C is for Courage, Not Cancer

The photograph on the big screen was beautiful. Curvaceous, shell-pink clusters of little buds snuggled against one another, forming a sphere that was held afloat by a skein of creamy threads. Sitting in the dim lecture room at the Radcliffe Institute for Advanced Study at Harvard, where I had a fellowship a year ago, I looked around and realized I was the only one in the whole place who was smiling.

The slide on the screen illustrated a lecture about cancer research. It showed a magnified image of metastatic breast cancer cells that had invaded someone's lung tissue. Nothing to smile about. But I had spent so much time being afraid of cells like these that it was a relief to actually see them, to meet up with them in the anonymous dark of a university lecture hall, and to know them for what they were.

I felt a kind of calmness that day, the way I'd felt on a night long ago in 1991, during a battle in the Iraqi city of Kirkuk, when the sky suddenly lit up with a streaking peacock's tail of green and blue tracer fire. The explosions were beautiful and deadly, like the multifoliate metastasis on the medical lecturer's slide. A newspaper reporter at the time, I had been afraid of finding myself in the midst of a firefight. But when it actually happened, the fear dissolved. "So it's this," I remember thinking. "But it's only this. I will survive it, or not. And if I do, there will be one less thing in life to be afraid of."

The day in 2004 when the radiologist told me I had invasive cancer, I walked down the hospital corridor looking for a phone to call my husband, and I could almost see the fear coming toward me like a big, black shadow. I had been so sure the call for more tests following a routine mammogram would turn up nothing that I had gone to the appointment alone. Now I knew if that approaching shadow caught up with me, there was a good chance it would crush me. I would crumple into a sobbing heap.

The fear coming for me was an old adversary. I had been afraid of breast cancer, as I suspect most women are, from the time I hit adolescence. At that age, when our emerging sexuality is our central preoccupation, the idea of disfigurement of a breast is particularly horrifying. There were plenty of things I had more business being afraid of: actual, statistically significant risks such as boyfriends who drove too fast or drank too much, party drugs from sketchy sources, adolescent recklessness in treacherous surf or on too-difficult ski slopes. But somehow my imagination could not compass the very real, proven danger of these behaviors; cancer was the killer that stalked my teenage nightmares.

It is a most commonplace fear. Although a cursory exploration of health statistics reveals that heart disease kills many more of us, cancer remains our most potent metaphor for that which is deadly and dreaded and out of our control. In the last century, wrote Susan Sontag in her memorable 1978 essay “Illness as Metaphor,” it was tuberculosis that provoked fearful fantasy. “Now it is cancer's turn to be the disease that doesn't knock before it enters...treated as an evil, invincible predator.”

Why is this? Blame the movies, in part. If screenwriters have to kill off a female character, they love to give her cancer. We've seen so many great actresses go down to the Big C: Ali MacGraw, Meryl Streep, Emma Thompson, Debra Winger, Susan Sarandon.

Hollywood cancer distorts the truth of the disease in two highly significant ways. In a study of American movies from the 1930s to the 1990s, more than half of all cancer patients depicted are under 30, and three-quarters under 40. In the real world, cancer is overwhelmingly a disease of older age.