The woman is dreaming of breasts. She is young and pretty and she smiles down at a rack of sleeveless dresses set on widely spaced wooden hangers. The dresses, though, are hardly the point, for a thought bubble shows what's really on the woman's mind: a line drawing of an hourglass torso with—I’m guessing here—a perfect pair of size 36Cs. Because of the way she's been photographed, it's not possible to gauge the size of the woman's actual breasts, but her wish is clear: she wants to fill out those dresses with some vavoom! 

​

     I'm on a Downtown 3 train on my way to an afternoon of radiation. The woman with a rack is one of a subgenre of subway ads that preys upon people's insecurities about their appearance.  Rhinoplasty, hammer toe, Dr. Zizmor's dermabrasion—most of the ads are targeted at women—acne-pitted, sandal-wearing, flat-chested, large-nosed, imperfect women. As these things go, this ad isn’t even the worst of the lot. That honor goes to a split panel poster featuring a woman in a white tank top. In the left panel she frowns as she displays a pair of tangerines in front of her chest while the right panel depicts her beaming as she holds up a pair of grapefruit. The ad's message is clear: small breasts = unhappy life.

 

⎯

     

     In the waiting room Donald Trump is on TV. Today's story concerns how he reportedly paid porn star Stormy Daniels $130,000 to keep quiet about a sexual encounter they had while his wife was recovering from childbirth. There onscreen is Daniels, all long blonde hair and imposing cleavage. Donald Trump, as we know, likes to rate women on a scale from 1–10—cherries to cantaloupes—and Daniels would probably score at least a nine. Many of the women in the waiting room are, like me, here for post-surgical breast cancer treatment, and given the circumstances, I can't help wondering how we would rate. It's perverse, I know.  But what strikes me as even more perverse is that someone apparently thinks it's a good idea to make a group of breast cancer patients watch a man who is infamous for objectifying women and boasting of sexual assault.

 

     They tell us not to stress out, a woman seated beside me says, and then they put this on.

 

     I could live without myself, I reply. 

 

     The receptionist clearly hears us, for without saying a word, she comes over, mutes the TV, and puts on some Bob Marley. This is a huge improvement, but the next day Trump is back.

 

     Some days I skip the main waiting area and am sent directly to the women's changing room. There I strip from the waist up and put on a hospital gown. The gowns are pink, a neat bit of irony given that it is our essential femaleness—our breasts and cervixes and uteruses—that has landed most of us in this place. I always choose the darkest gown in the stack—mauve as opposed to bubblegum—both as a way of deflecting this irony and because I know that those gowns are softer.  The pinker the fabric, the pricklier the gown.

 

     Three other women have their daily treatment at the same time as me: a cheerful West Indian woman in a knit cap, a woman with Julianne Moore hair who stares ahead, expressionless, disengaging as much as possible from her surroundings, and a talkative psychotherapist. In our matching pink gowns we look like hospital handmaids. One day we are joined by a woman who keeps her turtleneck on but removes her black velvet stretch pants. This can't be good, I think, and sure enough it turns out that this woman is being treated for a double whammy: rectal and cervical cancer. She's had a hysterectomy and she shows us her colostomy bag. There's not a lot of modesty in the women's changing room. When it comes to appearance, we've learned to swallow our pride. The psychotherapist, who's already been through chemotherapy, has shown me her radiation blisters and I've seen the knitted cap woman's mastectomy scars. Because my own tumor was discovered early, I've been able to avoid both a mastectomy and chemotherapy. Some days I feel like the proverbial one-eyed man in the kingdom of the blind.

 

     The radiation dressing room, thankfully, has no TV. There are no distractions whatsoever unless you count the small pile of magazines: Real Simples and Glamours and, implausibly, a single copy of Astronomy. ("How to Observe Dark Nebulae" is the issue's cover story and, really, I think, isn't that why we're all here? Because some "dark nebula" was observed deep in our bodies?) There are several copies of tlc, the magazine for women cancer patients that features the Raquel Welch wig collection with product names like "Enigma," and "Sparkle," and "Whisper." "Voltage" depicts the actress touching a pink rose to her shoulder. In most of the photos she smiles; her tops are low cut. What do they have in the men’s changing room? Sports Illustrated? Car and Driver? Is there a magazine of toupees, and if so who is the 1970s-era sex symbol modeling them? Burt Reynolds? Then I realize how ridiculous this line of thought is. Of course there's no toupee magazine; bald men are acceptable in a way that bald women are not.

