Abstract: This paper looks at representations of ‘disfigurement’ resulting from surgical and therapy procedures in the treatment female cancers in select narratives understand the responses to altered body-self- images in the context of established notions about the ‘beauty’ of women’s body. In the memoirs and autobiographical pieces, I analyse for this study, the body-self image is closely linked to one’s perception about the quality of life. The paper reflects on the fairness of treatment options that aim at mere survival and prolongation of life, paying very little attention to what the ‘patient’ understands as quality of life and body-self-image. In the treatment of breast cancer, the transition from Halstead’s radical mastectomy to the present moderate surgical methods and reconstruction procedures indicate, to some extent, how the body-self-image has factored into the medical processes and decisions about treatment options. Audre Lorde’s critique of wig-hunting and prosthetic breast fitting frenzy of cancer survivors and Betty Rollin’s justification of women’s concerns about their ‘appearance’ post cancer surgery and chemotherapy illustrate how women who have experienced cancer differ in their priorities and perceptions. In the light of select narratives and photography projects such as SCAR focusing on women after cancer surgery, I would like to show how capturing disfigurement in art has a shock value that translates into a social critique. Reproducing grotesque body-self-images through the media of writing and photography may assault the prevalent aesthetic notions surrounding the body and its representation.
Keywords: disfigurement, plastic surgery, cosmetic surgery, cancer, illness narrative, cultural normativity, biopolitics„ heteronormativity, radical difference
Rilke’s ambivalent aphorism in Duino Elegies, “For beauty is nothing/ but the beginning of terror we can barely endure/ and we admire it so because it calmly disdains/ to destroy us. Every angel is terrible”1 (3) illustrates a philosophical-experiential impasse wherein the mind is in awe of a moment of discernment between beauty and terror. Such moments are not uncommon in the treatment of diseases popularly considered capricious and fatal. The treatment begins with beautiful promises of life, cure and healing; yet in powerless moments when one submits the body to the expertise of doctors, fear of death or of a survival worse than death may slowly overshadow the happy prospect of many more years to live. The treatment procedures of cancer often are more harrowing than the disease itself. Medical practitioners cannot always take into account the importance of healing or the quality of life since their primary concern is to save the patient’s life. One invariably has several confrontations with the terrible face of angels during presumably life-saving procedures. The side effects, scars and voids left on the body might stay on, giving a sense of ugliness despite the assurance of an extended life.
This paper looks at representations of ‘disfigurement’ resulting from surgical and therapy procedures in the cancer treatment for women in select narratives and tries to analyse how the standards of beauty formed and circulated in society influence the body-self-image of people undergoing such procedures. Women’s responses to their experience of cancer are filtered through and to a great extent, produced by their situatedness in a culture. The anxieties of the milieu about the gender roles and expectations about women and their sexuality might generate fear and shame in women who decide to write about the experience of illness. Heteronormativity has shaped the ways in which women interpret and narrate their illness and issues concerning body-self image, suffering, pain, and mortality. By telling one’s life-stories, a writer constructs an identity of the self for the readers. Writing about oneself may or may not be ruled by concerns of veracity or authenticity. What should go into a narrative and how the self is represented in it are not always dependent on the free choice of the writing subject. Selection, exclusion and deployment of events in life writing can be influenced by one’s ideological positions. In some narratives, the life-worlds around one’s illness are often represented in conformity to certain norms. These could be the reasons why most of the autobiographical accounts of women who have experienced cancer have reinforced and perpetuated rather than critiqued and subverted the mainstream conceptions about women’s body, attitudes to beauty, pain, suffering and mortality. Rarely does one come across illness narratives that subvert the norm. Most cancer narratives are written as inspirational testimonials of healing. The book market demands feel-good stories about illness that are optimistic and bold, stories that observe an obligatory silence about anger, suffering and pain. Instead of generating radical ideas about the self, identity, gender and sexuality, cancer narratives by a majority of women sustain the established ideas about social obligation, virtues of tight-lipped suffering, individual responsibility, femininity and family.
Through an analysis of illness narratives, my attempt is to read body-self- images altered by illness against the rampant notions about the ‘beauty’ of women’s body. In order to make sense of the prevalent, popular and perpetuated norms of beauty, I have used segments of stories, advertisements of cosmetic and surgical services and discourses from mass-media consumer culture.
The contemporary healthcare and medical services are analysed as directly and indirectly embedded in, if not part of this culture. The cultural paraphernalia of femininity surrounds the bodies of women with normative practices, objects and objectives. When we look at the evisceration of subjectivity, body figures primarily as a medium or text of culture and also as a direct locus of social control that operates through subtle strategies. Human beings master the norms primarily through corporeal discourses and practices; cultural images and imaginings further tutor us in terms of attire, expressions, disposition and behaviour. The complex connection between the representation of women in culture and the everyday practices and expressions of women’s bodies and selves are worth examining from the angles of domination and subject formation.
