I had no choice. When I was diagnosed with stage III breast cancer, my course of action was already in place. Chemotherapy, surgery, radiation. I chose my doctors and I chose my wig, but other than that I did exactly what traditional medicine prescribed.
Jessica Queller had too many choices. In her compelling memoir, "Pretty Is What Changes," she does not have cancer. She is young and healthy, with a fabulous career and a full life. All she's missing is the man of her dreams, the one with whom she'd eventually have children. But she is smart, pretty and she has a beautiful body; the man will surely come. Then her mother dies of ovarian cancer after surviving breast cancer. Doctors tell Queller that her mother most likely had the "breast cancer gene," the BRCA genetic mutation, and that she has a 50% chance of also having it. As the book begins, Queller has made her first choice: to have the test. It comes back positive.
Having the BRCA1 gene meant Queller had an 87% chance of developing breast cancer and faced three new choices: ignore it -- surprisingly, women do; practice extreme vigilance, with frequent checkups, mammograms and other tests, and the constant worry that every twinge is cancer; have a prophylactic double mastectomy. Surgery reduces the odds of getting breast cancer to 10% but at a very large price for a disease that may never appear.
I read this book in one sitting. The descriptions of her mother's treatments and their side effects were particularly hard -- I found myself back in Cancerland, a place I thought I had left. And Queller got them exactly right. She is an accomplished TV writer and producer, including for "The Gilmore Girls." I expected more jokes, more snappy patter and witty repartee a la Lorelai and Rory Gilmore, but for most people, cancer is not a humorous topic. On the other hand, I was tempted to skim the long passages about her parents' histories, their meeting and first apartment, as well as Queller's personal anecdotes about her dates, her writers' meetings, and her friends -- even when those friends were Calista Flockhart and Cokie Roberts' daughter-in-law.
Queller spends most of the book giving us the back story leading to her decision. We see a lot of her day-to-day life, but frankly her life -- privileged and busy as it is -- is not that interesting. The conversations with her sister, her friends, even the various cancer patients she finds, begin to be redundant. I was growing impatient. I was 99% sure she would have the surgery -- why else write the book? -- but I wanted to see the moment that decision became clear and, even more, what happened afterward.
