"Palimpsest" is defined as "awrittendocument, typically on vellum or parchment, that has been writtenupon severaltimes, often with remnants of earlier, imperfectly erased writingstill visible,remnants of this kind being a major source for the recovery of lostliteraryworks of classical antiquity" (American Heritage Dictionary). Thisdefinitionprovides a way to theorize the intersection of photography withbreast cancer asa medical condition, a personal trial, and a discourse.
As breast cancerstatistics approach one ineight women, critics are beginning to theorize the ways in whichthe disease isnot only a health condition but a psycho-social and a culturalcondition. Themedical world develops a particular set of descriptions of andreactions topatients' health conditions, while individuals,families and groupsgeneratetheir own responses and vocabulary. In addition, larger patterns ofaction anddiscussion also shape and are shaped by culture, that is,society(s),lifestyles, media and artistic and literary production. "Breastcancer"therefore merits a better understanding of the forces ofrepresentation whichdefine the disease itself and its sufferers. Here I aim to examinethe interplayspecifically of photography with representation of breast cancerand breastcancer bodies. Part of the challenge of this project, and indeedits point isthat breast cancer photography is still not found in majorhistories ofphotography, or even anthologies of womenþs photography. Itstradition lies inx-rays, MRIs and collections of medical photographs designed forthe purposes ofdocumentation or instruction, or, alternately, in scatteredexhibitions orcollections. This history has only very recently been reclaimed andwrittendifferently by women photographers and writers, and feministacademics andactivists.
I have deliberately chosen twophotographswhose subject involves some type of writing literally on the bodyas a way ofconcentrating my discussion of the issues involved when photographyattempts toprocess or project experiences of breast cancer, or shape publicperceptions ofthe disease. In this essay, which is part of a more extensiveinvestigation, Iwill begin some readings focusing on how two women's work incombined image andtext points to desire and agency. The photographs have both strongsimilaritiesin their re-writing on and of the breast cancer body, and markeddifferences intheir attitudes and intentions. In each case, the photograph itselfis worthlooking at closely as a photograph on its own, yet the text whichaccompanieseach of them--the book it originally appears in with itsdescription of theimage or its production--crucially shapes the meaning of thephotograph. I usethe paradigm of the "palimpsest" in both fairly literal andmetaphorical ways inorder to look at several questions: 1. How these women's bodieshave beenimpacted by treatment, 2.Why and how they have "inscribed" themthemselves, andultimately, 3. How their photography projects and their writing areall attemptsto write new socio-symbolic "texts" over existing ones. I myselfnow add a layerto these projects--a set of perceptions and inquiries inflected bymy ownposition as the daughter and, for a time, caretaker of a woman whodid notsurvive breast cancer.
My first example of a strikingimage of abreast cancer body is a photograph taken by Hella Hammid of (and incollaboration with) writer/poet Deena Metzger in 1978 (see fig. 1).Thephotograph shows Metzger nude, from the hips up, against a sky withclouds. Thephoto does not qualify as a traditional aesthetic nude shot becausethe femalesubject looks to be active rather than passive, and there is noconcealment orsubtlety about her unclothed body. However, the technique here isaesthetic inthat the image shows a certain amount of light and shade contraston the body,which emphasizes the depression in the rib cage, shows the sinew ofthe neck,and highlights the nipple. Her arms are outstretched and her headis bent,slightly back and to her right. The camera views the figurestraight on, but itsgaze is also upward, toward the sky, helping to lift Metzger orspring her up,making her a kind of heroine or goddess. There is an expression onher facewhich is somewhat smiling yet possibly strained. Unlike familiaraesthetic nudeshots, this one openly shows a subject whose right breast is gone.A tattoo of atree branch covers the scar, running from the armpit almost to thecenter of thechest. Barbara F. Sharf has learned from conversation with Metzgerthat thedetails of the tattoo include grapes on a vine, the Book of Life,and a bird(Sharf, 77). While the body pictured here is not model quality(young, thin,toned), it is clearly not overweight, noticeably wrinkled ordiscolored.
Figure 1: Deena Metzger, "Self-Portrait"; alsoknown as "TheWarrior." Reprinted with Deena Metzger'spermission.
