“Those of us who stand outside the circle of this society’s definition of acceptable women; those of us who have been forged in the crucibles of difference know that survival is not an academic skill. It is learning how to stand alone, unpopular and sometimes reviled, and how to make common cause with those others identified as outside the structures in order to define and seek a world in which we can all flourish. It is learning how to take our differences and make them strengths. For the ‘master’s tools will never dismantle the ‘master’s house. They may allow us temporarily to beat him at his own game, but they will never enable us to bring about genuine change. And this fact is only threatening to those women who still define the ‘master’s house as their only source of support.” Audre Lorde, Cancer Journals (pg. 112)
The Breast Cancer Industry has become a power house, a ‘master,’ at utilizing tools provided through medicalization enabling the silencing of women through ‘advocacy.’ Subverting women’s mental, physical and emotional expressions and needs unintentionally or intentionally, women may or may not consensually comply and consent is rarely informed; informed as having all the options available and easily accessible through education. Exploring how this is accomplished through the intersectional qualities of nationalism, medicalization, and marginalization we begin to see how the barriers are blurred, effectively distracting from the reality of any true boundary. Treatment options appear limited and confined to the ‘master’s tools’ of surgery, chemotherapy and radiation while in reality there are a multitude of successful treatment options and preventative measures that remain unexplored and unacknowledged by conventional western medicine, the ‘master.’ “Expert knowledge creates the conditions for measurement, surveillance, and calculation as means of managing and regulating populations as forms of governance.” (Nichter, pg. 6) Prevention remains an afterthought to diagnosis and denial while detection and treatment remain the sustainable focus given to women in the United States. “The judgment of ‘who is better qualified’ is fraught with complex and subjective assessments.” (Harris, pg. 1770) Women experience breast cancer as bystanders, patients, victims and or ‘survivors’. Efforts to wage a national ‘war’ on breast cancer are facilitated though investment and visibility of ‘viable’ options that have been predetermined by the ‘master’ and reinforced through medicalization. The function of medicalization marginalizes alternatives, their ‘viability’ and those who seek them. It is these marginalized women searching for their own options that deserve a voice to uncover options allowing their stories to be discovered by others who may be marginalized themselves and in need of alternative options.
Women maintain an ideal of nationalism defined by motherhood and nurturing manifested symbolically through breasts and breast health. The ‘traditional’ nuclear family consists of a heterosexual, white, middle to upper-class ideology. “American motherhood and family must be protected from a disease that threatens not just individual lives but also the normalized socioeconomic identities and relationships that constitute a nuclear family.” (King, pg. 45) Physical impairment assumed or real threatens the ideal nuclear family, home, community and feminine nationalism. Female nationalism standardizes values and reproduction of norms, beliefs and practices. A ‘good’ family is a healthy and productive, by working and reproducing, adding to the population and value of a state through human capital. If the visual symbolic source of reproduction is damaged or stigmatized the home, family and community are degraded. The symbolic nature of feminism, motherhood and motherland produced by the landscape of healthy reproductive women is destroyed by breast cancer. Stigmatizing and transforming the normal, healthy and pure into the abnormal, unhealthy and polluted. “The concept of social norm, an important element in labeling theory, has never been denotatively defined.” (Scheff, pg. 444) The normal or nuclear family epistemology is not sustainable within the reality of breast cancer. In order to save the nuclear family, breast cancer and the symbolic nature of the breast was transformed into heroic survivorship. “The process whereby a social representation is accepted and absorbed by an individual as her (or his) own representation, and so becomes, for that individual, real, even though it is in fact imaginary.” (de Lauret, pg. 12) Gayle Sulik sociologist and author of Pink Ribbon Blues: How Breast Cancer Culture Undermines Women’s Health, defines this imaginary woman as a ‘she-ro’, a battle hardened woman who maintains her femininity while surviving the brutal onslaught of a breast cancer ‘war.’
