Our choice? or her choice? The curious case of Angelina Jolie

8botticelli

A medical colleague recently did a spot check on my current affairs with the following question, “Have you heard about Angelina?” I had. “Then you are not a complete hermit.”

Amid the daily updates on civil war and suburban conflicts, Angie’s boobs have hit the literal buzzer around the world whatever your social circle.

While the expected anti-scientific movement within the homeopathic extreme left gathered ranks to roll out their views on the “GRAND medical deception” played on this “poor woman”, I was surprised to read the views of some authors also feminists from developing countries managing to paint this news as some modern patriarchal misogynistic conspiracy into female mutilation.

Anyone involved with any fundraising / charity / research group knows that getting the media and public attention for certain causes is difficult, even with the significant attention that conditions such as breast cancer currently have. It is a constant struggle to raise public awareness and research funds for these issues.

Cancer of the breast is a classic example, not just because it is such a mainstream symbol of being “female”, but more so because its objective discussion and examination has been such a taboo for centuries around the globe.

Today even in the West, I have seen countless (educated) women who have presented with large fungating tumour masses on a breast that has been growing, ulcerating, causing pain for many months. This is in Australia, in large specialty hospitals.

It is only in the past few decades that female specific conditions have started to get research dollars and public interest as more and more open dialogues have started on this very important but hidden subject.

Similarly with cervical cancer, a condition that was once only diagnosed at such advanced stages due to so many women being unable to seek timely medical attention. Only one or two generations ago our over-reproductive grand mothers were suffering from prolapsed uteruses, and severe urinary and faecal incontinence from the lack of timely surgical and medical help.

The HPV vaccine has been a very important breakthrough in reducing cervical cancer risks, despite the significant backlash from conservative groups that such a vaccine would promote promiscuity, in the same way they held back sex education in schools for decades. We don’t talk about the “health” of these body parts, we talk only of their “uses” in our mainstream conversations, but slowly this is changing.

Whether it is mastectomy or hysterectomy there are countless generations of women who have suffered in silence and shame, and these are just a few of the myriad number of other health problems that affect women.

I agree Angie’s breasts are no more important than any other woman’s, however I am very glad to see that her high profile as an actress has raised awareness of a condition that medicine still has limited treatment options for. There is no “cure” for breast cancer, only risk reduction, ESPECIALLY in women who carry the gene known as BRCA, (the moment we hear about this alarm bells are ringing in our heads!)

As a result of growing knowledge from research and genetic breakthroughs we have seen commendable and committed volunteer groups raising awareness and research funds for Breast Cancer, from pink ribbon day, to regular marathons. Many lay people, in Australia especially, are aware of the risks of breast cancer purely from the media information that has filtered through, and are much more vigilant in terms of their own health and those of their female friends and relatives. While targeted therapies are in early stages for this condition, especially at a genetic level, there has been recent conflict between the scientific and pharmaceutical companies regarding the patenting of genes, such as the BRCA.

The argument from the companies to patent such genes is based on the concept of “returns” in exchange for research funding they provide. Those in the scientific and public community, however, are fighting with a more valid and altruistic point in that human tissue should not be patentable, and be public property for the benefit of all. This is not a new philanthropic idea, Dr. Jonas Salk (1914-1995) the inventor of the first Polio vaccine was once asked:

“Who owns the patent on this vaccine?”

He replied: “Well, the people, I would say. There is no patent. Could you patent the sun?”

To this day the WHO funded vaccination schemes in developing nations is free, yet we still see a plethora of misleading articles on the “capitalistic conspiracy” that is behind vaccination programs.

Ideological backlash to medical treatments is not a new issue. Only recently we saw the arbitrary killing of UN health workers who were implementing a vaccination program, by the Pakistani Taliban who saw it as a Western capitalistic conspiracy. Even in the developed world there is ongoing debate and dissent within parent groups who actively refuse vaccination for their children based on information that has time again been proven incorrect. Yet, it is these very same parents who depend on the vaccinated communities herd immunity to protect their child, and will also expect first grade medical attention when their child is unwell from a very preventable illness; the recent measles outbreak in the US is a case in point.

The very same logic is being applied to Angie’s double mastectomy, a cruel irony when many of the authors themselves originate from developing nations where so little of medical care is able to trickle through to those that need it the most.

