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Bathsheba's Breast: Women, Cancer, and History Format Kindle
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A cancer diagnosis today is not necessarily a death sentence. Olson explains how breast cancer has threatened all women, regardless of demography, since at least the time of the pharaohs and probably since creation of the species. The fifth of Olson's 11 carefully referenced chapters inaugurates the book's evolution of Hope for breast cancer sufferers, signaling with its title, "New Beginnings: Assault on the Radical Mastectomy." Make no mistake, neither the chapter nor the book reveal the silver bullet that will conquer breast cancer. However, from this point forward, Bathsheba's Breast explains how medical science has made progress against the disease - sometimes despite itself - and how that progress appeared to be accelerating at the end of the 20th century, albeit in tortuously slow steps for those fighting the disease. Increasingly credible optimism emerges as Olson explains the evolution of medicine's knowledge and attitudes about breast cancer, the birth of breast cancer patient advocacy and the growing arsenal of weapons that medical researchers, physicians and patients are bringing to the fight.
Olson is comprehensive, well organized and even entertaining in an appropriate tone for such a serious topic as he gives us the history, evolution and status of the war against breast cancer. Bathsheba's Breast is suitable for all readers, regardless of gender, ethnicity, age or health. Its appeal to such a broad audience lies mainly in the mature tone and integrated style with which Olson approaches all aspects of the subject. It's also because he's deciphered cancer's jargon of "omas" and "ectomies" so they're understandable, both in definition and in context. Readers will be pleased how smoothly he combines history, complicated medical research, political science and public opinion with the personal stories of patients to produce a compelling read.
Faithful to the historigraphical method, the book ventures 3,500 years back to an Egyptian surgeon who wrote about "bulging tumors" in the breast for which "There is no treatment." Olson tells how Hippocrates, the father of Western medicine, studied the nature and cause of cancer, attributing its cause to "black bile," one of his four theoretical fluids of the body: blood, phlegm, yellow and black bile. The book develops a special character as it links these ancients to women of subsequent history who suffered from breast cancer. We learn about victims like Theodora, wife of Justinian, the emperor of Byzantium in the sixth century, Anne of Austria, the mother of Louis XIV in the 17th century, George Washington's mother in the 18th century, Abigail Adams, daughter of President John Adams in the 19th century and many sufferers in the 20th century. These personal experiences of breast cancer victims provide substantive information and welcomed inspiration for all readers, no doubt especially for those with the disease. Some stories are optimistic, others sad, some even humorous. Teddy Roosevelt's far-from-bashful, strong-willed daughter, Alice Roosevelt Longworth, battled the disease throughout much of her life. She lost one breast to cancer in 1956 and in 1970, at age 86, underwent a second mastectomy on the other breast. Emerging from the second operation, she announced unashamedly she was "America's only topless octogenarian."
The 20th century's sexual revolution, catalyzed by nude photos of Marilyn Monroe and increasingly large monthly circulations of Hugh Hefner's "Playboy" magazine beginning in the 1950's, established the cult of the breast in America. Olson explains how big breasts became big business as society placed new value on them because of their erotic appeal. As America's fascination with the breast was exported around the world, women, men and physicians became more amenable to alternative treatments for breast cancer. Ironically, preoccupation with eroticism encouraged the pursuit of a cure.
Bathsheba's Breast adds credibility and emotion to the history of breast cancer by sharing experiences of many 20th century women who've fought the disease with bravery and hope. The legacy of Rose Kushner's 16-year battle against breast cancer and the indifference it often suffered from arrogant physicians and disinterested politicians is unforgettable. Her emotions flared - as do those of readers today - as we read about a surgeon shouting at her, "No patient is going to tell me how to do my surgery."
No doubt Kushner told that surgeon what she wrote in her best-selling, 1975 book, Breast Cancer, "We women should be free, knowledgeable, and completely conscious when the time comes for decision, so that we can make it for ourselves. Our lives are at stake, not a surgeon's." Kushner is the founder of the American breast cancer advocacy movement who battled valiantly but ultimately lost her war with the disease in January, 1990.
