As an engineer, I looked forward to taking a writing class amid my heavy math and science course load. Professor Erol’s Writing 101 class, “Visualizing Medicine,” initially caught my eye because of its science-based curriculum. When brainstorming for ideas to write about, I immediately thought of my family’s history of chronic illness. My mother was just diagnosed with breast cancer a little more than a year ago and my grandmother passed away from breast cancer, so the topic definitely struck a chord with me. In having such a strong connection to the disease, I have paid special attention to breast cancer advertisements, especially the pink ribbon campaigns for breast cancer research. For a textual analysis assignment, I chose to examine the dichotomy between breast cancer images, specifically focusing on a National Geographic image I had come across that seemed to stand out from the rest. In writing my final analytical paper, I decided to expand on the topic and analyze four distinct breast cancer narratives prevalent in today’s culture. The collaborative editing workshops were extremely helpful to me in developing my initial brainstorm into a full-fledged essay because of the candid feedback I received from my peers and professor in every step of the writing process. The Pink Ribbon Culture Caroline Lehman Academic Writing (Spring 2012) Visualizing Medicine Professor Maral Erol I n early January, I participated in the tradition of “rushing” a sorority. One of the days was themed “philanthropy,” during which the sororities expressed their involvement in different national organizations. I vividly remember walking into a room with girls dressed in pink shirts and being summoned to a table with pink beads and safety pins scattered on top. The upperclassmen told me we were to decorate the pins so that women could wear them during their annual Race for the Cure event. I recall haphazardly creating these pins while simultaneously trying to keep up a conversation with the upperclassman and “selling” myself to the sorority. Little did I know that corporations around the world sell themselves to consumers by adding a pink lid to their yogurt or a pink ribbon logo to their cosmetics. These business strategies were not clear to me until further inspection: the pink ribbon has been transformed from the symbol of an awareness campaign into that of a marketing strategy. Later in the day, an upperclassman read a memoir of her mother’s battle with breast cancer to the eager-eyed freshmen that were waiting for a “bid” from a sorority. Her personal account mirrored my story exactly: her mother, like mine, was diagnosed with breast cancer the summer before college. I immediately felt connected to the sorority and walked out of the room finding myself sold. Only later did I realize that the sorority—like Avon, Campbell Soup, Yoplait, and many other companies—manipulated my emotions to further their own agenda. It worked. I am now a proud member of this same sorority. As a welcome gift from an upperclassman, I received a pink purse with pink ribbons lining the interior. Inside the purse was a package of tissues, with a pink ribbon imprinted on one side of each tissue and the phrase “a portion of the sales of this product will be donated to Breast Cancer Research” on the back. I am glad that now whenever I blow my nose, people will see I support a cause. 38 This guise of social activism through consumerism has become especially prevalent in today’s breast cancer culture. As a consumer, I find myself drawn to products that prominently display a pink ribbon on their packaging because, however deceptive it may be, I feel like I make an impact by purchasing that product. Many companies utilize phrases such as the one on the tissues to advertise to consumers that they are socially conscious, yet they often do not disclose exactly how much of the proceeds are donated or where the money actually goes. Breast Cancer Action, a grassroots education campaign, recently listed forty corporate marketing campaigns that take advantage of the popularity of the breast cancer movement to further the company’s own profits (Klawiter, 2008, 250). The surge of corporate interest in breast cancer research and awareness first coincided with an increase in breast cancer diagnoses and, in the past decade, outpaced it. From the 1940’s until the beginning of the 21st century, breast cancer incidence rates increased an average of 1 percent each year. The rate of breast cancer cases significantly rose in the 1980s due to an increase in screenings but leveled off in the 1990s. There has been an apparent decrease of new breast cancer diagnoses since 2003. Still, in the past two decades, more women have died of the disease than all Americans killed in World War I, World War II, the Korean War, and the Vietnam War combined (Eisenstein, 2001, 116). And while statistics show that more women die from heart disease than breast cancer, according to professor and breast cancer survivor Zillah R. Eisenstein, “it is breast cancer that women seem to fear the most” (Eisenstein, 2001, 68). Compared to other illnesses, breast cancer is unique in that it is highly visible in the media with awareness campaigns cropping up everywhere from television commercials to newspapers and magazines. In fact, breast cancer has become one of the most massmediated illnesses of the 21st century (Sulik, 2011, 113). Breast cancer awareness campaigns and images, while seemingly beneficial, actually devalue the emotions of breast cancer survivors by primarily portraying breast cancer in an unrealistic fashion. In looking at breast cancer images over the past two decades, themes of