Abstract
In 2007, I wrote an essay on breast-cancer narratives and their public function; in 2012, I wrote another essay on the same topic. In 2009, I was diagnosed with breast cancer. This chapter takes up the shift between essays in my authorial position: I did not, for example, slip, with my diagnosis, from objectivity to subjectivity. Moreover, just as personal illness narratives are not innocent of cultural values or simply subjective, so accounts of neutral-seeming experts about cancer are not free of ideology or politics or desire, and are not simply objective. This chapter uses rhetoric as a theoretical framework for approaching questions of objectivity both in research and in cancer discourse.
After a tumor, the world looks much more huggable.
Nicholas Kristof
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- 1.
In a personal op-ed in the Sunday New York Times, columnist Nicholas Kristof (2010) explained that “the world looks more huggable after you have a tumor”—or, actually, in his case, that it looks more huggable after you think you have cancer (but actually do not have it). Some New York Times readers might have objected to Kristof attaching himself to a narrative of survivorship when what he had was a cancer scare, and not cancer. That is, perhaps having cancer does change one’s outlook on the world—that change is, in part, what my chapter is about—but does significant change come also from spending a month thinking you might have cancer? More likely, the appreciation following that experience is like the appreciation you have of running water after you’ve been camping for a week: it’s real appreciation, but it seldom lasts past your first couple of showers. Kristof’s huggability claim exemplifies the tone of public discourse about cancer, and the difficulty, in part because of that tone, of subjecting the personal cancer narrative to any unblinking critique. Kristof: “A brush with mortality turns out to be the best way to appreciate how blue the sky is, how sensuous grass feels underfoot, how melodious kids’ voices are” (n.p.).
- 2.
In AIDS and its Metaphors (1990), Susan Sontag wrote the following about the writing of Illness as Metaphor (1978):
I didn’t think it would be useful and I wanted to be useful—to tell yet one more story in the first person of how someone learned that she or he had cancer, wept, struggled, was comforted, suffered, took courage … though mine was also that story. A narrative, it seemed to me, would be less useful than an idea. (101)
My own essay strives to be more idea than narrative, although it will sound like a narrative at times. It is not meant to be about me, except as I now occupy the space vacated by another researcher: the previous me.
- 3.
I have since learned from Ian Hacking (in conversation) that the more common term for the study of ignorance is agniology, so named in the nineteenth century. My thanks to Professor Hacking.
- 4.
The most oft-cited source on this understanding of genre is Carolyn Miller (1984).
- 5.
The special issue was guest-edited by Débora Figueiredo, Charles Bazerman, and Adair Bonini.
- 6.
On rhetorical analysis as a methodology, see the Introduction to my Health and the Rhetoric of Medicine (Segal 2005).
- 7.
While, as I have said, I do not believe that authors must experience what they write about, I did wonder then, faced with this critique, whether, if I were ever diagnosed with breast cancer, I would go to bed as myself and wake up as someone with a sudden taste for pink t-shirts and group runs. That didn’t happen. My critics were right that breast cancer would reveal itself to me differently once I became a character in a breast-cancer story. They were wrong, however, about the sorts of things that would change with diagnosis. Both my critics, for example, had said that, as a breast-cancer patient, one is so grateful for breast-cancer fundraising that one is not appalled by pink merchandising. That turned out not to be the case for me.
- 8.
Moreover, books about cancer are frequently reviewed by reviewers who have/had cancer, and who foreground their own experience in the review. See, for example, Sarah Harvey’s (2006) review of Marisa Acocella Marchetto’s Cancer Vixen—or Adam Baer’s (2011) hybrid personal narrative/book review of Siddhartha Mukherjee’s Emperor of all Maladies. Even cancer television is reviewed by reviewers who have/had cancer. See, for example, reviews of Showtime’s The Big C by Jenni Murray (2010) and Deborah Orr (2010), each review referencing the author’s personal cancer experience. (Murray’s byline includes, “Journalist and broadcaster who was diagnosed with breast cancer in 2006.”)
- 9.
“Survival” itself is a contested term—not only ideologically (what does the term connote?) but also empirically (when does survivorship begin?). While, in some accounts, survivorship begins when a person, having been diagnosed, is 5-years cancer-free, in others, it begins with completion of treatment; in still others, survivorship begins from the moment of diagnosis. For discussions of survival, see Mullen (1985) and Rowland (2008).
- 10.
Despite critiques of the battle metaphor for cancer—and for medicine more generally (see, e.g. Fuks [2011])—the metaphor persists, and seems even to have become more aggressive. In a recent advertisement in the New York Times Magazine, North Shore-LIJ [Long Island Jewish] Hospital Cancer Institute promises to marshal “a relentless army of doctors”: “Isolate. Attack. Overwhelm. Together, it’s what we do to cancer” (North Shore-LIJ 2013).
- 11.
