Literature Annotations


Ehrenreich, Barbara
Welcome to Cancerland


On-Line Text
Genre Essay (10 pp.)
KeywordsAcculturation, Body Self-Image, Cancer, Communication, Death and Dying, Disease and Health, History of Medicine, Illness Narrative/Pathography, Medical Advances, Medical Testing, Patient Experience, Patient Experience, Society, Surgery, Survival, Women's Health
SummaryA “drive-by mammogram” leads the writer, Barbara, to a biopsy of a suspicious breast lump. She awakes from the fog of anesthesia to hear the surgeon’s bland remark: “Unfortunately, there is a cancer.” Welcome to Cancerland, a place where her identity is displaced by the vast implications of the diagnosis, another operation, and arduous months of chemotherapy. What works for her own peace of mind has little to do with the trappings of pink-ribbon sentimentalism in the survivors groups.

Barbara resorts to her knowledge of cell biology, asks to see her own tumor under the microscope, and contemplates the meaning of visualizing the malignant cells even if she does not believe the exercise can help her. She dissects the rank commercialism and denial in the survivor movement: let me die of “anything but the sticky sentimentalism in that Teddy Bear.” She decries the claims that cancer therapy makes better skin, better hair, and better people, with better bodies, especially when an implant on one side subtends a cosmetic procedure on the other.

Posting these thoughts on a chat line, she discovers that most women berate her attitude and suggest she needs a psychiatrist. But one dying woman agrees with her distress, and writes of having cancer, “IT IS NOT OK.” Admitting feminists can be found in the “survivor” community, Barbara faults its underlying tone for being coercively optimistic, infantilizing, and insulting to the dying and the dead. She is angry. Very angry, and her “purifying rage” spares no one: doctors, support groups, feminists, drug companies, and the Cancer Society. Nevertheless--and in keeping with her earlier work--she credits the women’s movement with helping to rid the world of three medical evils: the radical Halsted mastectomy, the practice of proceeding to mastectomy from biopsy without waking up the patient, and high dose chemotherapy.

Two disturbing ironies bring the essay to a close. The first, is the possibility that mammograms may not be saving or even prolonging lives, even as they detect cancers; they make women dwell in Cancerland for longer and cause too many “unnecessary” biopsies. The mammogram is a ritual, she says. The second irony lies in the role of the pharmaceutical industry which fosters the pink power movement –the ribbons, the teddy bears, the marathons-- while manufacturing the expensive poisons that seem to have anticancer side effects. These same companies, she argues, have also manufactured carcinogenic pesticides that pollute the environment. Having profitably poisoned women into having breast cancers, they continue to profit from poisons of chemotherapy.
She faults both the “cult” of the survivors movement and the American Cancer Society for their “unquestioning faith” in these imperfect instruments of action.
CommentaryGreat writing by a veteran activist for women’s issues and workers’ rights who never shrinks from taking on established truths. Following a PhD thesis in cell biology, her earlier works attacked medical care of women (see for example the annotation of (see for example the annotation of The Sexual Politics of Sickness) and American life in poverty (see Nickel and Dimed: On (Not) Getting By in America). Had she waited a mere seven months, she could have expanded her anti-medical, anti-drug industry rant to include the carcinogenic effects of widely used “Hormone Replacement Therapy,” exposed in an influential article in the Journal of the American Medical Association of July 2002.

The rage that fuels her insight is as much against human mortality in general as it is against breast cancer in particular. “Why is there no room in this cult for some gracious acceptance of death, when the time comes, which it surely will, through cancer or some other misfortune? . . . I will not go into that last good night with a teddy bear tucked under my arm” (53). But she omitted one word: whenever it will be, teddy bear or not, Barbara Ehrenreich will surely not go “gentle.”

Minor quibbles could be made against her historical claims. Many doctors and epidemiologists also worked with feminists–sometimes even engaging them with their statistics--to bring about the demise of those eclipsed medical evils. And, as she admits, none of the evil practices were invented to harm—they were invented, like our current practices, in the hopeful expectation that they might help. Recent statistics suggest that present modalities actually do help, though no one involved with administering them would argue that they are perfect. Ironies notwithstanding, few women would be willing to forego mammography or adjuvant chemotherapy. And if some are comforted by teddy bears, why not?

Just as Susan Sontag dealt with her cancer diagnosis by writing the influential Illness as Metaphor, Erhenreich vigorously expiated her own trajectory with this articulate demonstration of classic anger. Although she is unlikely to agree, something good came from her cancer.
SourceHarper's Magazine
EditionNovember 2001, 43-53
Annotated by Duffin, Jacalyn
Date of Entry 01/28/08