Audre Lorde’s critique of women’s wig-hunting and prosthetic-breast-fitting frenzy after cancer treatment and Betty Rollin’ sjustification of women’s anxiety about their appearance post cancer surgery and chemotherapy illustrate how women who have experienced cancer differ in their priorities and perceptions. The body-self-image is closely linked to one’s point of view about the quality of life and wellbeing. Some narrators emphasise the need for research directed towards efficient healing methods and less dehumanising treatment procedures. Sadly, medicines, surgery, radiation, chemotherapy and other methods used for cancer care may subject a person to more suffering than cancer itself. In the treatment of breast cancer, the transition from Halstead’s radical mastectomy (removal of the entire breast, lymphatic tissue in the area, and the pectoral muscle) to moderate contemporary surgical methods such as lumpectomy and reconstruction procedures indicates how the concerns about the quality of life and body-self-image have factored into medical processes and decisions about treatment options2.
The Politics of Looking Good and Problems in Healing
This paper is not an indictment on women who had opted for reconstruction surgeries or wigs. I do not intend to suggest that such choices are frivolous or shallow. However, I approach with caution the argument that by making such choices, a woman is able to exercise the right to look good after struggling with a devastating illness. Supporting such an argument would amount to underestimating the force of cultural normativity that engineers one’s choices about looking good in order to feel better. Acculturating practices surround one’s body-self-image in such a way that the need for looking good is internalised as an essential condition for self-confidence. The ideal body-self-image has an intimate connection with the aesthetics of the body or what is considered to be a ‘beautiful’ body. In other words, in contemporary discourses of corporeality, the boundaries between the beautiful and the ideal are permeable. Breast cancer usually makes women intensely body conscious and binds their thoughts to the aesthetics of the body. Deborah Nobler Kahane observes that during an experience of breast cancer:
Your breast becomes the focus of everyone else’s attention; they become part of the public domain. During diagnosis, you feel that you have been involuntarily thrust stark naked on a stage, with the audience free to question, examine, x-ray, inject and cut you. Throughout treatment, you continue to feel on stage and exposed. You become increasingly vulnerable, desexualised, and dehumanised. (No Less a Woman 202)
In a neoliberal capitalist culture, conditions for one’s sense of wellbeing, social acceptability, mobility, security, success in relationships and professional accomplishments become increasingly dependent on the attractiveness of body. With a ring of irony, Germaine Greer points out the nature of the cultural conditioning that reinforces women’s obsession with beauty which is highly unjust and disheartening: “Every woman knows that, regardless of all her other achievements, she is a failure if she is not beautiful (19).”3 The concerns about one’s appearance and desirability may usher even very talented and accomplished women into the path of self abhorrence. Lucy Grealy, in her Autobiography of a Face, a poignant narrative of her cancer treatment and surgical removal of her jaw, shares the distressing memories of humiliation and alienation. She opines: “Beauty, as defined by society at large, seemed to be only about who was best at looking like everyone else” (187). She understands desirability in terms of beauty: “What was beauty for, after all, if not to attract the attention of men, of lovers” (Ibid). In her memoir, Truth & Beauty: A Friendship, Grealy’s friend and writer, Ann Patchett remembers the debilitating self consciousness and despair Grealy experienced in her short life put to a premature end by drug overdose. Despite being a proficient writer, Grealy starts seeing herself as an embodiment of ugliness and so puts herself through the painful ordeal of a series of expensive plastic and reconstructive surgeries with a hope of becoming beautiful enough to be worthy of someone’s love. Grealy’s anxiety about the rare possibility of finding the next man who would be willing to sleep with her illustrates a self-defeating aspect of her body-self-image. Kathlyn. Conway, a writer and psychotherapist, in her Ordinary Life: A Memoir of Illness narrates about a phase of self-loathing and self – consciousness after cancer treatment. She was troubled by the impact of her hairless, breastless ravaged appearance on her patients. Her search for wigs and shopping for prosthesis are portrayed in darkly humorous tones.
Several feminist thinkers, especially Susan Bordo have cautioned women to seek freedom from the aspiration to conform to a culturally constructed (constricted?) ideal body image in order to please others. It is more liberating and empowering if women are comfortable with their own bodies and do not care about how they are gazed at. The culturally constricted ideal body image operates like an Iron Maiden that Naomi Wolf discusses in The Beauty Myth.4 Iron Maiden, a cold metallic instrument of torture shaped like the body of a perfect woman has spikes or saws fitted inside; a body shut within it would die bleeding in the suffocating darkness. Wolf illustrates, using the analogy of the Iron Maiden, how torturous it would be for a woman to confine herself within an overpowering and deeply penetrating cultural normativity enclosing her corporeal identity. This kind of cultural normativity targeting the body is a death sentence to all other aspects of women’s identity, annihilating everything except a biologically/corporeally restricted selfhood. In other words, a woman’s worth is reduced to a culturally prescribed norm of a perfect body and that’s why it is essential to break free from the Iron Maiden ideal.
However, popular perceptions about plastic and cosmetic surgery do not generate the impression of a painfully restricted body-self image. The constricted nature of a corporeal identity that ‘beautifying’ or ‘repairing’ surgery promotes is hidden under images and strategic verbiage of freedom, informed aesthetic choices and power over one’s own life. Ironically, the cosmetic industry and especially cosmetic surgery repackage certain feminist terminology such as ‘autonomy,’ reaffirming control over one’s body and one’s self’ and ‘self-empowerment` to justify and promote their products and services. Though post cancer cosmetic surgery has very little to do with curing the disease, it is projected as an essential condition for psychological and emotional healing after a devastating and disfiguring phase of illness. Choices conforming to patriarchal norms and heterosexist power equations have been packaged in the guise of sovereignty of the self. Studying individual choices without examining the temporality and cultural contexts of those choices would lead to a serious analytic flaw that would make conformity appear as freewill.