After posing some possiblereadings of thephotograph itself, I will return the photograph to its originalcontext toregain some of the meanings Metzger's writing shapes for it.Standing alone, thephotograph is usually read as an unequivocal celebration ofstrength, joy and/orfreedom, a statement of vitality and exuberance, an image of lovefor life. Thescar draws the eye, and both disturbs and fascinates. One can alsoperceive thephotograph as a message of empowerment or triumph. An alternatereading is thatthe image is an echo or a revision of the crucifixion scene: thearms arestretched straight, the body is nude like Christ's, the branchrecalls the crownof thorns, but is shifted to the breast area. In this image,however, the bodyis not emaciated, and seems to lift rather than slump or hang, andthe facialexpression is joyous. Most readings of the photograph are drawn tothe placementof the tattoo in the site of the missing breast. The female bodyhere is apalimpsest on several levels: this body bears the evidence ofmedical treatment,a "text" which is laid over the body's previous history byhospitalization,surgery, and the medical philosophy behind them. The resulting(undesirable)scar which records physical trauma and physical healing, has beenoverlain withthe tattoo, which probably traumatized the site a second time.Metzger intendsthe tattoo as a sign of a regained or new kind of beauty andpositive growth, anencoded "text" of her narrative of spiritual renewal. Thus the siteof theconspicuous absence of the breast has been overwritten with anothertext ofpresence. This act is at once a filling, a redescribing and areclaiming of thatspace. The photograph conveys reassurance and/or liberation. As Ihave noted,the angle from which the photograph was taken hoists the exuberantwoman up,with her arms extended and hands opened in a kind of centrifugalgesture.
There is a continued powerto this pose andits fixing (photographically and culturally) as a heroine image, asmuch as itis a typical popular front icon from the context of 1970s Americancelebratoryfeminism. However, given my experience with a mother who was notable to triumphor celebrate, I share a concern with some feminists, cancer careadvocates andpatients with images like this one may envision optimism too soonor efface theworst pain or difficulties of the disease. This objection alsohinges on thesituations the image is used in, and the frequency and form of itsreproductionand distribution. Elsewhere, I examine how the photograph has beenreprinted ina variety of formats and contexts. Some uses are much lessconscientious thanothers. We need to attend to what exchanges or economies thephotographpunctuates or influences, and which it elides. The image lendsitself to beingisolated from context and used too simplistically. Moreover, thisicon providesno way in which to do the labor of working through anger orsurvivor guilt. Forsome of us, the image may not recall anything of our relativesþ orpatientsþbodies or histories, and so may consolidate a resolution orrestoration which iselusive or unreachable. Although Metzger claims to have beenaddressing a broadaudience, the photograph may speak most effectively to women whohave just beendiagnosed, or whose cancer is not aggressive, or women and men whoareattempting to face or support a sufferer. My sensitivity to suchissues on apersonal and critical level informs but also conflicts with mycommitment as ascholar and a developing feminist to investigate and credit whatthis one womandid experience and how she perceived and mobilized her agency.
Understanding that thephotograph was partof a highly personal as well as political text written by thesubject of thephotograph helps to defuse objections that it is a dangerouslyaestheticizedrepresentation of breast cancer, or that it is too easilyoptimistic. In 1978Metzger published the journal she kept during her experience ofbeing diagnosedand treated for breast cancer, under the title Tree. As the bookwas going topress, Metzger collaborated with Hammid to produce the image. ThePeace Presswas unwilling to publish the photograph either in the book or as aposter toaccompany the book. Metzger produced the poster independently. Thephotographwas not included in subsequent editions until it appeared on thethird coverdesigned for the edition by Wingbow Press. It also appears on thecover of the1997 North Atlantic edition. Lest we think this photographþsattitude is one-dimensional or euphemistic, the palimpsestic placement of the imageon top ofMetzgerþs previous experiences in text--laying its desire againststruggle andanger¥ helps the image make the most sense. Metzger's journalrecords all hermoods: fear, indecision, anxiety, isolation as well as hope and herfaith in herpower to heal her body and soul. She refers to her inner feelingsandfrustrations, her own work as a writer as it is juxtaposed with herillness, andher support system of particular friends and family in alternatelylyrical,fearful, scathing and sarcastic tones. She asks crucial questionssuch as, "Whatshall I decide about being responsible for my own life?" (35) and"Can I utilizemedical knowledge without undermining my belief in my own healingpowers?" (29).In other levels of her text which she lays on top of her breastcancer illness,Metzger politicizes the above questions, and addresses not onlyherself butother women collectively and in inciting terms. Metzger muses onthe affinitieswhich her struggle with cancer has with military war, anddestruction waged onthe environment. In the Preface to the Second Edition, Metzgerclearly says"cancer is a larger political metaphor" (xii). In one of the mostforcefullypolitical and theoretical moves of her text, Metzger demands aninvestigationinto where her doctors invest their money--in what environmentallyharmfulcorporations or practices: "I want to know what they have alreadydone againstmy life" (28). At another moment, she describes mourning the lossof her breastand its positive functions. There is a great deal of emotional,theoretical,poetic, political, spiritual and symbolic material in this text,but for thepurposes of the present discussion of the photograph, I would liketo examinethree passages which specifically describe the photograph, orcreate otherimages of the breast in words. I wish to show how these excerpts(as examples ofthe work as a whole) complement, influence or condition the messageof thephotograph.
