Body Image, Femininity and Health

The number one cause of death for women in the U.S. is heart disease; cancer is number two, with lung cancer being the leading cause. So why is it that the thought of breast cancer scares the beejesus out of us? It’s not even on the top 10 list.

Back in 2000, I rode in a motorcycle fundraiser for the Susan G. Komen Foundation. It’s called the Pony Express, and I rode 6,000 or so miles in two weeks. In July. Through the plains and into Missouri.

I was originally going to ride only the first few legs: Seattle to San Francisco. After all, I’d been riding only a little more than a year when I started thinking about the trip, slightly less than two years when I did the ride. Could I really ride that far in such a short timeframe? I did the ride in part as a personal challenge, in part because a friend’s wife had breast cancer, in part because a friend was riding and I would meet up with her in Omaha. But before I “self-educated” a bit (prep’ing) breast cancer worried me a whole lot more than heart disease and stroke.

I did a followup ride in 2003 (Seattle to LA), but my heart was falling out of it. I’d almost convinced myself that the emotional strings being pulled were at the expense of preventable risk. In 2004, I was convinced, probably due to health issue with both parents. In the intervening years, every-now-and-then I think about organizing a ride for heart disease. It’s not nearly as sexy (ie, emotionally engaging) as breast cancer, but it kills more women (like my mom) and it’s at least partially preventable, unlike breast cancer.

But today my rational brain bumped up against my emotional brain.

I had my annual mammogram this morning.* Later, I wasn’t surprised to see I’d missed a call from Virginia Mason. I’m, erh, busty and have, to quote the radiologists, “dense breast tissue.” (Those of you who know me can stop laughing now!) This means that I often have to go back for a follow-up. I even had a biopsy last year. Until today, the “we’re not sure what we are seeing” object has always been a (benign) cyst. Not today. It’s an unknown mass on the left chest wall.

So I go back to Virginia Mason Tuesday afternoon at 2.30. There was an unspoken urgency in making that appointment. I returned the call at 3.56; the appointments person’s voice mail said she worked 8-4.I did not expect to get a call back until Tuesday morning, but the phone rang at 4.03. When she said, “when would you like to come in?” I said, “what do you have?” She said, “how’s 2.30 or 3.30 tomorrow?” I said “2.30” and she followed up, “It will take about an hour, and you’ll know the results before you leave.”

After I hung up the phone (well, pressed “end call”), I started thinking about the opening question: why does the thought of breast cancer strike such fear in our hearts? And why did my heart race a bit, even though I know that these follow-ups are almost always a false alarm?

I wonder if the hint of breast cancer strikes fear in the hearts of women in cultures that are not as breast-fixated as the U.S. I’m thinking that the answer might be “yes” because the breast is such a symbol of femininity. It is the organ that provides sustenance to the newborn, after all. So we have this body part that represents nurturing … and then it turns potentially deadly and disrupts our lives and the lives of those around us. As Betsy Lee-Frye writes:

It can be difficult to express the sense that one’s body has betrayed her or that the loss of one or both breasts can feel like an end to being female.

I know the stats: 5-15 percent of mammograms yield some sort of false positive that leads to further tests, and most of those tests are negative. But a part of me worries (math illiteracy illustrated here) that given I have had so many false positives, I’ve used up my karma — that the cards, so to speak, will turn against me, that my luck will run out. Irrational, I know, but then we’re irrational animals, despite what they teach you in economics class.

So I totally ‘get’ the recommended change in the health care reform (HCR) debate about mammography and women under 50 who do not have elevated risk factors (like having breast cancer in the family). Well, my rational mind gets it.

But tonight, my irrational mind does not.

* I have risk factors: maternal first cousin with breast cancer at age 50, DES exposure in the womb.

Updated: Another false alarm.

2000 Pony Express Ride
Here’s a three-minute recap of one day of that ride, made during a Center For Digital Storytelling workshop. (It’s my first “video-like” piece ever.) I had thought this day-from-hell was a “hero’s journey” sort of narrative, but my coach suggested that there was something more personal at work. She was right.