anneiskeepingbusy

The time has come to a) examine breasts, and b) return to art.

If you have been following me on twitter, you may know that I have been consulting surgeons about having a bilateral mastectomy, followed by reconstruction. This is because my breast cancer is the result of me being a carrier of the inherited BRACA1 gene. The geneticist from Great Ormond Street tells me that having this gene meant that I had an eighty percent chance of developing breast cancer over the course of my life – yes, bloody hell, eighty percent.  I still have a fifty percent chance of developing a brand new tumor. Not being that keen to repeat the experience, I am opting to have both breasts removed and replaced either by implants or tissue from my stomach.

Not surprisingly therefore, breasts have been on my mind, so to speak. Here are some thoughts, illustrated by work I have shamelessly raided from the Tate’s 20th Century collection. (Apologies to them.)

1. Vanessa Bell, Nude  circa 1922-3

I like this because the model looks like a normal woman (i.e. me). She’s also a bit lob-sided, which apparently is usual. One of the problems for a surgeon undertaking reconstruction on a single breast is matching its size to the remaining one. My file at the hospital is full of sketches and measurements, although having both done at once makes this mismatching less of an issue. I also sympathise with the general fed-up look of this woman.

2. John Currin, The Wizard circa 1994

I’m not entirely sure what is going on here, but it reminded me of my many examinations (and yes, I usually look like the lady here). Surgeons do a lot of looking and weighing up. And, while my science friends will reject this, they are something like modern-day wizards. The options I am being given are pretty damn amazing.

3. Mark Gertler,  Queen of Sheba 1922

One of the options for reconstruction is to take tissue from the stomach and reallocate it. This would be an eleven hour operation, involving three consultants. Blimey. You have to have enough of a stomach to do this, so for once the larger, pie-eating woman comes into her own. The Queen of Sheba would have been a good candidate.

4. Hans Bellmer, The Doll  1936/1965

The issue with using the stomach is whether there is enough there to make breasts of “an appropriate size”, appropriate I assume to the particular patient. You don’t want to wake up after eleven hours of surgery and be disappointed, I suppose. Here, we see something of an inappropriate size.

4. Rineke Dijkstra, Julie, Den Haag, Netherlands, February 29 1994

The point of breasts, 1: for the baby.

4. Eric Gill, Ibi Dabo Tibi  1925

The point of breasts, 2: self-evident. (Plus, I have a soft spot for Eric Gill, only because a Walter Shewring – no relation – edited his letters.)

5. Eric Gill, Skaters  1926

The point of breasts, 3: admittedly less common, but nude ice skating.

6. David Bomberg, Lilian  1932

This is a portrait of Bomberg’s wife, Lilian. The Tate says, “Lilian remembered that she sat with a black satin dressing-gown around her shoulders and arms, because she was shy of posing completely nude.”  I like this painting because it reminds me that there was a time when the world and his wife had not measured, poked, photographed and sketched my chest, when I did care who saw and who didn’t. I like her modesty and the way the artist keeps something back from the viewer. This is how it was and maybe how it will be again.

Last week, to celebrate World Aids Day, I went to a lecture given by Professor Mary Collins. Mary, aside from being my friend, is Professor of Immunology and Dean of Life Sciences at University College London and her lecture was titled, “From pathogen to ally: engineering viruses to treat disease.” I didn’t understand much of it, but here’s what I think Mary and her team are doing.

The HIV virus is very good at making its way through the body to attack the body’s immune system via its T-cells. What Mary is doing is turning this on its head, genetically engineer the HIV virus so that it can carry good stuff into cells where nasty stuff is happening. At the moment, the practical uses for this are limited, although a team in Paris have used a modified HIV virus to treat children with a disease called adrenoleukodystrophy, a severe hereditary condition in which the nerves gradually lose function leading to increased mental and physical disability – it’s the disease featured in the film Lorenzo’s Oil. What Mary and her colleagues hope to do in increase the uses of the HIV virus to improve vaccinations for a range of other diseases from Parkinson’s to influenza.

Tactless nurse shows man with polio that, thanks to vaccines, for everyone else, polio is over.

Now I may have got the science wrong (and you can read Mary in her own words here). This is difficult stuff for the lay person: the words are unfamiliar, the diagrams make only minimal sense and this is before we even contemplate what’s going on here. A virus that has killed 24 million people since 1981, that is still reducing life expectancy for people in countries like Botswana by at least 20 years, is being manipulated to offer other people will all kinds of horrible conditions the hope of a cure. How amazing is that?

Tricky science diagram

At the same time, Siddhartha Mukherjee’s book, The Emperor of All Maladies, about the history of cancer, won the Guardian First Book Award. I can’t quite bring myself to read this at the moment, but it does sound good, covering everything from 19th century mastectomies, performed without anaesthetic or penicillin, to the development of chemotherapy from observations of the effects of mustard gas during World War I.

In an interview with the Guardian, Mr Mukherjee answers the question; can a positive attitude cure cancer?

“No, I think it’s not true. It’s not true. In a spiritual sense, a positive attitude may help you get through chemotherapy and surgery and radiation and what have you. But a positive mental attitude does not cure cancer – any more than a negative mental attitude causes cancer.”

I like this. I don’t believe that my life is dependent on whether I think good thoughts or not, which is just as well as my thoughts are not always very positive. It’s more comfortable if you can think positively but who can do that every day? I would much rather believe that my fate is in the hands of people like Mary, who work away, year after year, making progress, inch by inch.

Coincidently, on the way to Mary’s lecture, I was listening to a downloaded edition of In Our Time about Miracles. One of the contributors made the point that miracles may well just be phenomenon that we just don’t understand yet. His example: if you have no knowledge of optics, a rainbow would seem like a miracle.

Modern medicine is not a miracle – someone understands it, even if that someone isn’t really me. All I think is how grateful I am that people like Mary and her colleagues and students are wearing their white coats and doing things with test tubes and microscopes and making this stuff happen.