The text which mostclosely refers to thephotograph, and which accompanies many reproductions of the imageoccurs in theconcluding entry of Metzger's journal. After her mastectomy, andafter manymonths of physical and spiritual healing, Metzger has the tattoodone in theplace of the missing breast, and writes about it on Sunday August1, 1977 in away which clarifies the palimpsestic status of the tattoo as actand photograph:
I am no longer afraid of mirrors where I see the signof the amazon,the one who shoots arrows. There is a fine red line across my chestwhere aknife entered, but now a branch winds about the scar and travelsfrom arm toheart. Green leaves cover the branch, grapes hang there and a birdappears. Whatgrows in me now is vital and does not cause me harm. I think thebird issinging....I have relinquished some of the scars. I have designedmy chest withthe care given to an illuminated manuscript. I am no longer ashamedto makelove. In the night, a hand caressed my chest and once again I cameto life. Loveis a battle I can win. I have the body of a warrior who does notkill or wound.On the book of my body, I have permanently inscribed a tree(91).This entry lays one descriptive and interpretive text over thetransformed bodyin a verbal, declarative way, while the photograph adds a visual"text" of andon the same subject. What stands out in this entry is theamazon/warrior motif.Metzger has discussed this metaphor for the breast cancer suffererearlier inher journal in references to comments by friends and her ownevaluation of howthis symbolism might operate. Here, she first identifies with thecommon imageof the amazon through the element of the missing breast. However,Metzgerclearly wishes to revolutionize the image of the warrior woman andits affinitywith the mastectomy body: the battle in Metzger's context is allabout what doesnot cause harm; love; life. She redefines the amazon/warrior byboth likeningherself to its image and rejecting the act of wounding or killingat the sametime. In this way, she can reenvision "strength" and "battle" notas violencebut as healing, loving, writing and/or inscribing.
By comparing her tattoo toan illuminatedmanuscript, Metzger makes the scar into art as well as a carefullywritten text.That text she inscribes is a tree, a symbol meant to overwrite thenegative orlethal story of what is growing in her into a life-affirming one.The tree is arecurring symbol in Metzger's journal, used to designate a lifeforce or vitalenergy, or the potential she believes love to have forregeneration. Morespecifically, "tree" stands for a curing weapon (68), or thehealing forceharnessed and augmented by communal support and meditation withthose closest toher as they focus their love (70, 76).
In an Afterword writtenfor Tree in January1997, Metzger explains the aim of taking the photograph:
The photograph taken of me by Hella Hammid has becomeknown as theWarrior. Our intention in turning it into a poster was to invitethe world tolook at a one-breasted woman and exult in the health and vitalityshe had notcarried so powerfully before cancer. The illness I suffered was themeans ofprofound spiritual transformation (268).The statement that Metzger was asking the world to view themastectomy bodybetrays that this was not previously done, or was not being donecurrently inthe late 1970s. At that time making the image highly public was aradicalimpulse which was meant to subvert a perception of the cancersurvivor whichfailed to see beyond deformity, weakness, disability, or encouragedconcealment.
