When Angelina Jolie announced that she'd undergone a bilateral mastectomy to prevent the breast cancer for which a genetic mutation puts her at high risk, I found myself, as a doctor and as a woman, full of admiration and gratitude for her...and also, in retrospect, for Betty Ford.
In a single New York Times op-ed piece, Ms. Jolie used her celebrity to accomplish several things: she brought attention to the high prevalence of breast cancer; she brought attention to the availability (but also, for most people, the prohibitively high cost) of genetic testing; and, no less important, as Rebecca Mead pointed out in this newyorker.com post, she shifted the public discussion of a celebrity's breasts away from "Are they big enough? Are they sexy enough? Are they really hers?—[questions that] are objectifying and demeaning." (Anyone who saw Seth MacFarlane's "We Saw Your Boobs" number at this year's Oscars knows that this is a welcome and needed shift, indeed).
I expect that a number of my patients will be asking more questions about genetic testing for cancer and that more people than previously will be receptive to referrals for genetic counseling if they, like Angelina Jolie, have family histories that warrant it.
I'm thankful to her for this.
But I find myself also thankful to Betty Ford--a woman of a different generation and political persuasion than Jolie who, four decades ago, pioneered the use of celebrity in public health.
In late September, 1974, barely a month after Richard Nixon's resignation placed her husband in the Oval Office, Ms. Ford announced that she had breast cancer and was undergoing a mastectomy. It was not the norm at that time for public figures to speak openly about cancer. Perhaps the closest anyone had come was 10 years earlier when actor John Wayne declared, euphemistically, after his lung cancer surgery, that he had "licked the big C." But Betty Ford felt that, after Watergate, secrecy about even such a personal matter wasn't the best start to her husband's presidency. Also, she wanted to help other women, make them feel less embarrassed about examining their breasts and seeing their doctors for breast cancer screening. She accomplished her goal. In what was known as the "Betty Ford blip," thousands of women--including Happy Rockefeller, the Vice-President's wife--were diagnosed.
Perhaps even more impressive, just a few years later, Betty Ford spoke openly about her alcoholism and addiction to prescription narcotic pills. Her openness, and her establishment of the addiction treatment center that bears her name, went a long way toward de-stigmatizing addiction and enabling people to seek help.
In the past few years, several celebrities have associated their names with various medical issues by publicly acknowledging that they have been personally affected: Kitty Dukakis (depression and addiction), Gilda Radner (ovarian cancer), Michael J. Fox (Parkinson's disease), Magic Johnson (HIV). Sometimes their announcements are met with a certain amount of eye-rolling and grumbling about attention-seeking behavior, spreading of misleading information, and the unusual access the famous and wealthy have to superior health care. We're already seeing some of that in reaction to Angelina Jolie's announcement.
Lighten up, people.
If a celebrity chooses to surrender some of her privacy to make it easier for the rest of us to seek help for a sensitive medical concern we should be grateful to her.
...and to Betty Ford.
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