Promise Me

by Nancy G. Brinker

  The chemical treatment of the tumor and recovery process that followed was laborious and slow. Fredi sat at the computer for hours, learning her own language from the beginning, her head pounding, the words hanging just out of reach, tantalizing and torturing.

  “I’d tell myself just fifteen minutes more and after that just fifteen minutes more. It took a lot of persistence. I was forty-four years old and learning like a first grader would learn.”

  She battled her way back and was eventually able to resume her work.

  In August 2008, Dr. Robertson stood in a hangar at Dallas/Fort Worth International Airport, celebrating the award of the first SGK Promise Grant. Parked out on the tarmac like a mommy, daddy, and half a dozen hatchlings were an American Airlines 757, a 777, and a group of American Eagle commuter jets, gleaming in the sunshine, freshly painted with their new livery. A vivid pink ribbon unfurled the entire length of each fuselage from one end to the other, and each tail fin was emblazoned with our trademark “running ribbon.”

  In addition to flying our color all over the world, American Airlines was funding an important five-year study of IBC—inflammatory breast cancer—to the tune of $8 million. Fredi and her co-principal investigator, Dr. Massimo Christofanilli, are conducting transitional research using critical blood and tissue samples from IBC patients, advancing our understanding of the disease and identifying IBC biomarkers.

  “The collaboration between patients, physicians, and laboratory scientists has created a one-of-a-kind environment for robust team science,” said Dr. Christofanilli.

  “The day they pulled those planes up in Dallas,” says Fredi, “what a thrill. A few months later, I gave a talk in Dresden, and coming into the Frankfurt airport, there was one of those planes. I got tears in my eyes. That support means everything.”

  The Promise Grant will enable her team at M. D. Anderson to continue studies that bring her into daily contact with the women whose lives are at stake. One of those patients is Jenee Jongebloed Bobbora, who was diagnosed in 2003—a thirty-two-year-old woman with a two-year-old daughter.

  “The survival rate at that time was about 5 percent,” says Dr. Robertson. “But seven years later, she’s NED—no evidence of disease—and life is good. She knows what it is to be a survivor; she sees what could have been, and she’s grateful for what is. She has this tremendous life force, and she’s so funny.”

  Jenee was a teacher before, and now she’s on fire to educate women about the factors that contribute to misdiagnosis, which is a factor in the low survival rates for women with IBC. It’s rare, and those who get it are generally much younger than the average breast cancer patient. Instead of presenting with a lump in the breast, it often appears as a rash or redness. It’s often invisible on a mammogram or ultrasound. And it is hellishly aggressive. Early detection is key, but IBC is most often diagnosed at Stage IIIB, which is most often too late. Jenee helped establish the Inflammatory Breast Cancer Foundation, whose mission is to advance understanding of this rare but virulent cancer.

  In 2006, M. D. Anderson opened the world’s first dedicated Inflammatory Breast Cancer Clinic. Fredi Robertson still suffers from searing chronic headaches, but there’s nowhere else she’d rather be.

  “I’ve had friends who opted to retire early, but how could you possibly? I learn every day,” she says with obvious relish. “From advocates, from patients, from team members. M. D. Anderson is Disneyland for scientists. I feel really blessed to be here.”

  We take a lot of flack (speaking of searing chronic headaches) from people who feel our corporate sponsors get more from the relationship than they ought to. I wish I could personally introduce each of those critics to Dr. Fredi Robertson.

  People are fond of saying, “It’s not personal; it’s business.” But in my experience, those who achieve the greatest success in business take it very personally. They see a personal stake in the welfare of the customers from whom they derive their bottom line. At the end of the day, of course, they’re in business to make money. When we started down the road toward significant use of cause-related marketing, Norman cautioned me never to lose sight of that fact, and I never have. Susan G. Komen for the Cure is a nonprofit organization; our corporate sponsors are not. Their raison d’être is profit. Every one of our corporate sponsors has a fiduciary duty to its stockholders, and stockholders are hoping for a pleasant retirement. We want them to thrive, because we need their help. We give and take, and if all goes as it should, we help each other muddle through to duel another day. That’s how money and love make the world go ’round.