To go back further, on theFriday rightafter her mastectomy, after having written about how she isimaginativelyprocessing being "flat as a boy on my right side" (57), Metzgermentions adream, perhaps one of the nightmares she has recently alluded to.In describingit, she records an image of the breast cancer body which isextremely differentfrom that in her photograph:
A dream. While undressing before the mirror, I see mydeformedbreast sticking up at any angle as if the drainage disc were mybreast. It is sougly. Greg is in the room and I realize he has seen my body.Ashamed, Iapologize. The breast is now down to my waist. Jane and Sheila arealso presentand I apologize to them as well. I can not hide my body even whenI throw myselfface down upon the bed. But the breast is only pinned on. As Iunpin it, I seethe nipple hanging on like a tag. And I see Iþm flat... As indeedI am (57).In this section, Metzger is forced to confront, through theuncontrolled mode ofdream, the worst fears about the appearance of her mastectomy. Theemphasiswhich Western culture has put on womenþs appearance leads Metzgerto view herillness as ugliness, to feel shame, to apologize for theoffensiveness of herappearance, to attempt to hide it. She seems to be able neither tore-integrateher breast in a positive way, or to completely detach it.Associated with thisself-hating, mortified, apologetic scene, the revealing, unabashed,affirmativephotograph of Metzger seems a less automatic gesture. Far frombeing naively orswiftly ecstatic, the photograph occupies a place in a largerpattern: thedifficult modulation out of despair into recovery, healing andefforts towardtranscendence. In other words, the photograph is clearly not avisual text ofreward without work or pain. If a viewer of the photographconsiders it incontext, knowing the text, particularly what Metzger writes aboutfacingextremely unpleasant views of her own body, this leads him/her tounderstandfirst, that the representation in the photograph fixes one momentor phase, evenas it carries traces of earlier more fearful moments of Metzger'snarrative; andsecond, that it is a choice. The photograph represents a respitefrom previousperiods of revulsion toward the breast cancer body, and Metzgerchooses toemphasize her accomplishment.
Another palimpsest of thebreast cancer bodyis a non-traditional self-portrait by photographer Jo Spence (seefig. 2)Spence's palimpsest is also replete with desire, though a differentkind. Herimage has a number of things in common with the photograph ofMetzger, includinga straightforward gaze at the site of the illness, writingliterally on thebody, and an attempt to overwrite the inscriptions of surgery, andthe culturalmyth of the passive or infantilized patient. Despite the successand power ofMetzger's image as an act of transcendence and as a motivatingfeminist icon,and despite strong affinities between the two images, Spenceþs useofphotography is more aggressively critical, and more self-reflexivethanMetzger's. Her anger is overt in the photograph. As much as I seekto validatethe bravery and force of Metzger's photograph, as the daughter ofsomeone whodied from breast cancer, I feel a stronger accord with Spence'swork than withMetzger's triumphal stance. The personal and historical momentsrepresented bythe two photographs are quite different: Metzger produces an imageof a body ata point after healing, working in America in the late 1970s; Spencewrites andphotographs continuously during her illness from a 1980s Britishmaterialfeminist viewpoint. Metzger lived to write, lecture and tour intothe presentday; Spence died in 1992, after suffering breast cancer andleukemia. 
Figure 2:Jo Spence, self-portrait. FromPutting Myself inthe Picture (c) 1986, U.S. Edition, The Real Comet Press,Seattle, WA. Reprinted with permission.
The photograph of/by Spence showsher, nudefrom the waist up, in the foreground, filling nearly all of theframe,apparently in a room with what look like posters or clippings onthe wall behindher. She is wearing tinted glasses and is not smiling; thus thesubject, thoughphotographed clearly, can flirt with and defeat the cameraþs gaze,since she canstare back while preventing the viewer from actually seeing hereyes gazing. Shefaces the camera straight on, with her arms at her sides in aslightly rigidpose. Her breasts appear large and slightly drooping. On her leftbreast appearthe words "PROPERTY OF JO SPENCE?". A piece of tape runs from theouter side ofthe breast and underneath.
