it comes into contact with the air (which it doesn't while still in the vagina).

To make the stakes even higher, in 1972 the National Association of Broadcasters lifted its ban on TV advertising of menstrual products. Women were inundated with shrouded messages of vaginal odors and tampon "bypass" (what the tampon industry calls menstrual leakage). So brainwashed were we that women began using tampons between their periods to guard against "unpleasant" secretions and odors.

One of the most interesting stories Friedman unfolds is that of Proctor & Gamble's Rely tampon. Proctor & Gamble, makers of such products as Crest, Tide and Ivory, was the first manufacturing giant to enter the tampon industry. It began to testmarket Rely in 1974 but only started distributing it nationally in 1980. Rely's distinguishing features included a unique construction that allowed the tampon to expand to two or three times its original size and a plastic "petal construction" applicator. Proctor & Gamble spent $10 million in 1980 to distribute free tampons to 80 percent of U.S. households, and Rely quickly became the nation's third best seller.

This onslaught of change for change's sake brought with it some serious, but for a time ignored, consequences. Women began to complain that their tampons caused itching and burning and broke apart in their vaginas. Many of these complaints were leveled at Rely. Most vocal were women's self-help groups which in the mid-1970's began seriously to question tampon safety, especially the deodorant variety. When they demanded to know the tampons contents, manufacturers refused, claiming it was proprietary information. Rumors began to fly, for example, that tampons contained asbestos (which has never been proven). But without the cooperation of the manufacturers and the attention of the medical establishment, there was little anyone could do.

It was only when doctors started to see patients with actual tampon damage that womer began to be 'heard. In 1977, the American Journal of Obstetrics and Gynecology published a report of four cases of "tampon-induced vaginal or cervical ulcerations" in women who used tampons throughout the month. A 1979 study reported a case of a serious hemorrhage caused by a plastic applicator. In 1980 two reports appeared linking pathological changes in vaginal mucosa to superabsorbent tampons, a condition that could only be detected by a physician or the woman herself through self-exam. It was not definitively established that tampons were the cause, but in each case the condition cleared up when tampon usage was discontinued.

Interest in tampon usage was heightened in July of 1980 when the mainstream press picked up the story of Toxic Shock Syndrome. Friedman traces the history of TSS from its identification by a Denver pediatrician in 1978 through the debate over its link to tampons and the government's and manufacturers' response. She concludes that even though the link is unclear and the incidence of TSS small (estimates range from .003 to .015 percent of tampon users), the publicity has not been merely sensational:

It's made women more aware that they knew little about what had been a generally accepted, widely used product. It's drawn public attention to the question of how tampons are tested, manufactured, marketed, and regulated. And it has stimulated the medical community to continue looking into the relationship between tampons and illness and injury.

The crucial question of how tampons are tested, manufactured, marketed, and regulated is probably the most frustrating. The government has been ineffective as a watchdog for the industry, and manufacturers are reluctant to reveal any information about testing procedures, manufacturing processes, and contents of their products. (Johnson & Johnson, for example, would not even release the name of the (continued on page 10)

Breast Cancer: Fear and Hope

The Cancer Journals, by Audre Lorde. Spinsters, Ink (RD 1, Argyle, NY 12809), 1980. 77 pages, $4. Available through Coventry Books.

By Carol Epstein

>

I am 46 years living today and very pleased to be alive, very glad and very happy. Fear and pain and despair do not disappear. They only become slowly less and less important. Although sometimes I still long for a simple orderly life with a hunger sharp as that sudden vegetarian hunger for meat.

-Audre Lorde

2/18/80

As a nurse I've tended to the needs of those who have suffered through the last stages of terminal cancer. I've never "gotten used to" the impact this time has on a person's feelings. Not only does a person have a malignancy; the cancer is also said to have metastasized (the process by which cancerous cells spread throughout a body system via the blood stream or lymphatics, and harbor in other organs). Such a change produces an emotional response in everyone concerned. We switch gears, suddenly realizing the imminence of death.

Anything short of metastasis, then, always seems like a victory, a triumph in the sense that, compared with the inevitable end to which metastasis leads, the eradication of a cancerous growth in a single organ appears to be a blessing. The Cancer Journals, however, forces me to re-focus on the complex condition of loss and survival which confronts someone in the vague middle zone-a time when one only knows that cancer exists and when the future idles in suspense. In this case, a woman learns she has a malignant breast tumor and chooses to have a mastectomy..

