Shirley Temple Black, that cherubic child star of the thirties, died last year, but did you know that she was a very public face of advocacy for better breast cancer care for women? In the end-of-year issue memorializing those who died in 2014, the New York Times Magazine ran a story on Temple Black that had nothing to do with tap dancing and singing. In 1972 she discovered a suspicious lump in her breast, and refused the usual protocol of care. As the author of the piece, Peggy Orenstein notes,
In those days, a woman with a suspicious mass was typically rushed into surgery for what she was told would be a biopsy. If a preliminary pathology revealed cancer, though, the doctor would just keep on cutting while his patient remained unconscious. Instead of the assumed minor operation, she would awaken having undergone a mastectomy. And not just a mastectomy, but radical surgery in which the underlying muscles of the chest wall were stripped along with the breast. That so-called one-step procedure, which combined biopsy with treatment, was thought to be potentially lifesaving for patients and, equally important, was convenient for doctors. If the on-the-spot read later proved incorrect, as it sometimes did, the presumption was that the patient would simply be grateful that she didn’t have cancer.
Today, we would find that kind of care barbaric and paternalistic. While today’s breast cancer medical protocol of “cut, poison, and burn” can be brutal, the surgery involved has become less radical and women are generally given informed choices at every stage of their treatment. (The choices still aren’t great and more research is needed to prevent breast cancer in the first place.) But the progress that has been made is because of the bravery and advocacy of women like Shirley Temple Black. The year she was diagnosed, she wrote powerfully in defense of patient rights in an essay in McCall’s Magazine:
I find intellectually distasteful the prospect of waking up and finding that someone else had made a decision and taken action in which I, lying quite inert on the operating table, had had no voice.
In the essay, she broke another barrier by mentioning the socially unmentionable: her grief over the removal of a breast. At a time when cancer was “the big C” and spoken of only in hushed tones, especially cancer of reproductive or sexual parts of the body, she publically acknowledged that what happened to her was “an amputation,” giving voice to so many women’s unspoken experiences.
The medical establishment didn’t respond well to her bucking the system. The American Cancer Society criticized her for questioning and going against her doctors’ orders. Her very public act of defiance was an important step in changing the role of doctors in health care. The god-like pedestal they had been placed on didn’t produce the best care, and didn’t respect the needs and preferences of the patient. For America’s Sweetheart to insist on respect and participation in the decision-making process about her cancer treatment was a significant contribution to the development of patients’ rights of informed consent and involvement in their care. Thank you, Shirley!