Promise Me (43 page)
Authors: Nancy G. Brinker
The year 2008 was a contentious one in American politics, and I tried to exert a calming, nonpartisan influence. Winding down my time at the White House, I was already looking outward into the world where I knew I belonged now, and I saw the vital connection, this bridge I’d crossed. I had friends and allies in every corner of the globe. I’d sought first to understand; now I was ready to seek their understanding.
Laura Bush and I had done a lot of traveling together, and we talked a lot about the particular challenges facing women in developing nations. Together we formed the U.S.–Middle East Partnership for Breast Cancer Awareness and Research, forging relationships with remarkable men and women who were positioned to help us launch awareness-building campaigns, grassroots advocacy and support efforts, and technical training.
We orchestrated outreach that would include tasks as tangible as needle biopsy training and as esoteric as empowerment for girls and women.
In October, Laura and I hosted a breast cancer conference at Blair House, and in celebration of the event, the White House was illuminated in pink. Meanwhile, Katrina McGhee, SGK’s VP of Global Partnerships, traveled to Africa with other staffers, preparing for the launch of the Ghana Breast Cancer Alliance with actress Gabrielle Union; Malaak Rock, Chris Rock’s philanthropist-activist wife; and Billye Aaron, the gracious wife of baseball great Hank Aaron. SGK’s CEO announced a grant of $250,000 and plans for a symposium that would bring together the great minds and hard resources needed to bring breast cancer care to women in desperate need.
Barack Obama took office on January 20, 2009, and the next day I was on a train and back to work at SGK, which had been christened Susan G. Komen for the Cure two years earlier, a rebranding that captured a fresh vision encompassing so much more than we originally dreamed it would. I’d met with political and spiritual leaders from all over the world and laid the foundation for important dialogue to come. I’d also worked with many amazing people in the State Department and at the White House and was lucky enough to bring some of them along as this new phase unfolded. It felt good to be back at board meetings, my focus back where I wanted it to be, but with a whole new perspective. I’d been appointed to a position with the United Nations as the World Health Organization’s Goodwill Ambassador for Cancer Control. In addition to advocating for cancer awareness and prevention, I would investigate and report on the state of cancer care in all parts of the world and help form WHO’s global strategy for prevention and control of noncommunicable diseases.
I had a lot on my plate, but compared with the pressures and pace at the White House, the 60-hour weeks felt like a pleasure cruise. It occurred to me that I could have a bit more of a social life now.
It had taken me a while to learn how to date again after Norman remarried. I did see a number of interesting men and was actually pretty fond of a few of them, but none of them had me flying into Love as he had once upon a time. I’ve always had a penchant for bad boys, and I was now
in a position where any indiscretion on my part might reflect poorly on others. I couldn’t allow myself to be led down the garden path.
After I’d been seeing one wonderful fellow for a while, I came to the conclusion he wasn’t the right fit for my life. Instead of trying to reform him, I sat him down at his private club and said, “You’re fired.”
“Fired?” he echoed.
“Yes. You’re fired. From dating me. From my life. I’m sorry, I have to let you go.”
“Oh.” He looked like he wanted to laugh but wasn’t sure he should. “I’ve never been fired from somebody’s life before.”
I saw a long black car arrive outside the window.
“Well. There’s my date for the evening,” I said. “Best of luck to you.”
He looked a bit shell-shocked as I gathered my things and walked away, but we actually laughed about it later, and we’ve remained the very best of friends. (Bad boys make wonderful best friends.) When I told Norman about it, he laughed, but then he told me very seriously, “No one will ever love you like I do.”
He’d told me this many times over the years, and it always felt like both a blessing and a curse. I certainly didn’t want it that way, but I knew it was true. I knew I’d never marry someone else as long as Norman was alive.
“Don’t settle,” he said. “Somebody out there will see what a great package you are.”
“I’m not everyone’s cup of tea,” I reminded him.
