Beyond Slash, Burn, and Poison: Transforming Breast Cancer Stories into Action (review)

Marcy Jane Knopf-Newman's Beyond Slash, Burn, and Poison: Transforming Breast Cancer Stories into Action is a readable and engaging account of twentieth-century breast-cancer narratives in the United States. The book is focused on women whose writings on breast cancer "explore the symbiotic relationship among culture, politics, and medicine," and whose writings, Knopf-Newman argues, "had an impact and led to changes in public policy or medical practices or both" (5). A major strength of the book is its complex analysis of culture, politics, and medicine deeply informed by not only gender, but also race, class, and global considerations. And, as her acknowledgements attest, the book is indebted to feminist and activist scholarship, and thus, well suited for use in a feminist classroom dealing with feminist narratives or topics such as gender and the body, medicine/ environment, and public policy.

Knopf-Newman opens with an early nineteenth-century account of mastectomy performed on the English novelist Frances Burney. Describing the procedure (without anesthesia or antiseptic), Burney uses legal metaphors to chart her experience "as a criminal who must submit to her sentence" (3). For Burney, writing about the procedure was a tool that assisted her in becoming empowered and through which she gained agency by representing her body and experience. For Knopf-Newman, the role of language and literature in negotiating breast cancer as a gendered medical condition, the power of literature in the public sphere, and individual/ female agency are key terms constituting her discussion.

If there is one issue that fascinates Knopf-Newman, it's the history and evolution of the Halstead mastectomy as the gold-standard treatment for breast cancer (the choice for many years was seen as Halstead or certain death). The Halstead mastectomy was the removal of all the pectoral muscles during mastectomy (later critiqued by physicians like George Crile, who argued that a wide array of options were preferable to this extremely painful procedure). The ubiquity of the procedure was also a result of the structure of the insurance industry that financially rewarded massively invasive procedures. Part of the horror of the Halstead was in how it was performed, a result of the medical community's belief in the need for speed between diagnosis and surgery. Thus, women did not know what their diagnosis or prognosis was until the mastectomy and biopsy were done simultaneously. Women would often have no idea that they would wake up without a breast (or pectoral muscles). To Knopf-Newman, this medical procedure, unchallenged for nearly a century as the sole answer to breast cancer, resulted in suppressing women's agency and in silencing them as autonomous agents.

To counter the culture of the Halstead mastectomy, which represents the suppression of female agency and silence, Knopf-Newman analyzes four well-known women who had and wrote about breast cancer. She focuses on Rachel Carson, who wrote the landmark environmental tract Silent Spring, First Lady Betty Ford, journalist and health activist Rose Kushner, and African-American poet, writer, lesbian, and anti-apartheid activist, Audre Lorde. Organized chronologically, her text "highlights women who wrote about their breast cancer and resisted the impulse to contain breast cancer in an apolitical private space for doing so contributes to blaming the victim, which saturates mass media representations of the disease" (23). Thus, these women each engage with central topics in feminist scholarship, specifically, the relationship between the personal and the political, and the body. They also engage (to varying degrees) important topics in environmental and public health scholarship, specifically, what causes breast cancer? Or, what are the environmental influences on breast cancer that destabilize a dominant causation narrative focused on family genetics and lifestyle choices?

Probably, the most well known of the four women Knopf-Newman discusses is Betty Ford. As First Lady (along with the near simultaneous announcement of the vice president's wife's cancer), Ford drew mass media attention. Knopf-Newman situates Ford's self...