Hear it from Zora Brown, then. People are falling through the cracks, she says. Black women are falling through the cracks. She went to a mammography summit on Capitol Hill last year -- a big event, a big-deal gathering. She looked around the room.
"You could count the number of black women in attendance on one hand," she says. "I was mortified."
Falling through the cracks. The number of black women dying from breast cancer is increasing. It's up 13 percent since 1974, according to the National Cancer Institute. During the same period the number of white women dying from breast cancer has decreased, down 11 percent for those under 50. What's happening? "We're falling through the cracks," says Brown. "There's a big gap between those who understand and have access to information and treatment ... and those who don't."
After the summit, Brown called five women -- advocates in the making, and some breast cancer survivors like herself -- and invited them to lunch. They formed the Breast Cancer Resource Committee. "We're loosely formed," she says, to educate minority women about breast cancer, about early detection, about mammograms, about how it's not just a white woman's problem.
White women like Nancy Reagan. Happy Rockefeller. Betty Ford. Sandra Day O'Connor. "Many prominent women," says Brown, "have suffered from this disease." Marilyn Quayle has recently brought more attention to breast cancer, in memory of her mother, who died of it. Last year, after meeting Zora Brown, Quayle appeared with her in churches and meeting halls around Washington, but not many people came.
"She was surprised when she didn't generate more interest," Brown says carefully, not wanting to seem unappreciative. "But black women tend not to pay attention when white women are telling them something. Particularly rich white women."
Well then, hear it from Zora Brown.
She's a young Diana Ross. Standing there in her slim model's body, you wouldn't know whether the 41-year-old Zora Brown has breasts, or ever had breasts. You wouldn't care much either. Walking to a luncheon table at Sam & Harry's, she's lovely, delicate. She wears a double-breasted blue coatdress. She's the public relations director for the Broadcast Capital Fund -- which helps finance minorities who want to own TV and radio stations. She moves like a dancer.
"Women aren't reading pamphlets," she shrugs. "Television is what they are watching."
Her voice is wobbly and sweet, but her words are matter-of-fact. Brown is a realist, after all. She's traveled close to death. She has spent nights and weekends counseling others close to it. She was 32 years old when she found a hard lump in one breast. "It was no bigger than this," she says, pressing a hand down to the white tablecloth and producing a bread crumb stuck to one fingertip. "No bigger than this."
She was on the "Joan Rivers" show last week. Her photograph will run in Mirabella next month. Brown has sent letters out, spoken before the U.S. Department of Health and Human Services. She's been talking about herself, about black women and breast cancer. She's been talking about a new, state-of-the-art public service announcement for television "geared finally," she says, "for the inner-city woman."
This is not your average PSA -- a blurry midnight blast of lecturing, finger-pointing, flag-waving. It's a film called "Once a Year ... for a Lifetime," a 30-minute drama featuring Phylicia Rashad from "The Cosby Show," Jane Pauley, Eva Marie Saint and a handful of other television and movie stars. Before developing the story line, scriptwriter Donald Ham interviewed Zora Brown, and he read the diaries of her sister, Belva Brissett. The program airs on WRC-TV (Channel 4) tomorrow at noon.
Afterward, the blitz begins. A telephone number (1-800-4-CANCER) will flash on the screen, and on screens in six major NBC markets. The National Cancer Institute (it's the NCI's cancer hot line number) has prepared to answer thousands of questions, specific and general, about breast cancer -- about symptoms, about mammograms and possible ways to get free mammograms in the District. Later this month the National Association of Broadcasters will offer the program, via satellite, to 950 member stations.
"It's telemarketing, really, to get the word out," says Sharon Sutton, chief of educational programs at NCI. "When we wind up doing public speaking or announcements, you're always talking to the middle-class whites. But how do you talk to the black community? Well, look at who does talk to them. It's Revlon. It's Nike. ... We need marketing experts, advertisers, to tell us how to bring that message out."
It was the Revlon Foundation, in fact, that funded the film, as well as a luncheon and symposium on breast cancer hosted by Jane Pauley at the Departmental Auditorium yesterday. Four hundred seats went to members of Congress working on new breast cancer legislation, D.C. Council members, NCI experts, doctors, hospital administrators and the media.
And it was, in fact, the entertainment world's own Lilly Tartikoff, wife of NBC President Brandon Tartikoff, who came up with the TV-movie idea, hit up Revlon's chairman and CEO Ron Perelman for the money, twisted arms from coast to coast, kept faxing Phylicia Rashad, and who stumbled into kindred spirit Zora Brown last June.