  In 2008, our corporate sponsors enabled us to invest an additional $55 million in discovering and delivering the cure for breast cancer. Whatever goodwill American Airlines realizes from its continued partnership with us—however many times that translates into someone buying a ticket from American instead of another provider—the airline deserves it. I value every yes I get. Our corporate partners do a lot of good for us, and I believe in the adage “what comes around, goes around.” I strive to be as tenacious and unflappable as my father, but he told me from the time I was young: “For every five yeses you get in life, you hear a hundred nos.”

  Certainly, if the people critical of cause-related marketing were to offer to provide us with $55 million a year, we’d be happy to stay home and put our feet up. Till then, we’ll keep knocking on doors. In the early days of SGK, I pursued meetings with CEOs I admired, but I didn’t go to them with my hand out; I went to them asking for advice. Their wisdom was a great asset to us, and one of those benefactors was Bob Crandall of American Airlines. He gave me a lot of sound advice that stayed with me, but one particular point resonated with me.

  “Don’t put all your eggs in one basket,” he cautioned. “When you see a source of revenue on the rise, it’s tempting to put all your energy there, but that’s a mistake.”

  At the time, the Race for the Cure was really catching fire all over the country, and we were already seeing how it could go global. It was thrilling, but I was a little nervous about it taking over the organization. Without taking any energy away from that effort, I redoubled my outreach to corporate partners, and we’ve worked hard over the years to keep all the plates spinning.

  When Eric was working with his teammates at JetBlue to design a new sort of customer experience, he said, “You have to go where you need to go. That’s the first thing. But getting there is more than just Point A to Point B.”

  The same could be said for research. It’s a spiral staircase, not an elevator. The give-and-take goes around and comes around, peopled by scientists, physicians, patients, and supporters.

  Mary Woodard Lasker has been called the “fairy godmother of medical research” for the way she facilitated symbiotic connections between the will and the way. Jonas Salk said, “She is a matchmaker between science and society.” When Suzy and I were growing up, Mary Lasker was a role model, and as I was beginning my career in business, I recognized the political savvy and social grace she wielded with the precision of a scalpel. She was responsible for the perennial daffodils visible from Lady Bird Johnson’s window at the White House—and for the congressional declaration of a national War on Cancer. The lesson wasn’t lost on me back then, but I only recently grasped its full meaning.

  Not long ago, while visiting our affiliate in Orange County, California, I met Leslie Whitfield, who’s survived eighteen years since being diagnosed with Stage IV breast cancer.

  “Eighteen years?” I gasped. “After the worst possible prognosis? That’s unheard of!”

  “It hasn’t been easy,” she said, “but I’m alive, and I’m having a good life.”

  “Tell me about your treatment. Walk me through it from the beginning.”

  As she described her journey, every protocol, every chemo regimen, every blast of radiation, every setback and step forward, I was overwhelmed with emotion. Every therapy she’d received had been funded by SGK grant money. And now, against all odds, here she stood tel
ling me about her family, working to raise money for research, reaching out to help other women with breast cancer.

  I consider her an excellent investment.

  ∼ 16 ∼

  My Kingdom for a Horse

  If you want a crash course in Activism 101, observe the efforts on behalf of AIDS awareness. I paid close attention, was continually inspired, and learned a lot. On December 1, 1989, the Visual AIDS Artists Caucus of New York City staged their first DWA—Day Without Art—an eloquent and powerful “national day of action and mourning” that garnered a tremendous amount of attention. In 1991, they launched the Red Ribbon Project, purposely keeping the campaign creator’s name anonymous and the copyright for the image free. They wanted to preserve it as a sincere, personal symbol of compassion. At the 1991 Tony Awards, the red ribbon was seen on Jeremy Irons and other Broadway denizens. Within months, it was the must-have fashion accessory of the season.