hope, empowerment, and positivity are omnipresent. In this essay I will analyze four distinct breast cancer narratives to reveal how America’s present-day breast cancer culture undermines survivors. The pink ribbon serves as the dominant symbol in breast cancer culture and is exploited by companies as well as nonprofit organizations to raise awareness and money for research. Breasts are also inextricably tied to the cause and are often sexually objectified by the media in association with breast cancer awareness. Conversely, mastectomized breasts are 39 “Themes of hope, empowerment, and positivity are omnipresent. ” rarely depicted, as they remind viewers of the horrors of breast cancer and that the disease does not discriminate (Casamayou, 2001, 104). When audiences see images of cancer treatments, such as mastectomies, they remember that breast cancer can strike anyone at any time, especially females. Similarly, rare are the images of anger and blame toward possible environmental factors of breast cancer. Case Study 1: The Pink Ribbon Copyright has expired. From the New York Times, December 22, 1996 ©1996. The New York Times. All rights reserved. Used by permission and protected by the Copyright Laws of the United States. The printing, copying redistribution, or transmission of this Content without express written permission is prohibited. As evidenced in the logo for the Susan G. Komen Foundation, breast cancer cannot escape association with the feminine pink ribbon. This image is prominently displayed at the top of the Susan G. Komen for the Cure website, the fifth website that pops up when one types the words “breast cancer” into Google. Although the pink logo is subdued and does not explicitly state that the ad supports breast cancer funding, audiences, as well as the search engine Google, immediately link the pink ribbon with breast cancer and the Susan G. Komen brand. Komen introduced its new “running ribbon” logo in 2007 in hope of developing a stronger brand association and a dominant hold over the breast cancer market, such as survivors and researchers, as well as the pink ribbon culture (Sulik, 2011, 150). The pink ribbon is central in most breast cancer campaigns, serving as a reminder for women to exercise, remain nutritionally healthy, and stay proactive about detection (Eisenstein, 2001, 129). As seen in the logo for the Race for the Cure event, the pink ribbon moves forward like a runner trying to cross a finish line or a cancer patient trying to complete a chemotherapy treatment. This symbolism reveals the themes of hope and positive thinking that are pervasive within breast cancer culture. According to Barbara Ehrenreich, “positive thinking seems to be mandatory in the breast cancer world, to the point that unhappiness requires a kind of apology” (Ehrenreich, 2009, 26). While the pink ribbon symbolizes a person, there is no actual depiction of a person struggling to survive. Instead, the feminine curvature of the ribbon serves as a link to the curvature of a woman’s body. Even the words “Susan G. Komen for the Cure” that accompany the Race for the Cure logo have arched, rounded letters, giving off a girly, positive, and lighthearted aura. The foundation is named after Komen and its logo similarly emphasizes one woman’s name rather than the collective of women fighting breast cancer. The lone “running ribbon” further characterizes the struggle with disease as a singular one, revealing the isolation some women may feel in their fight against breast cancer. The two tones of pink within the ribbon stand in stark contrast to the bold, black text. Breast cancer’s association with the color pink makes perfect sense, as pink is most heavily associated with femininity. The color pink was first linked with breast cancer in 1990, when Nancy Brinker founded the Susan G. Komen Breast Cancer Foundation and the Race for the Cure. Initially, pink visors were handed out to women, signifying that they were breast cancer survivors. The movement quickly grew, however, and pink ribbons were handed out to every participant in the Race for the Cure. Estée Lauder immediately recognized the opportunity for commercial success and joined the effort by launching a national pink-ribbon campaign in 1992. According to Lauder, “there had been no publicity about breast cancer, but a confluence of events—the pink ribbon, the color, the press… having Estée Lauder as an advertiser in so many magazines and persuading so many of my friends who are health and beauty editors to do stories about breast health—got people talking” (Associated Press, 2011). Estée Lauder wanted to partner with Charlotte Haley, a 68-year-old grassroots activist who handed out peach ribbons to promote funding for breast cancer prevention. While Lauder offered Haley national attention, Haley wanted nothing to do with the commercialization. From its inception, the pink ribbon rapidly transformed from a personal emblem of survival to a method of furthering corporate agendas. Today, the ribbon not only symbolizes breast cancer survivors, but also embodies 40 the entire community of women afflicted by breast cancer, as well as awareness, research, and support for the cause (Elliott, 2007). Case Study 2: This Year’s Hot Charity It was not long after the inception of the pink ribbon and the creation of multiple breast cancer nonprofit organizations that the disease became a national headline. In 1996, The New York Times Magazine ran a quite controversial cover, shown at left, concerning the rapid rise in attention being paid to breast cancer. Instead of using an image of women’s empowerment, the magazine’s editors decided to run a picture of an overly