"When I heard they named a hurricane Lilly," says Brown, "I thought, 'Ohhh, now that's perfect.' "
"Getting to know Zora," gushes Tartikoff, "was the best part of this wonderful nightmare project. She's so out-there. I think from the day she realized her mother had breast cancer until Zora herself dies, this will be her cause."
One by One Zora Brown doesn't feel persecuted by fate. She doesn't feel singled out, specially chosen for cancer. In her family, they all got it -- the women, at least. Her great-grandmother. Her grandmother. Her mother. The youngest of eight children growing up in Oklahoma City, Brown watched her three older sisters, one by one, come down with tumors, get treatment, try to carry on. Her sister Margaret had a mastectomy at 27, and sister Belva in her mid-thirties.
Brown studied business administration at Oklahoma State. At 21, she moved to Washington and lived with Belva, who was pregnant with her second baby while her husband was in Saigon. At 25, Zora was given a mammogram, and told that she had dysplasia and fibrocystic breast disease -- both possible precancerous conditions. The doctor suggested, given her family history, that she have all the tissue removed from her breasts.
"I just couldn't," she says. "I was just out of college. Just beginning to date, or whatever. I was a late bloomer. I had just gotten breasts, and I didn't want to lose them already."
The days, the months passed. Seven years went by. She wasn't "paranoid," she says, just worried that someday her turn might come. She tried a macrobiotic diet, became a strict vegetarian. She avoided preservatives and processed foods. She looked at her body in the mirror every day for any signs of change. She examined her breasts. She searched for lumps.
And she found one. "The size of this crumb, a pinpoint," she says.
She'd been married a year. She was 32 years old. She was given some choices.
"Zora was always very picky about her appearance," says her mother, Helen Brown. "All her life. Even when she was a little girl, if she didn't like a dress I put on her, she'd take it right off. I guess she's still like that."
"I went to the doctor with my husband and my mother and sister," Zora says. "I'd done so much research. I'd thought about it over the years -- if I should get a mastectomy. My husband said, 'It's your body, you have to make that decision.' "
She did. "I wanted to be cured," she says. "Initially many women are very frightened by losing a breast -- or saddened by it. But when they learn the options, and what the cure rate is, I think women say, 'Cure me. Keep me living... .' "
"And I absolutely hate the word 'mutilation,' " she says. "I have a scar on my arm which is more mutilated-looking than the one on my chest." Unlike some women, she hasn't wanted a breast implant to replace what was lost. "It wasn't important to me," she says, "and I didn't think it would look natural." She pats her heart. Her chest. "I'd rather have this look like a natural scar," she says, "than look like an unnatural breast."
While recovering from surgery, Brown gave up her vegetarian diet. Her macrobiotics. She had a craving for "a McDonald's hamburger and Godiva chocolates," she says. She ate them. At Sam & Harry's she orders a hamburger with an enormous plate of fries.
"One of the really great things that came out of this," she says, "is that I became completely self-indulgent. You only live once. People like to forget that."
'Or You Go Under' She's a realist, after all. But when Zora Brown talks sometimes, her huge brown eyes turn glassy and close, then open very far away. Her oldest sister, Joyce, was diagnosed with ovarian cancer at age 55. Her sister Margaret's breast cancer came back six years later. She had another mastectomy. Their grandmother lived to be 94. Their mother is now 76. Belva is struggling to live that long, but she's spent the last three weeks at George Washington University Hospital. Her breast cancer came back and has spread.
"She's a real fighter," says Zora, "and she makes me come to the hospital every morning and read her the newspaper."
For years they've been compatriots in the battle -- speaking in church basements, organizing workshops, sending out mass mailings. God's truth: Belva addressed the envelopes. Zora licked the stamps.
"Zora and my mother are the ones who are community-oriented in the family," says Monica Brissett, Belva's 24-year-old daughter, who deferred going to law school this year to look after her mother. "It's hard, but because of our family history, it's something that Zora and my mom feel they can't ignore or neglect."
Helen Brown has spent the last few weeks here, visiting her daughter Belva. "I tried to instill this in all my kids," she says. "You stick with things, or you go under."
Doesn't she think that her family has had more than its share of problems? "I think that way, sometimes," she says, "but then remember that God does know what we can bear."
A Million Things Cancer is so complicated, Zora Brown keeps saying. There are so many angles. There are so many things to tell people. There are a million pamphlets. A million medical words of advice. A million options -- just taking the lump out, taking the breast, radiation, chemotherapy and carrot diets. There are a million half-truths, superstitions.
Until this TV project came along, Brown was feeling down. "I was becoming frustrated," she says, "because I felt I wasn't reaching as many minority women as I wanted to."