​

⎯

 

     The sameness of days becomes a balm. In the mornings I write and then around 2:30 I head downtown. After I change I wait to be called into the treatment room where I disrobe, climb onto the table, and lie facedown in a plaster mold of my own torso. The mold, conforming as it does to my body, cradles me; I find it oddly comforting. I turn my head to the right and grip two handholds at the top of the table. The next part is tricky. I must be positioned exactly the same way each time to keep the radiation on target. That’s the phrase they use—targeted radiation—and I imagine a bullseye at the surgical site, my breast as ground zero. The technicians move me this way and that, micro adjustments. When they are ready, when I am precisely where they need me to be, they go into a booth and remotely slide the table into the donut, the big metal circle that shoots out killer beams of radiation like some torture device for Batman or James Bond. In the donut I must be absolutely still. I make my breathing shallow and listen for the beeps that indicate how the treatment is progressing—a long one, two short ones, then a final long one, nearly a minute in duration. After that the table slides out and I am free to go.

 

     The hospital where I'm being treated is home to The Louis Armstrong Center for Music and Medicine. Both radiation rooms have iPod decks, and patients can choose the soundtracks they want to hear. Because I have to lie still, I don't want anything frenetic. At first I ask for classical music, but I soon realize that vocals are a better distraction; I can put myself in the story and mark time by the number of songs. As one might expect, Louis Armstrong dominates the jazz vocalist playlist, which is fine by me. If you have to undergo cancer treatment there are worse things to listen to than Satchmo singing "What A Wonderful World."

 

     One afternoon, early in my treatment, I share an elevator with a woman carrying a bass cello. When I ask, she tells me she's the music intern and offers to make me my own individual playlist. The requests I send her lean heavily on The Great American Songbook as interpreted by, among others, Diana Krall, Cassandra Wilson, and Ella Fitzgerald. While machines whir and radiation blasts I listen to Ella sing about copulating oysters and how sniffing cocaine would bore her terr-if-i-cally. What ebullience in her voice; clearly, she's having a ball! And why not? She was only sixteen when she brought down the house at the Apollo Theater, winning its Amateur Night. Within a year she was fronting Chick Webb's band, despite his initial concern that she was "too ugly" to put onstage. Webb, small and hunchbacked from spinal tuberculosis, worried that his new singer lacked sufficient sex appeal to draw crowds. But audiences adored her.

 

     My first memory of Ella Fitzgerald was as the woman whose voice could shatter glass. She was in her fifties by then and had made a commercial for Memorex cassette tapes. The commercial showed a wine glass shattering when Ella hit a high note. Replayed on tape, her voice still shattered glass. "Is it live or is it Memorex?" the announcer asked.

 

     I was eleven and had never heard of Ella Fitzgerald but was mesmerized by the idea of a voice so potent it could break glass. Who was this woman? Was this even for real? I wanted to break glass; I wanted to be that powerful.

 

     Our "good" wine goblets were kept in the living room hutch. Lalique crystal, they had frosted stems in the shape of a naked woman. At some point during every holiday meal my mother's husband, flush with wine, could be counted on to rub his thumb over the stem's protruding breasts and say something like We should use these every day! I took one down from its high shelf and started shrieking. How wonderful it would be to destroy this object I hated so much! But I was no Ella Fitzgerald.

 

     The next time I see the subway ad, near the end of my treatment, it's been defaced by a sticker that says "This Insults Women." 

 

     Good for you, I think, whoever you are. Even if everyone else on this train ignores your message, you’ve just made me feel a little better. 

 

     By now my breast looks severely sunburned, though its fundamental nature (shape, density, volume, those tenth grade geometry words) is unchanged. I'd been warned that this might not be the case. The word "divot" had been used, the word "concave." Before my lumpectomy, the breast surgeon had referred me to a cosmetic surgeon, an aggressively handsome young doctor with practices in Westchester and Manhattan. He'd measured my breasts, noted that, post-surgically, my left one would be smaller than my right, and had spent the remainder of our fifteen-minute appointment talking excitedly about my reconstructive options. He could lift my left breast, enlarge it with tissue taken from my back, slice off my nipple and reattach it higher, then raise my right breast, too, so that like a car's headlights my breasts would be perfectly aligned. He'd made diagrams on a Xeroxed drawing of a woman's torso—diagonal lines radiating out from the nipple, upward pointing arrows—and had inked in words like "pectoralis," "alloderm," and "lower pole shape" on the woman's chest. Cost, he assured me, would not be an issue since the procedure was fully covered. And because there was no statute of limitations on reconstructive surgery, there was no hurry for me to decide. Weeks, months, years, you can come back, he said, whenever you choose.