National feminism informs and shapes the space that women inhabit. “Woman’s place in human social life is not in any direct sense a product of the things she does (or even less, a function of what, biologically she is) but the meaning her activities acquired through concrete social interactions.” (Mohanty, pg. 68) Women are placed in the domestic space; it is this space that creates complicated socialization in the arena of breast cancer. Help that is offered especially by another ‘aggressive’ woman who refuses to take no for an answer is acceptable assistance while asking for help is a social taboo and weakens the ‘nation.’ A true ‘she-ro’ would not ask for or accept help, she helps others while miraculously healing. Women colonize each other, monitoring appropriate behavior and decorum, allowing for the ‘she-ro’ model to prosper. Breast cancer walk-a-thon participants are discouraged from negativity by posted no whining signs on walk-a-thon route as observed by Samantha King the author of Pink Ribbons, Inc. and associate professor of physical and health education and women’s studies at Queen’s University in Kingston, Ontario. “To be ‘colonized’ is to be subjected to modern regimes of measurement and surveillance at the level of the body, which is subject to notice at the moment of its difference (insane, deaf, dumb, and blind) from a whole and well body.” (Hong, pg. 80) ‘Good’ women must therefore maintain their own healthy body projecting appropriate qualities to sustain the nuclear family as a ‘good’ family and capable of exemplifying the state of nationalistic prosperity.
The boundaries and intersections between individual, family, community and state become blurred in the mechanism of nationalism informed by neoliberalism. “The emergence of a reconfigured ‘neoliberal’ state formation in which boundaries between the state and the corporate world are increasingly blurred as each elaborates the interests of the other, often at dispersed sites throughout the social body and through practices that misleadingly appear to be outside the realms of government or consumer capitalism.” (King, pg. xi) Blurring allows misdirection and distraction from the reality of mortality relations to breast cancer. The mortality numbers are no longer daughters, wives, sisters or mothers they become collateral damage, faceless. She is a heroic soldier lost in the ‘war’ against cancer leaving her compatriots behind in a state of ‘she-roic’ martyrdom. Sulik defines the ‘she-ro’ as a hybrid between acceptable feminine and masculine qualities that perform nationalism. The ‘good’ ‘she-ro’ has a feminine appearance, conciliatory behavior, emotional sensitivity, social restraint and is adorned by feminine accoutrements. She is a successful soldier returned from battle victorious and a shining example for others to follow. “Although women are considered to be peace-makers, they have no voice in arbitration, and in times of ‘war’, more civilian women and children are injured, tortured and killed than are men in combat.” (Wetzel, pg. 207) This is true of ‘real’ ‘war’ and the ‘war’ on breast cancer, where the male deaths from breast cancer are also outnumbered. The nuclear family does not exist in reality here it is only an imagined space. Breast cancer in our society allows for minimal arbitration and the ‘master’s tools’ are forms of torture that must be survived to claim your space as a ‘she-ro’.
Proper nationalism has stigmatized breast cancer and even though the ‘advocacy’ movement is alive and well so are the stigmas, they have not been erased or forgotten. “Denial of [breast cancer] had been ingrained in the culture for so long that resistance to it had become second nature. Any woman drawing attention to her own cancer brought disgrace not just on herself but on everyone else with the disease….Shame itself proved to be contagious. Given these obstacles, the surprise may not be that it took so long for women to speak out about it rather that they ever had the courage to do it at all.” (Leopold, pg 214) Leopold’s statement could be shrunken to become a nationalistic motto of: ‘Drawing attention brings disgrace not just on herself but on everyone.’ Nationalism does not advocate or accept sustaining polluted burdens or nuisances of the weaker sex. “Within social fields (networks of social positions), perceptions are structured by repeated and reinforcing practices and sanctions that lead one to acquire predisposed ways of thinking, classifying, acting, and feeling, from his position within local worlds.” (Nichter, pg. 4) It is here that women have the preformed foundations of acceptable social nationalistic qualities of accepting breast cancer. “Women have learned to see our resentment and despair about our social place in the social structure, as an individual problem, and emotional disorder. Women are trained to invalidate our own experiences, understanding and feelings and to look to men to tell us how to view ourselves. Ideas, concepts, images and vocabularies available to women to think about our experiences have been formulated from the male view point by universities, professionals, industries and other organizations.” (Murphy, pg. 291) The current electronic technological resources are being utilized for questioning the relevance of practiced ideals, demanding information, and creating individual agency to determine personal relevance and irrelevance.