I’m afraid some men viewing my life from a rotunda perspective don’t see how they’d fit in. Friends try to fix me up and coach me to be “less intense,” which rankles me; men are never told that their accomplishments make them less desirable. I don’t sit around waiting for a man to give my life meaning, but I’m always willing to find time and energy for the right relationship. I’m an able ally for a strong man, and I must say (because Suzy’s not here to say it for me) I still look pretty good in a sports car. I’ve had a little work done, but just before the anesthesiologist put the mask over my face, I stopped the surgeon’s hand and said, “Don’t give me my money’s worth.” I aspire to the kind of beauty my mother has; it’s physical and classic, and comes from taking care of herself with the same tender vigilance she extends to others.
Norman’s health had deteriorated over the years. He was increasingly unstable on his feet and often used a motorized scooter now. Along with the progressive effects of his brain injury, he’d had cancer in his throat and a host of other complications that accompany a lifetime of high mileage, but he made the Herculean effort it took to participate in every SGK board meeting, even if he had to come in a wheelchair or tune in via video conference. He always held my hand under the table and always parted with “I love you.”
I’m so grateful those were the last words I heard from him.
The last board meeting Norman attended was in March 2009. Margaret Valentine (who works for us at SGK now) told me that on his way home, he said to her with great satisfaction, “Boy, oh boy. They are on
fire.
”
Norman died that summer. June 2009. The news left poor Eric utterly bereft, but Norman would have been proud of how fiercely protective he was of me in the difficult days that followed. There was a huge memorial service planned at Meyerson Symphony Center in Dallas, but I was bluntly uninvited. A close friend of Norman’s who knew it wasn’t his style to exclude anyone interceded on my behalf so I could attend the memorial, but I wasn’t allowed to sit with my son or accompany him to his dad’s gravesite.
Eric arranged private visitation the night before the service, but when I saw Norman laid out in a pedestrian suit and tie, I was stricken with the same heartsick reaction I’d had to seeing Suzy in her coffin. He’d always said he wanted to die with his boots on, and if it had been up to me, that’s how he would have been buried. White jeans, fresh polo shirt, stick by his side. Ready to ride. But it wasn’t up to me. I had no standing here, no right to feel as profoundly widowed as I did. I was reminded of the way I’d felt when Jake, the man I’d dated during my early days at Neiman Marcus, died just as our relationship had begun to blossom. Polite society knows what to do with a widow or an orphan, but who are we when etiquette hasn’t invented a word for our particular form of bereavement?
During the funeral, a famous friend of Norman’s got up and made a statement about how “the last few years of Norman’s life were the happiest,” and my face burned as if I’d been slapped. The platitude was such an insult to Maureen, to Norman’s beautiful children, and to the man Norman was when he was
Norman:
the vital, brilliant businessman, the
spring-step entrepreneur, the empire builder, athletic lover, and fearless horseman. How small and chauvinistic to eulogize him as someone who prized dotage over powerful partnerships that produced amazing human beings. Among the thousands who came to honor Norman that day, in addition to the hundreds who knew and loved him as a tour de force in the restaurant industry, were hundreds of others who knew and loved him because of the work he’d done during his twenty-six years on the board of Susan G. Komen for the Cure, people who knew the organization wouldn’t be what it is if not for this man who gave me a platform and taught me how to use it. Nothing was said about the lives he’d saved.
That night, Larry Lavine, Norman’s partner in Chili’s and beyond, brought together all of Norman’s protégés, the people of whom Norman was proudest. Managers and innovators he’d raised up and mentored. Entrepreneurs and restaurateurs who’d thrived on his guiding principles. There was Eric, who’d delighted his dad by leaving a handprint on JetBlue’s unique branding, then found his way back to Peoria, where he carried my father’s work into the future. I was so honored to be included. We toasted Norman’s memory, shared stories and laughter, and warmly agreed to come together every year to celebrate that little bit of Norman’s great heart still beating within each of us.