 

     What, I wondered later, had I expected? He was a cosmetic surgeon, doing his job. He knew that breasts matter. Look at Stormy, look at Raquel. Look at my former student, at a university where I no longer teach, who'd boasted to her classmates that for graduation her parents were giving her the gift of breast augmentation. Those subway ads wouldn't exist if the services they offered weren't profitable. I told the doctor I'd think about it, and he handed me his card.

 

     I begin to suffer from fatigue. Every afternoon I fall asleep on the couch; routine chores become enervating. The fatigue lingers once the treatment ends, the effects of radiation being cumulative. I was told to expect this, cautioned not to become alarmed.

 

     Only it's not just the radiation.

It's the fatigue of being female, of inhabiting a body with breasts. The fatigue of constant low-level humiliation in the form of sexist subway ads and infantilizing pink gowns and the pressure to achieve physical perfection. It's the naked lady stemware, and the public shaming of women who score low on the desirability scale, and the fact that there's a desirability scale to begin with. Above all, it's the fatigue of realizing that the most socially prized aspect of one's anatomy—those endlessly commodified, fetishized, talked about breasts—have gone dangerously rogue and may someday (not today, please not today) need to be removed altogether. How, in the face of this barrage, does one maintain one's sense of self?

 

⎯

​

     Ella Fitzgerald made two more commercials for Memorex. You can find them on YouTube. There she is in her windshield glasses, big-boned, smiling, owning the stage. No liposuction, no facelift, just that voice that could rock you to sleep or shatter glass.

 

     "Take care of Ella," Chick Webb told his friend Teddy McRae as he was dying. But Ella didn't need taking care of. She ran Chick Webb's band, renamed Ella Fitzgerald and Her Famous Orchestra, for another three years before embarking on a solo career that included over two hundred albums, sold out gigs at Carnegie Hall, and collaborations with Louis Armstrong, Duke Ellington, and Frank Sinatra, among many others. She put on weight, lots of it, started wearing those glasses, and turned herself into America's "First Lady of Song." She was a force. What would the raters of women make of her if she were performing today? What would she care? She'd flick off their comments like so much dust and keep right on singing.

 

     During the brief interregnum between the end of my cancer treatment and my husband’s terminal diagnosis a few months later, I return to work. One morning, on the commuter rail, the train is running behind schedule and, worried that I’ll be late for class, I ask the conductor what time the train will reach my stop. 

 

     He takes a paper schedule from his pocket, shakes it open ostentatiously.

 

     The train, he announces in a stage voice, will arrive by this evening. A couple of passengers laugh.

     

      The train, he says even louder, will be there by Saturday.

 

     Clearly, he’s enjoying his performance. The funny conductor, putting on a show. I’ve asked a straightforward question, seeking information I need, information he has no intention of sharing.

 

     I must look less than amused because he tells me to smile. This, too, garners laughs. What he does not do is deign to answer my question.

 

     A week later, it happens again.

 

     Smile! he commands as he punches my ticket.

 

     Only this time, I’m prepared.

 

     In a calm, quiet voice I begin the little speech I’ve practiced in my head.

You don’t know me, I say. You don’t have any idea what’s going on in my life. Maybe I’m ill. Maybe I have a loved one who’s ill, maybe even seriously. Or maybe I’ve just lost my job. Or someone I care about has just passed away. And if any one of these things is true, how do you suppose it makes me feel to be told to smile?

 

     His big fat look-at-me grin vanishes. 

 

     You’re right, he says, in a normal tone of voice. I’m sorry.

     

     That’s okay, I say. Only, you might not want to keep telling people—women—to smile. Because I doubt you do this to men.

 

     Now I’ve gone too far. His face tightens. I’ve just challenged the unwritten norm that women exist to be decorative. Here he was trying to be friendly—what’s so wrong with that?—when some worn out middle aged bitch starts giving him a hard time. Can’t even take a joke. Fine then, fine. He won’t speak to me anymore. And, to my relief, he never does.

 

     But it will happen again, I know, the command to smile on cue, and it does, all those months when Jeff is in decline, when I can no longer bring myself to smile, it happens on street corners and supermarkets, pharmacies, cafés, in the Starbucks next to the hospital, it happens on subways and buses until the day arrives when we all start wearing masks, those great equalizers in literal self-effacement. 

 

     One day, a few months after finishing treatment, I decide to sort through the accumulated papers on my desk. In a folder stuffed with medical documents—receipts, notes, my pathology report, post-treatment instructions, explanations of benefits—I come across the surgeon's card. Tossing it out is too small a gesture to be truly liberating, nothing like breaking glass with one's voice. Still, it feels good, a silent act of self-assertion, a pushback, however minor, against the forces of smiling conformity.

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