Promise Me

by Nancy G. Brinker

  “People have died for this country,” she said. “People have sacrificed their lives so you could live in peace and freedom, and all that’s asked of you is that you take care of it. Stewardship. That’s all. You care enough about your community to look after those who aren’t as fortunate as you. When you see someone in need, you give. When you see something wrong, you fix it. Because this is your country, it’s your community. You can’t sit around on your duff waiting for someone else to make it better. It’s up to you.”

  She shook her finger at us, genuinely angry. Suzy and I stared down at our Mary Janes, waiting for something we hadn’t heard a thousand times.

  “If you girls devoted half the energy you use complaining and bickering to actually doing something for somebody else, I think you’d be amazed at what you can accomplish. So can I count on you? Are you willing to be good stewards for your country?” asked Mother. “Because I’ll tell you right now, you’re not getting back in that car until I hear you say it. Both of you.”

  “I’ll be a good steward,” Suzy responded immediately.

  Mother cut her pointed gaze over to me, but I locked my arms in front of my round little middle, sun prickling at the back of my neck. I’m five, I wanted to tell her. Big enough to know I wasn’t big enough to do anything huge or meaningful or missionary. But there was no use arguing that angle with Ellie Goodman, Standard Bearer, Doer of Good, Righter of Wrongs, Mitzvah Maven.

  Suzy jimmied me with her elbow and hissed, “Just say it so we can go.”

  “I’ll be a good steward,” I said without budging the square set of my jaw.

  Mother opened the car door. Suzy and I climbed in, thoroughly abashed. Returning to the road before her, Mom steered back into the traffic and proceeded with her errands, and we trooped dutifully, if not cheerfully, behind her. That night, as I lay thinking wistfully about cold hose water in a plastic pool, Suzy bounded onto my bed.

  “Nanny! I know what we should do to be good stewards.”

  “What?” I yawned.

  “Variety show.” Suzy hatched her brilliant idea like a magician turning a pigeon out of a top hat. “A song-and-dance variety show and you can sing and dance and I’ll sell tickets. We’ll get everybody to help.”

  It was an ambitious undertaking, but I had no doubt Suzy could rally all the neighborhood children into cast and crew and sell tickets to all the adults, because everyone loved Suzy and would pretty much give her whatever she asked for. I could belt out all the words to “The Secretary Song.” (Remember that great old Rosemary Clooney number with the “bibidi boo bot” chorus?) Just in case, I fortified my stage presence with a Donald Duck hat that actually quacked. A bit of the razzle-dazzle, I figured, to compensate for any vocal prowess that might be slightly lacking.

  By noon the next day, all twenty-three children who lived in our neighborhood were on board. Suzy and I were like a couple of Broadway impresarios, auditioning talent, casting acts, herding crew. Suzy had most of the roughneck little boys corralled with her irresistible smile, and I strong-armed the stragglers. A grand theater was jury-rigged, employing the side of our garage as a backdrop. Something right out of a Mickey Rooney movie. Suzy went out and sold sixty-four tickets. That evening, friends and neighbors gathered on the lawn with folding chairs and picnic blankets.

  I can’t begin to remember what was on the program. Some of the kids were genuinely talented, but there were a few painfully unpracticed performances on school band instruments, I suppose, maybe a mangled magic trick or two, a few fruits of tap and ballet class, some cheerleading and gymnastics, but of course, the whole program was inherently adorable because our appreciative audience was composed of people who adored us. I trotted out for my Rosemary Clooney number and delivered that thing like a wrecking ball.

  Understand that I was a chubby little girl—and not endearingly chubby like Darla in The Little Rascals. More of an ungainly chubby. Like Chubby in The Little Rascals. But I’d never been made to feel self-conscious about it, so when the time came, I put myself out there, completely confident, uninhibited, the way consistently loved children naturally are. (How I wish I could go back and bottle a little of that chutzpah for my grown-up self.) Thinking back to that moment, it’s plain to see that the first thing Mom did to prepare me and my sister for a life of service was to nurture in us a sense of self-worth. The very first step toward giving to others is grateful recognition of our own assets.