  A few months later at the New York City Race for the Cure, inspired by the elegant simplicity of the red ribbon loop, volunteers pinned loops of our signature pink ribbon on participating survivors. We were still using the logo with the runner outlined by a pink ribbon. It wasn’t something we did on purpose, but it was so poignantly reminiscent of the pink ribbon sash on Suzy’s homecoming queen dress. Low-cost, easy to execute, and pleasing to the eye, the loop of pink ribbon quickly caught on as a way to identify participants, survivors, and supporters at Susan G. Komen events. Following the example of the Red Ribbon activists, who welcomed all comers (including sponsors who enabled them to take their important work into schools, museums, galleries, and parks), we didn’t trademark the ribbon or any particular derivation of it at that time.

  The following year, when Self magazine editor Alexandra Penney teamed up with Estée Lauder to promote the second annual Breast Cancer Awareness Month issue for October 1992, they went back and forth over the rights to a peach ribbon, but Penney was advised to pick another color, and she chose pink. Understandably, there was some rumbling from our camp, but when the subject was raised at a board meeting, I held up my hand like a traffic cop.

  “We have no dog in that fight. They distributed 1.5 million breast self-exam cards. Why should we be unhappy about that? We have a lot of work to do. Let’s not waste energy being territorial about less than a penny’s worth of pink ribbon.”

  I felt Norman’s hand on my knee under the table. A quick squeeze of approval. Breast Cancer Awareness Month—a collaborative effort involving many terrific organizations—was a whirlwind, as every October has been since BCAM began, and after that Norman and I waltzed through the holiday party season. As we did every year, we spent New Year’s Eve in Norman’s office. Knowing the restaurant managers would be working hard, he spent the evening at his desk, calling every single one of them to ask after their families, thank them for their dedication, and wish them a prosperous New Year. I lay on the couch, listening to a master manager in action. At first I thought he did this to make his people feel important. Then I realized he did it to acknowledge that they are important.

  That year, 1993, promised to be a thrilling year for SGK. U.S. Olympic runner Francie Larrieu Smith was our National Honorary Chair of the Race for the Cure Series. We were funding some amazing research, and with the passage of the Mammography Quality Standards Act, we were looking into the art of the possible, considering alliances and actions that might have a great effect from Capitol Hill.

  About to celebrate our twelfth wedding anniversary, Norman and I headed for our home in Florida. Norman was leading the Chili’s polo team in the Challenge Cup Tournament at the Palm Beach Polo and Country Club. The first week, play was postponed because of a relentless rain that had the players pacing in the bar and horses stamping restlessly in the stables.

  January 21, 1993 was bright and beautiful. Perfect weather for polo.

  Norman and his teammates—Stewart Armstrong, Fortunato Gomez, and George Olivas—rode out looking tan and invincible to face the Cadillac team led by Joe Henderson. The field was still a bit mucky, but the players went at it with their typical fervor. At the end of the second chukker, it was Chili’s 3, Cadillac 2. The horses huffed and whinnied, visibly winded from slogging in the mud. Stewart and Norman both decided to change mounts during the break. When the players rode out again, Norman was on a quick and pretty little horse named Kachobie.

  I’d been tending to some business, but before the third chukker began, I pulled my Land Cruiser into a spot right about midfield and climbed up to sit on the roof. The whistle blew, but play was suspended almost immediately. One of the horses had kicked up a dollop of mud that hit Norman in the face. The horses shuffled and hedged and the players ribbed each other in good nature while Norman dismounted and wiped his eye with a clean towel.

  He glanced my way, and I waved, but I don’t know if he saw me.

  Norman swung back into the saddle and loped down the field. The ball was back in play with Cadillac in control. Henderson hit a cut shot, and Norman countered from a defensive position, but the ball clipped off at an angle between Kachobie’s dancing feet. Norman turned and blazed after it. I’m not sure he even realized that Henderson’s mount was coming at him. It’s possible he was having trouble seeing because of the mud in his eye. Or maybe Kachobie, who was usually fleet and fierce, was lumbering a bit because of the field conditions. Norman and Henderson were both galloping at breakneck speed. In the split second before they came together, Norman and Kachobie reeled to the side.

  T-boned is the term for what happened next.