A week or so later, Brenda’s daughter Connolly graduated from junior high in San Francisco, and I was slated to give the commencement address. Norman and I had both been looking forward to it. Now the occasion felt so weighted with emotion, I wasn’t sure I’d be able to speak. But standing at the podium next to the wide-open water, looking at this beautiful grandchild Norman Brinker and Maureen Connolly were kind enough to share with me, I felt nothing but joy and humble gratitude. I dedicated my remarks to her grandfather and did my best to let this girl know what extraordinary love and valor resided in her DNA.
Those two events were the fitting tribute Norman had earned, the fruit of his best and happiest years. I didn’t need to be part of his burial; I was part of his living legacy.
I
RECENTLY
found myself on
Meet the Press
, seated next to a physician I’ve known and respected for a long time, rehashing those controversial “Don’t bother with those inconvenient mammograms” recommendations issued by the U.S. Preventive Services Task Force in fall 2009. This was the physician who called breast self-examination a “search-and-destroy mission,” so I suppose they were expecting a good mud wrestling match. I brushed off my note cards and armed myself with the same truths and ideals with which I gird my loins every five years or so when a similar study makes similar statements for similar reasons and similar broadcasts seat me next to similar physicians for similar discussions.
Not my first time at the rodeo, nor my last, I’m sure.
We were collegial and polite as we squared off. The moderator chuckled and finessed us, hoping the gloves would come off and good television would ensue. But I’m not a gloves-off sort of guest. In fact, I’m not a gloves-on sort of guest. I don’t wear gloves unless it’s with a nice winter coat or on the back of a horse at full gallop. I’m not looking to box anyone’s ears. I know what I know, and I won’t back down, but I always hope to forge some common ground where we can plant a support and start building a bridge that will serve women in some way.
I started by pointing out that my life was saved by early detection, and my sister died without benefit of screening. Anecdotal evidence, but compelling nonetheless.
“Cancer is personal.
I get that,
” the physician said. She went on to make the valid point that we have to screen 1,900 women for ten years to reliably prevent one death. A lot of effort, some would say, for a relatively small return.
“But one out of 1,900,” I protested. “That’s a lot of women!”
The physician seated next to me bumped past that thought like a busy yellow school bus.
“This is about
science,
” she said.
I get that. But do the math.
In a town the size of Auburn, Maine, losing one woman out of 1,900 over ten years would be a little more than half a dozen women: the entire staff at Betty Lou’s Beauty Nook. In a city the size of Billings, Montana, that’s about two dozen women: all the altos and sopranos in a Full Gospel Church choir. In a metro area the size of Detroit, that’s about 1,500 women: all the mothers of all the fourth graders in a sizable school district. In New York State, it’s the Metropolitan Opera, filled to capacity from cheap seats to orchestra pit, including the fat lady singing.
Approximately 17 million people visit Disney World’s Magic Kingdom each year. One out of 1,900 would be 8,947 people over ten years. If “Pirates of the Caribbean” killed
75 people every month
, would anyone argue against implementing life-saving precautions?
One woman counts. One woman adds up.
The science of cancer is fascinating when applied to the enigma of cause and the intricacies of treatment. But the medical reality of breast cancer itself—the disease in its rawest form, advancing undetected until it can’t be denied, then advancing unimpeded until the death of its host—defies scientific thought. There’s no histology that can fixate sorrow. Human suffering can’t be mapped on a mammogram. Statistics that detail losses say nothing about loss.
Breast cancer unnamed is a spiritual death by isolation; breast cancer untreated takes a physically hideous course. But that’s just rhetoric until the one woman with breast cancer is you or someone you love.
Thank goodness, there are many physicians out there who get
that
.
Sitting across the table from Dr. Eric Winer, I can’t believe my good fortune. He’s brilliant and pleasant to listen to, a man of good humor and great integrity, dedicated to his precise and compassionate science and to his wife and children. They say a good man is hard to find. A good oncologist is even harder.
I first met Dr. Winer in 1995 at Duke; I was exploring Duke’s bone marrow transplant program, and he was an earnest young scientist. Eventually, he moved on to Dana Farber in Boston, and I ran into him
there half a dozen times over the years. As SGK grew, surpassing the billion-dollar mark for project funding, we decided we needed to put someone in charge of our scientific position. This person would advise me and other spokespersons on the official scientific stand of SGK, assist us in the grant-making process, and act as an interpreter between the scientists we sought to fund and the patients we sought to serve.
