As always, the shaded lawn out front is dotted with unwashed, laid back, mostly bearded men, gathered together in loose cirlces, talking and playing music with each other. Like ornaments on these chains of humans, their dogs and bicycles tumble out around them, bright with life and color in the dark green grass. The bikes are bungee-bundled high with extra clothes and blankets. It gets cold here at night.
As always, the gallery at the north entrance is filled with local art on display. Today's eclectic collection is all samples from the current Open Studios tour. For two weekends every October, local artists invite the public into their production spaces and sometimes their homes. I'm planning to go on Saturday morning with guy named Peter who just moved here from Cayucos. I introduced myself to him yesterday, hoping to make some new friends here in Colorado. I was shocked to learn he hails from the beach-town less than ten miles from my own.
As always, all the desks and study carrols with a view are taken already. I end up working at a small purple table next to a blank white wall and too close to the noise of the Bridge Cafe. The guy working at the counter seems like a mentally well-developed adult so I don't understand why he keeps shouting across the room to the manager. Does she really need to know RIGHT NOW that a cucumber has gone bad? Do the rest of us EVER need to know?
The library recognizes me too. They gave me a fresh card even though my driver's license says California and I don't have any officially current local residence. The have me in the system as "Magic," which means I've been coming here since I was twenty-one and hadn't yet legally changed my name to "Mage." Maybe they were lax on the proof of address requirement because my loyal patronage goes back 15 years. Or, maybe they just gave me the card so I would pay the $32.50 I owed them in late fees.
I have come here to meet the reference librarians. I plan to enlist them in my project of becoming a well-paid and sought-after freelance magazine journalist. I want my narrative accounts to be studded with well-reasearched background information. I want facts and figures to provide context and cohesion to the drama and hilarity of my personal experiences. I want my own insights to fit elegantly within the larger body of public knowledge. I can't make any of this come true if I don't get better at doing research. I'm hoping they can teach me how.
This is how I do research now.
1. I type a question into the google search engine.
"Do Breast Self Exams help detect cancer earlier? "
2. I read the long list of headlines that google thinks apply to my problem:
Breast Self-Exams: Don't Let the News Confuse You
Breast Self-Exams don't help. Or do they?
Breast Self-Exams Do Not Appear to Reduce Breast Cancer Deaths
Information Sheet Breast Self Exam (Awareness)
Breast Self-Examination
Breast Self -Examination Yahoo! Health
Detecting Breast Cancer Early: Doctors Catch Cancer Earlier with...
Planned Parenthood Breast Exam
Self-Exams of Breast Questioned- Chicagotribune.com
Reader's Digest Canada-Breast Cancer Breast Cancer Screening
Lab Notes: Breast Self Exam: Don't Count on it
Breast Self-Exam in Too Valuable to Discard
Protect and Detect: What women should know about Cancer
New wasy to detect breast cancer or the stage earlier
3. I feel a little overwhelmed, wondering which one is going to answer my question, and wondering how long it would take if i clicked on all of them.
4. I realize that this is only page one of an endless number of pages listing the available results. Suddenly, I am completely overwhelmed, so I just click on the first one.
5. I read the article and glean some good quotes.
The monthly breast self-exam (or BSE) has been in the cross hairs for a while. The American Cancer Society's screening recommendations made it optional in 2003.
There's no evidence that monthly self-exams reduce breast cancer deaths.
There's a distinction, as fine as it may seem, between what longtime breast self-exam critic Susan Love calls "the formal, high church breast exam" and simply being familiar with your own body. The normal poking around that women (or their partners) do is good enough, says Love.
The studies included in the latest review can't tell us why a formal BSE program doesn't work.
6. I try to make sense of the quotes and come up with more questions that I had already.
Before 2003, what did the American Cancer Society have to say about BSE's, and why did they change their minds?
Is reducing breast cancer related deaths the only goal of BSE's? What study is this information from and how was it designed? How long were these women followed? What other results were they measuring for? What was the control population doing?
What's a "formal, high-church breast exam?" How many suspicious lumps are found by partners rather than by women themselves. Do sexually inactive women find lumps later than sexually active women? What are the consequences of finding lumps later?
What studies where included in the "latest reveiw?" The lastest review of WHAT? By WHOM?
7. Frustrated and confused, I start poking around in the margins of the article. I find a link to a video explaining how to do a proper BSE.
http://link.brightcove.com/services/link/bcpid1274008720/bclid196251067/bctid196215070
8. I start to watch it, but I get bored. So, I click on another link called "What is Breast Cancer?"
http://link.brightcove.com/services/link/bcpid1274008720/bclid196214856/bctid44147265
9. I get totally pissed off at the speaker, Pat Murphy Stark. I know it doesn't make sense to get angry at her, she didn't write the words. But she is the one saying them and I don't like what she's saying. She introduces the video by saying:
"Because body image issues weigh so heavily on women, it makes sense that the illness many women fear the most is the one that targets the most obvious sign of femininity, the breasts."
Excuse me!? I guess this plays some part in the complexity of our emotional response to breast cancer, but the real reason I was scared when I had breast cancer was:
IT CAN KILL YOU.
After the sexual self-image psychobabble, she goes on to explain that "two hundred thousand american women will be diagnosed with breast cancer this year. This means about 1 in 8 women will be told they have breast cancer at some point in their life."
First, this inference and the way she's presenting it is statistically sloppy. Second, here's another reason why we might be a little freaked out about breast cancer OTHER than our body image issues. It's unbelievably common. What else do we have a 1 in 8 chance of in our lifetime?
10. I ask google and find out that, according to Will Fairbrother (what a great name!), assistant professor of biology at Brown University, if McCain gets elected, there is a 1 in 8 chance that Sarah Palin will succeed to the presidency.
That scares me more than breast cancer. It scares me so bad that I give up researching and go buy a huge oatmeal raisin cookie from the guy who has, thankfully, stopped yelling about bad cucumbers.
3 comments:
Awesome 1 in 8 comparison.
I am posting that on my Blog. With link of course!
Well, according to a large, worth considering study, the BSEs don't make us live any longer than a woman who finds her cancer through a mammo or her health care provider. What wasn't asked about in that study, however, is quality of life. It's like this: "Sure I may not live any longer, but perhaps if I find my own cancer 4 months earlier than I would have had it been found at my annual exam, then maybe I can conserve a breast, or skip the chemo or radiation."
As for 1:8, we need to live to 90 to see those odds. Heart disease is more likely (statistically) to kill any person in the US reading this comment right now- than breast cancer.
Why am I saying all this on my dear friend's "breast cancer blog?" Because I tell my patients this info. Because women feel guilty about not checking their breasts. Because eating a low fat, high veggie diet and getting regular exercise is the best thing we can do to protect ourselves from cancer, and the #1 killer, heart disease. Because my patients look at me funny when I tell them it can feel good to check your breasts, but they think I'm being a good midwife when I tell them eating well and exercising feel good.
We don't have any control, just the ability to do the best we can.
Here's a little breast screening post http://callmezari.blogspot.com/2008/05/friday-and-little-bit-about-breasts.html
THANK YOU KIM! I was secretly hoping you might weigh in with some clarification on this issue.
You rock.
xxxooo
M
P.S. Happy Birthday!
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