How Cancer Crossed the Color Line

Wailoo (The Troubled Dream of Genetic Medicine) uses breast cancer as a prism to look at how gender, race, and economic class not only determines the availability of medical treatment but also the way disease is defined. Referencing literary and medical sources, he shows how views of cancer have changed over the course of a century; statistics from the 1920s, for instance, showed that affluent white women had the highest mortality rate from cancer, having moved from ninth place at the beginning of the century, to sixth. One explanation given at the time was a "growing female political and economic independence" that allowed them to have fewer children and to bottle feed rather than nurse them. By contrast, blacks were considered to be leading a more natural, "primitive" existence believed at the time to be free of the "stresses of modern life" and intrinsically healthier. Urbanization and the Civil Rights movement introduced reforms like Medicare and Medicaid, opening treatment to the poor; the statistical gap has steadily decreased since. Wailoo also explores the transformation of the paternalistic doctor/patient relationship from the 1920s–when doctors routinely lied to patients with fatal ailments–to the present. A nuanced study of a complex subject. (Feb.)