When we talked about assessing people, looking for what you need in a team member—or a team leader—Norman always said, “If you always agree, one of you is unnecessary.”
SGK offered the position to Dr. Eric Winer, but he turned it down.
“I don’t think you want a chief science officer,” he said, off to a good start on that disagreement thing. “You need a committee with a chair as adviser. And you want that person to be actively working in the field, rather than someone who’s left the field to work for you.”
We followed his recommendation, formed the SGK Scientific Advisory Board and asked him to chair. This time he accepted the offer. (Off to a good start on disagreeing only half the time.) I knew we could count on him to render a thoughtful, science-based opinion, not the SGK party line. Of course, this makes me want to shake him every once in a while, but only in those moments when I’m so damn tired, I just wish someone would tell me what I want to hear and not befuddle my righteous wrath with facts. Fortunately, Dr. Winer understands the need to deliver hard information with tact and good humor, another job skill you look for in a good oncologist.
“I view this organization as a large steamship,” he says. “When maneuvering a great ship, it’s important to move slowly and deliberately.”
I don’t know where he finds all the hours he requires each day, but Dr. Winer still sees patients, and more important, his patients see him. He insists that “mission” is too lofty a term for what he does, but will reluctantly concede “calling.”
“It’s the work I do. It’s a privilege to be able to do work that helps others and gives me a lot of gratification.”
Dr. Winer came to his calling early, and it was hard earned.
“I had a lot of exposure to medicine as a child. A kid with hemophilia—that meant I was chronically having bleeding into my joints. I missed a great deal of school and could not play sports or participate in most activities.
When I was eleven years old, treatments became available that made me essentially normal for the first time. I witnessed a revolution in the way we care for people with hemophilia and experienced a dramatic change in my own life. That really brought me into it and made me want to forge a practice where I’d have the opportunity for those close relationships.”
He considered pediatrics, but ultimately became fascinated with the chemistry of cancer—cellular, psychological, and emotional. Sitting across the table from him, I’m always energized by his blood-borne vitality and a weltanschauung I can only describe as
healthy
. Even with the complications he’s had to deal with, he looks at the complications that might have been, and he’s grateful.
“What drew me to oncology was really the incredible need I thought existed on the part of patients and the fact that so much progress might be made,” says Dr. Winer. “Most important, there’s that intimate, intense experience with patients. When you become someone’s cancer doctor, you enter their lives in an extraordinary way. People who go into oncology want to take care of people—take care of families—at a time when that’s very difficult, getting involved in the nitty gritty. But of course, some degree of emotional detachment, or perhaps emotional neutrality, is critical,” he adds. “Objectivity is paramount. Once you lose that objectivity, you just can’t make the best decisions.”
When the Preventive Services Task Force rolled out those controversial recommendations that seemed to fly in the face of everything we’d been telling women about the importance of yearly mammograms, there were some complaints that Susan G. Komen for the Cure was slow to respond—and I’m proud to say, we were. Rather than leap into the fray, our Scientific Advisory Board took a few days to wade through the panel’s recommendations and all the small print of their supporting documentation. A lot of people, including me, were surprised to find that there was really nothing groundbreaking or even particularly fresh about the research from which the task force had extrapolated their opinion, and nothing all that new about the opinion itself. They’d just innovated a new and extraordinarily ham-fisted way of talking about it.
I can’t speculate on their motivation, but the immediate effect was the heaving of an international sigh, women all over the world rolling
their eyes as if to say,
Make up your mind already
. Our switchboard lit up. E-mail flooded in. Women weren’t confused; they were angry.
Editorials editorialized and bloggers flogged away, all true to their agendas. Health care reform was the hot political topic at the moment, so those in favor of reform held up the recommendations and said, “You see? This is why we need reform!” and those opposed to it held up the recommendations and said, “You see? This is why reform is evil!”
