Tag Archives: Gail Collins

Weighing In on Breast Cancer

Or at least on the raging debate that has occurred this week.  Warning notice:  I’m about to express some opinions.  Some of those opinions will be supported by “facts” (I place quotes around “facts”, because facts can never be separated from our perception of them–that must be the philosophy student in me rearing its ugly head), but I will not be posting any links for you to check where I got my “facts”.  If you don’t believe me, look it up yourself.  As I am fond of saying, this is a blog, not a term paper.  You won’t find any op. cits. here.  Additional warning:  You can dispute the “facts” all you want unless it concerns my personal body, which you don’t have enough information about to dispute. 

That doesn’t mean you won’t get some links.  To begin with, Thursday’s op-ed column in the NY Times by Gail Collins, always one of my favorites, who pretty much pokes fun at the hysteria the “new” recommendations concerning mammograms has engendered.  “New”, as in, returning to previous recommendations, with now even more evidence to support them.  But the hysteria involves “rationing” and “death panels”.  God, you people (and you know who you are) make me tired.  I suggested to my most rabidly conservative friend that he read her column, and he did, and sent me a message afterwards that I would describe as a diatribe, if I weren’t trying to be kinder and gentler.  In his defense, his mother and many other people he knows have had breast cancer, so it is a very emotional issue for him.  Yeah, well, me too.  In her column, Gail mentions that she had breast cancer herself.  I think she should be cut a little slack for that.  But never underestimate the power of fear, and men fear for their wives, their mothers, their daughters, their sisters, and their friends, and fear is never subject to logic.  It would be foolish to think that only women are affected by breast cancer, and I’m not talking about the fact that men get breast cancer too, which they do.  I’m talking about it affecting the men who love the women who get it.  And if you are the person who has cancer, you feel very much that the situation is out of your control.  As the friend or family member of a person with cancer, you are that much more out of control.  It’s like helpless, then helpless once removed.  That’s why you find people with cancer comforting those around them;  it’s actually worse for you. 

Now we move to the “facts”.  Most breast cancers are extremely slow growing.  It takes years for a tumor to be large enough to be visible on a mammogram.  So two years is not an unreasonable interval. 

Most women develop breast cancer after age 50. 

The value of self-exams has been questioned for forever.  I understand in theory that if you know your own body, you’re better able to detect changes.  Nothing wrong with that.  The problem is that most women don’t know what they’re looking for.  Many women have “lumpy” breasts (sorry to get so technical).  It’s called fibrocystic disease, which is benign (although I’ve recently learned that a history of it is now considered a risk factor for breast cancer), so even if you were to detect a new lump, your response might be “whatever”. 

Mammograms are far better than self-exams, except they aren’t very good.  Collins notes that having just had a clear mammogram, she then found a lump on her own.  In this case, self-exam worked.  The most sensible thing I heard all week was a quote by someone from the Susan B. Komen Foundation who said that this was at least a good debate, since it sheds light on the fact that mammograms are a poor test.  CT scans are much better, but they cost ten times what a mammogram does.  Now there is the debate we should be having:  about why we aren’t doing the best testing available.  Mammograms are crude, and reading them is subject to varying levels of competence by the radiologist.  Of course, so are CT scans. 

Now we get to the part about cutting me some slack too.  In my own case, the tumor was detected by CT scan–a scan I had for an entirely different reason.  Afterwards, I had a mammogram and an ultrasound, but it’s important to note that the mammogram I had was “diagnostic” as opposed to “screening”.  Screening mammograms, which are of the type women have every year, are very general, and I think of them as tests that something has to jump off the screen for the radiologist to recognize.  Between the screening mammogram and the breast exam by a doctor, you hope you will pick up something, operative word here being hope.  Not guaranteed.  Diagnostic mammograms are a lot more detailed (and a lot less fun).  After the CT scan I had, I had that diagnostic mammogram and that’s what I have every year now.  And the results of that first diagnostic were, yeah, there’s something there…not sure what it is….

I will never know for sure whether a screening mammogram would have picked up the tumor first, before I had the CT.  But I seriously doubt it.  My personal advice is, if you can afford it, have a CT scan.  (You have to do that anyway if you have breast implants, I recently learned!)

Finally, for a bit more factual information.  This op-ed article appeared in today’s NY Times and it’s entitled Addicted to Mammograms.  The author explains rather well the history of breast cancer treatment and recommendations, and really, it would apply to most cancers. 

If you’ve read this blog for any length of time, you know that I have a friend who is dying of breast cancer that metastasized to bone.  In distress, I once asked our (mutual) radiation oncologist, if you know where breast cancer is likely to metastasize, why don’t you test for it?  To make a long answer short, the answer was, “It wouldn’t do any good.”  Our methods of detection are primitive, and methods of treatment are worse.   

But I have to tell you, it positively insults me to the core to have politicians trying to tell me that the government wants to kill me.  It’s almost too ignorant to dignify with a comment.  If you care so much, give some money to the NIH for cancer research.  Oh wait, that’s a government agency (Government bad, Tarzan good.)  Okay then, give it to the American Cancer Society.  But your grandstanding is definitely not working for me.

Closing Guantanamo

Normally I don’t do this, but I’m about to copy today’s Gail Collins column from the NY Times here.  I’ve done this before–once I copied a post from Andy Borowitz, and another time from Dave Barry of the Miami Herald, where I more or less begged them not to prosecute me for giving them more publicity.  Today Collins ‘ op-ed concerns the closing of the Guantanamo prison.  I was about to post my own thoughts on it, but some days, people just say it better than you ever could.  Okay.  Gail Collins always says it better than I ever could. 

