The design of the experiment hinders its ability to do any more than gesture to these bigger issues. Its use of insubstantial snack foods, for example, nudges the interpreter to think about material gains rather than other kinds of satisfaction that could result from an ability to concentrate. (The experiment might have focused on an ability to learn math or fall asleep.) Its time limit of a few minutes and the lack of data on the home lives of the children render the possible failures detailed above not only into externalities, but as somewhat ridiculous. But they aren’t. Too close an extrapolation from the experiment obscures the critical fact that what you do, when you do it, and how these things magically converge for some people all relate to a world beyond one’s control—including the chance to have a home situation that enabled trust to begin with. When read in this light, the experiment reminds us that the stipulation to defer gratification, for a life-cycle retirement account, say, offers merely the opportunity to enter a routinized casino bureaucracy, not a means to show off an individual propensity toward managing the frustrative effects of delay.
Above all, let us never forget that without marshmallow eaters, the marshmallow business would go broke and we’d live in a dim, s’moreless world. The noneaters need the eaters, as much as vice versa, just as the married workers depend on the unmarried ones, and the heroic survivors depend on those not so lucky.
If wealth rots the soul, accreting tumors rot the host. Cancer just grows, sometimes as a tumor you should have noticed but didn’t, sometimes as a tumor you can’t help but notice but can’t have removed. It may just live there; you may touch it each day. It may disappear, or it may wrap its way around your tongue. Its changing size may make it seem to be living or dying. Described by words such as apoptotic and runaway, cancer inhabits a competing version of time—not yours, not the one in which savings, Rice Krispie squares, and retirement exist.
Alas, the Lance Face can’t look in the eye the cancer survivors whose bodies experience these fissures. Unlike many people who calculate their odds and cash out their retirement policies after diagnosis, unlike the friends of mine who told me that I was the inspiration for them to live in the moment and renovate their homes (not dead yet!), unlike those ads in Cure magazine that offer to buy the life insurance policies of people with cancer in exchange for a percentage, the Lance Face returns our focus to future thinking through sheer determination. The ACI ad applies this notion of cancer survivorship to banking products for its own ends, pulling the wool over all of our eyes.
BABY FACE
From cashing in the retirement savings to hours spent in the waiting room, from the prognosis to the too quickly dividing cells, cancer is always about time. But if cells reproduce, so do people, and if anything can provide a foil for cancer’s temporality, it’s the children—new ones who arrive as fast as the prior ones exit. Both the child and early detection campaigns work with embedded ideas of temporality that reflect back on the bald insistence behind representations of lifespan. Recently, the American Cancer Society (ACS) played on the tropes of both in a widely distributed campaign intended to draw attention to the high number of Americans without health insurance (fig. 8).
FIGURE 8. An American Cancer Society Cancer Action Network (ASC CAN) advertisement, circa 2009.
The ad at once builds on a century of emphasis on early detection and implicitly critiques the logic of accumulation that I have been outlining. It presents a simple enough message: acting now by seeing a doctor means saving cash in the long run. Stuck between registers of accumulation, the ad cautions us to be careful what we defer.
Early-detection campaigns have always walked a knife-edge: they aim to provoke sufficient fear that people take symptoms seriously, but not so much that they bury their heads in the sand. An ad needs to inspire some confidence that medicine can work on the cancer (when diagnosed early), but not so much that a person thinks treatment will work if cancer is caught later on. Likewise, an ad needs to impart enough anxiety that the patient makes sure the doc does the test, but not so much that she doesn’t go to the doc in the first place or that she pesters the doctor with benign symptoms.
Based on the current theory that cancer starts in one area of the body and may spread to distant organs, early detection encourages people to take advantage of the brief window of opportunity offered by even a small tumor. Early-detection narratives, suggesting future and past counterfactuals, seek to break the deeply held association between cancer and death with one simple directive: You won’t die if you just see your doctor! The directive has a foreboding undertone: It could have been different. We can change the course of history—and if we can’t now because we waited too long, we could have before.
The ACS ad highlights the key mechanisms of early-detection campaigns. A simple cost-benefit analysis maintains that it is cheaper to “keep his mother healthy” now, for $700, than it will be to “try to keep her alive” later, for $200,000. Early detection means saving money and saving lives: it’s win-win.22 The ad also relies on the myth that if you find and treat cancer later, you could probably have found it sooner, with the additional promise that cancer death rates and overall cancer expenditure could go down. The small print informs the reader that “60% of cancer deaths could be prevented” and urges “access to prevention and early detection. For all Americans.”23 The gap between “keeping” and “trying to keep” the mother healthy is unsettlingly similar to the hedge at the bottom of the American Century Investments ad: “Past performance is not a guarantee of future results.” Like financial accumulation, cancer treatment offers only uncertainty.
To whom is the ACS message—money and lives are being lost—addressed? In other words, who cares? The difference between $700 and $200,000 might in fact invite incredulity. While there may be investments that increase twenty-five-fold over some unspecified amount of time, as a financial wager it’s dubious, especially since it’s unclear how the various pockets will lose and gain coin. Thus the ad must cite not only the Market, but also the other key referent of the future, the Child who stands to lose his mother.
English professor Lee Edelman has argued that the Child holds a critical rhetorical place in American politics.24 The wide-eyed face of the Child has ideologically justified everything from marriage with its unequal distributions of wealth to the Patriot Act. Mothers used their children to curb drunk driving in the 1980s, and after the deaths of hundreds of gay men, only the presexual child Ryan White finally brought AIDS to national attention. From Megan’s Law to denying gay marriage to expelling gay school teachers, political action has harnessed the power of the Child. The Child gains his potency in his abstract permanence and his winsome innocence, in his asexuality, in his disconnection from the market and his prepolitical sensibility.25 This Child, not as a person but as fetishized ideal, plays a critical role in laying out expectations about life course.
Without portraying a child and referencing its archetype, the ad would uneasily tangle with the “who cares?” question, since the state doesn’t generally care about any individual’s health. Such is the premise of the private insurance system and the reason that some forty-five million Americans remain uninsured, with sixty million more underinsured. Even given recent legislation that may change this for the moment, to ask the state to care for any particular individual using a market logic can’t work. Not only does the pre- and postcancer money come from different, incommensurate pockets, but with only a few exceptions, health insurance, we’ve decided, is not a benefit to be distributed by the state. The ad needs, then, to appeal to another logic: humanitarianism.
While his mother might be blamed for not getting insurance, this boy has done nothing to deserve losing her. The young woman on her own may generate resistance (why doesn’t she have a [better] job?), yet children remain outside the market exigencies that underlie the moral economy of who has healthcare. The ad purveys the message that “we” owe him, if not his mother, at least the initial $700, while it also assures the self-interest of saving ourselves $200,000. The “who cares?” question