in the final analysis, “dier.”
The Armstrong story comes with real social costs for many people surviving with and dying of cancer. Like so many cancer narratives, Miriam Engelberg’s graphic novel Cancer Made Me a Shallower Person ends abruptly with the recurrence of her disease and her subsequent death. In one frame she holds a placard stating, “Lance Armstrong had a different form of cancer!” (fig. 6).15 Her friends’ and colleagues’ comparison of her situation with Armstrong’s offered only a terrifying denial of her actual situation.
The ACI advertisement summons you to gaze into the close-up image of a determined-looking Armstrong, and after thinking to yourself, What the fuck? you read that “to put your Lance face on . . . means taking responsibility for your future. . . . It means staying focused and determined in the face of challenges.” Control over one’s future weaves cancer survival, Tour de France victories, and smart investing into a common thread. But all this unravels, much as his own cycling success has, in the tiny hedge at the bottom of the ad: “Past performance is not a guarantee of future results. . . . It is possible to lose money by investing.” Even the Lance Face can’t see the future.
This warning, necessary by law, echoes a skill essential for capitalism. In a study of financial risk, Caitlin Zaloom finds that a market trader “must learn to manage both his own engagements with risk and the physical sensations and social stakes that accompany the highs and lows of winning and losing. . . . Aggressive risk-taking is established and sustained by routinization and bureaucracy; it is not an escape from it.”16 The ACI ad’s conflation of Armstrong as athlete and cancer survivor proffers the ideal personification of market investing, since capitalism requires a valorization of focused determination and responsibility for one’s future, even as one risks one’s savings. By now a truism, liberal economic and political ideals require citizens to place themselves within a particular masochistic relationship toward time: we save money now for imagined pleasures and security in the future. Without this ethos of deferred gratification, banks couldn’t remain solvent.
FIGURE 6. Cartoonist Miriam Engelberg captures the confusing, misleading, and sometimes undermining ideas about cancer and survivorship in light of Lance Armstrong’s iconic status as a cancer survivor. (From Cancer Made Me a Shallower Person [New York: Harper, 2006], n.p.)
In Armstrong, age, class, gender, and a curable cancer along with his brilliantly choreographed cheating, masochistic training schedule, and dazzling marketing skill combined to form an icon of cancer survivorship. His status overshadows a simple fact: cancer can completely destroy your finances and your family’s future. Sixty percent of personal bankruptcies in the United States result from the high cost of healthcare.17 Cancer can be a long, expensive disease, paid for over generations. When your financial planner asks, semi-ironically, how long you plan to live, he calls up the paradox of survivorship. Middle- and upper-class Americans plan for an assumed longevity, and to be sure, a properly planned lifespan combined with a little luck comes with its rewards. But in times of trouble, the language of financial service starts to ring hollow, even for healthy youngish people. In a meeting with a Fidelity representative about my decreasing retirement account—and the decreasing value of virtually all of Fidelity’s offerings—he kept saying, “As your retirement plan grows.” When I pointed out that it had, in fact, shrunk by 45 percent, he stared at me blankly. When I asked him about people who don’t make it to the age of sixty-five, he pleaded: “You really need to think about it as a retirement plan.” In his training, the age of the investor offered the proxy for lifespan prognosis.
An implied lifespan grounds many economic benefits: you work now, we’ll pay you later. Social Security benefits are based on how much you put into the system over years, and they last until you or your survivors are no longer eligible. Middle-class jobs often include not only salaries, but also “deferred payments” such as pensions, penalty-free retirement savings, and, for some academics, tuition breaks for children’s college education.
If you croak early, some of these contributions may revert back to your estate, others are disbursed to qualifying survivors, and still others are recycled into plans that pay for the education of your colleagues’ children. As with any insurance policy, the state or the employer calculates averages over the whole workforce and offers a salary package as a financial bet on your mortality. If you get paid a certain amount when you’re old, it’s because some died young. It’s nothing personal; this is actuarial time.
Wait—I take that back. There is little more personal than your sex life, your orientation, and your marriage status, which greatly affect your survivorship. That is, if you say you are sleeping with one person and one person only, and if that person is of the opposite sex (as of this writing!), you are over a certain age, and you have sealed the deal with the court, your cancer card will play more lucratively. If you fill these criteria, you can pass on your benefits and enable your loved ones to pay off some of your medical debts or live out a more comfortable life in spite of your absence (and sometimes because of it).
Every American worker pays Social Security taxes in accordance with income rather than by the type of support they will be withdrawing from the system. Thus, the surplus skimmed from the nearly half of American adults who choose not to live with, sleep with, or bicker with someone over eighteen of the opposite sex—or at least to do so, by choice or exclusion, under the radar—underwrites the benefits that others receive. (Actuarially speaking.)
A Social Security check is one of the few dependable modes of retirement income now, in the insecure world of private investment for retirement (given that there are not many guaranteed pension programs left). The quarterly slip of paper that tells each working person how much money their spouse and dependents will receive each month if the worker dies or becomes disabled offers different measures of security. To some it will offer a sense of relief that her main “peeps” will be taken care of, and to others it generates an awareness of disenfranchisement, a reminder that his labor will not result in the same benefits for his social support systems and the folks who depend on him. With its two categories—married or unmarried—the quarterly chart offers the trappings of democracy: any adult can join the institution, and once you do, more cash is available to you. But in fact, those who join the system rely on the exclusion of benefits and the financial contributions of those who don’t sign up.18
Several friends of mine have found a way around this status quo. One young man described the reasoning behind his recent gender change: he can now legally convert his girlfriend into a wife, legally bring her into the country, and offer her the protections of Social Security. For the same reasons, my lawyer advised me to marry a man, so that my husband could give the survivor-cash to my girlfriend. But the question is both more and less one of who can marry whom—regardless of who fits in the box, it’s still an exclusive relationship with benefits, reliant on those buttressing it from the outside.
Health is not just physical, but social and institutional, and the currency of survivor street-cred varies. Capital and kinship legitimate and augment each other in ways that require a fair amount of massaging to seem logical. The economic rewards and costs that underpin these notions of survivorship remind me of an idea common a few generations ago, which is that cancer results from a degenerate lifestyle (fig. 7). Few people would still argue outright that remaining single or living in sin counts as degenerate, though certain demographics still cling to the idea that same-sex couples deserve to burn in hell. But the systematic privileging of marriage results in an increased vulnerability for others, no matter how it is justified. More important to my argument here, the benefit structure encourages us to expect a certain lifespan. You expect to live until the children grow up; you put money away that you will have access to when you turn fifty-nine and a half. Lifespan becomes a financial and moral calling, one that the state will partially subsidize in disability and death for all citizens who fulfill its principles of economic and sexual responsibility.
All
