rhodium filters again reduced radiation exposure and improved imaging. In 2000, we
took a giant step forward when General Electric introduced the first FDA-approved digital mammography system. We’ve seen significant advances in mammogram technology like clockwork every ten years since it was introduced, and it’s time for the next step.

Meanwhile, we have to use what we’ve got to our best advantage. I’m delighted that the “yield is low for the average woman.” But does that mean I can safely assume
I’m
average? Or is that just the cover story I’m supposed to tell myself?

Judy Holliday used to sing a song called “The Party’s Over”; with palpable sadness, she called it a day. “
They’ve burst your pretty balloon and taken the moon away …

Late in the spring of ’65, while Suzy and I sat at the kitchen table with our maps and guidebooks, Judy Holliday was quietly admitted to Mount Sinai. By the time we reached Venice, she was dead. Suzy flew off to Spain, unaware of Judy’s fate. Judy died in her sleep, unaware of Suzy’s existence. Would it have changed Suzy’s life if she’d known she was on that same terrible path? Would it have changed Judy’s death to know that someday women would stand up and demand the truth?

I believe knowledge is power, but I don’t deny that ignorance is bliss. The trouble with bliss, however, is that it’s often short lived. There’s only one way to stay blonde forever.

BOOK: Promise Me
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