A cure that does not heal is indeed a terrible angel. After undergoing ‘disfiguring’ treatment that saves one’s life or offers a temporary cure, a person’s attitudes towards her/his altered body and ominous fear of transience (of life, of wellness, of happiness, etc.) determine the degree of healing. A person may feel healed even if not cured of the illness by coming to terms with one’s illness, altered body and impending death. On the other hand, despite being asymptomatic after a successful phase of treatment, s/he may not experience ‘healing’ if the changed body and fear of death continue to haunt her or him.
David Morris argues that, “Even without our knowing it, ideas of beauty hold a significant influence on the ways we come to experience pain” (The Culture of Pain 199). The consciousness about the ugliness of one’s own body may make pain and emotional suffering more acute. We tend to think of cancer in terms of metaphors: demonic and animal imagery (crab, proliferating worms, surgical scar as curled up millipedes) associated with cancer further increases the sense of foreboding and ugliness surrounding the illness. Susan Sontag warns in her Illness as Metaphor: “The healthiest way of being ill — is the one most purified of, most resistant to, metaphoric thinking. Yet it is hardly possible to take up one’s residence in the kingdom of the ill unprejudiced by the lurid metaphors with which it has been landscaped” (3).
The transformations after surgery and chemotherapy often trigger apprehensions whether the body is ‘desirable’ and appealing anymore especially in the context of heterosexual erotic relationships. The physical and psychological trauma of mastectomies would be directly proportional to the degree of discomfort one has with an altered body-self-image. Meredith Norton in her Memoir, Lopsided, remembers how the precise instructions handed over to her – Chemotherapy, double mastectomy, no reconstruction and radiation- first filled her with an ugly sense of loss and then fear of pain and death. She, a black heterosexual woman married to a white man, finds it hard to reconcile with the image of herself in the mirror as ‘the pajamaed orangutan staring back’ (46). This debilitating self-consciousness emerges from constructing the body-self-image on the norms of appeal and attractiveness of the body from another’s perspective. Kathlyn Conway’s Memoir shows us how she senses a shift in her priorities before and after mastectomy. Although she readily agreed for mastectomy asserting that life is more important than the breast, after the surgical removal, she was overcome by concerns about her ‘appearance.’ Even a reassurance from her spouse, David, that she looks fine does not alleviate her sorrow. She adores him for “loving these swollen stitched, artificial, reconstructed, and reduced breasts” (Ordinary Life 224). Though the idea of inserting a foreign object in the body and pretend to have a breast seemed strange to her, Kathlyn Conway opted for reconstruction. Her attempt to rationalise her decision shows her doubts and inner conflict:
People report feeling better about themselves afterward, and I reasoned that I would feel more comfortable wearing a T-shirt or bathrobe in front of the kids. But I see now that I would have grown comfortable with my body even without reconstruction. Still, I’ve made my decision and I’ll live with it. I try to console myself with the advantage of having the tissue in my second breast analysed. At least this rationale is better than my wish to make my breasts match. (Ordinary Life 202)
Many cancer survivors invariably resort to cosmetic and plastic surgery options for getting the body repaired and restored to ‘normalcy.’ They argue that cosmetic processes, make up and surgery, boosts one’s self-esteem. Such a view is corroborated by the rhetoric of several organisations and programs that offer help and solace to cancer patients. For example, ‘Look Good Feel Better,’5 “a non-medical, brand-neutral public service program that teaches beauty techniques to cancer patients to help them manage the appearance-related side effects of cancer treatment” emphatically states in bold pink letters on their webpage: “Cancer can rob a woman of her energy, appetite and strength. But it does not have to take away her self confidence” as if to suggest that looking good would compensate for everything else. ‘Look Good, Feel Better’ (LGFB) a campaign jointly launched by the American Cancer Society and the cosmetics industry instructs women how to re-beautify themselves after chemotherapy by covering up the signs of cancer with makeup, new hair styles and cosmetic techniques. Media industry, and medical discourses and practices represent breast cancer as a cosmetic issue by emphasising heteronormativity. The resulting pressure on women to erase all tangible evidence of aging, ill health and pain is quite harrowing. This is often done in total oblivion of the carcinogenic chemicals in some make-up and turning a blind eye to the risks of cosmetic surgery.
