By the end of the twentieth century, breast cancer narratives constituted a genre of their own. What had begun in the United States in the 1970s with a few scattered memoirs had, by the late 1990s, become a veritable torrent. (1) The popularity of these narratives marked the final--and irreversible--lifting of the veil from a disease that, with few exceptions, had been hidden away since time immemorial. The new genre also delineates significant changes in the course of the disease itself. Earlier diagnosis and treatment now gave women many more years of life. Suddenly transformed into breast cancer "survivors," women were surprised to discover that they had lived to tell their tale and were eager--and extremely grateful--for the opportunity to do so. Fortified by second-wave feminism, they picked up their pens. Casting themselves as reluctant heroines, the writers trace their dangerous passage through a dark thicket of toxic treatments. Ultimately they prevail, regaining a place of relative safety in their former lives. (2)
The proliferation of these accounts has naturally crowded out the earlier and much deadlier experience of breast cancer among American women. Until the 1970s, there was, in fact, little evidence that the disease actually existed. Although it killed more than a million American women in the first six decades of the twentieth century, breast cancer was never acknowledged in any public arena--not in the press, on television or radio, nor in any books written for a lay audience. Whatever evidence survives of the early twentieth-century experience of the disease, therefore, must come from private sources. But for families with a breast cancer history, there may have been little incentive to hold on to anything that kept their pain alive and fresh. Whether described in diaries or letters, the illnesses these families endured could last for several years and would be full of terrible disfigurement and pain. Unlike contemporary accounts, letters and diaries written before the 1970s record no return journeys to the land of the living; rather, there is an inexorable decline into suffering and death. Such accounts would not only be difficult to reread, but they might also be a source of family shame, to be destroyed as quickly as possible.
The scarcity of surviving evidence from the early twentieth century makes Katharine Lee Bates's 1915 unpublished narrative about the breast cancer and death of her partner of twenty-five years, Katharine Coman, all the more important. (3) During her lifetime, Katharine Lee Bates (1859-1929) was an academic and literary luminary. (4) Remembered today primarily as the woman who wrote the words for "America the Beautiful," in her own time period Bates was an esteemed teacher, a prolific poet, and a widely published author. Her partner, Katharine Coman (1857-1915), an economic historian and social reformer, was only slightly less well known. (5) Bates's narrative appears to be the earliest American account of breast cancer conceived explicitly as the history of an illness, written sixty years before the first published accounts began to appear. (6) Bates wrote the memorial in a concentrated burst of a few days, shortly after Coman's death, when the memory and pain of it were both still fresh. For the early twenty-first-century reader, this narrative highlights the radical changes that have taken place over the past century in the way women experience and understand breast cancer. Bates's account also reveals the language, etiquette, and tropes of attachment between two educated women of the early twentieth century and the coterie of women who surrounded and supported them throughout their lives.
BREAST CANCER IN THE EARLY TWENTIETH CENTURY
By the time Katharine Coman was diagnosed with breast cancer, radical mastectomy had already become the standard treatment. The form of the procedure used in the United States was introduced by William Stewart Halsted (1852-1922) at Johns Hopkins. …