She's given seminar after seminar. For years. She attends symposiums, support groups and luncheons. She's lectured in churches and hospitals. She does it for her mother, she says. For Belva and her other sisters. She does it for her nieces. Someday, maybe they won't have to worry the way she has. Most of her friends are women -- like Lilly Tartikoff and local Revlon executive Marydale De Bor -- who share this agenda.
"We just try," Brown says about her work, "to focus on mammography."
A million statistics. Falling through the cracks. In the District, about 175 women every year die of breast cancer, according to D.C. Health Commissioner Georges Benjamin. A third of those women didn't have to die -- mammograms could have detected their tumors early enough to allow them to live.
"Combine breast self-exam and mammography," says Benjamin, "and it's incredible what we can do. Women come in to the doctor with huge lesions, huge lumps, which they've ignored. It's just denial."
The latest survey done by the D.C Health Commission suggests that 50 percent of women over 40 in the District haven't had a mammogram in two years or more. Maybe they've never had one. (A mammogram is recommended at age 35, then annually for women over 40 -- hence the title "Once a Year ... for a Lifetime.") The national average of women over 40 who haven't had a recent mammogram is much lower. It's 25 percent.
"Black women don't like going to the doctor," says Brown. "And we die of breast cancer because we don't get treated. We go out and buy jewelry and scarves and dresses. We care how we look, but we don't take care of ourselves."
"I haven't had the advantage of being a black woman," says Benjamin, who is black, but a man. "But when I interview them, I notice there is a fundamental belief that cancer -- and breast cancer -- is incurable. There is also a lot of procrastination. Women say they can't get to the clinic, that they can't find transportation, that they are too busy, that they have children to look after... .
"But imagine the loss of a mother," he says, "and how that devastates a family."
Black women, says Brown, think mammograms hurt, and cost too much. They think if you don't talk about cancer, maybe it won't come to you. They believe they'd feel sick if they had breast cancer, or that their breasts would hurt. They don't know you can feel fine and be dying. They think that having cancer is an automatic death sentence, that the surgery will kill you.
Hear it from Zora Brown:
"A mammogram hurts less than getting your hair frosted. It costs less than getting your hair done three times a year. And if you don't have the surgery, then you're asking to die."
You Forget On the "Joan Rivers" show last week, Brown talked about her breast cancer. It was quick, like 60 seconds of human tragedy in between two commercial breaks. Television -- at least people watch it. She sat with Phylicia Rashad and said, "I was lucky. I am one of the people who has breast cancer in the family, so I knew to pay attention."
She was lucky?
Sometimes Brown takes off her dress just to convince a woman. Afraid of surgery? Wonder how you'll look? She shows where one whole breast has been removed, the nipple, the works.
"I say, 'That doesn't look so bad, does it?' And they agree."
A couple weeks ago, she spent a glorious Indian summer Saturday talking to 15 women who showed up at John Wesley Zion Church on 14th Street NW. There were 10 rows of mostly empty chairs. "No," she says, "even if only three women were there, it would have been worth it."
There was a working lunch last month. Lilly Tartikoff flew in from Beverly Hills. She sat around a table at publicist Carolyne Peachey's apartment with Zora Brown and some other organizers of yesterday's symposium and luncheon. Lilly and Zora sat next to each other. They looked like a pair of chess queens -- one black, one white. Diana Ross and Sean Young. They decided that the luncheon tablecloths should be pink. They decided -- after much debate -- to serve wine, even though Brown said she just wanted cranberry juice.
Brown started talking about Belva. About her family. A pause fell, a dead silence. The luncheon table leaned forward at once. Two men. Four women. It was the kind of conversation that makes your guts move. "Your grandmother? Your mother? All your sisters?" one woman asked in disbelief.
"I'd just gotten breasts," Brown said. "And I didn't want to lose them so fast."
She arrived at the luncheon yesterday in a bright red coat. Her hair was shorter, and pulled back. At the reception, she became lost in a luxe crowd. Ron Perelman turned up with wife Claudia Cohen. Georges Benjamin came. And Surgeon General Antonia Novello. Lilly Tartikoff managed to bring Brandon. Deborah Norville came -- in a maternity dress and that smile of hers.
Then Jane Pauley appeared, and wrapped her arm around Brown. They posed for pictures. They nearly bumped heads. "Boy," said Pauley, "you and I are getting really good at this."
Life is short. Life is precious. It has a way of going on. You forget, from time to time, that it isn't forever. Zora Brown was left with this: a thin diagonal scar across her chest -- the Mark of Zora -- and a golden piece of wisdom. "I was lucky."