For example, a set of personal narratives appears in the breast-cancer-survivor magazine, Beyond, under the heading, “Cancer is one of the best things that ever happened to me” (2007). This excerpt is from a story called, “Curly Hair and Other Gifts Cancer Gave Me”:
Just before my diagnosis, my husband and I decided to try for a third child. Instead of getting pregnant, I got cancer. A cruel trade, I thought at the time, but now … I think perhaps I was not meant to conceive a child at that moment …. Another baby might have sent me over the edge. Cancer was a blessing in disguise. … Also, I have always wanted curly hair. … Cancer inspires me. I’ve been given a wake-up call that many people will never receive [and] I am happy to simply be alive. (Donaldson 2007, 26)
For a recent illustration of cancer-discourse tone, see Silcoff (2011). The subject of her “Every Cancer Has a Silver Lining” is “wellness warrior” and “cancer entrepreneur,” Kris Carr, maker of the film, Crazy Sexy Cancer, and author of its associated books.
- 12.
The workshop, “Critically Interrogating Cancer Survivorship: Social Science and Humanities Perspectives,” was held in Vancouver, British Columbia, July 21–22, 2011. The workshop was organized by Kirstin Bell and Svetlana Ristovski-Slijepcevic, with funding by the Canadian Institutes of Health Research, the Social Sciences and Humanities Research Council, and the University of British Columbia. Bell has recently (2014) published an illuminating essay on the “breast-cancerization of cancer survivorship.”
- 13.
While not comparing myself to Ehrenreich, I could not stop thinking about her. Her well-known Harper’s essay, “Welcome to Cancerland” (2001), documents the reception of her negative postings about her cancer experience to the Susan G. Komen message board: her postings were met, she said, with “a chorus of rebukes” (50). Letters to the editor of Harper’s in response to “Cancerland” were no more sympathetic. Even cancer researcher Barron H. Lerner (2002) chastised Ehrenreich: “Although pink ribbons and teddy bears may be infantilizing,” he wrote, “many survivors appreciate these touches or at least tolerate them as furthering a worthwhile cause” (4).
- 14.
For some of the same reasons that we sometimes pluralize “knowledge,” we take a special interest in health professionals who have become patients (see, for example, Glouberman [2011] and Klitzman [2008]), and patients who, on particular topics, have become medically expert (see, for example, Montgomery [2006], on breast cancer). In certain situations, it is possible to think about empathy and epistemology together.
- 15.
The BC Cancer Foundation “raises funds to support research and enhancements to patient care at the BC Cancer Agency.” The mandate of the BC Cancer Agency “covers the spectrum of cancer care and research, from prevention and screening to diagnosis, treatment, supportive care, rehabilitation and palliative care” (Vim and Vigour masthead). In other words, Vim and Vigour is the institutional voice of cancer in British Columbia.
- 16.
I could cite countless such breezy articles from Vim and Vigour. More recent cover stories are headlined, “Breath of Fresh Air: The always perky—and quirky—DIANE KEATON doesn’t let asthma slow her down” (Paterik 2013) and “New Hope for Brain Cancer Patients” (Anonymous 2013). (Really? The “new hope” trope—here? The phrase “new hope for” today gets over 80 million hits on Google [July 14, 2014], most pertaining to illness or disease.)
- 17.
- 18.
In 2012, Nancy Brinker, CEO of Susan G. Komen for the Cure proved this by moving to defund Planned Parenthood, despite the work Planned Parenthood does in making screening mammography available to women who could not otherwise afford it. (The benefits of screening mammography are another topic, and controversial; the point here is that Komen is not pro-feminist and, it seems, not completely pro-woman.) Brinker reversed her position under public pressure.
- 19.
The response might seem a curious one to what was really just investigative journalism. I believe Mesley inspired such ire for two reasons: first, she did, in the documentary, directly challenge the Canadian Cancer Society, an agency that is seen by many to be sacrosanct; second, she jumped genres. Here was a national celebrity (Mesley) who was known to have had breast cancer. Members of the viewing audience expecting to be treated to a personal narrative were jolted by a different sort of report—not about Mesley’s own cancer experience but about carcinogens and the public policies that keep them in our midst.
- 20.
But also see Ho (2009) on “epistemic humility.”
- 21.
In a landmark essay in rhetoric of science, Paul Newell Campbell (1975) takes up questions of objectivity through the trope of persona, the implied character of the speaker in any work. Persona itself, he says, which is unavoidable, is also at odds with claims of objectivity, because it necessarily calls for ethical judgment: there is no character without values. In this view, objectivity itself is a stance (and therefore not objective [in the sense of aperspectival]): to view something dispassionately is to stand in relation to it—to attribute a value to it, only not a very high one.
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Segal, J.Z. (2015). The View from Here and There: Objectivity and the Rhetoric of Breast Cancer. In: Padovani, F., Richardson, A., Tsou, J. (eds) Objectivity in Science. Boston Studies in the Philosophy and History of Science, vol 310. Springer, Cham. https://doi.org/10.1007/978-3-319-14349-1_11
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