Past training provided the production of ‘good’ soldiers, women who occupied the space given to them and followed the ‘correct’ protocols. Women turned to men for these answers and trusted that their best interests were being protected and maintained. The ‘good’ soldier did not question her orders, she did as she was told and continued to uphold to the best of her ability the ideology of the nuclear family. “The logic of rationalized, categorization, measurement, and classification is that of Fordist capital, which is portrayed as having its own self-perpetuating existence. Rather than validating the human will, it subsumes the human as merely another component of the factory. Human agency is pointless and nonexistent.” (Hong, pg. 67) The breast cancer industry has implemented Fordist protocol utilizing women’s bodies as spaces to manipulate and capitalize on through detection, treatment and consumerism. “Corporations, politicians, and consumers alike use the purchase of breast cancer-related ‘good’ and services as a proxy for ‘good’ will and responsible citizenship.” (Sulik, pg. 112) Responsible citizenship is propagated from the individual, family, community up to the corporation unifying the national image while going global. Volunteer participant purchases of breast cancer-related products also osmotically transposes to consumer the ‘good’ nationalism female characteristics from the corporation associated with pink ribbon branding. Qualities of innocence, ‘good’ness, decency, morality, dependence, virtue and optimism just to name a few are for sale.
Marketing visually reinforces the national feminist image. It, however, maintains the first wave feminist image, supplying us with a majority of representatives that are heterosexual, white and middle to upper class. “The popularity of representations and the rationalities they propagate beg examination given cultural heterogeneity, unequal distribution of knowledge and power within societies, contests of meaning, and the subtle and not so subtle agendas of stakeholders.” (Nichter, pg. 3) The stakeholders are in reality the women who are sustaining the image of nationalism and productive citizens, yet the capital stakeholders are the corporations that have sprung up around a disease that has turned a considerable profit from anything incorporated into the pink ribbon space. The ribbon is the ultimate symbol of female nationalism, projecting generosity, inspiration and hope while suppressing the pain and death experienced through breast cancer. “The pink ribbon is an instantly recognizable set of meanings and values related to femininity, charity, white middle-class womanhood and survivorship.” (King, pg. xxiii) The pink ribbon is protected by philanthropy, the standard of ‘good’will towards all men, the surface projects ‘good,’ the ‘good’ motivations of the corporate stakeholders are profitable.
Advocacy and awareness sells: “The assumption that quick, convenient, and relatively inexpensive acts of giving have nonetheless powerful effects and deep spiritual meaning constitutes a common theme in contemporary discourse on philanthropy.” (King, pg. 73) Nationalism encourages ‘good’ citizens to help their neighbors through donations and volunteering, corporations have invested and profited from this ‘good’will. The pink ribbon was débuted at a polo club by Nancy Brinker, the founder of the Komen Foundation. This reality lends to the perceived marketability of the product, the market being heavily defined in an upper-class white environment. “A broad cultural preoccupation with philanthropic solutions to social problems, the discourse of efficiency and cost-cutting in business practice, changing psychological conceptions of the consumer, and invigorated consumer demands for a more ethical form of capitalism have converged to produce the transformation of corporate philanthropy from a relatively random, eclectic, and unscientific activity to a highly calculated and measured strategy that is integral to a business’s profit-making function.” (King, pg. 2) The profitability has attracted association from automobiles to lingerie and stuffed animals. “Breast cancer became a philanthropic cause par excellence not simply because of effective political organizing at the grassroots level, but because of an informal alliance of large corporations (particularly pharmaceutical companies, mammography equipment manufacturers, and cosmetic producers), major cancer charities, the state, and the media that emerged at around the same time and was able to capitalize on growing public interest in the disease.” (King, pg. 111) The ‘war’ on cancer supports this growth, participation of the masses in the ‘war’ through volunteerism and generosity, qualities of ‘good’ citizens validate the process of nationalism through consumerism.