sexualized half-naked supermodel posing as the face for “This Year’s Hot Charity,” breast cancer. Having a famous model rather than an unknown cancer patient pose for the cover, the magazine used the practiced approach of associating a familiar face with the disease to attract more attention to the cause (Casamayou, 2001, 105). As the cover photo vaguely hints, the article discusses how breast cancer quickly transformed into a “chic” enterprise, one in which wealthy individuals, CEOs, and politicians could take part (King, 2006, viii). The cover does not explicitly indicate that breast cancer is the topic of interest except for the fact that the naked model is covering up her breasts. Surprisingly, there is not even the slightest trace of the color pink or a pink ribbon. The image clearly sexualizes the female figure, with the model’s body glistening and her mouth slightly open. The model looks unhealthily skinny with some of her ribs visibly sticking out. Images that sexualize the female body like this one does are unfortunately prevalent in breast cancer culture. Breast cancer is unique among illnesses in that it continues to mirror socially sanctioned forms of discrimination against women (Ferguson et al., 2000, 365). Unlike people diagnosed with heart disease or other cancers, breast cancer patients continually hear social messages that they will lose their gender identity and sexuality if diagnosed with the oftdisfiguring disease. This image perpetuates the stereotype that women are purely sexual beings and reaffirms societal gender expectations. In the foreground of this image are a man and woman in formal attire, attire that would perhaps be worn to a large gala fundraiser for breast cancer research. Their hidden faces emphasize anonymity, paralleling that of large corporations which can hide behind carefully constructed smokescreens of donating large amounts of money to nonprofits. As the image and article suggest, it has become fashionable for corporations to appear to “think pink,” especially since strategic corporate philanthropy improves public relations and builds consumer loyalty (Sulik, 2011, 128). The strategy of using the body of a supermodel reflects the common use of celebrity in American culture, as well as breast cancer culture, as a way to further promote products and ideas. Case Study 3: You Can’t Look Away Anymore Just three years earlier, in 1993, The New York Times Magazine ran a cover story depicting the breast cancer activist and artist Matuschka and her mastectomy scar. The article was dedicated to the “Anguished Politics of Breast Cancer” and the rapid rise of the National Breast Cancer Coalition (NBCC), a feminist lobbying organization founded in 1991. It details the agenda of the NBCC and its ambitious goals of garnering more scientific and governmental attention to prevention, expanding the federal budget for research, and increasing the influence of breast cancer survivors over the federal research agenda (King, 2006, viii). Matuschka, like the headline boldly states, looks away from the audience, almost ashamed of her condition. She is dressed in all white, signifying an innocence and purity that coincide with womanhood and femininity. However, her innate femininity is lost due to her invasive breast cancer treatment. In today’s society, like in the 1990s, it is a cultural taboo to amputate the part of our bodies associated with maternity and sexuality. Therefore, for many in U.S. culture, mastectomies are an 41 Photo courtesy of Peter Essick assault on beauty and a violation of femininity (Potts, 2000, 44). Even though Matuschka’s face is turned away, her powerful gaze and dominant posture instigate a sense of hope and empowerment among readers. She wears a dress, emphasizing that while half of what makes her “feminine” may be gone forever, her sense of womanhood will never be lost. The flowing white headscarf, an article of clothing usually worn by women who have lost their hair due to chemotherapy treatment, serves as a symbol of endurance, survival, and unity among breast cancer patients. Unlike the pervasive narrative of the sexualized female body seen in Case Study 2, this image portrays a mastectomy scar. In a culture in which breasts are “concealed, revealed, adorned and exhibited primarily for and from a male point of view” (Potts, 2000, 40), images of anything other than large, voluptuous bosoms are rare in popular magazines. In a study conducted during a three-year period, which analyzed over 800 breast cancer images in newspapers, only two pictures were found of mastectomized breasts (Potts, 2000, 43). Mastectomy images are not prevalent in media because audiences would rather not be reminded that cancer can strike anyone at any time, no matter how proactive one is in getting routine mammograms or performing monthly breast self examinations. Through these images, women are told that they are vulnerable and are reminded of the seriousness of their responsibility to perform breast examinations to prevent death. Yet, studies show that while self-examinations increase the likelihood of detecting cancerous tumors early, it does not cut the chances of dying from breast cancer (Kösters, 2003). Case Study 4: Breast Cancer Survivors An image found on National Geographic magazine’s website, above left, shows three women from Richmond, California, all of whom have been diagnosed with breast cancer. A blurb accompanying the photo discloses that the women are trying to force a nearby oil refinery to reduce its emission of excess gases into the atmosphere, gases that most likely contributed to their cancer. The woman in front, Marleen Quint, holds a portrait of