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Harriet S.MeyerMD, Contributing EditorJonathan D.EldredgeMLS, PhD, Journal Review EditorRobertHoganMD, adviser for new media
Living on the Margins is a literary anthology of breast cancer with a distinguished list of eight contributors, all writers—poets, critics, academics, editors, essayists. Their writing, wide-ranging in genre, style, and tone, includes personal narratives, poetry, academic essays, and an interview.
The editor, Hilda Raz, begins the book with an argument that a "margin of missing literature" surrounds breast cancer, and that "margins of silence" confine artists living with the disease. Throughout the introduction she further develops the "margins" imagery, sometimes too insistently: the contributors have all traveled beyond the "margins of the known world," often pushing the "margins of acceptable treatment," all of them looking for "clean margins" around a cancerous site in their breasts, all of them "living on the margins" because of what they've experienced. Raz is most persuasive when she writes of the healing potential of art. Her purpose for the collection, in fact, is "to discover ways writers accept the risk cancer brings and use it in their work." Artists repair, reorganize, and reconceptualize the familiar and the unknown, "seducing," as Linda McCarriston is quoted here, "the reluctant knower with the pleasure, the intellectual thrill, the ‘terrible beauty' of the unwanted lesson: into knowing."
As a whole, the volume succeeds in giving readers such lessons. There are many stunning chapters, beautifully written, full of imagery that cracks open the experience of breast cancer, each situated within the unique context of one woman's life. Pamela Post reflects on what breast cancer did, not only to her body but to her mind and spirit: "Had they removed my heart? Stitched my mouth shut? I had nothing to say. My spirit is as scarred as my body." She refers to a kind of "place" women diagnosed with breast cancer share, what Carole Simmons Oles calls the "world of the ill," a "membrane" separating them from others. Alicia Ostriker similarly writes of crossing a "border" the moment she hears the word positive, becoming a "permanent citizen of the nation of fear. It is as if a coat of ice has formed around me."
Most of the contributors write convincingly about the healing power of family and friends. Ostriker does it best: "Everyone puts me in touch with someone else. Everyone is so kind, so generous, it is a gift. Each new human contact is like a warm penny pressed against the icy window of my spirit, melting a spot, turning it from cold white to blurry swimming color." While Claudia MonPere McIsaac's memoir of her mother's life and death from breast cancer does not romanticize what a family "becomes" at the bedside of their dying mother, she nonetheless maintains, "if dying can be good, this was." Lucille Clifton finds strength in Amazon imagery upon her diagnosis, "when they each / with one nipple lifted / beckoned to me."
The book is full of good doctor/bad doctor anecdotes, many of them familiar. Maxine Kumin refers to an "icy" surgeon who "never addressed [her] as human"; Amy Ling describes an oncologist "more concerned about saving money than about [her] comfort and . . . health"; Marilyn Hacker depicts her doctor as "enthroned behind an enormous mahogany desk, the three of us crowded on the other side"; Carole Simmons Oles describes a hostile reaction when she challenged her doctor, going against the "medico-hero-worship" of her upbringing. Yet for every "bad" doctor there is a "good" one—for these writers, someone who is respectfully forthright, generous with information, and treats them as intelligent decision makers in the course of their treatment.
The book is superbly written and well worth reading by anyone who provides care to women with breast cancer (or anyone who has it). That said, the collection has several organizational problems. First, Eve Kosofsky Sedgwick's "watershed" essay "White Glasses" and Sandra Spanier's essay on Kay Boyle are not a good fit with the others and belong in a more academically or theoretically focused collection.
Second, Raz's introduction fails to mention a long tradition of women writing about their breast cancer, many of them writers and artists "testifying" about their experience, clearly not living in "margins of silence": Betty Rollin's memoir First, You Cry (1976); Lyn Lifshitz's edited anthology of poetry Her Soul Beneath the Bone (1988); Sandra Butler and Barbara Rosenblum's memoir Cancer in Two Voices (1991); and Art. Rage. Us.: Art and Writing by Women with Breast Cancer (1998), a stunningly powerful collection of works by more than 70 artists and writers sponsored by the Breast Cancer Fund, the American Cancer Society, and the Susan G. Komen Breast Cancer Foundation (San Francisco chapters), to name a few.
Finally, a more global concern is that the entire collection provides a very narrow glimpse of the lived experience of breast cancer. The contributors' social, economic, and educational privilege permeates the collection (eg, Marilyn Hacker worries about medical connections in Paris, her second home). This collection would benefit from an interview with, perhaps, an uninsured woman or a woman without a network of support who worries about time away from her job and who will care for her children.
Breast Cancer: Living on the Margins: Women Writers on Breast Cancer. JAMA. 2000;283(4):539–540. doi:10.1001/jama.283.4.539-JBK0126-4-1
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