Feminism is associated to consumerism by the assumed ‘innate’ female need to shop. Consumerism facilitates production contributing to the ‘good’ citizen and productive nation. “The insidious gendered nature of cause related marketing that helps reproduce associations between women and shopping, and of a more general tendency to deploy consumption as a major avenue of political participation.” (King, pg. xxv) Thus coupling of shopping with political volunteerism and generosity associated with philanthropy was perfect for the successful flourishing of a breast cancer industry and the pink ribbon. The nationalism imbedded in the success of a ‘good’ cause is rendered invisible by the emotional connection, satisfaction and the desire to do ‘good’.’ The Fordist model is apparent here. The industrious assembly line worker mentality limits the worker from being involved or having knowledge of what happens beyond that particular moment or space, this is apparent in popularity of consuming pink ribbon culture. The purchase is a satisfying and limiting experience with the consumer alleviating guilt towards an ‘afflicted’ woman through donation, as a final benevolent act with no desire to follow-up or impose any accountability upon the corporation selling ‘good’ in regards to the ‘afflicted.’ “The character’s will and desire have nothing to do with their eventual outcomes. The character’s collective inability to become cogs in the machine is not portrayed as the individualized faults of these flawed characters. The irony of evacuating agency and will from human subjects is that their failings are not their own either. Rather, the process of being incorporated into labor discipline produces the material histories of difference at the very moment these differences are supposedly being erased. Capitalism must attempt to perform the impossible trick of using these differences in the service of uniformity and standardization.” (Hong, pg. 104) The act of generosity is enough for the donor, the donor trusts that the stakeholders will utilize his or her donation in the spirit that the donation was made. These assumptions of ‘good’ uses of money donated to ‘good’ causes had varying definitions between donator, intermediary and promoted beneficiary. Ford and Tayor models ensure the continuation of uniformity and standardization of the advocacy message supporting breast cancer.
Prevention through screening is not prevention. The breast cancer industry purports that screening and mammograms save lives, this is under criticism. “Angie’s mother had died from the disease; she already knew that early detection was a misnomer for all breast cancers.” (Sulik, pg. 258) Angie’s mother had followed all the ‘rules,’ participating in frequent screening that never found her cancer: “for every 2,000 women screened in a 10-year period, ten women will be treated unnecessarily and only one woman will have her life prolonged.” (Sulik, pg. 20) Suggestions for screening aggressively begin at the age of 40 and earlier if you have a family history. Breast tissue in this age group is dense and the success of mammograms significantly decreases. “Mammograms frequently provide insufficient information to reach clear conclusions about the presence of tumors, and suspicious areas on a mammogram may or may not indicate cancer. The Institute of Medicine reported that 75 percent of all positive mammograms, upon biopsy, were ‘false positives.’” (Sulik, pg. 181) False positives are not the only mammography mistakes that are missed, masses undetectable in denser tissue fall into a false negative category. “Mammograms on average miss 25 to 40 percent of tumors that are actually cancerous.” (Sulik, pg. 181) The American Cancer Society states “only 2-4 mammograms of every 1,000 lead to diagnosis of cancer. About 10% of women who have a mammogram will require more tests, and the majority will only need an additional mammogram. Don’t panic if this happens to you. Only 8% to 10% of those women will need a biopsy, and most (80%) of those biopsies will not be cancer. The oft repeated statement: “Don’t panic if you are one of these women” is an impossible bit of advice to follow. Panic is the primary emotion when a mammogram must be repeated or a biopsy performed, transcendence through breast cancer is not desired nor is the loss of hair or breast. Women attach their identity to their body and losing control of it along with possibilities of breast amputation creates a well founded panic in the reality of breast cancer mortality.
