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CONFRONTING OUR CANCERS // Emotional ups and downs of breast cancer

PICASSO'S WOMAN: A Breast Cancer Story

By Rosalind MacPhee

Kodansha, $20

Reviewed by Gail Hegarty Fell

This year, 184,000 women in this country will be diagnosed with breast cancer. Their parents, friends, sons and daughters will learn to live with the terror and uncertainty associated with the course of this disease. As a result, nearly every single American will be affected by breast cancer in some way in 1996.

I picked up these statistics at our local post office last week. The U.S. Postal Service is selling a new $.32 stamp with "Breast Cancer Awareness" written sideways on the left hand margin and a woman, half buried in shadows, looking over her right shoulder at a pink ribbon. As I stood in line I couldn't help but wonder at this fairly low key approach to a disease that is killing one woman every 10 minutes.

Rosalind MacPhee, an extremely articulate and witty writer, has written an astonishing book about her experience with breast cancer, one that is as gripping as it is informative. This is no mere recitation of the clinical facts of the disease. Instead, MacPhee has done an extraordinary job of pulling the reader along with her every step of the way, through her emotional ups and downs after the discovery of her first lump, her terror at facing a mastectomy, her exhausting battle to regain physical strength and her changed relationships with her family and friends.

MacPhee opens her book by telling us how much she likes adventures. "Adventures are about being brave, fighting back, and keeping your wits about you. Adventures are about taking control. Survival. I believe that, in any adventure, who people are can be determined not by what happens to them but by how they deal with it." If this is true, then MacPhee is a true heroine.

MacPhee is not only a writer but also an experienced paramedic. She is used to dealing with crises, quickly gathering all the available information and making difficult decisions. These skills serve her well in the early days of the disease. After being told her lump is malignant, she goes to the library to begin gathering the facts regarding her treatment options. She visualizes a debate between Dr. Surgeon, Dr. Radiation and Dr. Chemotherapy, playing devil's advocate with each of them until she is comfortable that a mastectomy is the right choice for her.

Throughout the book, we are constantly struck by the grace and wit used by women to cope with breast cancer. After MacPhee gets her prosthesis she recognizes its entertainment value! "I would make deals with my daughters: "If you get me some tea, I'll let you play with my boob.' "

Overweight Jessie, with whom MacPhee shares a hospital room, cups a hand under her large breast the night before her surgery, saying, ". . . tomorrow I'm on an instant weight reduction plan . . . I figure this thing must be a few pounds."

MacPhee enlists the help of both friends and family in fighting for survival. Early in the book, one friend tells MacPhee that people have a need to help, and that it was her responsibility to let them do so. MacPhee wisely follows her advice. She lets her friends throw a party for her when she gets home from the hospital. She asks them for rides to and from her doctors' offices. She asks her daughters for help in bathing and washing her hair when she returns home from the hospital.

MacPhee has a talent for conveying not only the emotional trauma but the physical devastation of having a breast removed. Articles about breast cancer often inundate us with statistics but they don't often describe the extreme pain after surgery, the difficulty in regaining full movement in your arm if the lymph nodes were involved, the difficulty in finding a comfortable way to sleep or the horror of first seeing the incision.

"The first glance was shocking. I felt strangely disoriented, but I couldn't stop looking. It was like staring at something that was not part of my body. A long diagonal scar ran from the centre of my chest to somewhere underneath my arm. I thought of a railroad track crossing a prairie. . . . To me it looked like a war zone _ they may have saved the country but, my god, look what they did to the land."

MacPhee goes through her surgery during the time of the Persian Gulf war and can't resist contrasting the television views of smart bombs chasing Iraqis through Baghdad with the lack of progress in developing any magic bullets or new treatments for breast cancer in the last 20 years.

This year in North America, there will be more than 50,000 deaths from breast cancer. Breast cancer is an epidemic that doesn't make the headlines. In the United States it kills almost twice as many people as does AIDS. Yet women have never mobilized for funding or clamored for public attention in the same way as the AIDS lobby. Unlike AIDS we still don't even know what causes breast cancer or who is most at risk. Right now the disease is winning _ its incidence has increased 130 percent over the last 30 years. MacPhee has performed a great service in telling her story. Let it serve as a call to arms.

Gail Hegarty Fell is a writer who lives in Rye, N.Y.

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