‘Look Good Feel Better’ apparently does commendable work in achieving its objective of making many ‘feel better’ though it follows an often unjustifiable and restricted means of ‘looking good’ to accomplish that end. This organisation/ campaign, established in 1989 has an interesting history6 in which more than doctors or patients, significant stakeholders of the cosmetic industry such as Personal Care Products ‘Council Foundation (formerly The Cosmetic Toiletry and Fragrance Association) play a crucial role. Here is the story of ‘Look Good Feel Better’ that began with one patient:
In 1987, a physician asked former Personal Care Products Council President Ed Kavanaugh how he could organise a “makeover” for a woman in cancer treatment who was experiencing dramatic appearance side effects. The woman was so depressed and self-conscious she would not venture outside her hospital room. Kavanaugh made some calls and was able to provide cosmetics and a cosmetologist – and the makeover transformed not only the woman’s look, but also her outlook. She felt happier, less burdened and laughed for the first time in weeks.7
The change of name of the organisation from ‘cosmetic toiletry and fragrances’ to ‘personal care products council’ is a momentous cultural leap due to its implicit shift of emphasis from mere cosmetic concerns to a biopolitical emphasis on the care of the self. The predominantly pink-themed website of the organisation has a section on year-wise timeline of accomplishments and links to video testimonials. The site has ‘Ask the Experts,’ Virtual Makeover,’ and ‘Beauty Guide’ sections and pages dedicated to the care of hair, nail, and skin damaged during the treatment of cancer. One frequently encounters words such as ‘self esteem,’ ‘hope,’ ‘confidence,’ ‘courage,’ and ‘community’ quite strategically and convincingly woven into the narrative that urges one to look good by trying out new hair styles, makeup and accessories endorsed by the site. The site also has a long list of corporate partners, the giants in cosmetic industry, whose products and services are subtly promoted.8 ‘The Look Good Feel Better’ campaign has a powerful presence on the social networking sites.
Cosmetic surgery after cancer is often interpreted as nurturing and tending to the self by making the body insular to physical and emotional suffering through a makeover. This makeover is being projected as a joyful event (as it conforms to the prevalent ‘look good, feel better formula), a privilege and even an opportunity to get a body more perfect than it was before. The website of plasticsurgery. org will give an idea of what I am hinting at. This website has an eye-catching picture of women in white tops posing with pink ribbons to endorse the reconstruction surgery after mastectomy. The tagline reads, “Breast Reconstruction Helping You Become Whole Again.” There is a predominantly highlighted ‘note about symmetry’ in the site which carries many Before-After pictures that bring hope and assurance about getting a body crafted to superhuman/ super-feminine perfection: “If only one breast is affected, it alone may be reconstructed. In addition, a breast lift, breast reduction or breast augmentation may be recommended for the opposite breast to improve symmetry of the size and position of both breasts.” On a link from the same website, there is a menacing revelation: “The possible risks of breast reconstruction include, but are not limited to, bleeding, infection, poor healing of incisions, and anesthesia risks. The use of implants carries the risk of breast firmness (capsular contracture) and implant rupture.” Despite the dangers, ‘wholeness’ and ‘symmetry’ are highlighted more emphatically. The site represents in a masked celebratory vein, mastectomy and reconstruction as an opportunity to have the kind of breasts one always wanted to have: symmetrical breasts of the right size that defy gravity and never sag so that a woman who has them feels like a goddess. According to this view, post mastectomy cosmetic surgery gets the disadvantage of cancer translated into a triumph over one’s existing imperfections. However, experiences shared on innumerous online discussion forums indicate that all is not well with cosmetic and reconstruction surgery; people have different stories to tell about the non-fulfilment of the promises of retrieving or augmenting perfection and symmetry, not to mention the traumatic experiences of infections, implant ruptures and malformed growth of scar tissues. Controversies about the safety of having implants and the fear whether the presence of implants could be a risk factor resulting in the recurrence of cancer surface in the discussions forums.9 The point I am trying to emphasise here is that the narratives of cancer should be read in the context of such discourses and publicity of products and services circulating abundantly.
Some women get accustomed to the altered body-image and start feeling more comfortable without prosthesis and reconstruction. On the other hand, many women do not opt for breast reconstruction for the fear of being judged as vain and shallow. Terri who had undergone mastectomy and reconstruction says:
Our cultural attitudes create a crazy-making situation for women. On the one hand, they tell you it is vanity to want to look good, and on the other hand they tell you that without a breast and being whole, you are not attractive and sexually good. Whatever makes a woman feel better about herself is okay. We shouldn’t be judgemental10 (qtd. in No Less a Woman 211)
Varieties of feminism that take a judgmental stance against women who decide to opt for cosmetic and reconstruction surgeries are not of any help to women. The feminist rage should be directed at the unrealistic, demeaning standards of beauty upheld by media and many other industries that commoditise human body. Plastic surgery, cosmetic surgery, pornography and advertisement become instrumental in the commodification of body because of their commercial interests as profit making industries. Surgeons claim to give women (who have the means) the freedom of choice to perfect their body to conform to and chase an ideal endorsed by culture. Seeking freedom from such cultural normativity that endorses the ideal of a perfect perfectible body is a need of the hour.