Audre Lorde approaches her experience from a holistic perspective, explaining that each woman "responds to the crisis that breast cancer brings to her life out of a whole pattern, which is the design of who she is and how her life has been lived. The weave of her everyday existence is the training ground for how she handles crisis." As a black, lesbian, feminist poet, Lorde also understands that she must make sense of this time not only by living through it, but by translating her experience into creative activity. She believes in the power of words as symbols. She knows the importance of transforming silence into selfrevelation. In spite of her commitment to the value of language, Lorde found it frightening to begin speaking about her experience.

Breast cancer differs from the loss of an organ or limb, however devastating such a loss may be, because in our society breasts are so often objectified and examined with scrutiny. As women we have a variety of feelings about our breasts: they may be treasured, rejected, taken for granted, rated by size and symmetry, or seen as a vehicle for communicating love or denial. In spite of how a woman privately perceives herself, her anger, fear and pain about breast cancer in the context of sexism can easily "fossilize in yet another silence...that imposed silence about any area of our lives is a tool for separation and powerlessness." The core of The Cancer Journals lies in Lorde's recognition of how particularly difficult it is for a woman to achieve meaning from her crisis: "I want to illuminate the implications of breast cancer for me, and the threats to self-revelation that are so quickly aligned against any woman who seeks to explore those questions, those answers. Even in the face of our own deaths and dignity, we are not allowed to define our needs nor our feelings nor our lives' d

Lorde begins her journal with the "inside pieces," the very personal responses she experiences, coupled with a most universal human tendency, "a reluctance.

to deal with myself...a reluctance to living or reliving, giving life or new life to that pain." As the journal grows, Lorde's private world enlarges. Making use of a feminist dialectic, she moves back and forth from the personal voice to that which is outside. herself-sister-friends and lovers, the hospital staff, institutions in the larger society such as Reach for Recovery, the American Cancer Society, and finally the racist-sexist dominant culture in general. Some external forces such as her women friends encouraged her to face her crisis in order to derive meaning from it; others threatened to "program" her responses into superficial reactions which only serve to bury feelings in confusion and despair. This final synthesis brings to The Cancer Journals a completeness that strengthens and sustains the personal voice, placing it within a politically feminist framework.

Three days after her operation, a woman representative from Reach for Recovery visited Lorde, delivering a "very upbeat message" as well as a soft sleep bra and lambswool that was pressed into a pale pink heart-shaped pad: "Her niessage was, you are just as good as you were before because you can look exactly the same. But what she said was, 'You'll never know the difference,' and she lost me right there, because I knew sure as hell I'd know the difference."

Lorde tries very hard to understand the plight of post-mastectomy women who must face the pressure to conform and the "loneliness of difference" that arises when the choice of wearing a prosthesis is posed: "There is a commonality of isolation and painful reassessment which is shared by all women with breast cancer, whether this commonality is recognized or not. It is not my intention to judge the woman who has chosen the path of prosthesis, of silence and invisibility, the woman who wishes to be 'the same as before.' She has survived on another kind of courage, and she is not alone...." More importantly, Lorde strongly protests our society's emphasis of physical pretense at the expense of any examination of what a mastectomy means and how it can be integrated in the totality of a woman's life: “I am talking here about the need for every woman to live a considered life....Any short-circuiting of this quest for self-definition and power, however wellmeaning and under whatever guise, must be seen as damaging, for it keeps the post-mastectomy woman in a position of perpetual and secret insufficiency, infantilized and dependent for her identity upon an external definition by appearance....In addition, we withhold that visibility and support from one another which is such an aid to perspective and selfacceptance. Surrounded by other women day by day, all of whom appear to have two breasts, it is very difficult to remember that I AM NOT ALONE.” [Lorde's italics]

We know now that early detection of breast tumors, most often found by women in their monthly self-examination, does not reduce the incidence of breast cancer but does reduce the rate of mortality from it. Perhaps if we became accustomed to seeing one-breasted women in our daily lives, be it among friends, in commercial and in educational ads, in the choice of sewing patterns and clothing, we would also remember the importance of that monthly examination. In American women, the highest incidence of breast cancer occurs between the ages of 40 and 55. Of women diagnosed with breast cancer, only 50 percent are alive after three years and according to the American Cancer Society's statistics (in Lorde's words), the figure "drops to 30 percent if you are poor, Black, or in any other way part of the underside of this society." Lorde insists that we must become free enough from our stereotypes of normali-

(continued on page 11)

July-August, 1981/What She Wants/Page 7