I just remembered that I was going to let Gail Collins speak for me.  Yeah.  What she said. 

When Did Cowboys Get Wimpy?

By GAIL COLLINS

Published: May 22, 2009

Out of all the problems we have run into in dealing with the giant hairball that is known as the Bush War on Terror, one of the weirdest is the reaction to President Obama’s plan to close down Guantánamo.

 

In the rank of threats to public safety, putting the Guantánamo inmates in maximum-security prisons in the United States has got to come in way behind, say, making it easy for customers to purchase firearms at gun shows.

But to hear the howls coming from Congress, you’d think the Obama administration was planning to house the prisoners in suburban preschools. “Terrorists. Coming soon to a neighborhood near you,” warned a Republican Web video, which mixed pictures of accused terrorists with road signs in states where the G.O.P. predicted they might be sent. In another production, the occasionally loyal opposition resurrected the infamous “Daisy” countdown ad to show a little girl picking petals off a flower while the president prepares to close Gitmo.

“To bring the worst of the worst terrorists inside the United States would be cause for great danger and regret in the years to come,” snarled Dick Cheney in his “no middle ground” speech. Although really, for the sake of the national mental health, it might be better if we all just ignore the former vice president until he agrees to undergo therapy. Forget I ever mentioned it.

Instead, consider the case of Hardin, Mont., a community of 3,400 people just down the road from the place where Custer made his Last Stand.

Lately, things have not been going any better for Hardin than they did for the general. Unemployment is rife. “You go look at our downtown, there’s many closed businesses … you’ll see drunks laying in the street. It’s not a pretty sight,” the head of the town’s economic development authority told National Public Radio. The town built a $27 million, 464-bed prison under the theory that other parts of the state would pay to have Hardin look after their problem residents. But it’s been empty since it was declared open for business nearly two years ago, and the construction loans are in default.

So, with the town council’s enthusiastic support, Hardin volunteered to take the Guantánamo prisoners.

It’s unlikely that the White House would have accepted the offer, but it was certainly an example of pluck and you’d think everyone would give Hardin three cheers. Instead, Montana’s Democratic senators went ballistic.

“We’re not going to bring Al Qaeda to Big Sky Country — no way, not on my watch,” said Max Baucus.

“If these prisoners need a new place, it’s not going to be anywhere near The Last Best Place,” said Jon Tester.

This shows us two things:

1) Montana has given itself many nicknames.

2) Montanans are more easily frightened than Manhattanites.

Think about it. New Yorkers live in the top terror target in the nation. This week four new would-be terrorists were arrested for plotting to blow up synagogues in the Bronx. On the same day, President Obama announced that the first Guantánamo prisoner to be tried in the United States would be coming to court in Lower Manhattan.

Even though it appears the guys involved in the Bronx case were deeply, deeply inept, this is still not the kind of news package you want to hear. But nobody had a fit over it. “Bottom line is we have had terrorists housed in New York before,” said Senator Charles Schumer.

New Yorkers aren’t the only ones who have learned to calmly resist both international terrorism and national hysteria. The small town of Florence, Colo., has a 490-bed high-security facility known as Supermax, which houses 33 terrorists, including Ramzi Yousef, who led the first World Trade Center bombing; the failed shoe-bomber Richard Reid; and Zacarias Moussaoui, convicted of conspiring in the Sept. 11 attacks.

The local residents seem fine with it, possibly because they know the prisoners spend 23 hours a day in their cells, which are made of poured concrete and furnished with concrete tables and bunks.

Nobody escapes from maximum-security prisons. But even if they did, who would you rather have on the lam in your neighborhood — a native of Afghanistan whose history suggests an affinity for jihad? Or a resident of your own state whose history suggests an affinity for breaking into people’s houses, tying them up and torturing them?

The nation, as we all know, is divided into crowded states and empty states, and I was always under the impression that folks in the empty places were particularly brave and self-reliant. Those of us who live in the crowded parts have many good qualities, but we are not necessarily all of pioneer stock, given the critical importance we assign to restaurants that deliver at 2 in the morning.

Who knew we were tougher than Montanans?

Let’s All Get Mad

Only yesterday I was saying that I can’t bear to hear the letters “AIG” one more time.  I’m now boycotting network newscasts until they stop talking about it, which shouldn’t take long.  Soon there will be another Octomom or killer chimpanzee or Bernard Madoff to take our minds off AIG.  But really, my mind has been off AIG for at least a week. 

Everyone who knows me well knows that this is my morning routine:  1)  Do the NY Times crossword puzzle online.  2)  Read the NY Times op-ed columnists of the day.  So today, Gail Collins, whom I suspect is a long-lost twin , said everything I was thinking except better.  http://www.nytimes.com/2009/03/21/opinion/21collins.html?_r=1&ref=opinion  The best part of her column was talking about “outrage creds”.  Which is my point exactly.  There are people in Congress who must be getting daily injections of mad-sustaining drugs in order to maintain this level of silly, phony anger. 

Charles Blow of the Times had a different take on the issue, which was equally pointed and registered with me just as much.  http://www.nytimes.com/2009/03/21/opinion/21blow.html?ref=opinion   So really, am I mad?  Sure.  Except I quit about a week ago. 

And why?  Because it doesn’t make a hoot’s worth of difference to my life.  I raged about the unfairness of it all for about a day.  But to KEEP being mad about it for weeks would require me to get some of those injections Congress is apparently getting.  I’m done.  It’s a blip.  Get over it.