The question here is; are there any answers to be found out of all of these ‘false’ answers? “Even the most conservative scientists agree that approximately 80 percent of all cancers are in some way related to environmental factors. The inescapable conclusion is that if cancer is largely environmental in origin, it is largely preventable.” (Arditti, pg. 666) Cancer is defined as a disease derived from an assumed exposure that you had no control over, when in reality cancer is your body attempting to heal itself from chronic injury. Rapid growth and healing cells, T cells, that created us in the womb are suppose to remain dormant after birth but in the face of chronic injury they become desperate and attempt to help, creating uncontrollable growths as they were never suppose to be stimulated in this way. “AstraZeneca and its allies in the National Breast Cancer Awareness Month, such as the American Cancer Society, continue to carefully avoid environmental issues, or indeed reference to prevention in general.” (King, pg. xxi) Cancer and other diseases are not ubiquitous; the high rates of cancer in the U.S. do not correlate globally, yet. “The incidence of breast cancer and of heart disease in [Japanese] men and women is about one-third of that in North America.” (Lock, pg. 500) The Japanese culture as the leaders of global health statistically proven through longevity and incidence of illness and disease results in analysis of what are we doing differently than the Japanese and how can we change to become healthier. Change is difficult in a nationalism attitude that potentiates instant gratification as a social entitlement, especially when the change comes from a culture that we are socially and economically competitive with. “Focus on finding a cure for breast cancer, rather than on prevention of the disease, has been subject to critique from some prominent scientists and breast cancer activists.” (King, pg. 38)
If there is any questioning left about the corporate interest in cancer Ralph Moss answers it in The Cancer Industry exposed in 1989. “The close ties between industry and two of the most influential groups determining our national cancer agenda – the National Cancer Advisory Board and the President’s Cancer Panel—are revealing. The chair of the President’s Cancer Panel throughout most of the ‘80’s, for example, was Armand Hammer, head of Occidental International Corporation. Among its subsidiaries is Hooker Chemical Company, implicated in the environmental disaster in Love Canal. In addition, Moss, formerly assistant director of public affairs at Memorial Sloan-Kettering Cancer Center (MSKCC), outlines the structure and affiliations of that institution’s leadership. MSKCC is the world’s largest private cancer center, and the picture that emerges borders on the surreal: in 1988, 32.7 percent of its board of overseers were tied to the oil, chemical and automobile industries; 34.6 percent were professional investors (bankers, stockbrokers, venture capitalists) Board members included top officials of drug companies—Squib, Bristol-Myers, Merck and influential members of media—CBS, the New York Times, Warner’s Communications, and Reader’s Digest—as well as leaders of the $55 billion cigarette industry.” (Arditti, pg. 669) The cancer industry search for a cure is better defined by the American Cancer Society’s statistical definition of the term cure, any patient that survives beyond 5 years of initial diagnosis living to be treated again with the ‘master’s tools’ creating the economic dependency on this cycle of treatment. “Lorde was concerned that normalizing women’s experience through appearance and artificial restoration gave the medical system permission to pathologize, discipline, and profit from women’s cancerous bodies.” (Sulik, pg. 341)
“I believe that socially sanctioned prosthesis is merely another way of keeping women with breast cancer silent and separate from each other.” (Lorde, pg. 14)The female body is regenerated through prosthetic manipulation to secure the healthy appearance of the medicalized body. “The strategy of much beauty-related advertising is to suggest to women that their bodies are deficient; but even to those without such explicit teaching, the media images of perfect female beauty that bombard us daily leave no doubt in the minds of most women that they fail to measure up.” (Bartky, pg. 33) Media direct to consumer advertising leaving imprinted ideology indelibly written on the subconscious of women. The idea that a pill can fix any of your ‘problems’ no matter the contraindication or side effects, a pill is the answer. In other words western medicine is infallible. “The danger, of course, is that the ‘Western’ body remains unproblematized. But increasingly research suggests that perhaps it is this body that should be thought of as anomalous.” (Lock, pg. 503)
