Yesterday Angelina Jolie announced to the world that she underwent an elective, preventative double mastectomy after learning that she was positive for the BRCA1 gene mutation that greatly increases her risk of breast and ovarian cancer. For being aware and doing what she felt was the right decision for her and her family in the face of heightened risk, I applaud her.
But all over Twitter, Facebook, and the Google News aggregate, people are harrowing her as a 21st century heroine; a pioneer in women’s health and preventative medicine. She is so brave and an inspiration to us all – blah blah blah.
Huh? Are we really supposed to believe Angelina Jolie is a heroine or something?
Jolie decided to undergo a genetic test after careful consideration that she might be at heightened risk because of her mother’s own cancer death. She had the money to spend on a test that many, many women cannot afford, and that very few insurance companies even cover. Why does the fact that Jolie had the money to have this test, and therefore went ahead with it, make her brave? A national heroine? Wealthy women around the country do this test every day. Do they all get to write op-ed pieces about their harrowing experience? Does Twitter make them national legends and pioneers in modern medicine?
Or what about all the women that very likely carry the gene, know they probably carry the gene because of their strong family history of disease, and yet cannot afford to ever know? Do they get hashtag trends like #bravewomenthatwillneverknow or #alwayslivinginfear?
When Jolie found out she was positive for the gene mutation, she decided to have an elective, preventative, double mastectomy, with nipple preservation and complete reconstructive surgery. In other words: another pile of procedures that are expensive and usually not covered by the vast majority of American health insurance policies. So basically, up to this point, all Jolie has done is opt to have a number of medical tests and procedures done that are reserved for the wealthiest and most elite members of society. She has opted for luxuries when it comes to her medical care, which many women in this country have absolutely no access or ability to afford.
How is Angelina Jolie a heroine and pioneer in women’s health again?
Many doctors do not even recommend prophylactic mastectomy in the event that a woman has a heightened risk with the BRCA1 and BRCA2 gene mutations. There are a number of preventative hormone treatment options available, increased preventative testing, and lumpectomy options that are much less invasive and expensive. Why this is worth mentioning is in the discussion over our country’s current trend towards going to extreme lengths to eliminate risk (which can never truly be eliminated entirely). And in understanding the drastic difference between risk factor and cause – as Americans, we tend to misunderstand that risk does not equal certainty or causality.
But as a culture obsessed with trying to cheat death, we tend to heighten risk into the most extreme measures possible to the point that we do more damage than good. People are so afraid of the extremely rare risks of vaccines, so they avoid them altogether and then die of polio. Families are fearful of GMOs and processed foods, so eat only whole foods and fats then die of heart disease from ingesting high fat foods for years on end. And we look to national figures, such as Jolie, for guidance on what we should do. How we should think. Even when we don’t have the same resources that they do.
Each woman’s health is a different matter entirely, though. As is her financial status, and the risks and health issues that she will face. I am not suggesting that Jolie or anyone should or shouldn’t do any particular thing relative to her own health. That is not what I’m saying here. What I am saying is that none is more special of a circumstance than the next. We are all the same in the playing field of life. We just have different stories.
I have always believed that the only real preventative medicine we should be engaging in is accepting the imminence of our own deaths and enjoying every minute of our lives, rather than spending them all cowering in fear of what may come. Or at the very least, let’s worry about things that are really important right now. Not saying breast cancer risk is unimportant or should be forgotten, but much worse by the dozen is heart disease risk, obesity, diabetes, war, famine, the threat of nuclear holocaust, global warming.
Congratulations to Angelina Jolie on her new, risk-free boobs. Now can we all shut up and move on already?