  They say you’re happiest doing what you did as a child, and those were the moments I remember most: when Suzy and I were fully engaged, performing—not in the sense of putting on a show to generate applause—performing in the sense of doing. Performing an act of kindness—or an act of will. Generating a response. I probably could have been a good theater producer.

  “If there’s a dog that needs biting,” Daddy used to say, “Nancy’s the one to bite it.”

  I’ve always excelled at backstage cat-herding and organization, but I’m a pretty good entertainer, too, and you have to entertain people at least a little if you want them truly on your side. Suzy was the visual artist. She understood the dynamics of drama and spectacle, what it takes to sweep people in and make them fall in love with an idea, a place, or a cause. In retrospect, I understand how moving it must have been for these terrified parents to see their healthy children dance. Our neighborhood variety show was a resounding success. There was no lack of applause for the Clooney number, but my “bibidi boo bot” may have been a little off, because the next day, Suzy tactfully suggested, “Next time, Nanny, it might be better if I sing and you sell tickets.”

  Mother drove us to St. Francis Hospital on Glen Oak Avenue. Elated, Suzy and I marched to the administrative desk in the front lobby and presented the receptionist with a crisp white envelope containing $50.14 in pure polio-killing, spine-saving, all-American do-gooding cash. A few days later we got a thank-you note from Sister Walburga, the hospital superintendent, assuring us the money would be “put to very good advantage.”

  Nuts and bolts. Dollars and cents. Cause and effect. The lesson wasn’t lost on Suzy or me. This is where the rubber meets the road, I realized. This is where will meets way.

  A fundraiser is born.

  So began Suzy’s and my charitable life together. It was my earliest inkling of what goes into the chemistry of change: moment meets messenger, information becomes action. Hearts and minds shift to a new paradigm, money happens, and it all comes together.

  A Brief History of the Beast

  THE EARLIEST documented cases of breast cancer appear in the Edwin Smith Papyrus, one of several existing papyri that detail ancient Egyptian medical practices. The unknown physician who crafted this document described a number of ailments and injuries and how they should be treated with surgery, magic, or medicinal herbs. Warm tumors in the breast were likely the result of an infection. The remedy: cauterization. A shuddering thought, but the patient probably lived to tell about it. In the case of hard, cold tumors deep within the breast, the scroll states simply, “There is no treatment.”

  This wasn’t a disease the Egyptian physician saw often. Malignant tumors of all kinds were noted with about the same frequency in most of the same gender and age demographics that apply today. Since he recognized that breast tumors varied in nature, it’s possible this physician may have also observed that those presenting in younger women tended to kill with a swift, unstoppable virulence. But breast cancer is far more prevalent in women over fifty, and most women in ancient Egypt didn’t live past thirty-five, so this patient was rare.

  One woman in thousands.

  Given what we know about this disease and about ancient Egyptian culture, I imagine One Woman watched with interest as the physician carefully recorded her case. She almost certainly didn’t know how to read or write. There is no treatment, he told her, straightforward but not without compassion, I think. He seems like a “good doctor” sort in his other writings. Perhaps he offered her a tincture made from alcohol and flowers, a pra
yer, a little stone god, some comfort she could cling to.

  One Woman went home to her family and went on with her life. The tumor in her breast grew steadily over the coming months. The breast itself seemed larger, the skin thick and red, spidered with veins and stretch marks, but she felt strong and went about her daily business. Some days were better than others, and she felt a flash of hope. She laid fruit in front of the little stone god, whispered in its ear. Then came another day, and her hope faded.

  The cancer metastasized, spreading from breast to breast, then riddling lymph nodes, lungs, spine, and liver. First, she felt a firm bulge under her right arm. Her fingers tingled and burned with neuralgia. She dropped things sometimes. Then there was a stabbing pain in her spine when she bent to lift her small child. Eventually, she had to sit on the floor and let him climb into her lap, holding him over on the side where she could still stand the pain if he leaned against her breast. When she laughed or yawned, there was a stitching pull deep inside her chest. It seemed to form a tight fist in her lung at times. She’d wake up coughing, struggling for breath. It made the baby cry, but when she tried to go to him, she was dizzy and nauseous. She was bent with the effort of getting up in the morning. Her complexion yellowed. The coughing spells settled into a nagging pattern of hoarse, painful barking.