Feminine medicalization has been compliant with feminine nationalism leading to breast cancer marginalization. “The construction of gender is the product and the process of both representation and self-representation.” (de Lauret, pg. 9) This compliance has lead to the medicalized transformation or transcendence through breast cancer, where women enter the realm of breast cancer weak, agreeable, compliant and fearful and emerge like a newly formed butterfly; strong, determined, assertive, courageous, prideful and last but not least beautiful. The ideology surrounding ‘survivorship’ advocates these transitions as expected outcomes. “The insignificance of these character’s lives leads to a sense of their interchangeability. Not only are the events of character’s lives repetitive within their own narratives, but they start to repeat each other.” (Hong, pg. 101) Sulik’s ‘she-ro’ lives here enforcing the necessary steps toward transcendence as a rite of passage to true womanhood. Proper participation is monitored, there is no room for negative emotions or experiences and as King noted ‘whiners are not allowed.’ “Breast cancer groups that embrace patient-empowerment as a way to mobilize critical engagement with biomedical research, anger at governmental inaction, and resistance to social discrimination remain a small minority, swimming against the tide of pink ribbon perkiness.” (King, pg. 108) The myth that a positive attitude towards breast cancer will heal becomes overpowering in the pink ribbon culture. “Social support and positive mental attitude can contribute to positive health outcomes, but they do not predict survival.” (Sulik, pg. 243)
“The assumption of women as an already constituted and coherent group with identical interests and desires, regardless of class, ethnic or racial location, implies a notion of gender or sexual difference of even patriarchy which can be applied universally and cross-culturally.” (Mohanty, pg. 64) The largest mistake in the machinery of the breast cancer industry is implied identical status of all women, that each woman enters the machinery of Taylorism or Fordist quality and is produced into a ‘she-ro’ assembly line quantity. “While we thought that we marking the F on the form, in fact the F was marking us.” (de Lauret, pg. 12) The social conditions here are out numbering and overpowering the biological conditions. “If the deconstruction of gender inevitably effects its [re] construction, the question is, in which terms and in whose interest is the de-re-construction being effected.” (de Lauret, pg. 24) The stakeholders are controlling the effect and the affected interests. Class is marginalized by the machinery while it confuses it simultaneously; several studies have noted that there is a higher incidence of breast cancer in affluent women. Syd Singer a medical anthropologist contributes this to fashion and specifically to bra use. Affluent women wear tighter bras for longer periods of time effectively castrating their breast from their bodies with a tourniquet like action.
Women’s disadvantage in the realm of breast cancer is not balanced with their resistance to it. “When group identity is a predicate for exclusion of disadvantage, the law has acknowledged it; when it is a predicate for resistance or claim of right to be free from subordination, the law determines it to be illusionary.” (Harris, pg. 1766) The illusionary status of women who resist the ‘she-ro’ status and the pink culture around it find themselves in segregated states. “Setting the standard for survivorship, ‘she-ro’ has become the public voice for breast cancer survivors, drowning out alternative ways of thinking about, and dealing with, breast cancer.” (Sulik, pg. 326) The women who resist become the missing women in statistical evidence of breast cancer. “Today’s breast cancer culture dictates the terms of women’s shared experience in ways that marginalize those who do not passionately participate and cheerfully comply with the culture’s rules of survivorship. There is no room for lackluster support, contemplation of scientific controversies that do not rely on the mass proliferation of screening programs.” (Sulik, pg. 274) Vicki has stage 4 breast cancer; the evidence is in her missing breast and the pictures she has taken of its evolution and separation from her body. Vicki has chosen to use nutrition as her tool to health and life; she has lived 6 years pain free and is now healing as evidenced by her body’s attempt to rebuild breast tissue. The ‘master’s tools’ were never used on Vicki’s body, and according to the American Cancer Society she is already cured surviving 5 years after diagnosis. The resistance to conformity and conventional medicine here is a voice silenced by the lack of medical acknowledgement that she could and does exist outside their boundaries and intersections. “As a key figure in the women’s health and breast cancer movements, Rose Kushner especially emphasized a medical consumerist philosophy that recognized that information varied in quality and did not necessarily lead to the kind of knowledge that would save a person’s life.” (Sulik, pg. 34)
