I often wonder how so many women out there manage to face health decisions and catastrophes with courage, independently of how varied their circumstances. Making life and death decisions around illness or reproductive choices in itself is hard enough – if you add to that a hostile environment, economic factors like lack of employment or risk to employment, no health insurance, family needs etc., it can become an overwhelming task.

I was reminded of that by two pieces I read this weekend, marveling at the courage around us. One was an article by a young Health Care reporter at Politico, Alexandra Glorioso, whose last name is an apt description for her candor in speaking about her breast cancer diagnosis at age 31. The candor is glorious. We live in a time when the enforced silence that even only two generations earlier had to endure, is no longer an issue. If anything, there is such a flood of testimonials about going through cancer (of all kinds) and living with disease, that interest has been saturated. Or in any case devoted to hearing the success stories, not the fact that 42.200 women each year in this country still die from breast cancer.

Among this deluge, Glorioso stands out for her willingness to admit to all of the factors driving her choices about treatment and how to deal with the effects of treatment, less heroic ones like vanity included. And how can you not feel for a 30-year old dealing with issues of threats to fertility and artificially induced menopause (potentially reversible) so that the cancer can be fought without estrogen feeding it. Yet this young woman also has a support structure that is phenomenally helpful – beginning with a scientist father who knows all the right experts, to a fresh boyfriend who soon becomes a fiancee, to a health insurance that covers, if not all, then seemingly a lot of the procedures and medications. She thrives on the solidarity between strangers on the web-wide “cancer club,” who add succor and practical help with their electronic interactions.

I was moved, but it was nothing in comparison to the other piece on my desk, a book review of poet Anne Boyer’s new book The Undying. The very first paragraph had me jump up and call a book order in at my local bookstore:

The pink ribbon, that ubiquitous emblem of breast cancer awareness, has long been an object of controversy and derision, but the poet and essayist Anne Boyer doesn’t just pull it loose, unfastening its dainty loop; she feeds it through a shredder and lights it on fire, incinerating its remains. “The world is blood pink with respectability politics,” she writes, “as if anyone who dies from breast cancer has died of a bad attitude or eating a sausage or not trusting the word of a junior oncologist.”

Boyer, a single mom in precarious employment circumstances as a teacher, also still young when diagnosed at age 41, has an unusually lethal type of breast cancer that now, 5 years and many extraordinary debilitating treatments later, seems to be absent. From what I gather from the reviews (and here is another one by Sarah Resnick that is intellectually richer and putting the memoir within a larger framework of society’s interaction with cancer,) the book is only partially about the author’s experience on the medical front. Instead it deals with how the world reacts if you disclose the anguish, the fear, the exhaustion, the pain and the losses not within a narrative of heroic survival, sticking to your on personal war story. As Resnick notes:

To linger in the grammar of pain or anger or sorrow, in the bleak syntax of one’s illness, risks summoning “a chorus of people, many of whom have never had cancer, accusing her of ingratitude, saying she is lucky, warning her that her bad attitude might kill her, reminding her she could be dead.” These impositions, Boyer explains, arrive as diktats from a new boss: “the boss that is everyone.” “Self-manage,” they cry from their open-plan workspace. Avoid speaking of death, practice meditation, do yoga. Take care of others. Summon your inner warrior. Smile. Fight! This new boss is doing the bidding of our unjust and unhinged economic system (“white supremacist capitalist patriarchy”): If the onus of responsibility—for recovery, for health, for well-being—falls on the person who is sick, the rest of the world gets a pass, is not accountable for whether a person lives or dies, and if she lives, in what state…..Breast cancer, Boyer insists, cannot be understood as an ahistorical sameness, an uncontrolled division of abnormal cells. It is, rather, a socially and historically constructed nebula, and the women who have it do not suffer from the illness alone. They suffer from the world.

A world, we might add, that faces ever increasing attacks on our ability to stay healthy and avoid carcinogenic exposure: this week we learned about new EPA restrictions on using science to draft and monitor health regulations. Let’s breathe poisonous air, drink poisonous water, have the kids be exposed to lead – as long as industrial profits are not endangered….

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Why was I so much more receptive to the issues raised within the book review than the Politico essay? Partly from admiration for the harder fate of the poet, facing much more radical treatment, who might leave an orphan behind if things didn’t work out, who had to do all this without the network of supporters. More likely, though, because I always thrive on reading about the larger picture – not purely the human interest story, no matter how much I can relate to it, but the anchoring within the system, the world that surrounds us, whose parameters affect us all. Again, the red thread of this week, receptivity to information is so much defined by what is already there. Which leaves me wondering, what kind of information is not getting through to me when it should, caught in the net of preconceived notions or habits.

As William Congreve once said: music can tame the savage breast. It can also tame the sorrow over the absent breast. This is particularly true for music written by someone unwell himself, in this case Beethoven who suffered severely from Inflammatory Bowel Disease and after a bout wrote a string quartet (Opus 132) in 1825 with one movement titled: “Song of thanksgiving to God for recovery from an illness, in the Lydian mode.” It washes over you with anguish and joy, echoing the everlasting longing for recovery.

Photographs today ignore pink ribbons and instead offer multitudes of silvery slivers of hope.