look in the eye the cancer survivors whose bodies experience these fissures. Unlike many people who calculate their odds and cash out their retirement policies after diagnosis, unlike the friends of mine who told me that I was the inspiration for them to live in the moment and renovate their homes (not dead yet!), unlike those ads in Cure magazine that offer to buy the life insurance policies of people with cancer in exchange for a percentage, the Lance Face returns our focus to future thinking through sheer determination. The ACI ad applies this notion of cancer survivorship to banking products for its own ends, pulling the wool over all of our eyes.
BABY FACE
From cashing in the retirement savings to hours spent in the waiting room, from the prognosis to the too quickly dividing cells, cancer is always about time. But if cells reproduce, so do people, and if anything can provide a foil for cancer’s temporality, it’s the children—new ones who arrive as fast as the prior ones exit. Both the child and early detection campaigns work with embedded ideas of temporality that reflect back on the bald insistence behind representations of lifespan. Recently, the American Cancer Society (ACS) played on the tropes of both in a widely distributed campaign intended to draw attention to the high number of Americans without health insurance (fig. 8).
FIGURE 8. An American Cancer Society Cancer Action Network (ASC CAN) advertisement, circa 2009.
The ad at once builds on a century of emphasis on early detection and implicitly critiques the logic of accumulation that I have been outlining. It presents a simple enough message: acting now by seeing a doctor means saving cash in the long run. Stuck between registers of accumulation, the ad cautions us to be careful what we defer.
Early-detection campaigns have always walked a knife-edge: they aim to provoke sufficient fear that people take symptoms seriously, but not so much that they bury their heads in the sand. An ad needs to inspire some confidence that medicine can work on the cancer (when diagnosed early), but not so much that a person thinks treatment will work if cancer is caught later on. Likewise, an ad needs to impart enough anxiety that the patient makes sure the doc does the test, but not so much that she doesn’t go to the doc in the first place or that she pesters the doctor with benign symptoms.
Based on the current theory that cancer starts in one area of the body and may spread to distant organs, early detection encourages people to take advantage of the brief window of opportunity offered by even a small tumor. Early-detection narratives, suggesting future and past counterfactuals, seek to break the deeply held association between cancer and death with one simple directive: You won’t die if you just see your doctor! The directive has a foreboding undertone: It could have been different. We can change the course of history—and if we can’t now because we waited too long, we could have before.
The ACS ad highlights the key mechanisms of early-detection campaigns. A simple cost-benefit analysis maintains that it is cheaper to “keep his mother healthy” now, for $700, than it will be to “try to keep her alive” later, for $200,000. Early detection means saving money and saving lives: it’s win-win.22 The ad also relies on the myth that if you find and treat cancer later, you could probably have found it sooner, with the additional promise that cancer death rates and overall cancer expenditure could go down. The small print informs the reader that “60% of cancer deaths could be prevented” and urges “access to prevention and early detection. For all Americans.”23 The gap between “keeping” and “trying to keep” the mother healthy is unsettlingly similar to the hedge at the bottom of the American Century Investments ad: “Past performance is not a guarantee of future results.” Like financial accumulation, cancer treatment offers only uncertainty.
To whom is the ACS message—money and lives are being lost—addressed? In other words, who cares? The difference between $700 and $200,000 might in fact invite incredulity. While there may be investments that increase twenty-five-fold over some unspecified amount of time, as a financial wager it’s dubious, especially since it’s unclear how the various pockets will lose and gain coin. Thus the ad must cite not only the Market, but also the other key referent of the future, the Child who stands to lose his mother.
English professor Lee Edelman has argued that the Child holds a critical rhetorical place in American politics.24 The wide-eyed face of the Child has ideologically justified everything from marriage with its unequal distributions of wealth to the Patriot Act. Mothers used their children to curb drunk driving in the 1980s, and after the deaths of hundreds of gay men, only the presexual child Ryan White finally brought AIDS to national attention. From Megan’s Law to denying gay marriage to expelling gay school teachers, political action has harnessed the power of the Child. The Child gains his potency in his abstract permanence and his winsome innocence, in his asexuality, in his disconnection from the market and his prepolitical sensibility.25 This Child, not as a person but as fetishized ideal, plays a critical role in laying out expectations about life course.
Without portraying a child and referencing its archetype, the ad would uneasily tangle with the “who cares?” question, since the state doesn’t generally care about any individual’s health. Such is the premise of the private insurance system and the reason that some forty-five million Americans remain uninsured, with sixty million more underinsured. Even given recent legislation that may change this for the moment, to ask the state to care for any particular individual using a market logic can’t work. Not only does the pre- and postcancer money come from different, incommensurate pockets, but with only a few exceptions, health insurance, we’ve decided, is not a benefit to be distributed by the state. The ad needs, then, to appeal to another logic: humanitarianism.
While his mother might be blamed for not getting insurance, this boy has done nothing to deserve losing her. The young woman on her own may generate resistance (why doesn’t she have a [better] job?), yet children remain outside the market exigencies that underlie the moral economy of who has healthcare. The ad purveys the message that “we” owe him, if not his mother, at least the initial $700, while it also assures the self-interest of saving ourselves $200,000. The “who cares?” question is both artfully raised and clunkily avoided.
Such ads can easily be understood as rhetoric, mere attempts to lacquer political ideals onto a ruse of sentimental innocence. Had the ACS portrayed a person of color, a homeless person, or a childless queer person, the ad would certainly have been less palatable. If strategic reference to children’s safety achieves a broader goal, then so be it. But the representational power of the Child is especially potent, for none of the other cast of uninsured characters would help us make the rhetorical and political leap toward a cancerless future.
In bringing our attention, justly, to the huge effect that insurance has on mortality rates and pointing the way to a future fantasy in which all Americans have insurance, the ad diverts attention from the way statist ideologies justify the market distribution of medical insurance. Indeed, in an internal contradiction it supports, rather than challenges, these same ideologies.26 The ad, ultimately, recants the ways in which the ideology of the Child denies benefits to huge swaths of the population (as in the justifications for marriage benefits) and forecloses a more earthy discussion of who has insurance and who does not and why both insurance and healthcare are so expensive.
STRAIGHT FACE
The Young Adult, too, holds a critical rhetorical place in U.S. politics. Years ago at a funeral I attended for a grad school colleague who had died of leukemia at thirty-three, her cousin comforted herself in a speech with the idea that Chaney had been lucky, for she would not have to experience the horrific event of turning forty, as the cousin recently had. Chaney would not have to pass that invisible, ineluctable birthday that drew the speaker one step closer to disposability. Virtually any comment at a funeral gets a special pass, but this remark is telling for its unashamed embrace of the fetishization of Young Adulthood, of the person at the height of intellectual