Imaginary knowledge and ideals surround breasts. Breasts do not uniformly fit into A, B, C, D or DD categories any more than women fit into assumed homogenous categories capable of ‘she-ro’ transformation. “Poor women for example, are much more likely to suffer from cervical cancer. By contrast, at least among older women, breast cancer is more common among the affluent. These patterns, which at times can become quite complex, illustrate the general point that, even in the case of reproductive health, more than biological sex is at issue.” (Krieger, pg. 18) It is the patterns that separate women in the U.S. from Japanese women that need to be addressed as Syd Singer has done to initiate movement towards a healthier outlook for breast cancer. “It is a particular academic arrogance to assume any discussion of feminist theory without examining our many differences.” (Lorde, pg. 110)
Women’s position in medicine and society repeats the cyclic reproduction of nationalism, medicalization and marginalization. “Identity of ‘the other’ is still objectified, the complex, negotiated quality of identity is ignored, and the impact of inequitable power on identity is masked.” (Harris, pg. 1764) The ‘she-ro’ identity while forcefully presented as the majority position lacks power and sustainability. She cannot exist in this imaginary vacuum forever. “The crux of the problem lies in that initial assumption of women as a homogeneous group or category (‘the oppressed’), a familiar assumption in western radical and liberal feminisms.” (Mohanty, pg. 79) The ‘she-ro’ attempts to reinstall first wave feminism, the ideology of the white heterosexual middle to upper class women performing super human feats and becoming stronger in the process when in reality she weakened by the mirage she must maintain and the reality of what the ‘master’s tools’ have written into her body in Kafkaesque qualities. “To being to understand how our social constitution affects our health, we must ask, repeatedly, what is different and what is similar across the social divides of gender, color, and class. We cannot assume that biology alone will provide answers we need; instead, we must reframe the issues in context of the social shaping of our human lives- as both biological creatures and historical actors. Otherwise, we will continue to mistake—as many before us have done—with is for what must be, and leave unchallenged the social forces that continue to create vast inequalities in health.” (Krieger, pg. 21)
“As long as the breast cancer agenda is dominated by multinational corporations and their nonprofit partners, there is little hope that the ‘barriers and burdens’ encountered by poor women will penetrate the peppy public consciousness or elicit the kinds of policy responses that might actually make a difference to them. Indeed, one of the key features of the neoliberal state is its refusal to view the amelioration of poverty as one of its central obligations or to view the ‘subject of compassionate action, to quote Lauren Berlant, as ‘any member of a historically and structurally subordinated population.’” (King, pg. 118) The female subordinated position leaves her victim to social contributions to her medicalized status and her marginalized state. “It is not always possible to see where nature ends and culture begins.” (Scheper-Hughes, pg. 19) It is possible today to see how culture affects nature and vice versa, the answers are not where the two meet but in the areas where the two overlap. The dichotomous world does not create answers only questions, in moving beyond dichotomies and searching out the patterns answers may be found. “The idea that users of health services should be able to make informed decisions about their medical choices seemingly places control in the hands of patients and advocates. In reality, the medical system, the breast cancer industry, and the pink ribbon culture work together to control the information women need when making their choices, while defining the options available to them. The industry that benefits from the increased use of mammography and pharmaceuticals is at the core of what has become pink ribbon culture.” (Sulik, pg. 210)
