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Of Privilege, Health Care and Tits

Angelina Jolie Under the Knife

by RUTH FOWLER

Angelina Jolie, scion of Hollywood beauty, has gone under the knife for medical, rather than cosmetic reasons and guess what – it’s news! Angelina’s double-mastectomy, undertaken because she carries the BRCA1 gene which doctors have estimated gave her an 87% chance of having breast cancer, and a 57% chance of having ovarian cancer, is pretty radical news.

Our pop icons, our actors and our stars, seem almost immune to the petty, dirty tragedies affecting the rest of the world. Sure, their weight goes up and down, they get pregnant and adopt, they get married and get divorced, but rarely do they get cancer, which is a macabre and threatening shadow reserved predominantly for small bald children who are told to smile when some idiot shows up in the middle of their chemo for a photo-op. Kylie Minogue, Jade Goody and Barbara Ehrenreich are high profile women who have suffered through breast and ovarian cancer very publicly, but I can’t remember a female star of Jolie’s caliber ‘coming out’ about a preventive double mastectomy. As The Guardian writes “Health campaigners praised her decision to go public with the news, which she said was prompted by a desire to encourage other women to get gene-tested and to raise awareness of the options available to those at risk.”

Woah, woah! Let’s hold back a little. What exactly has she done that deserves praise? She wrote about an invasive, often brutal medically (un?)necessary procedure which 56% of women with breast cancer in the US choose to undergo. Hands up everyone in the US who hasn’t heard of breast cancer and mastectomy! Anyone? Umm, anyone….?

OK. So now, thanks to Jolie, we’re MORE aware. And guess what? There are really, really expensive tests you can get which tell you beforehand how likely you are to get cancer and die! Hands up who knew about that one? Oh, quite a few of you? Mainly the ones who can afford it, am I right? The ones who can’t afford it – well what good is knowing that there’s a test out there only privileged rich people can get?

Jolie claims, in her stilted Op-Ed in The New York Times, that she wants to “bring awareness” to breast cancer, and specifically expensive screening tests which can calculate one’s likelihood of getting it. Ah, that old chestnut! When one can’t be arsed to do shit, make a statement and “bring awareness” to something. The Susan G Komen foundation, the Pink Ribbon Brigade and its horrendous pink walks designed to raise money for expensive and ultimately ineffective breast cancer “cures” at the expense of examining prevention highlight the absolute inefficacy of “raising awareness” as a means of combating a disease or reducing one’s risk of carrying it.  The problem is, Jolie herself seems utterly unaware of what carrying the BRAC1 gene, and what having a high probability of breast cancer, means for most women in the US. She writes: “I want to encourage every woman, especially if you have a family history of breast or ovarian cancer, to seek out the information and medical experts who can help you through this aspect of your life, and to make your own informed choices.”

Really, Angelina? You honestly think that the 27 million (20%) of women in the US who don’t have health care, and the 77% who apparently have it, but still have to forego care because they can’t fowlerafford it even with insurance — you think that your Op Ed is actually going to do anything for these women except remind them that they don’t have access to the expensive screening tests you seem to think people don’t undertake simply because they haven’t read your article?

Do you think even if these women know they have the BRAC1 gene, that they can go to the extremely expensive Pink Lotus Breast Center for not one, but three “preventive” procedures, including nipple delay, mastectomy and expert breast reconstruction, which while some women who have had mastectomies have found to be absolutely essential for their recovery and self esteem, are rarely available on any kind of insurance because its deemed unnecessary plastic surgery?

Jolie gives a trifling nod to the 77% of women in this country who probably can’t afford more than a Pap smear and a breast exam at Planned Parenthood when she writes:

Breast cancer alone kills some 458,000 people each year, according to the World Health Organization, mainly in low- and middle-income countries. It has got to be a priority to ensure that more women can access gene testing and lifesaving preventive treatment, whatever their means and background, wherever they live. The cost of testing for BRCA1 and BRCA2, at more than $3,000 in the United States, remains an obstacle for many women.

No, Angelina, it does not remain an obstacle for “many women” in the United States. It remains an obstacle for most women in the United States. Why don’t you raise our awareness of your own overpriced, privileged medical treatment a little more, and continue to NOT raise awareness of any actual fact? Facts like ashkenazi Jewish women have a higher chance of carrying the BRAC1 and 2 mutations than other ethnic groups? Facts like double mastectomies are not always the most effective way of preventing breast cancer for at risk individuals, and that other treatments – surgeries, screenings, monitoring, medication – are available and can be more more appropriate depending on a woman’s specific case? What about highlighting the other affordable and effective ways women can keep an eye on their health – through free Pap smears, breast exams and mammograms provided by their local Planned Parenthood? Why don’t you acknowledge that many breast cancer deaths could have  been prevented by free and available access  not only to screening tests, but to Pap smears, mammograms and cancer treatment? Why don’t you write about the charities out there who are striving to provide women with affordable treatment in the US – like the Breast Cancer Relief Foundation? Why don’t you “raise awareness” of the fact  40% more black women  are likely to die of breast cancer than white women, that black women are more likely to get more aggressive cancers, and be denied access to healthcare due to their socio-economics?

The Guardian, ever optimistic in its adoration of dumb Liberals, quotes a female cancer patient from the UK, Wendy Watson, who founded the UK’s National Hereditary Breast Cancer Helpline. Wendy, of course, safe in her NHS bubble, welcomed Jolie’s decision to write publicly about her operation.

“It is excellent, because it is the highest profile you can get for it,” she said. “It raises the profile for other women to look to if they have a family history and would benefit from being screened more frequently, or having surgery or having a genetic test,” she said. “She probably feels that undergoing the operation is common sense but it probably does take a certain amount of courage to face it.”

Hey Wendy, listen up! The US doesn’t HAVE A NHS! Women sure would benefit from being screened over here, but that ain’t news! You know what would be news? A Hollywood star with Angelina’s profile and power actually highlighting how fucking disgraceful the United States healthcare system is, rather than waxing lyrical about her own fucking bravery and encouraging women to plop down 3k they will never, ever be able to afford on a test to see how likely it is that they’re going to die from a disease they won’t be able to get adequate treatment for.

You know what, Angelina. It sounds like you’ve had a hard time recently. I guess I can forgive the complete absence of awareness in your privilege-denying Op-Ed, because after all, it’s hard to understand that some Americans – yes, not only black and brown Americans, but white ones too! – can be just as deprived as those brown people in foreign countries you’re so invested in “saving”. When the fuss has died down about your elaborately reconstructed chest and your incredible bravery in submitting to top-end, essential preventive treatments in order to avoid a painful and abhorrent death, perhaps you’ll do the decent thing and spend some of your vast resources on addressing some of the issues you seem pretty ignorant about right now.

In Loving Memory of Mavis and Stephanie – women who weren’t afraid to be pissed off.

Ruth Fowler is a journalist and screenwriter living in Los Angeles. She’s the author of Girl Undressed. She can be followed on Twitter at @fowlerruth.