  Under her linen dress, her breasts were visibly misshapen and distended now. When she was naked, she could see a shadow rising to the surface. The skin became translucent purple and gradually gave way like a slit in a temple curtain. The lesions wept a thin blackish-bloody fluid. The skin crusted and opened, an unblinking eye with the slick, eel-colored tumor at its center. Her sisters tried to clean and care for her, but on a cellular level, the tumors were dying as rapidly as they multiplied, so the bulging tissue became necrotic, and the smell of death hung in the air, permeating the bedclothes, lingering in her hair. The woman’s strength leaked out of her. Loved ones tried to feed her broth and soft meal cakes, but she was quickly wasting away, barely a thread of herself.

  At the end, her sisters sat next to the bed, whispering to each other. Is she breathing? Did you see her eyelids flicker? They were terrified to touch her now. What if this dark disease was contagious? They had to think of their children. Lying in bed at night, they moved their hands over their own breasts, afraid to exhale. Here? Didn’t she say it started here, with a bump like a small pebble?

  It would be nice to think someone who loved her held her when she died.

  A thousand years went by.

  Four centuries before the birth of Jesus—about the time Siddhartha became the Buddha and Malachi the last of the Hebrew prophets—the Greek scientist Hippocrates observed coal-black tumors erupting through the skin of his patients and concluded that the malady was a manifestation of too much black bile or melanchole in a woman overly influenced by the element of earth, an internalization of autumn’s dry cold. Tentacled tumors examined during autopsies spidered into the body, evoking the image of a crab.

  Karkinos.

  Cancer.

  There was no hope of treatment or cure, so it was better, Hippocrates hypothesized, to prolong the life of the afflicted by making her as comfortable as possible in all other respects. He discouraged his students from surgically excising tumors from their patients’ breasts, based on his assumption that pervasive black bile was a systemic problem. Barring intervention by the gods, the disease would invariably return with swiftly killing insistence.

  For two thousand years, his conclusions remained the conventional wisdom. There was a glimmer in 200 C.E. when Galen, a devoted follower and biographer of Hippocrates, recorded his observation that not all breast tumors were created equal; some were slow and insidious, others quick and virulent. Not all had the iconic crab legs; some blossomed deep in the bosom and remained isolated from surrounding tissue like a lily floating in a pond. Galen treated patients with opium, licorice, castor oil, and incantations, but ultimately, he confirmed the six-hundred-year-old findings of Hippocrates: Breast cancer was a systemic disease caused by the darkest humor, surgery was contraindicated, sufferers were doomed. This remained the final word on breast cancer for another fifteen centuries.

  Roughly around the time of the American Revolution, in an effort to discredit the time-honored ideas of humoral medicine, French physician Jean Astruc placed a slice of a breast cancer tumor in the oven next to a slice of beef, cooked both to a jerkylike consistency, chewed each one thoroughly, and declared that they tasted exactly the same, proving (among other things I can’t even bear to joke about) that the breast cancer tumor contained neither bile nor acid.

  Out with the old superstitions; in with empirical state-of-the-art methods. Now the true cause of breast cancer was wide open for speculation.

  One school of thought pointed to the high incidence of breast cancer among nuns as evidence that breast cancer was caused by a lack of sex. Because breasts are sexual organs, n’est-ce pas? Without the fulfillment of their bountifully natural purpose, what could they do but atrophy and became cancerous? (I imagine there was no shortage of selfless lads willing to hurl themselves between innocent young women and this dreaded disease.) In women who did voluntarily engage in “relations”—randy wives and scurrilous hookers—tumors were said to arise from a lymphatic blockage caused by an overly vigorous libido. Another popular theory cited constriction of lymphatic vessels due to depression. Others blamed the curdling of unexpressed milk and the coagulation of blood caused by a sedentary lifestyle.