The evolution of breast cancer advocacy in America inspired by Rose Kushner is a compelling part of the book. Olson visits labs and legislatures to explain breast cancer's clinical and political issues, ranging from the campaign for lumpectomies and radiation instead of radical mastectomies as initial treatment alternatives to the need for greater government support for cancer research. He tells how Shirley Temple Black, Betty Ford, Happy Rockefeller, Betty Rollin, Jill Ireland, Linda McCartney, Dr. Jerri Nielsen and many others had the courage to go public with their battles against breast cancer, generating publicity that kept the disease in clinical and political focus.
Although Olson mentions it only quietly in a brief preface at the beginning of the book, his personal battle against cancer has permitted him to fuse Bathsheba's Breast with an empathy that's probably the ultimate reason why the book is as good as it is. It wastes no time with irrelevance as it moves seamlessly from history, medical science and politics to the media, pop culture and patients. The story of the battle against breast cancer is multi-faceted and James Olson shines a bright light on all of them.
I particularly appreciate his appropriately savage treatment of the hucksters and charlatans that have swirled around breast cancer patients (and all patients, regardless of the type of disease, whose survival is uncertain), and I enjoyed the survey of prior theories about what caused breast cancer and some of the sillier ancient treatments.
There are also a few moments that are somewhat painful. He outlines a murder-suicide, for example, and describes surgeries from before the invention of anesthesia. It's hard to face the fact that some parts of the women's movement were either so anti-male or so ignorant of medical science as to claim that if breast cancer happened to men, it would have been cured already.
In fact, if you compare cancers by either the number of lives lost or the age at which people die, breast cancer receives a disproportionately high share of resources. There are basic subjects, such as cancer-related fatigue, for which all or nearly all of the research is conducted exclusively in women with breast cancer--creating obvious problems, if you're a man with any form of cancer, or a woman with some other form of cancer (90% of women with cancer DO NOT have breast cancer).
Although he doesn't emphasize this point, this book helps identify the trends and events that resulted in 5% of cancer patients--the women with breast cancer--getting far more than 5% of the research, attention, treatment, or support.
And I do mean political. Although Olson takes specific case-- Annie of Austria, Nancy Reagan, and antarctica scientist Julia Nielson to name a few--what he shows in this book is the public's attitude and depth (or lack thereof) of knowledge vis a vis breast cancer in each case.
The strength of this book is the focus on how politics, cultural trends, and gender pay a large part in how the US has funded and treated cancer. One of the most interesting threads that exemplifies this is how the book traces the rise and fall of the radical mastectomy, the Halstead procedure (where not only breast, but chest muscle and sometimes even shoulder bones were amputated).
Heralded as one of the only procedures to truly show clinical results in an era awash with quack remedies, in Europe it lost favor much earlier than in the United States once physicians realized the mutilation was unnecessary and women with lumpectomies and radiotherapy had similar 5 year survival figures.
It's quite scary to think about the thousands and thousands of women who underwent this procedure. As a breast cancer survivor who has undergone the lumpectomy myself, I am grateful to the activists mentioned in this book (including notables such as Dr. Susan Love and Rose Kushner) who were lone voices in a male-dominated medical and medical policy culture making decisions about women's bodies.
Olson doesn't spend as much time as I would have liked on the current state of cancer research, focusing just a bit on Tamoxifen and the BRCA genes without going too much into the genetic strides breast cancer researchers have gone in putting together clinical trials involving different genetic make up of tumors reacting to different chemotherapy cocktails.
And as a survivor, it is sometimes disheartening to read the statistics sprinkled throughout the book that show that not much changed in terms of mortality or disease free life expectancy for most of the 1900's.
But the book itself is readable, informative, and definitely makes one a bit irritated at how politics has influenced breast cancer treatment. I can only give a sigh of relief there are more female surgeons, oncologists, and researchers today.
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