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Impossible Choices

Christina Applegate has confronted breast cancer with admirable courage, and has brought some of the details of her struggle into the public eye.  For people who are dealing with this illness, or know someone who is, I'd also recommend Pretty Is What Changes:  Impossible Choices, The Breast Cancer Gene, and How I Defied My Destiny, Jessica Queller's poignant and--improbably--funny account of her own ultimately successful battle against cancer-prone genes. 

The author is a successful and, yes, pretty television writer who, according to her website, 

...At age 34, while writing on Gilmore Girls...tested positive for a BRCA genetic mutation, otherwise known as The Breast Cancer Gene. The test gave her up to an 87% chance of developing breast cancer and up to a 44% chance of ovarian cancer. Jessica’s mother had suffered from both diseases and ultimately died of ovarian cancer.

Queller's Scylla-and-Charybdis choice is whether to undergo preventative surgery--a double mastectomy--in order to avoid suffering the same fate as her mother.  Still youthful, healthy and unattached, should she subject herself to such a radical and irrevocable procedure?  

That she ultimately decides in favor of surgery is not the point so much as her eloquent account of the dilemma itself.  We can now crystal-ball a host of genes like BRCA (Applegate has the same mutation).  Expectant parents are presented with an all-you-can-eat buffet of pre-natal testing options.  Huge personal and ethical questions follow hard upon this kind of scientific prognostication.  

When my wife was pregnant with our first child, she was given a blood test and told that our unborn child had a one-in-eighteen chance of having Down's Syndrome.  A genetic counselor (a distinctly 21st-century job title) spoke to us; more testing was offered; a hushed, comforting demeanor was observed.  In the event, we opted not to test further; a few months later, Kate was born syndrome-free, and all was well.  

Ours was nothing compared to the choice presented to Applegate and Queller; still, I imagine that more and more of us will be forced to make this kind of judgment call at some point in our lives, as someone in a white coat slides a sheet of estimates and percentages to us across a desk and says, in a practiced, professional tone, "You decide."  

 

 

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