A 19th Century Mastectomy

Angelina Jolie’s recent brave decision to go ahead with a pre-emptive double mastectomy and her frank publication, calls to mind another brave decision made more than two hundred years ago.

Having to make life-changing decisions while you’re reeling from shock at a diagnosis is incredibly difficult. The physician sets before you the type and degree of aggression of your cancer, a five year percentage survival rate for each of the possible treatments and says, “You choose.”

It is not always as stark as that, but it can be. Ultimately, you have to make very difficult decisions. No-one can say, “This is the way. If you follow it, you will get well.”

This is one reason to be thankful for the support of other breast cancer survivors and groups like the Breast Cancer Network and the Cancer Council. They’ve been there. They know what you’re going through. They can help you fight your way through the fog.

If you already have warning of a time bomb ticking away in the form of a breast cancer gene, maybe before it happens is a better time to make a decision.

One thing is certain: the decision must be made by you. Gather all the information; add up the odds; make the decision. If you can afford it!

Medical Insurance regards pre-emptive breast surgery and reconstruction as cosmetic. Yes, girls, a double mastectomy is cosmetic! Where are these people coming from? Even in the 1920s they didn’t take fashion that far!

While researching capitalisation in letters and diaries, I came across a letter from the 18th and 19th century novelist and diarist, Frances Burney (Madame D’Arblay) to her sister. In it she describes her 1811 mastectomy conducted without anaesthetic in France by seven surgeons (one to perform the surgery, the other six to hold her down. Although she says she refused to be held).

She describes the procedure, her reactions and her agony in graphic detail. And, yes, she used capitals (Though not as many as she might!), ruining my theory that only nouns were capitalised. She used the adjective ‘Bright’.

Her experience traumatised her so much that she could not bring herself to write about it for nine months. If you have not already seen it, her unabridged letter can be found here.

Some people speculate that Fanny’s breast lump could not have been cancer, but I like to think that she was rewarded for her courage and fortitude because she lived another 29 years to the grand old age of 87. She published her most famous novel Evelina when she was 26, married at 41, had one son, and lived a full life after the shocking trauma of her surgery, her journal letters giving us great social insight into her life and times.

In our time, however hard our journey, at least, we can be thankful that we do not have to endure surgery without anaesthetic.

Bravo, Madame D’Arblay! We can all learn Something from your Courage.