  Henderson’s mount screamed like the braking of a freight train. The impact smashed Kachobie to the ground. Norman took the blunt force of the fall directly to the side of his head and was instantly rendered unconscious with the full weight of his horse on top of him. Kachobie lay stunned for a moment, then began heaving in panic. She struggled to find her legs, but couldn’t and rolled back on Norman’s body, crushing his ribs. The other players scrambled from their mounts and rolled her onto her back, trying to gentle her thrashing.

  By this time I was off the roof of the SUV and running down the field, my boots pounding over the hardpan areas, slipping and stumbling in the mud between. Norman had fallen about a hundred yards from where I was sitting. He always raised his hand when he fell, even if he couldn’t get up right away—all I needed to see was his hand—but he lay motionless.

  Don’t scream. Don’t scream. He’ll be embarrassed.

  I reached Norman just as the little medical van bumped up across the sod and lurched to a stop. Someone with the best of intentions had rolled Norman onto his back and removed his helmet. When I fell to my knees beside him, he was gray and lifeless.

  “Oh, God—Norman! Norman, can you hear me?”

  Norman’s eyes were closed, his mouth bluish gray.

  I shrieked over my shoulder to the attendant climbing out of the medical van. “He’s not breathing! Get oxygen! Get the oxygen and bring the board! He has to be immobilized.”

  The young man looked at me wide-eyed. He was used to splinting broken fingers, maybe slinging a broken arm firmly enough for the ride to the hospital. Nothing like this.

  “It’s—it’s locked.” He pointed at the back of the van. “I don’t know where they keep the oxygen.”

  His partner finally got the door open and located the oxygen bags.

  “Do you know how to activate it?” I asked.

  “Um … I think you pull this …”

  “Give it to me.”

  He cleared Norman’s mouth while I activated the bag. (Suzy had used a similar device. It’s not something you forget.) As soon as it was strapped over Norman’s face, he dragged in a deep, tortured breath.

  “Norman? Norman.” I stroked his face and kissed his forehead. “Norman, hang on.”

  Someone had volunteered to run to the clubhouse to call for an ambulance, but I knew that would take at least thirty minutes. I gripped Norman’s hand, cursing myself for leaving the Land Cruiser back at
midfield.

  “Get him in the van,” I told the attendant. “We’re taking him to the hospital.”

  “We can’t transport patients. It’s against state law.”

  “Screw the state law! Get him in there.” I heard myself roar like a wolverine. I struggled to my feet, fists clenched at my sides. “I accept full responsibility. Whatever the consequences—just—just help me. Please.”

  We got him on the board and into the van.

  “Take him to Wellington Regional,” I told the attendant. “I’ll follow you.”

  There was a mobile phone in my car. (This was back in the day when the damn thing was the size of a brick and tethered to a base under the dashboard.) I ran for the Land Cruiser as fast as I could, fighting for calm, for a thought process. It had been about five minutes since he hit the ground. How long had he stopped breathing? Three minutes? I got in, gunned the engine, and peeled out of the gravel parking lot, groping for the phone. I bumped up onto the road behind the medical van and called Dr. Sandy Carden, a friend at St. Mary’s Hospital in Palm Beach.

  “Sandy. Sandy, thank God you’re there. Please, help me. Norman’s hurt. It’s bad. He’s unconscious. We’re taking him to the Wellington ER.”

  “I’m calling a neurosurgeon. He’ll meet you there,” said Sandy.

  His voice was even and cool. That helped. I hung up the phone but tried to hold on to that even, cool undertone as we wheeled into the breezeway at the small hospital. My heart sank. It was late in the afternoon. I wasn’t even sure there would be a doctor on deck. It was a sleepy little facility back then. If the doctor was on call …

  It had been almost twenty minutes now.

  I threw open the car door and ran for the van. A male nurse pushed through the double doors and strolled out toward the curb in no particular rush. A combination of Medical Center reruns, panic, and a lot of time spent in cancer wards took over.

  “Code Blue! Code Blue! I’m Dr. Brinker. This is my patient.” I didn’t think about it. I just did it. “He’s in respiratory arrest. Get him to ICU. Get him intubated. Stat! Let’s move!”