Plastic Corporeality, Breast and Biopolitics
Despite the anxieties about its risks and viability, cosmetic surgery is still popular and highly in demand. Susan Bordo’s readings of the postmodern body in her Unbearable Weight, as an entity increasingly fed on fantasies of rearranging, transforming, and correcting, limitless improvement and change, defying historicity, the mortality, and indeed, the very materiality of the body”11 (xvi-xvii) is a dig at the triumphant corporeal individualism cultivated by the mass-media consumer culture. Bordo further elaborates that in place of the materiality of the body, we now have cultural plastic12 (lipid). Roberto Esposito’s interpretation of the prosthesis and its interconnectedness to life sheds light on the problems of a ‘plastic’ conceptualisation of being and its ‘othering.’ He observes that prosthesis reconstitutes the subject as a functional entity. A prosthesis which has no life begins to be looked at as a life giver, something that preserves and conserves life. Such an idea of self preservation operates through all kinds of body modification and regulation. While doing so, “the body suspends itself- it interrupts and doubles itself- with the aim of extending its duration ….it enters into a problematic relationship with the other in order to protect itself from itself” (Immunitas 149)
36 Bini B. S.
Any modification of the body comes in the guise of self-love and answerability to oneself. Perceived ugliness resulting from cancer used to be covered up with scarves hiding the post-chemo baldness, wigs, cloth pouches stuffed with cotton or sponge and prosthetic breasts that could be worn like a bra. Now women are surrounded with choices of hyperreal wigs and breasts, besides the remedies to remove surgical scars. Those in favour of cosmetic surgery argue that after the experience of cancer, women do not have to feel wounded, scooped out and marred anymore; they can face the world with optimism and poise. The unchanged or even better appearance of one’s body reduces the possibility of post treatment depression. Is it something to be uncritically celebrated? A part of my apprehension emerges from the thought that here a woman is being reduced to or defined only in terms of her physical features, as if she cannot and should not be comfortable with her ‘self’ that has been deprived of certain corporeal attributes considered feminine. Breast, a visible material signifier of womanliness and sexuality often turns into a site of objectification. For many women, it is an organ imprinted with memories, pleasant or unpleasant: erotic memories, memories of motherhood, of objectifying sexual or medical gazes and touches. In her poem, “What was Lost,” Alicia Ostriker writes:
What fed my daughters, my son
Trickles of bliss,
My right guess, my true information,
What my husband sucked on
For decades, so that I thought
Myself safe, I thought love
Protected the breast (The Crack in Everything 90)
The discomfort with an altered body-self-image would be more intense to a woman who perceives her body as a site of pleasure and desire owned by her children or partner in sex than a site of memories of pleasurable sensations that she had experienced through her flesh. Both these imaginings of the body are fraught with problems such as resentment for oneself or nostalgia for the lost organ. In another poem, “Mastectomy,” Ostriker connects her mastectomy experience with mythological sacrifice and retribution. Invoking the story of Persephone, she looks at her breast as a forbidden fruit packed with seeds of temptation and desire. Her address to Alison Estabrook, the surgeon who “knifed, chopped and divided it (the breast)/ Like a watermelon’s ruby flesh” (Ibid 89) brims with irony and veiled anger at the ‘figuration’ of female body:
Was I succulent? Was I juicy?
Flesh is grass, yet I dreamed you displayed me
In pleated paper like a candied fruit,
I thought you sliced me like green honeydew
Or like pomegranate full of seeds
Tart as Persephone’s, those electric dots
That kept that girl in hell,
Those jelly pips that made her queen of death. (Ostriker 88)
Loss of hair or breast during cancer is often interpreted as an offering or a sacrifice. Eve Ensler uses the sacrifice imagery to talk about the post-chemo loss of hair and her decision to shave the head. She alludes to the Hindu religious practice of offering the hair to a deity. Her impression of the self revolves, with a cool detachment, around the consciousness of what others think or say:
Some people think I look sexy with a shaved head. Some say I look like a boy and it turns them on. Some get that I am sick and this is not a hairdo at all. Many think I look like a dyke. I feel exposed. Present. Humble. Clean. Clear, I don’t have to do anything… with my hair. It is not who I am. I am suddenly face. All face. (Ensler 107)
38 Bini B. S.
Mastectomy is associated with offering of a sacrifice that in return would give the blessing of life. When the sacrifice of a visible signifier of femininity is looked at through a male perspective, the loss of breast is equated with a sacrifice of sex appeal. Such attitudes make women miserable and extremely self-conscious in their relationships with husbands and lovers. In media dominated consumer cultures where the female body is represented as a pleasure/ sex object to fuel and feed heterosexual male fantasies, a demand to hide the visible traces of illness from the body is operative. In many narratives, I see how women’s clamouring fears about risk factors involved in cosmetic surgery are hushed and regulated by their conception of themselves as sex objects. It is out of desperation and insecurity about relationships that many opt for surgery.
Cosmetic surgery is often part of a vicious and vitiating consumer culture that flourishes by creating longings and offering possibilities. The industry of cosmetic surgery thrives on the cultural imagery that defines a woman mainly in terms of a ‘perfectible’ body. People’s perception on what is flawed and what is normal is trained to a great extent by the media, entertainment industry and mechanisms of biopolitical propaganda all of which often use digitally modified icons of perfection and health as means of deception. The consumer culture surrounds one with chronic discontentment. It is a cancer that grows and spreads by making a person conscious about one’s appearance; fat body, aging skin, graying or thinning hair, stretch marks, surgical scars and amputation become synonymous with imperfections, defects and disfigurement. Baudrillard discusses the omnipresent cult of the body prevalent in the contemporary times:
It (body) is the only object on which everyone is made to concentrate, not as a source of pleasure, but as an object of frantic concern, in the obsessive fear of failure or substandard performance, a sign and an anticipation of death, that death to which no one can any longer give a meaning, but which everyone knows has at all times be prevented. (America 35)
The mass media consumer culture also constructs desires for flawlessness and provides endless options for fulfilling them. Cosmetic surgery, even the one after cancer treatment, feeds on the fantasies of limitless options and choices. Those who can afford cosmetic surgery may interpret it as a victory over devastating illness and fragility of beauty. The subtle strategy to project a scarred, amputated body as flawed, unworthy of being desired and not even presentable makes ‘looking good’ and ‘going under the knife’ a social responsibility of the (neoliberal?) citizen. Post-cancer cosmetic surgery for many also becomes a matter of moral accountability to one’s body and to those who share an intimate equation with that body. Cosmetic surgery has an implicit promise that certain degree of ‘perfection’ is attainable, though it involves spending astronomical sums of money. “The Greeks called it hubris. We call it our ‘right’ to be all that we can be”13 (Gordo, The Unbearable Weight xvii).