As is always the case, the truth was in the quiet middle ground, where people like Dr. Eric Winer reside, and that voice of reason is our only hope of breaking the gridlock of resentment between people who could—and should—be working together toward the same goal.
“The thing they got most wrong,” Dr. Winer told me, “is the rollout. The rest is more complicated, but what we agree on is the technology gap. They’re saying mammography is inadequate, and they’re right. We’ve been looking at the same studies and coming to the same conclusion for years.”
“So let’s talk about improving mammography,” I said.
“Exactly.”
“Meanwhile, how do we get some spin control on it? I’m not suggesting we ignore the science when it doesn’t fit our talking points, but we can’t be naïve about what insurance providers are going to do with this. Whatever a woman decides to do with this information, it ought to be her choice.”
“Then say that,” said the good doctor.
The following week, I stood before the National Press Club, told the women of America our recommendations hadn’t changed, and reminded the insurance companies that the all-seeing eye of Susan G. Komen was upon them.
No matter where a woman is in this world, help is nearby—agonizingly close to her reach in many cases. What ends up separating her from her life and the people who love her is often a lack of knowledge, but more often, a lack of money. Awareness and access. It almost always comes down to these two issues, whether you’re talking about women in the United States who are stuck outside a broken health care system, women in developing nations who are deprived of education, or women everywhere who are marginalized by poverty and politics.
At the 2009 UN Economic and Social Council Summit, Secretary General Ban Ki-moon appealed to the citizens of a world in crisis. Everything goes south in an economy like this; funding stumbles, the food chain breaks down. He touched on “cancer and other noncommunicable diseases” in the context of global health. Translation: It’ll be a long time before this subject bubbles up through the immediate issues of food, clean water, and rampant communicable diseases. That year’s focus, however, was global health, and that felt like a handhold. Now something innovative was needed, something that would capture the public consciousness.
In October of 2009, we pinked the Pyramids.
We planned a week of groundbreaking, silence-shattering events in partnership with the Suzanne Mubarak Women’s International Peace Movement, the Breast Cancer Foundation of Egypt, and other organizations as deeply committed as we are to the health and well-being of women. There was an unfortunate tempest in the teapot a few days before we arrived; two Israeli attendees were told—quite incorrectly—that they were no longer welcome to attend. That morphed into false reports that we’d slammed the door in the face of the Israelis. The blogosphere was abuzz with misinformation, calls for boycott, howling for my head on a platter, but those of us on the ground (and occasionally on camels) remained focused on our common purpose.
“Who’s the purse?” my Man Friday, John Pearson, always asks when we arrive at whatever far-flung airfield we’re landing on. If no one else volunteers, he shoulders the large pink bag I schlep around wherever I go. I have no idea what all is in it, but I’m fairly certain I could perform an appendectomy if called upon. Someone else usually has to carry the purse because I still have trouble with my arm from that damned old lymphedema after my mastectomy. It’s a good metaphor for how I do what I do. Over the course of a lifetime, I’ve amassed my proud pink toolkit. It’s portable, versatile, and I depend on strong, smart people to help me wield it.
The moment we heard about the misinformation circulating, we pulled everything we had out of the diplomatic bag, clarified facts, and made sure everyone understood that no one would be excluded from this event. Sadly, the Israelis opted not to attend, but they remain our allies as we move forward in the region. We supported their important clinical
research and community programs prior to this misunderstanding, and we continue to support them now. I was scheduled to visit Israel the following week to discuss plans for a major international think tank and our first Israel SGK Race for the Cure. My travel plans didn’t change and at this writing, I’m very much looking forward to those events. Did I win the heart of the blogger who said I was Adolf Eichmann’s lap dancer? Probably not. Hopefully, he’s moved on to how the moon landing never happened. We can’t be distracted by misinformed chatter or by political differences that don’t involve us.
The week-long series of events in Egypt brought together physicians, advocates, scientists, and survivors from all over the Middle East and northern Africa. The Great Pyramids at Giza were illuminated in pink light, and the following morning, walkers and runners gathered for the first Egyptian SGK Race for the Cure.