  And so, in the enlightened age of Mozart, after three thousand years of observation and experimentation, it was scientifically deduced that if a woman presented with breast cancer, it was due to frigidity, promiscuity, craziness, laziness, or all of the above in some combination with the unknowable will of God.

  One Woman after Another passed into ancient history, each less than a grain of sand, and there are places in the world where nothing has changed. Today women in developing countries echo the story of the woman in the papyrus and face their fate as if the last three thousand years never happened. I’ve seen One Woman’s face, and I can’t forget her. Sitting on a wooden stool by an ancient stone wall, wearing clothes right out of a Cecil B. DeMille Bible epic, she looked up at me and asked, “This disease—is it contagious?”

  She has to think of her children.

  At this writing, according to statistics, breast cancer is the leading cause of cancer death for American women between forty and fifty-five years of age. In One Woman’s corner of the world, there are no statistics, never mind screening or even the possibility of treatment. Breast cancer comes and goes unnoted, misunderstood, taking thousands of lives with it.

  One Woman at a time.

  ∼ 2 ∼

  Founder Effect

  Our father, Marvin Goodman, was of robust Russian and Lithuanian ancestry. We suspected a little Irish, though for some reason, no one in his family would talk about it. Daddy and his sister, Ruth, had white hair, greenish eyes, and fair skin. The old family portraits are sharply angled with square jaws and stiff upper lips. Daddy’s father was a deputy sheriff in Colorado, which was an extraordinary thing for a Jewish man to be back then. Daddy’s mother was smart and articulate, but quick and unforgiving as a mousetrap. She ended up with Alzheimer’s, but even as her mind and memories abandoned her, she remained constant about what mattered to her, most notably (it seemed to Suzy and me) the cleanliness, proper behavior, and mandatory silence of children.

  Our hardworking father was a driven but principled businessman, and I’m glad to be my father’s daughter in so many ways. In those days, it was hard to find any Jewish family who hadn’t lost someone in the Holocaust, and our family was no exception. Yet Daddy never forfeited one ounce of his soul to hatred. I learned from him the empowering nature of purpose, how our own courage will rise up and surprise us when beckoned in service of family, country, or passion for a cause greater than ourselves. I also saw what his driven nature cost him. The years have outfitted me
with that same hard-earned hockey gear.

  Suzy, of course, remains forever carefree and barelegged in a summer dress. She has the advantage of never growing older, never knowing bereavement, never making it to a place where unwelcome wisdom interferes with a decent night’s sleep.

  I understand now that charity is a form of gratitude, and certainly, Suzy and I had much to be grateful for, but the dynamics of stewardship and volunteerism were central to our upbringing, a family tradition that stayed with us powerfully because we were shown, not told. Our parents were sincere but comfortably reformed Jews, and we attended a scandalously easygoing temple, Anshai Emeth, where people were zealous about service to their country, community, and each other, but fairly wide open when it came to religious dogma and ritual. The fun-loving, affectionate community met in a building that used to be a Baptist church. They had their share of family squabbles, but I think it speaks volumes that in several old photographs of temple events, the son of one of the members is surrounded by friends and beaming broadly, wearing a cocktail dress and full makeup.

  Mom was far too busy to ponder the orthodoxy of charity, but she embodied the idea of tzedakah, which isn’t about performing acts of kindness; it’s about the state of being kind. This isn’t something my mother has to think about. It’s simply who she is. Her mother’s daughter.

  Mother’s tribe was a boisterous, demonstrative bunch. This branch of the prosperous Silberstein family started over from scratch when Great-Grandpa Moses emigrated from Berlin to the United States in the late 1800s, but he prospered in America as well. Mommy’s mother, Freda Newman—affectionately called “Fritzi”—was a founding member of the local Red Cross chapter in Peoria and dedicated most of her life to serving in hospitals and hospice. During World War I, Fritzi and her family took in soldiers, tended the wounded, comforted the dying. It offended her faith and her sense of justice to think that each of these brave young men had made it through the trenches and mustard gas, only to come home and die in his bed.