Basic treatment and healthcare for cancer are expensive. The inability to have a body corrected of its flaws and voids because of economic reasons might be a frustrating experience for many women. The proliferating images of the perfect flawless female body in the mass media and the expensive possibility of getting the body surgically repaired after the cancer treatment create a complex scenario in an unequal society despite the exaggerated boons of cosmetic surgery.
Audre Lorde thinks that a ‘disfigured’ of the body has a shock value due to its radical difference from the norm and so women with breast cancer should j oin together to influence the policy-making process regarding healthcare and cancer research funding. She expresses her resentment to the tendency to cover up differences as she considers this attitude to be complementing a highly demeaning normalising mechanism. The mask of prosthesis and wigs isolate women in their own private shells of suffering, closing all opportunities of sharing their concerns with other women who are in the same situation. Sharing Vine’s experiences of pain, fear and suffering through biographies and ,conversations is a kind of advocacy for policy change. Lorde suggests that rather than hiding behind smug wigs and prosthetics, women Should act more responsibly towards their vulnerable sisters. She imagines a powerful possibility: “What would happen if an army of one- breasted women descended upon Congress?” (The Cancer Journals 15) Lorde reminds that the prosthesis is a cover up and a standardising strategy in a society wherein women are judged for their appearance. She points out: “We are surrounded by media images portraying women as essentially decorative machines of consumer function, constantly doing battle with rampant decay … As women, we fight this depersonalisation everyday, this pressure toward the conversion of one’s own self image into a media expectation of what might satisfy male demand(Ibid 66). Prosthetic breasts hide the suffering and hence invisibilise the grave problem of increasing incidence of cancer that needs more research directed at prevention, more humane modes of treatment and healing. Plastic surgeons who perform reconstructive surgery in the name of ‘quality of life’ reinforce the ideal of normal femininity. Referring to the possibilities of healing oneself, Lorde emphasises the need to love one’s altered body, accepting it as it is and also receiving empathetic love from women around her. Being a black, lesbian poet-activist, Lorde affirms the need for visibility and voice; silence and covering up the absent breast with prosthesis do not empower or liberate.
It is taken for granted that conformity to standards of bodily acceptability is an essential condition for social and economic mobility. Our bodies are embedded in institutionally bound or unbound disciplinary mechanisms or affected by subtler biopolitical strategies operative in culture. Biopolitical thought projects justice as its goal, yet the major purpose of biopolitics is not to preserve health or justice; it aims at maintaining the institutional, normal, right quantities and kinds of pleasure and pain that maintains societal balance. The concepts of ‘species’ or ‘population’ average things and biopolitical strategies produce norms through such statistics. In this context, one should consider the possibilities of asserting radical difference in opposition to the norms of femininity. Susan Bordo rightly warns about the regulated practices of the self that implicate an internalised biopolitical schema which is more subtle than disciplinary mechanisms:
Through the pursuit of an ever-changing, homogenising, elusive ideal of femininity – a pursuit without a terminus, a resting point, requiring that women constantly attend to minute and whimsical changes in fashion – female bodies become what Foucault calls “docile bodies,” – bodies whose forces and energies are habituated to external regulation, subjection, transformation, improvement…. We are rendered less socially oriented and more centripetally focused on self modification. Through these disciplines, we continue to memorise on our bodies the feel and conviction of lack, insufficiency, of never being good enough. At the farthest extremes, the practices of femininity may lead us to utter demoralisation, debilitation and death.14 (14)
Betty Rollin’s much appreciated and much criticised First You Cry discusses how paying attention to trivial matters such as the right kind of wig and prosthesis helped her in diverting her mind from devastating concerns about mortality. Rollin’s work was criticised for frankly articulating her concerns about a changed body, lost breast, sex appeal, and inability to wear bikinis or strapless dresses. Such anxieties seemed to reinforce certain stereotypical views about women’s vanity. A surgeon warns: “Avoidance of adequate surgery due to ‘feminine whims’ might result in a ‘dead woman with a somewhat more pleasant-appearing chest wall”15 (57-62). The incapacitating self consciousness and awareness about her disfigured scarred body made Rollin spend hours putting on make up; it also affected the relationship with her partner. Still she justifies her obsession with looking good thus: “Scratch most feminists, heterosexual or homosexual, and underneath there is a woman who longs to be a sex object. The difference is, that is not all she longs to be…. For one thing they realise that wanting to be attractive and sexy is human – something that men want too, and nowadays more men are admitting to it” (Rollin 111).