In Angie’’s case she opted for a double mastectomy. She could have waited for potential breakthroughs in treatment in the future, that might be available if and when she developed breast cancer, or she could act now based on what we know from studies on her actual chance of developing cancer in the future. No one will want to play Russian Roulette with their health no matter how promising the future may look. In reply to many articles comparing this as “should I cut of my head in case I develop a brain tumour”, I am afraid their grasp on even basic biology must be poor to think that the breast is comparable to the brain.

Yes, mastectomy is a drastic solution, but we have nothing better currently in terms of significant prevention in BRCA positive women, and women do make that informed choice.  In terms of reconstructive surgery, it cannot heal the psychological impact in everyone completely.  Many women prefer to have some degree of reconstruction if possible, for many personal reasons, and yes to regain some degree of normalcy.

We may paint the breast with many nurturing and erotic roles, but are we not joining the public in criticising  women who decide to have a reconstruction?Are we not saying to her that “oh well you’re not sexy, you’re not nurturing, and oh you should be judged badly if you want your own breast back”? Surely this is the choice and autonomy of the women in question, and not that of the authors and commentators? Many women don’t have reconstruction and carry their Amazonian scars boldly, others choose differently. Merely painting these choices as vanity or as societal influences is too simplistic a view.

Interestingly did we see as much backlash against the “medicalization of women’s bodies” when the well-known Australian cricketer Glenn McGrath started a charity fund in name of his wife who died of Breast Cancer.

Let us look at some important conditions that are equally hidden and taboo, prostate cancer in men. There is still an ongoing battle in improving the awareness and diagnosis of this often-silent disease. Do we brand every celebrity and sports ambassador who champions this cause as some medical puppet championing the cause of patriarchy, capitalism?

So why is Angelina’s move drumming up such sensational misinformed shock jock type reactions? Is it because of the surgery itself, the reconstruction post, or that she made this decision after being informed of her risks from her genetic heritage.

But the outcry is not so much on the latter, but on the “barbaric” nature of the procedure. As much as many in the feminist camp would dislike to think breasts as one of their only defining feature, the loss / removal of these, still prompts a strong reaction. The scientific and medical world is currently being demonized as the perpetrator of misinformation for scare mongering the public, without careful understanding or research into the circumstances. The decision to have a double mastectomy is not one of narcissism or vanity, unlike many “enhancing” surgeries; these procedures are carried out as a therapy, a treatment. If we truly wish to discuss the “capitalist agenda” on women’s bodies, why not spotlight the barriers to reproductive control and contraception, the growing surrogacy business in developing worlds, the cosmetic enhancement industry, and lets not forget the booming life insurance industry that truly does capitalize on fear of the unknown!

Those on the band wagon calling for “anti-medicalisation of the female body” from Angie’s story are speaking from a very hollow platform. This is evident from their ignorance about the battles that are being fought everyday by people who are diagnosed with conditions that we still, despite significant advances, have very limited treatment options for. We are only starting to uncover the myriad genetic factors that come to play in predisposing people to diseases such as cancer, and while direct effective gene based treatments are still decades away, there are some ways of reducing the risk in those particularly susceptible.

The public who read these misinformed, ideologically driven articles will either, take it all on board, or having experienced the sickness of a loved one and knowing the pain of opportunities missed, will realize these knee jerk reactions for what they are. There is so much left to do still, we are only just beginning.

– Gauri

4 responses to “Our choice? or her choice? The curious case of Angelina Jolie

  1. Good essay. The so-called feminists who link the capitalist system with a woman’s decision to have a double masectomy in the face of overwhelming evidence that she is a candidate for cancer are the narcissistic and vain ones. So angry about everything that they cannot think logically. So fixated on the body (their own, really) that they can’t seem to see the children in all this: Jolie’s main argument is that she has 6 children to consider. Get real ratty (raddie) fems!

    • Thank you for commenting Mystic, there is so much manipulation of this story in the media and over dissection of a message that carries no other ulterior motive then to raise awareness in the public. It is so important that some of these feminist authors are able to step down from their soap boxes and support a movement that is ultimately for the benefit of women like themselves!

  2. I share your disappointment with some of the commentary on Angelina Jolie in poor taste.
    Breast cancer is a sensitive issue like any cancer but breasts seem to hold a special place in people’s minds. I don’t know if it has something to do with the fact that so many people are stuck in the oral phase of infantile sexual development.
    The sexualization of breast cancer awareness campaigns is offensive (slogans like squish a boob today to prevent breast cancer) but it seems to work in fund raising much more so than for others such as prostate cancer or bowel cancer.

