Tuesday, March 14, 2006


Language matters to me.

A lot.

Which is why I chafe at the way certain words are used. And why I have a shelf full of usage books sitting just over my left shoulder.

Here is my favorite entry from The New York Public Library Writer's Guide to Style and Usage, from the chapter called "Misused and Easily Confused Words":
impact, influence. All but the most punctilious of grammarians have given up the fight over the use of impact as a verb synonymous with "to influence or have an effect on." However, a caveat: editors and readers who hate to see impact used this way really, really hate it. . . ."
I am very punctilious.

I have not given up the fight.

I really, really hate it when I see "impact" used as a verb.

But I digress.

I also continue to be bugged by the term "breast cancer survivor."

Let me digress again.

Below is an essay I wrote about three years ago. It'll give you some sense of why "breast cancer survivor" bugs me. And a further sense of my punctiliousness. (It also happens to be the only piece I ever tried to get published. It was rejected by the New York Times Magazine—I submitted it to the "Lives" column—in less than 12 hours, which I think must be some kind of record.)

I have no illusions about supplanting the term "breast cancer survivor" in everyday usage—it's way too entrenched. (You might think I should give up the ghost with "impact," too, but that's just not going to happen.) But I kept thinking for the past five years that there might be an alternative out there. And just the other day, I finally came up with one: breast cancer veteran.

The good old Oxford American defines veteran as "a person who has had long experience in a particular field." (The military definition is secondary.) "Long experience" is in the eye of the beholder, but I have to say that in this particular realm, I think any experience qualifies.

So I'll be calling myself a breast cancer veteran from now on.

I feel much better.

Words Failed Me

Once someone in a white lab coat uses “you” and “cancer” in the same sentence, it’s not hard to predict the spectrum of unpleasant physical and emotional experiences you’ll have. Shock, fear, anxiety, pain, weakness, discomfort—these are all to be expected. But when I was diagnosed nearly three years ago, I had no idea that cancer would pose such a linguistic challenge.

Those who know me are well acquainted with my penchant for precision and accuracy in language. I can’t help but interrupt friends who unwittingly use “irregardless,” “a whole nother,” or any of a long laundry list of other malapropisms that my sensitive ears just can’t bear. My husband knows that any time we watch TV he can count on me to shout at the screen, correcting a character’s or news anchor’s grammar. I write letters to the editor when favorite publications commit what I consider to be egregious errors: using “women” as an adjective or “impact” as a verb.

During my bout with breast cancer, however, there was no editor to whom I could complain when I tried to describe my situation and found myself tongue-tied. I had a serious disease, but saying I was sick didn’t seem right. Like many cancer patients, I felt absolutely fine until the actual treatment began—no pain, no symptoms, just a really unfortunate lab result.

And if having breast cancer was tantamount to being ill, I’d been sick for all the time it took that first cancer cell to spawn a detectable colony of offspring—up to ten years, by some estimates. Did that mean I’d been sick on my wedding day, eight years earlier? At my law school graduation? At my last college reunion? I kept thinking of the proverbial tree falling in the forest. If I’d had cancer all these years but didn’t know it, had I really been sick?

If it was difficult to figure out when I first got “sick,” it was even harder to determine when I got “well.” I yearned to use the past tense with cancer, but I couldn’t figure out when it would be legitimate to do so. It wasn’t like my teenage years, when the transitions were obvious:

“I had braces.”

“I was a virgin.”

When would I graduate from “I have cancer” to “I had cancer?” This wasn’t just semantics: I needed to know when would I be able to get on with my life. When could I go back to answering “How are you doing?” with “Fine, thanks—and you?” instead of rattling off my white blood cell count or the number of chemotherapy or radiation sessions I had left? When would everything stop having a medical connotation?

My surgeon had an optimistic approach: presume the surgery was a complete success and all of the cancerous tissue had been removed. By her logic, I could start using the past tense just two weeks after my initial diagnosis—less time than a bout with mono. Another doctor drew the line nine months later, after I’d completed chemo and radiation. In the end, I took his approach: no matter how favorable things might have been at the cellular level, any stranger on the street could see that something was wrong. Bald may be beautiful, but on me it was a dead giveaway.

For months and months after I had finished treatment, I resisted saying, “I’m a breast cancer survivor.” The word “survivor” is just too loaded for me. As a Jew, I associate the term first and foremost with the Holocaust, and I couldn’t compare my plight with those who had lived through the horrors of that time. Of course, “Survivor,” the reality television show, is now part of the vernacular. When I was diagnosed, the show was sweeping the nation, and any use of the term conjured images of scantily clad contestants trying to win “immunity” and avoid getting voted off the island. If cancer were an island, I would have done anything to get off.

The term “survivor” also seems more suited to events that have a definite beginning and end, like high school or a really bad date. While I hope that I have survived cancer, it’s honestly just too soon to say. Are those rogue cells dead or merely dormant? Will cancer be part of my future, as well as my past? How ironic that only those who survive me will know if I was a true cancer survivor: if I die of something else someday, I guess I’ll have earned the title.

Family members, friends, colleagues, and even acquaintances can’t help but ask if I’m okay now. It’s the hardest question to answer, because I can’t bring myself to give them what I know they want to hear: an unequivocal “yes.” One could argue that it’s a legitimate response—my treatment was successful, by all accounts—but I just can’t manage it. So when someone asks if I’m okay now, I always say the same thing: “As far as we know.” It’s the most precise answer I can give.


Anonymous Christine said...

I can't wait til "As far as we know" extends much farther...both personally for you-- and medically for the rest of humanity.


ps-Hello Essay! Well Done! They are such losers for not publishing you!!

March 15, 2006 11:47 AM  
Anonymous Anonymous said...

I second Christine! Perhaps you should submit it to William Safire, if only to get the pleasure of him paraphrasing you if intrigued (and who wouldn't be!) by your essay...


March 15, 2006 6:14 PM  
Anonymous T said...

Actually, I can see why they didn't publish it: it's too erudite. Guess they figured their typical 8th-grade-educated audience wouldn't get it.

But I loved it. And also: it's fascinating to me to see the changes in your writing style between then and now. Many of the essays you've written for this blog show how much you learned in your first semester at Columbia. Yes, 3 years ago was good, but I notice the refinement since then. It's great!

Also, thanks for explaining the "impact" that the phrase "cancer survivor" has had on you. Something I never would have even considered, so thanks for enlightening me.


March 16, 2006 10:53 AM  
Anonymous Anonymous said...

I have a friend who had a precancerous tumor growth in her breast for years. When she was in her 60s her doctor advised her to have a lobectomy. The chances of the growth developing into cancer were apparently very small. However, due to her martyr like tendencies and need for attention she demanded bilateral mastectomy. She would not have required any treatments if she had the lobectomy. Now, four years later, I am pretty sure that half of the world knows that she is a cancer survivor because she does not stop claiming to be one. Her two sons are doctors and both agree she just wanted attention. So my question to you is....is she a cancer survivor or merely wants to be one?

December 3, 2007 9:12 AM  

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