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While this book is well written and engaging in many ways (and the divergence into "The Price Is Right" entertaining), I had a few problems with it. And not just because its heroine, Natalie Miller, is designed to be one of those unsympathetic protagonists, and maybe is even more so to me because she grew up a child of privilege (I didn't), is an ex-Ivy Leaguer and sorority girl (I'm not), and has a very tony job working for a NY senator (I don't) that allows her to wear shoes that cost in the three figures (etc.). She's also hard as nails and appears to have no conscience and no life beyond her work, and to have an ambition to someday become President because...well, she would love to be President. My issue with her is that this novel uses the experience of breast cancer to transform its unsympathetic protagonist from Ms. Hardass into Ms. Wonderful, and in some ways, the transformation is just a bit too magical for me.
Sure, Natalie has to cope with fatigue and depression and feeling ugly and out of sorts. Yes, she has to cope with feeling that she's falling behind at work and being left out of the loop. And she has to deal with losing her old body and getting used to a new one, from breasts to weight to hair. And yes, she even has to stare down the possibility of her own death if all of her efforts fail. Through these trials, she does become a more sympathetic and empathetic person. One more human and principled, who has learned to value what really matters, and how to tell people without values where they can stick it. She also becomes more able to reach out and ask for help when she needs to. And yeah, she learns to smoke pot, which I guess is supposed to be some kind of a virtue (whatever).
However, she also becomes someone whose biggest romantic dilemma is whether to stay with her returned ex, an up-and-coming rock star who's always abandoning her for a gig, or to fall for the Dr. McDreamy who seems to be falling for her (for no particular reason other than his admiration of how she's fighting her disease) yet allows himself to be manipulated into restarting a dead relationship with one of her friends (why? Is he so much of a wimp that he can't just say no?). In other words, when it comes to romance, we should all be so miserable...This stuff touches on fantasy fulfillment a bit, and makes me question whether some of her decisions are so wise. Is one man so terrible for her because the Stones invited him to tour with them and he wants to go? Is the other so wonderful, considering that he's letting himself get led around by the nose by an ex he doesn't seem to love anymore? Also, Natalie mentions a few times that she is looking for her "alpha." I wonder what she means by this: her "alpha and omega," as in, her be-all and end-all? Should anyone be that to anyone else? Or her "alpha person" or "alpha male," so she can just meekly follow behind while he takes the lead? She doesn't even seem like a person who wants to follow someone. One wonders why such a strong-personalitied woman would want to follow an even stronger-personalitied man. (In any case, it doesn't seem as if either of these men fit that description, or as if it would be good if they did.)
But finally, the flaw that most concerns me about this novel is that it maintains the non-cancer-sufferer's myth of the cancer patient as more brave and courageous than everyone else. From what I read in the interview with the author included at the end of my edition, she was inspired to write it by a friend who died of breast cancer. After I finished the book, I wasn't surprised to find that she was an onlooker to the breast cancer experience rather than someone who had experienced it herself, because if she was, she'd know better. She'd know that fighting cancer doesn't mean you're brave or courageous; it's just something you're doing because you have it, and the only other alternative is letting it take its course and dying, so you fight it. Natalie asks early in the book whether she isn't just doing what she has to do, but the question is never answered; at the end, we're left with the impression that she is indeed brave and courageous, and that her positive attitude has made a difference. In fact, she tells us, studies show that a positive attitude helps patients beat cancer. The truth is quite the opposite: studies are showing that positive attitudes DON'T necessarily improve survival rates. I feel that the author, while trying to pay tribute to her friend by telling the story of a cancer patient in first-person form, didn't pay her quite fair tribute by painting her as more of a heroic figure than she probably would have painted herself. Also, she gives the misleading impression that a breast cancer patient in remission is officially out of the woods after five years without a recurrence. That is true of other cancers, but breast cancer is not like that; technically, it can recur at any time, even if some forms of it are less likely to return than others. And that would be a fact that Natalie, as a younger person at diagnosis with a more aggressive form of cancer, would have to live with for the rest of her life. She's never shown here contemplating how this might affect her, her relationship with a man (it doesn't seem to worry the guys she's with at all), or her dreams to become President someday (can you imagine how her opposition would hype her unfitness for office by emphasizing that she might have a recurrence?).
The author mentions that this book isn't really about the experience of breast cancer, it's about the experience of self-transformation, and that the protagonist's breast cancer is merely used here as a catalyst to get that self-transformation process in motion. Maybe that's the problem, right there. I had hoped I'd be reading a book about breast cancer, and this book isn't really about breast cancer, it's about a woman in need of a life makeover. Breast cancer is merely the trigger that forces her to make over her life. If you're looking for a story about a woman who's happy with her life as it is and doesn't want breast cancer to change it, or one who's trying to deal with breast cancer at the same time as she's coping with other serious problems in her life (and I mean stuff more serious than "my boyfriend is dumping me" or "my boss might lose the election"), or one who has breast cancer whose problems involve not only getting better but also paying the treatment bills, best look elsewhere.
An interesting sidelight of this book is that it's about a woman who works for a fictional woman senator from New York, and one wonders whether the character of Senator Dupris is based on any real-life person we might know. Especially given that one of Senator Dupris' favorite phrases is "I'm in it to win it," and that she seems to have no moral compunctions and to be willing to do whatever is politically expedient. Perhaps her resemblance to any persons living or dead is, as they always say, entirely coincidental. I guess only the author knows for sure!
To wrap up: Yes, this is a story of breast cancer as Life-Transforming Experience for somebody who badly needs one. The danger? It perpetuates the idea that breast cancer can actually be a good thing, because it can make you change your life. Yes, it can (although it needn't), but it can also END your life. Maybe it would have been better if Natalie had just gotten canned by that senator at the beginning of the book. She could have had the same Life-Transforming Experience without any of the threat to her life--and she would've gotten to keep her breasts, too.