herself naked, disclosing the mastectomy she has undergone to combat the cancer, a procedure that altered her body forever. “My mother is 79 and has all her body parts,” describes Quint, who suspects that living near the oil refinery was a major contributor to her cancer. The photo plays with the emotions of the audience, hitting a nerve with those who know all too well what it is like to have friends and family members left disfigured by the scars of breast cancer. Even among people who do not have any connection with the disease, the photo is so shocking and unusual that it strikes a chord with them. This photo is unique amid breast cancer images in that it depicts anger. It is a call to action, expressing the need for the corporate world to take a stand against oil refineries and factories that emit toxic and often extremely harmful pollutants 42 into the atmosphere. Pink ribbons are nowhere to be seen in this image. Instead, the women are portrayed as survivors, fiercely fighting for their lives in a war against cancer. In a breast cancer culture in which being upbeat and positive is the norm, this photo is refreshing in that it ignites anger and fury, rather than passivity, in me and presumably in its audience. Discussion and Conclusion In analyzing the dominant narratives in breast cancer culture, those of the pink ribbon and the sexualized female body, similar themes of hope, courage, and optimism are evident. According to Dr. Susan J. Ferguson, “the pervasiveness of these kinds of depictions implicitly sends the message that feeling sad, angry, and entirely unlucky to have breast cancer are not appropriate responses” (Ferguson, 2000, 318). While optimistic images in breast cancer culture are extremely prevalent, they do not accurately represent the struggle breast cancer patients undergo every day in battling their disease. There is a large disconnect between society’s expectations for women diagnosed with breast cancer and women’s actual experiences with the illness (Ferguson et al., 2000, 364). Barbara Ehrenreich, author of Bright-Sided: How the Relentless Promotion of Positive Thinking has Undermined America, reveals what she first saw when walking into the doctor’s office for a routine mammogram. “Almost all of the eye-level space had been filled with photocopied bits of cuteness and sentimentality,” she writes, “pink ribbons, a cartoon about a woman with iatrogenically flattened breasts, an ‘Ode to a Mammogram,’ a list of the ‘Top Ten Things Only Women Understand’ (‘Fat Clothes’ and the ‘Eyelash Curlers,’ among them), and, inescapably, right next to the door, the poem ‘I Said a Prayer for You Today,’ illustrated with pink roses” (Ehrenreich, 2009, 16). In seeing this overwhelming cheerfulness and femininity among the décor, Ehrenreich, who learned that day that she had breast cancer, immediately felt the looming sense that she must stay upbeat about her diagnosis. Because the positive pink ribbon symbol is inescapable in breast cancer culture, some patients, like Ehrenreich, feel isolated in their disease, especially if they do not experience feelings of cheerfulness. In fact, Ehrenreich felt quite the opposite of hope after prognosis; she instead felt anger toward the possible environmental causes of her disease. The alternative narratives—the environmental narrative, and mastectomy imagery—are scarce in breast cancer awareness campaigns, but portray important themes of empowerment, activism, and social justice as well as stronger feelings of anger. Even though some alternative breast cancer campaigns are beginning to emerge, we must make greater strides to promote activism rather than passivism while we simultaneously shift away from the overwhelmingly positive pink ribbon culture. As one breast cancer survivor said, “We used to march in the streets, now we run for a cure” (King, 2006). Whether we are running for a cure, wearing a pink ribbon, or purchasing dog food to benefit breast cancer research, we passively support a cause. The fact is, our passive consumerism does not raise awareness for breast cancer nor does it help herald a safer environment free of toxic, cancercausing chemicals. By choosing Yoplait yogurt over another brand in hope of making an impact, we are submitting to the agendas of large businesses. Many breast cancer survivors feel undermined by companies’ use of breast cancer to increase their revenue. As one woman proclaimed, “It’s almost like our disease is being used for people to profit” (King, 2006). While action should be taken to eliminate corporate interests profiting from the disease, it is admittedly difficult due to the fact that large corporations fund breast cancer research. However, the corporate funding for breast cancer research is not necessarily the problem; it is the crass marketing of it. These companies spread awareness, advocate for women to perform selfexaminations and to regularly get mammograms, and raise millions of dollars each year for research. In a way, these corporations do more good than harm in the long 43 “Our passive consumerism does not raise awareness for breast cancer nor does it help herald a safer environment free of toxic, cancercausing chemicals.” run. Nevertheless, as consumers, we can do our part by becoming more aware of the lies we are being fed when we walk into the store during Breast Cancer Awareness Month, or, as it more accurately should be called, National Cancer Industry Awareness Month. Companies must be more proactive in clearly indicating exactly how much money is donated and where the money will go so that we as consumers can make more informed decisions. 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