Book Shelf: Pretty Is What Changes

I read Jessica Queller's compelling, bitter-sweet memoir, Pretty Is What Changes ($29.95; Vintage), in three consecutive sittings, in the same time it would take to watch, maybe, eight episodes of Sex and the City, devouring each chapter with equal devotion.

Queller's contemplative, often witty writing style could be compared to Carrie Bradshaw's (Queller is a real-life New York writer, who's worked on Gilmore Girls, Felicity, One Tree Hill and, more recently, Gossip Girl). Queller, too, is single in the city – at one stage hooking up with a fellow writer (hello, Jack Berger) – who has a formidable group of girlfriends and, of course, the proverbial gay friend. Only, in the non-fiction world of Queller, family – more particularly, her relationship with her mother and sister – is intrinsic to her life, with a bit of good-man hunting on the side, hastened by Queller's determination to have children before saying farewell to her ovaries...

The book begins with Queller sharing the news of her positive diagnosis for the cancer-causing gene BRCA-1 with her co-writer friend on Gilmore Girls. We then journey back three years to the death of her grandmother, Harriette, and the beginning of her glamorous mother's taxing battles with both breast and ovarian cancer. Queller paints herself as a privileged, cerebral, Jewish American girl who rails against her mother's materialism, shallowness and trivial vanities, symbolically changing her name from 'Tiffany' ("my powder-puff name") to the more acceptable 'Jessica', before the Big C strikes and their complex relationship is turned on its head (she later comes to appreciate her mother's fondness for Jimmy Choos, her unrelenting beauty regime and determination to hold onto her hair). To say Queller and her younger sister, Danielle, rallied around their mother in her time of need is an understatement: they were utterly committed to being by her bedside (and sharing her bed) until the bitter end. This daughterly devotion both humbled me and gave me insatiable mummy-cravings (thank God we're scheduled to spend time together this week!).

For me, the most compelling part of the book is the mother/daughter/sister/daddy dynamic (her parents divorced but Queller's father remained devoted to her mother) in the initial chapters, before cancer takes her mother's life and her own biomedical quest begins. The intimate moments they share and the insights into her mother's character are heart-warming – in a fuzzy Gilmore Girls kind of way – and reflective of the power, and necessity, of female friendship, as well as bloodline bonds.

As the story goes, after her mother's death, Queller opts to take a test for a BRCA mutation – a genetic marker for breast and ovarian cancer. The test results come back positive, much to her surprise, giving her an 87 per cent chance of developing breast cancer and 44 per cent chance of contracting ovarian cancer. She literally buries her results in her desk draw for three months before friends urge her to come out of her denial and take control of the situation. With such damning knowledge, what does one do? Her options are vigilant regular screenings, living with the ominous knowledge that cancer could come at any time, or a controversial prophylactic double mastectomy, which she fears, as a single 35-year-old woman, will dramatically reduce her chances of finding a man to settle down with.

What follows is an emotionally and ethically challenging journey, peppered with visits to various surgeons (of varying integrity and humanity), networking with fellow BRCA-positive women, consultations with family, friends and acquaintances and short-lived romantic flings (she also returns to the comforting arms of an ex – as we do!). She develops some deep new friendships (trying situations have a tendency to create such bonds) and throws herself into cancer research after a friend offers her the opportunity to write about BRCA for the New York Times – an Op-Ed piece which becomes the precursor for the book, an incentive to get moving on the elective surgery front and sees her become the poster-girl for genetic testing/optional preventative mastectomy.

Queller's decision to have her breasts removed despite no cancerous diagnosis poses many ethical questions. Many view the surgery as an extreme and unnecessary measure; others would think a gal silly to have the knowledge and not act to prevent cancer. Queller becomes well versed in the medical and moralistic discourse (she comes to rely on the message boards on the FORCE – Facing Our Risk Of Cancer Empowered – website), submerging herself in the issue and intricacies of the surgery and cancer treatment to the point of emotional and mental exhaustion (TMI – too much information is an all-too common modern-life ailment, no?). It is with a moment of clarity that she finally resolves to have the surgery and a post-op re-construction (she chooses to downsize her large boobs to a B cup from a D cup).

In her closing chapter, Queller refers to how the creators of Sex and the City wrote and shot three different endings to the series: "Millions of women around the country watched with vicarious pleasure as Carrie got her fairy-tale ending – the unobtainable rogue prince Mr Big gallops into Paris crying mea culpa and asks her to live with him happily ever after. Others were disgruntled with the finale. Anyone who had invested years in following the travails of Carrie and Mr Big knew that they'd never really just waltz off into the sunset. One of the reasons Sex and the City had struck a chord with its audience was that it had managed to capture the complexities of modern dating life with an emotional veracity (even if glamorized by money and designer clothes)."

Though there is no neat, happy ending or prince who sweeps her off her feet, gleefully impregnating Queller before the page numbers are up (oops, spoiler), Pretty Is What Changes is a rather glamorous, middle-class account of one woman's experience of cancer (I mean, Queller is beautiful – as was her mother and is her sister – counts Calista Flockhart amongst her best friends, has written for some of TV's best women's dramadies and spends time flitting between homes in LA and New York). If it can be called a privilege, I wonder how genetic testing, if it were government-funded, might affect someone of lower social standing for whom optional surgery might be a non-option? Is genetic testing the domain of the middle-class? Also, we have greater access to research and information than ever before – but is knowledge power? Is it still the case that what we don't know won't hurt us? Is this just adding to our post-feminist paranoia? And, isn't it true that God won't give us any more than we can handle?

Queller finishes on this note – "We are living in an age in which scientific advances give us new opportunities to live. Seize them." – after telling us she's looking into artificial insamination, which opens up a whole different set of ethical dilemmas (i.e. selecting only genetically 'perfect' embroyos, as determined by biomedical testing) and, of course, content for a new book. How very Sex and the City The Movie!

Read with a cuppa and biccie on the couch, cheese and wine while shrouded in a doona outdoors, or with chocolate in bed, before passing on to your mother/sister/aunty/friend.

Yours truly,
Girl With a Satchel