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Book
Review |
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Olson,
James S. Bathsheba's Breast: Women, Cancer and History (Baltimore,
MD: Johns Hopkins University Press, 2004). 302 pp, $16.95.
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In
February 2006, the National Center for Health Statistics released fatality
statistics on cancer between 2002 and 2003. Total annual deaths from cancer
had declined for the first time since the NCHS had begun keeping statistics
in 1930, while the death rate for breast cancer had been declining about
2% per year since 1990. Statistics like these mirror the final chapter in
James S. Olson's Bathsheba's Breast: Women, Cancer and History.
Earlier detection, combined with improvements in treatment, means that breast
cancer was no longer an automatic death sentence and women can actually
live with cancer and enjoy a relatively good quality of life. |
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Olson
begins that same chapter, however, with Jill Ireland's death in 1990 after
six years of battling breast cancer to remind readers of breast cancer's
devastating toll despite the latest medical advances. Her tragic story,
one of dozens Olson retells, is central to the book's significance and appeal.
Bathsheba's Breast stands as an important addition to the thin literature
on cancer history especially because the story it tells is so personal.
I studied under Olson at Sam Houston State University where he is Distinguished
Professor of History. He lost his left hand and forearm while writing the
book and the empathy it engendered in him for the women whom he profiles
helps to make Bathsheba's Breast accessible and instructive for both specialists
and students. |
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Olson
constructs a unique narrative by telling the history of cancer through individual
vignettes of patients and doctors, strung together with his underlying themes
of gender, power, and change. For most of history, breast cancer's victims
were powerless objects treated by authoritarian male doctors whose own understanding
of the disease meant a rush to destructive surgery. Portraits of women like
"Nabby" Adams and Klara Hitler put under the knife by men who eagerly performed
the earliest mastectomies, or who were later proponents of William Halsted's
radical mastectomy, make the gender divide unmistakable. Only 70 years after
Hitler's death when feminism and the sexual revolution had begun to challenge
that same divide could Rose Kushner write that women should make treatment
decisions for themselves because, "Our lives are at stake, not a surgeon's."
(174) |
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Surgeons
and researchers, however, are just as central to the story of cancer as
the patients. Olson reveals an ongoing dynamic between predominantly male
surgeons and scientists whose medical knowledge gave them the power to define
and redefine the terms upon which the female patient would confront her
disease. His vignettes also underline how for generations the medical establishment
treated breast cancer as a local disease, only recently recognizing it as
a systemic disorder. This evolving consensus has had immense implications
for treatment practices and in turn how women have lived through, or died
from, cancer. Olson, however, always keeps the doctors rooted in their own
time and reveals them to be men (and recently women like Dr. Susan Love)
struggling to master an incredibly confounding and complex disease, but
who are nevertheless products of their cultural biases and priorities. The
mastectomy, for instance, made sense only as long as medicine believed cancer
could be confined locally. As evidence slowly grew over time that it moved
through the bloodstream from the beginning, less disfiguring approaches
like chemotherapy and estrogen treatments assumed priority. By the close
of the twentieth century patient and doctor had begun to enter into a far
more cooperative relationship that centered on her quality of life, not
the surgeon's eagerness to operate. |
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Bathsheba's
Breast is perhaps not the ideal text for a study of disease within
the field of world history. With the exception of Olson's tale of the Persian
Queen Atosa's ancient encounter with breast cancer, his examples are drawn
exclusively from Western, and primarily American, history. It is difficult
to judge in that case to what degree the battle against breast cancer has
varied between Western and non-Western cultures. Using it in conjunction
with The Cambridge World History of Disease or Sheldon Watts' Disease
and Medicine in World History, however, instructors could begin to
establish a comparative setting for understanding how breast cancer has
been treated as well as its impact on the changing social status of women
outside the West. These works would enable a discussion of how the cultural
construction of gender, identity, and authority set the terms for the treatment
of disease and the part of the patient. For instance, by demonstrating that
the Western empirical method initially led to a treatment of breast cancer
that was particularly destructive of women's bodies and self-image, Olson's
work makes an essential point about medicine as a battleground for male
authority and female identity that instructors should discuss across cultural
boundaries. Furthermore, considering how changes in Western attitudes about
sexuality and beauty transformed the treatment of breast cancer would be
an entry point for discussing those attitudes in a world historical context. |
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Yet
above all, Bathsheba's Breast makes the fact plain that regardless
of improvements in treatment or survival rates, breast cancer, like all
disease, is incredibly disruptive. So often, Olson's vignettes begin with
a woman discovering a lump while shaving or being stunned by a positive
mammogram. Immediately, they too were hitched "on cancer's emotional roller
coaster." Beyond the political activism, the resistance to change, and the
medical advancements that run throughout the book, Olson forces readers
to empathize with cancer's victims, and like the disease itself, rocks them
out of their complacency. |
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Thaddeus
M. Romansky
Texas A&M University |