The pink culture must be questioned, how it works, what it creates and how it effects to find the answers outside of the dichotomy of participant or nonparticipant. “The upbeat message of breast cancer survivorship provides a counterbalance to the feelings of fear and uncertainty that accompany diagnosis and treatment. The simplistic overemphasis on normalization, transcendence, and empowerment in pink ribbon culture obscures this complexity. The mandate for optimism involves an aesthetic approach to normalization through appearance and self-preservation, which integrates social expectations for women’s conciliatory behavior, specifically the suppression of any feelings that might destabilize upbeat social interaction. Many diagnosed women refuse to participate in pink ribbon culture precisely for this reason.” (Sulik, pg. 237) Resistance to participation should not be grounds for action against these women socially or medically. “The social pressures that women serve others even when facing a life-threatening illness reverberated throughout interviews, making it difficult for women to set boundaries that would allow them to put their health first.” (Sulik, pg. 293)
Real women have real questions that medicalization has been unable to answer. “Have I survived? I won’t know unless I die of something besides breast cancer. The term is overused.” (Sulik, pg. 320) Women are demanding better answers and instigating a movement towards alternative medicine in the face of unsuccessful conventional options. “In our world, divide and conquer must become define and empower.” (Lorde, pg. 112) Women no longer want to participate in a stalemate ‘war.’ The risks are too great and the benefit too little for the foot soldiers involved. “The worst thing anyone can ask about any war is whether those who died in vain.” (Sulik, pg. 363) Sadly many may categorize the deaths from breast cancer that could possibly be prevented as senseless loss of life and meaning that could be prevented. “The embrace of a lie could occur only when oppression makes self denial and the obliteration of the identity rational and in significant measure, beneficial.” (Harris, pg. 1743) The obliteration of these foot soldiers in the ‘war’ on breast cancer is only beneficial to the machinery that continues to operate and flourish in cyclic system, we cannot use the ‘master’s tools’ to dismantle his house as Lorde states yet maybe we should take Kafka’s approach and destroy the machine.
“It is obvious enough that ever since a discipline such as history has existed, documents have been used, questioned, and have given rise to questions; scholars have asked not only what their documents meant, but also whether they were telling the truth, and by what right they could claim to be doing so, whether they were sincere or deliberately misleading, well informed or ignorant, authentic or tampered with.” Michele Foucault (pg. 6)
Arditti, R., & Schriber, T. “Breast cancer: The Environmental Connection.” Sojourner: A Women’s Forum. 1992.
Bartky,S.L. “Foucault, Femininity, and the Modernization of Patriarchial Power.” 2003.
De Lauret. “Technologies of Gender.” Bloomington: Indiana Univerisity Press, 1987 1-30.
Harris, Cheryl. “Whiteness as Property.” Harvard Law Review 1993:Vol. 106, #8, 1707-1791.
Krieger, N.,& Fee,E. “Man-made Medicine and Women’s Health: The Biopolitics of Sex/Gender and Race/Ethnicity.” Women’s Health, Politics and Power: Essays on Sex/Gender, Medicine, and Public Health. Amityville: Baywood Publishing Company. 1994.
Lock, M.M. and Kaufert, P. “Menopause, Local Biologies, and the Culture of Aging.” American Journal of Human Biology. 2001. 13, 494-504.
Lorde, A. Sister Outsider: Essays and Speeches. Tinmonsburg, NY: The Crossing Press. 1984.
Mohanty, Chandra. “Under Western Eyes: Feminist Scholarship and Colonial Discourses.” Femininist Review. 30, Autumn. 1998.
Murphy, M. “Women and Mental Health.” Personally Speaking. Dublin: Attic Press. 1985.
Nichter, M. “Theories of Representation:Why Cultural Perceptions, Social Representations, and Biopolitics Matter.” Global Health. Tucson: University of Arizona Press. 2008.
Osherson, S.,& Singham, L.A. “The Machine Metaphor in Medicine.” Social Contexts of Health, Illness, and Patient Care. Cambridge: Cambridge University Press. 1981.
Scheff, T. “The Labeling Theory of Mental Illness.” American Sociological Review 1974. 39, 444-452.
Scheper-Hughes, N. and Lock, M.M., 1987. The Mindful Body: a prolegomenon to future work in Medical Anthropology. Medical Anthropology Quarterly, 1, 6-41.
Tortora, Gerard J. & Sandra Reynolds Grabowski. Principles of Anatomy and Physiology. Harper Collins College Publishers.1996
Weitz. “The Politics of Women’s Bodies.” Sexuality, Appearance and Behavior. Oxford: Oxford University Press.
Wetzel, J.W. “Women and mental health: a global perspective.” International Social Work 2000. 43.