If all human beings want to be sex objects or expect others to be sex objects, though in varying degrees, one cannot blame individuals for that. A widespread awareness and caution about the forces operative behind the construction of such an attitude is needed. In the present consumer-mass media-patriarchal culture, all live with an awareness of the judging gaze surrounding the self. In her poem, “Wintering,” Alicia Ostriker gives the glimpse of a post-mastectomy experience:
I told a man I’ve resolved
To be as sexy with one breast
As other people are with two And he looked away.16 (93)
.
I use a few incidents from the narratives to illustrate the look Good, Feel Better’ fad that is being perpetuated. Here I use an incident with permission from the life of a friend to illustrate how women’s decisions are not really her decisions. After many years of the first occurrence of cancer and mastectomy, my friend had a recurrence, and underwent mastectomy again for the left breast. The reconstruction option was available, unlike in the case of the first mastectomy, and she could afford it. She remembered that after the first mastectomy, she was ‘hysterically self conscious’ in the classroom and would have done anything to get the lost breast back. Her explanation of the decision for not opting for bilateral reconstruction made me ponder on the question of agency in matters of corporeal choices: Now that I have retired from teaching and not sexually active anymore, why should I have reconstruction”? The look good-feel better nexus often emerges from a tendency to look at one’s body as the object of sex and evaluating gaze, especially of the opposite sex.
Though American Cancer Society’s Reach for Recovery Program does a valuable service in contacting women and letting them know they are not alone, Lorde criticises it for propagating a false assurance and devastating nostalgia for lost breasts. She remembers her post-mastectomy days and the encounter with a volunteer from the programs who showed up with a prosthetic breast and practical advice. Lorde responds hence in her Journal: “My primary concerns two days after mastectomy were hardly about what man I could capture in the future, whether or not my old boyfriend would still find me attractive enough, and even less about whether my two children would be embarrassed by me around their friends”17 (Cancer Journals 57).
Darlene Betteley refused to use prosthetic breasts after mastectomy and so was not allowed to pay a visit as a Reach to Recovery Volunteer to another woman who was preparing to undergo a double prophylactic mastectomy. The convener, shocked to find out that Darlene does not use prosthesis opined: “We like our volunteers to look normal.” It was mandatory for every woman to have breasts, if not real, at least prosthetic. On another occasion, the Cancer Society in Tennessee refused to hire as a volunteer Elaine Hill who had to use a lymphedema sleeve after the mastectomy” (Batt 138).
Marilyn Hacker’s sonnets, “Cancer Winter” in the collection, Winter Numbers candidly juxtapose moments from her life after diagnosis and mastectomy and portray the ways in which she grappled with an altered body-self-image. She describes the experience of infiltrative ductal carcinoma as a harrowing awareness about the incompleteness of her self-betraying body. Hacker is painfully awake to the responses of people such as her daughter and lover with whom the memories of her amputated breast are entangled. She finds healing and assurance in love with a woman. Though “one breast she kissed is dead meat, with its pickled blight in view,” the woman partner’s loving presence gives Hacker confidence. Hacker knows that without any hesitation, “She’ll kiss the scar and then the living breast.” The poet dreams about overcoming her self-consciousness and basking in a beach in the loving presence of her woman-love. She affirms:
I won’t be wearing falsies, and one day
I will bake my chest again at Juan-les-pins,
Round side and flat, gynandre/ androgyne
Close by my lover’s warm flanks. (Hacker 87)
Reproducing grotesque body-self-images through the media of writing and photography may assault the prevalent aesthetic notions surrounding the body and its representability. The SCAR project by David Jay is an affirmation that capturing ‘disfigurement’ in art by highlighting its aesthetic strength and shock value translates it into a powerful social critique. The homepage of the website19 states, “Breast Cancer Is Not A Pink Ribbon” and features a pregnant woman with a mastectomy scar on her flat chest. Tina Carroll’s testimony sheds light on the subversive potential of the Project: “An amazing testament to strength, courage and inner beauty that transcends society’s standards of outer beauty. Seriously, brilliant.” David Jay talks about the women who were part of the photographic project in the “Mission’ page: “Through these simple pictures, they seem to gain some acceptance of what has happened to them and the strength to move forward with pride”20 (http://www.thescarproject.org/mission).
Sites that provide information on women’s health are full of commercials focusing on care of the self and self-improvement. Women’s lives are affected, if not always regulated and limited, by the prevalent ideas and perceptions about the female body and the way these ideas and perceptions circulate and operate in societies. The demands of culture on our body are rampant and invasive, yet the permeability of culture, especially of the mass media culture and consumerism, is too subtle to notice and too clandestine to engender resistance. Many of us are beginning to be aware of the problems of deceiving oneself with the assurance of possessing an active, alert sense of agency as a (free-floating) subject. Roberto Esposito sensitively captures this indeterminacy of ‘bodily’ agency as there is a fluid intermingling of the ‘public’ and ‘private’; ‘natural’ and ‘technological’:
44 Rini B. S.
. . . as soon as the body substitutes, or ‘fills in,’ the abstract subjectivity of the juridical person, it is difficult, if not impossible, to distinguish what concerns the public sphere from what concerns the private one. But, in addition, it is difficult to distinguish what belongs to the natural order and what may be submitted to technological intervention, with all of the ethical and religious questions that such a choice carries with it. (Terms of the Political 110)
Despite the shift of emphasis from morality to aesthetics in the contemporary times, the formulations around the female body still revolve around the idea of shame. A strong resentment targeting one’s body and inability to feel comfortable about one’s body are still prevalent not merely because of the view of flesh as the springboard of desire and hence the seat of moral corruption. With a tutored vigour, we are now inclined to think of fat, body hair, aging, wrinkles, graying, scars, blemishes, amputations, etc. as shameful blots that should be eliminated or mended. I feel that sculpting the female body in order to conform to a cultural norm is strongly a misogynist choice. The loathing for a body that shows any divergence from the projected bodily aesthetic ideal is not less dangerous than the overtly or subtly expressed resentment for free expression of female sexuality. These are modes of control and definitely not occasions for free choice. Women who feel empowered by sculpting their bodies through surgery should realise that certain choices are exercised in a cultural context that endorses such choices and projects them as better than others. In general, absence of breasts is considered to be an imperfection and hence an impediment to a good quality life.
The Neoliberal Sense of Accountability and Selfhood
We are in a culture which gauges one’s worth and success in a scale of appearance. The neoliberal ethos and the self-help culture promote choices that give one a sense of control and agency over one’s life. Healthcare choices are also consumer choices in the current scenario. The nexus between freedom of choice and consumption of medical or cosmetic services is such that the notion of responsibility brings in a new complex problematics. Neoliberalism recommends normalisation and responsibilisation of the self in a scenario wherein healthcare amounts to shopping for the best doctors and services. One who chooses is often willing to take the responsibility of choices, often fully or partly aware of the risks involved in a choice.
In the ‘moral economy’ of neoliberalism, educated or informed audacious choices are projected as a sign of self-empowerment. We are in a culture that is capable creating an atmosphere of incessant discontentment with oneself and generate hopes that always loom large in the mental horizon like mirages. We are surrounded by consumerism that never rests from showcasing the means of attaining short-lived contentment till another new ideal appears to haunt us with a new desire and discontentment. Biopolitical strategies and technologies of the self implicate a control that does not make itself felt on the self. In other words, the self does not realise that it’s under the sway of a normalising mechanism. Neoliberal citizens deem it mandatory to improve and manage the bodies and selves and are blissfully oblivious of the practices of the self in alignment to the notions and norms operative in culture. Submitting oneself to the risks of cosmetic surgery, ironically, turns into a valiant act that enhances self worth; living with an unattractive body is an ‘ethical failure.’ Body s considered the spring board of self transformation. So risks are worth taking as the body is a plastic and flexible entity fraught with endless possibilities of improvement.
Women are not always the passive ‘victims’ of regulatory strategies; they often are active agents in the construction and sustenance of disciplinary mechanisms and practices detrimental to their bodies and selves. However, there is also a possibility that they can engender an informed and collective social critique and resistance. That’s why I consider the idea and practices of radical difference to be a powerful and subversive means of affirming self-worth.
NOTES
1 Rainer Maria Rilke, First Elegy, Duino Elegies, p 3. These lines, juxtaposed
with the narrated experiences of cancer, made me ponder deeply on the
paradoxes of cure and healing: beauty of life and terror of painful survival.
2 It has been clinically proved that radical surgery does not significantly
improve the survival rates.
3 The Whole Woman, p 19a
4 See pp 17-19 and 266 of The Beauty Myth
5 Please look at the home page and About Us page of http://
lookgoodfeelbetter.org–,
6 http://lookgoodfeelbetter.org/about-lgfb/history.
7 Ibid
8 http://lookgoodfeelbetter.org/ about-lgfb/corporate-partners.
9 See http://community.breastcancer.org/ forum/44, http://www.diepbreastreconstruction.org/forum/, http:// www.bcaus.org.au/ phpBB3//viewforum.php?f=33 and several such Forums on internet.
10 Quoted in No Less a Woman, p 211.
11 Unbearable Weight, pp xvi-xvii
12 Ibid
13 Ibid, xvii
14 Susan Bordo, “The Body and Reproduction of Femininity: A Feminist Appropriation of Foucault” Gender, Body, Knowledge: Feminist Reconstructions of Being and Knowing, p 14.
15 Ariel IM: The treatment of breast cancer by radical and super radical mastectomy. Resident & Staff Physician, September 1978, pp 57-62, sited by Barron H. Lerner, “First You Cry: 25 Years Later” http://jco.ascopubs.org/content/21/9_suppl/122.fu1l.pdf.
16 “The Mastectomy Poems” (pp 83-99) in °striker’s The Crack in Everything, p 93
17 Cancer Journals, p 57.
18 Sharon Batt, “‘Perfect People’: Cancer Charities” (pp 137-146). The Politics of Women’s Bodies: Sexuality, Appearance and Behavior, p 138.
19 http://www.thescarproject.org
20 http://www.thescarproject.org/mission
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Contributor:
BINI B.S. Research Associate, Balvant Parekh Centre for General Semantics and Other Human Sciences, Baroda.
