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of rebukes. “Suzy” wrote to tell me, “I really dislike saying you have a bad attitude towards all of this, but you do, and it’s not going to help you in the least.” “Mary” was a bit more tolerant, writing, “Barb, at this time in your life, it’s so important to put all your energies toward a peaceful, if not happy, existence. Cancer is a rotten thing to have happen and there are no answers for any of us as to why. But to live your life, whether you have one more year or 51, in anger and bitterness is such a waste. . . . I hope you can find some peace. You deserve it. We all do. God bless you and keep you in His loving care. Your sister, Mary.”

    “Kitty,” however, thought I’d gone around the bend: “You need to run, not walk, to some counseling. . . . Please, get yourself some help and I ask everyone on this site to pray for you so you can enjoy life to the fullest.” The only person who offered me any reinforcement was “Gerri,” who had been through all the treatments and now found herself in terminal condition, with only a few months of life remaining: “I am also angry. All the money that is raised, all the smiling faces of survivors who make it sound like itis o.k. to have breast cancer. IT IS NOT O.K.!” But Gerri’s message, like the others on the message board, was posted under the inadvertently mocking heading “What does it mean to be a breast cancer survivor?”

    The “Scientific” Argument for Cheer

    There was, I learned, an urgent medical reason to embrace cancer with a smile: a “positive attitude” is supposedly essential to recovery. During the months when I was undergoing chemotherapy, I encountered this assertion over and over—on Web sites, in books, from oncology nurses and fellow sufferers. Eight years later, it remains almost axiomatic, within the breast cancer culture, that survival hinges on “attitude.” One study found 60 percent of women who had been treated for the disease attributing their continued survival to a “positive attitude.” 8 In articles and on their Web sites, individuals routinely take pride in this supposedly lifesaving mental state. “The key is all about having a positive attitude, which I’ve tried to have since the beginning,” a woman named Sherry Young says in an article entitled “Positive Attitude Helped Woman Beat Cancer.” 9

    “Experts” of various sorts offer a plausible-sounding explanation for the salubrious properties of cheerfulness. A recent e-zine article entitled “Breast Cancer Prevention Tips”—and the notion of breast cancer “prevention” should itself set off alarms, since there is no known means of prevention—for example, advises that:

    A simple positive and optimistic attitude has been shown to reduce the risk of cancer. This will sound amazing to many people; however, it will suffice to explain that several medical studies have demonstrated the link between a positive attitude and animproved immune system. Laughter and humor has [ sic ] been shown to enhance the body’s immunity and prevents against cancer and other diseases. You must have heard the slogan “happy people don’t fall sick.” 10

    No wonder my “angry” post was greeted with so much dismay on the Komen site: my respondents no doubt believed that a positive attitude boosts the immune system, empowering it to battle cancer more effectively.

    You’ve probably read that assertion so often, in one form or another, that it glides by without a moment’s thought about what the immune system is, how it might be affected by emotions, and what, if anything, it could do to fight cancer. The business of the immune system is to defend the body against foreign intruders, such as microbes, and it does so with a huge onslaught of cells and whole cascades of different molecular weapons. The complexity, and diversity, of the mobilization is overwhelming: Whole tribes and subtribes of cells assemble at the site of infection, each with its own