    Breast cancer is an ancient malady and the issues such as fear of mastectomy haven’t changed in thousands of years. Many brave women (including my dear mum) have faced this disease in their own way with secrecy, shame, stigma and fear of loss of their femininity.

    I have recently read a book called Bathsheba’s breast by J Olsson. It is a beautiful book that is well worth reading if you are interested in the historical aspects of breast cancer and the modern battles with breast cancer.

    Bathsheba’s breast is an interesting title for a book especially with a Rembrandt nude portrait on the cover. This is a painting in the louvre museum (on my to-do list to go there someday just to see this 1654 painting.)

    You need to understand who Bathsheba is to appreciate the painting. This is an Old Testament story (2 Samuel 11) of King David on the roof of his terrace, watching this woman (a soldier’s wife) bathing. He summons her and sleeps with her. She later falls pregnant. He subsequently gets that soldier killed at the frontline so he can keep her. The child from that tryst dies but later on gives birth to King Solomon and that is the blood line from which Jesus is born.

    Bathsheba must have been extraordinarily beautiful for David to have seen her from that distance from his palace and be smitten by her. He had access to many women (including all those wives he inherited from King Saul). The painting however is great not only because of the beauty (supposedly the greatest nude of Rembrandt) but her contemplative gaze, with her moral dilemma: between her fidelity to her husband who is away at war and her obedience to the king who wants her right now. It is a masterpiece, you can find the image on Google.

    Some Italian scientist noticed that there is some asymmetry in the breasts and after much observation of the portrait, concluded that the model for that painting must have had breast cancer. Presuming the model must have been Rembrandt’s girlfriend, it is known that she died around 9 years later with a prolonged illness which people assume is the proof that she must have had breast cancer. There have been other studies of that painting later that suggest otherwise, but suffice to say that Bathsheba’s breast has become an icon for breast cancer. Beautiful women with beautiful breasts seem to be able to raise awareness about breast cancer even more than real women suffering with breast cancer. Should we complain about this? I think not, because a disease like breast cancer needs all the support it can get even if it is from women who may or may not have breast cancer.

    As for Angelina, let me start first by saying that she is a beautiful woman if you happen to see any of her earlier movies or even later movies like Mr & Mrs Smith. She is bold and she is beautiful. She has a number of social causes that she fights for. Having to imagine such a gorgeous woman having a double mastectomy is such an ouch experience.

    It has certainly thrust a taboo subject into the limelight. If this helps a single woman out there to take strength while facing the knife for a diagnosis of breast cancer, it is well worth it. Many women delay the diagnosis of breast cancer because of the fear of mastectomy. It is not just about the tough decision of women like Angelina with BRCA1 to decide to have prophylactic double mastectomy of perfectly healthy breasts or to live in constant fear.

    For a casual observer, it might just seem like a game of probabilities. For her, it is very real. Her mother had breast cancer at 46 and died after a 10 year struggle with it. Having watched that, you can imagine her genuine fear of disease and death that might leave her children motherless.

    For a woman who was many times labelled as the world’s most beautiful woman, Vogue perfection etc., choosing to have a double mastectomy at age 37 is a brave decision and choosing to let the public know is even more surprising. I can only see altruism in that.

    Would anyone who thinks that this is a publicity stunt be prepared to have a bilateral orchidectomy for their 15 minutes of fame? I guess not!

    Cheers

    Steven

    • Thank you for taking your time to comment and sharing your mother’s story Steven, her story highlights just how harmful social silence on these issues can be. In many ways like the story of Bathsheba breast cancer remains hidden by so many women, with few if any clues to the outside world, and even discovered their ability to access care is limited by fear and stigma. Unfortunately this also applies to so many other conditions, both in men and women.

      My concern has always been with the more and more extreme commentaries in mainstream media that are being published as “authorities” on such a sensitive issue, it will ultimately be those who have had personal experiences through family or work that will appreciate the true motives behind the Jolie letter.

      We may have access to more information than ever at our fingertips now, but Dr. Google is an indiscriminate provider, and is often fuelling the myths and misinformation that we are untangling in our clinics more and more each day, no matter what the malady maybe.

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