October is Breast Cancer Awareness Month. Welcome. Last Monday was Pink Ribbon Day. My local shopping mall is decked out like a maypole. Pink posters hang from the ceiling exhorting women to get ready for BRAnanza time. As one of the most well-funded public health campaigns in the country, I sincerely hope that the campaign succeeds in raising awareness of breast cancer. I also hope it goes away soon, because it makes me want to vomit.
I will be the first to admit that I don’t have breast cancer — and amen to that, because last year, it looked as though I did. I had ignored a small lump in my right breast until it was big enough to make the right look bigger than the left. I justified my apathy in increasingly creative ways. I didn’t have private health insurance. I was only 28. I wasn’t middle-aged. And I wasn’t, well, naff.
Cancer, most people will agree, is not cool. To me it seemed to follow that cool people did not get cancer. Cancer happens in the fluorescent-lit workaday, shopping mall-decked-out-in-pink world from which I, as a cool person, try to distance myself.
So six months passed before I did anything.
When I finally talked to my GP, she felt the intruder, gave me a stern talking to and referred me to the Breast Clinic at St Vincent’s. The specialist there said "hmmm" a few times, then performed a fine needle aspiration in order to get a bit of the lumpage out for testing. (A fine needle aspiration is what it’s called; I’m not commenting on how great a needle aspiration it was.) So, easy, yes?
On the way out, the specialist assured me that my little friend was most likely fibroadenoma, a benign, very common, fibrous mass of breast tissue. He also said that I should consider having it removed, because it could interfere with my future tumour hunting escapades. Just having a benign lump around, the inference went, invited its malignant cousins around for Christmas. I told him that if my little friend was benign, I was totally keeping him, because he had done wonders for the appearance of my right breast. The specialist agreed that, between him and me, this was indeed so.
Six months later I found another lump trying to muscle in on the same real estate. Two! Fearing a run on the market I went back to the Breast Clinic. Things didn’t go so smoothly the second time around. It turned out that the results of the first fine needle aspiration weren’t on record, and that my old friend had grown a centimetre in diameter and was threatening to invade Poland. Without so much as a "hmmm", the specialist referred me off to the medical imaging department for an ultrasound-guided core biopsy. Things weren’t looking so good.
Don’t be shocked, but an ultrasound-guided core biopsy is not as fun as it sounds. Having a javelin-sized needle rammed into one’s chest while listening to cries of "not there! that’s the pectoral wall!" is, ahem, a little deflating.
And I never realised that medical opinion could be so divided on the question of "so … can I have a drink after this?"
On the upside, the doctors and nurses were all very lovely, and afterwards I got to have tea and biscuits on a gurney as the anaesthetic wore off. When they checked me out of hospital, I took off my gown, fixed my hair, and hightailed it to the pub. The memories of the ultrasound picture — an X-ray needle penetrating my X-ray mammary — won’t be erased by beer. It’s not easy finding a bright side to the ever-present threat of cancer.
After all this, I watched coverage of Pink Ribbon Day on the news this week with a rising sense of bile. I remember telling my brother as I awaited the results of my biopsy that if my little friend had to come out, I would wrap him up in pink ribbons and keep him in my pocket as a memento of our time together. Alas, tumour couture is not the inspiration behind Pink Ribbon Day. Like Daffodil Day, Red Nose Day, and Jeans for Genes Day, the name provides an easily remembered symbol for fundraising purposes. Nevertheless it made me angry.
The difference between Pink Ribbon Day and these other public health campaigns is that they don’t stereotype their subject. My experience of life and death is not reducible to an insipid fundraising symbol.
Nor, I add, is the "risk" of death compatible with colour coding. I mean Pink Ribbon Day! Why not Doily Day or Lace Cushion Day? The "pink" here can only be intended to invoke either the type of femininity found in grandma’s bathroom, or a vagina. Either way, I can’t imagine that Pink Ribbon Day relieves the extraordinary stigma that male sufferers of breast cancer must endure. In addition to the usual list of cancer-related nuisances such as feeling like sh*t, looking worse, and worrying about imminent death, men with breast cancer cannot simply be men with cancer. They are men with an embarrassing cancer.
What frustrates me most, however, is that Pink Ribbon Day, in spite of admittedly fantastic public penetration, reinforces the perception that "women’s issues" are something for women to sort out themselves, and discreetly. Women’s health management is an old, gnarly taboo. Just because we’re lucky enough to live in a culture that doesn’t regard fistula as a faux pas does not mean that we’re beyond double standards. A man can make a joke to a co-ed audience about the doctor asking him to bend over and cough. A woman who jokes to the same audience about her recent pap smear is likely to be seen, by both women and men, to have crossed a line.
The health issues that women face aren’t just "women’s business", gendered by that most insidious symbols of femininity, the colour pink. Breast cancer is a public health issue in the same as diabetes, heart disease, and well, cancer. Don’t get me wrong — there is a need for research and action on the increasing instance of the disease, and I am proud of the achievements of Australian researchers and donors in this regard.
There are very good reasons for providing gender-specific public health information, and for targeting higher risk demographics in prevention campaigns. But there is no need to reinforce social stigma in the process. It seems to me Pink Ribbon Day reinforces the perceived girliness of what is ultimately a human disease.
The lump I found in my breast almost two years ago turned out to be fibroadenoma after all. And yes, I’m keeping him (in my breast, not in my pocket). Looking back at the reasons why I delayed seeking diagnosis, I have to admit that emotionally, I just could not identify with the social category popularly understood to be at risk of breast cancer. I was young, healthy, educated and avant garde, dammit. If Rome were burning, I would have preferred to burn than jump in a boat full of people wearing pink plastic ponchos. I was, in short, a twit. But I have learnt from this experience, and understand now that cancer just does what it does and we are all, to different degrees and for different reasons, at risk.
Because of this risk, public health campaigns are an excellent thing. Compared to countries without capital to support such campaigns, we are very lucky. But women don’t need to be patronised.
We all — women, men, young and old — just need to be better aware of the health risks we face, and to be encouraged to take responsibility for following through on available processes for prevention and treatment. Surely the best way to engender this responsibility in each one of us is to do away with social stereotypes in public health campaigns — not reinforce them.
So no. During Breast Cancer Awareness Month, I will not be wearing a pink ribbon, or donating my old bras, or altering my Facebook status, or sporting a poncho. But if anyone wants to cop a feel of my right boobie for diagnostic purposes, I consider it my public duty to consent.
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