In bringing our attention, justly, to the huge effect that insurance has on mortality rates and pointing the way to a future fantasy in which all Americans have insurance, the ad diverts attention from the way statist ideologies justify the market distribution of medical insurance. Indeed, in an internal contradiction it supports, rather than challenges, these same ideologies.26 The ad, ultimately, recants the ways in which the ideology of the Child denies benefits to huge swaths of the population (as in the justifications for marriage benefits) and forecloses a more earthy discussion of who has insurance and who does not and why both insurance and healthcare are so expensive.
STRAIGHT FACE
The Young Adult, too, holds a critical rhetorical place in U.S. politics. Years ago at a funeral I attended for a grad school colleague who had died of leukemia at thirty-three, her cousin comforted herself in a speech with the idea that Chaney had been lucky, for she would not have to experience the horrific event of turning forty, as the cousin recently had. Chaney would not have to pass that invisible, ineluctable birthday that drew the speaker one step closer to disposability. Virtually any comment at a funeral gets a special pass, but this remark is telling for its unashamed embrace of the fetishization of Young Adulthood, of the person at the height of intellectual potency and reproductive fertility, with boot-strapping promise, still marching up the sunny incline of the hill.
Like the Child and the Cancer Survivor, the Young Adult cuts a high-stakes ideal that can be exploited, as Lance Armstrong’s vast empire demonstrated. Still, the fetishization of Young Adulthood is all the more insistently enforced given the lack of, or finely parsed distribution of, social support. As heirs to these ideals of a lifespan, the best, and worst, young unmarried survivors can do is to fail our families by leaving parents to survive us (a crime against nature) or leaving our dependents without support. Regardless of who is listed as kin in the last line of an obituary (“. . . is survived by . . .”), those relationships are local. The broader economy, miraculously, has protected itself from being failed or survived by the illnesses of it citizens.
Legitimate, financially supported survivorship relies on kinship models. Specifically, marriage entitles one to benefits, some of which I have mentioned already: insurance, or increased odds of insurance, through a spouse’s employer; survivors’ benefits for the spouse, such as Social Security; and government and employer benefits for children. Quite distinct from individual success and hard work, these selective gifts result not from performance but from kinship. They also shore up the notion that some lives are more worth living than others and some lifespans more worthy of completion (if only by proxy). To put it coldly and without ascribing intent, not everyone deserves to survive or to be survived.
The early-detection trope routes the promise of a cancerless world through the fetishized child and the market (pay now, save later) and consolidates the notion that the problem of cancer can be solved through these ideals, rather than seeing them as part of the problem. The ACS ad shrugs off the same questions that all early-detection ads do: about missed cancers (especially in this mother’s age group), about the expense of treatment, about the causes of the disease. It also describes cancer as white and straight, and early detection as a duty of individuals and in the interests of the state. Given the conservatism of the ACS (some of the country’s top industrialists have served on its board of directors), one would not expect something so radical as a prevention statement that focused on the chemical, industrial, and medical causes of cancer. Still, the ad does more than not make waves; it erases the underlying politics of the disease.
The market relies on a notion of the future, which in turn drives ideas about expected lifespan. Retirement and children, the two carrots of futurity, are the key symbols of a life well lived. The productive reproductive young adult takes center stage in these ideals. Early-detection campaigns also play on some version of the defining market ideology of “pay a little now, save a lot later,” coming close to promising that, despite everything, we can succeed against cancer, both as individuals and as a society. But the disease also enables a unique insight into the disparities in the distribution of goods underwritten by the fantasies of fairness that justify the market.
Despite cancer culture’s nearly panicked generation of future thinking, the disease places futures radically in danger. In the United States, the redistribution that cancer entails—the massive expenses incurred and the mammoth profits made—puts the whole system at risk of failure. Lance’s poker face shamefacedly disguises the cancer that threatens the underwriting ideologies and promises of the market (lifespan, futurity, deferral). A culture may not have cells that can divide, but cancer has it by the pocketbook.
CHAPTER 3
Cancer Butch
Trip Up the Fast Lane
I didn’t set out to test-drive a sports car. Commuting one morning in my work-a-day Honda Civic, I noticed rows of BMWs and a huge banner inviting me to Come and drive one! Raise money for breast cancer! I screeched into a U-turn: I had always wanted to try out a BMW roadster. The showroom, decked out with pink roses, ribbons, helium balloons, and a huge array of finger foods donated by Whole Foods, reminded me of a movie star’s funeral, only the centerpiece was a BMW 3 Series instead of a coffin. That car would spend the summer purring through air-conditioned dealerships across the the southern swath of the United States being signed—yes, written on—by test drivers. The gleaming hostess, a cancer version of Vanna White, exclaimed, “You can drive as many times as you want to,” with the confided aside, “but you can only sign once.” That I was in North Carolina only added to the novelty of the experience.
Near the door, another exhibit—“The BMW Pink Ribbon Collection”—featured the usual array of logo’ed stuff—towels, coffee mugs, sport bags, caps—all embossed with the words The Ultimate Drive. A fellow test driver said, with real feeling, “It’s really beautiful, they did such a good job this year.” I took a pamphlet inviting me to “Show you care with style.”
Beckoned more by style than care, I turbo-charged down the highway minutes later, encapsulated within exquisite walnut and leather. (This was no CT scanner tube.) Five minutes after that, I accidentally diverged from the specified route, thus driving uninsured the same stretch of freeway on which my own car had been totaled by a semi the previous month. (For a minute, cancer seemed less dangerous than the current risk.) At least I was Earning-a-Dollar-a-Mile-for-Breast-Cancer. I turned pink at the thought.
It can be hard to untangle the motives of the breast cancer–corporate care nexus. I bought a Hansen’s grapefruit soda the other day, which bade me to “Save lives, Send tabs”: If I disengaged the pink opener from the can (“use extreme care!”), washed it, put it in an envelope, and sent it, they’d donate a dime to the cause. The right postage stamp would earn another two cents. Although it is difficult enough to find out how much money these campaigns collect, it is nearly impossible to figure out where that money goes. Nevertheless, BMW raised $9 million through its campaign, and I was able to drive the car I’ve long fetishized.1
Despite the thrill, something about the campaign struck me the wrong way. The advertising for the event made it seem as if a cure were just down the road, although survival rates have barely accelerated in the last century. Nor did the atmosphere of self-congratulation and celebration leave space to mention several known carcinogens that the auto industry has lobbied hard to allow in gasoline and in car manufacture (a paradox perhaps made easier to swallow after the collective loss of brain cells from decades of inhaling leaded gas fumes). And the whole event, with the pink, the products, the dealer’s marketing strategy, doubled down on the same traditional femininity that seeps through the entire complex of women’s cancer, such as the pamphlets that let women know how soon after mastectomy they can return to “washing walls.”2
It