One initial reaction to thisphotographmight be an amused puzzlement or a sense of absurdity at someoneþshavingscrawled on the body, particularly on the breast, which the viewermight thinkof as either a private space, or an object of erotic or sexualfantasy. Thewords and capitalization of the inscription on the breast mightremind theviewer of nametags in clothing, bookplates, or T-shirts issued byathleticdepartments. Adding the question mark to the message inflects itstone ofauthority with another voice, however, an either confused, criticalor sarcasticone. To even articulate this question indicates that there is, onsome level, acontest over this part of her body, and perhaps that Spence intendsto use thephotograph to lay an interrogative "text" over the declamatoryþtextþ written bymarks made by doctors to guide incisions, and by bandages. While some viewers might be curious about where the subjectis, the sizeof the breasts and what the inscription might imply, theinteresting oddity forme, something which I don't find much of in Metzger's image, occursin thecharacter of the penmanship. It may seem rebellious, similar tograffiti, orunskilled like a child's handwriting. I think particularly of thescrawling "P"and "E" of "SPENCE" and the awkward angle of the question mark.What is more,the question mark's placement leads the eye right to a frayingthread on thesurgical tape, and its shadow on Spence's arm. This distracts meand begs me totidy up this something-out-of-place, which is of course absurdagainst the scaleof the disorder of Spence's medical condition. It is here in thispeculiar spacethat Spenceþs desire to document and challenge prompts a desire inme, anexchange, a kind of connection which Metzger doesn't allow. While Spence's photograph and the body in it, like Hammidand Metzger'swork, are palimpsests, there are important differences. Spence,unlike Metzger,makes no use of traditional photographic nude aesthetics,preferring a techniqueapproximating that of the amateur frontal snapshot. The desire hereis toconfront the ill body, to crowd the camera lens with it. Spencepictures her ownbody close up, accentuating that she is overweight, her breasts arenotþbeautifulþ according to the popular ideal, and she is neitherhappy norunafraid in her expression. This photograph clearly reproduces afar differentmoment from Metzger's transcendence, and has addressed differentaudiences. Spence took this photograph with Terry Dennett in 1982. InPutting Myselfin the Picture, Spence reproduces the photograph with anexplanatory captionnext to it which reveals that she and Dennett purposely made herbreast apalimpsest by writing, erasing and writing new messages on it:
Before I went into hospital in 1982 I decided I wanteda talisman toremind myself that I had some rights over my own body. TerryDennett and I setup a series of tableaux, each with a different caption written onthe breast.This is the one I took with me. I felt I was entering unknownterritory andwanted to create my own magic fetish to take with me (Spence,Putting Myselfin the Picture, 157, see fig. 3).Ostensibly, Spence is addressing herself with the photograph. Herintention in1982 was also to use photography both therapeutically andpolitically, to assertthe patientþs ownership of the body amid an institution whichchallenges orusurps that right. While the palimpsest is always metamorphosizingand has manylevels of meaning, the photograph fixes several of its layers ormoments here.Spence wishes to use the photograph as a fetish with the power tosecure hersense of identity and ownership of the body, and the relationshipbetween thetwo as she enters the arena of institutional, orthodox medicinewhichdestabilizes her agency. Writing her own text over others'--with apen or with aseries of photographs--intensifies this act.
Spence herself wrote atlength and indifferent forums about her experience of illness and herphotographic project.Her documentation and troping of the impact of illness andtreatment on her ispart of a much larger archive of photography over many years whichquestionsperceptions of health and disease, and theorizes body image frompersonal aswell as academic, psychological and therapy-oriented perspectives.One goal ofthis work was to construct a strong critique of the dominantmedical system andthe British National Health Service and standard medical treatment.Writing inthe photography journal Views in 1990, Spence explains her interestin bothpersonal and analytical evaluations of her experiences as a cancerpatient, andspecifically speaks about how and why she had turned tophotographing herselfand her surroundings during her breast cancer. She notes havingmoved throughmany extremes from despair and suicide fantasies to anger andrebellion toaction. She writes in her book Cultural Sniping, that ratherthan"pouring more chemicals down my throat, or of disavowing my stateof health"(130), she decided to document her "processing" by the medicalprofession:
I used my camera as a third eye, almost as a separatepart of mewhich was ever watchful: analytical and critical, yet remainingattached to theemotional and frightening experiences I was undergoing. As a womanwhose motherwas euthenased for the same illness, I felt like an avenging angelas I took mythirteen rolls of film in the hospital, ostensibly for my familyalbum. By thetime I had finished, I had no clear idea what I had photographed(130-131).Far from acquiescing to the fixed authority of the medical staffand policies,Spence takes a hard look at hospitalization as an act of processingpatients.She refuses the traditional role of passivity and blindness whichmedicalpersonnel and their knowledgeability encourage, she uses her camerato see andto document or capture scenes of her own treatment as a techniqueof reclaimingher own body and her own state of health. In doing so, she uses herphotographsto write her own visual "text" (and later in Putting Myself inthePicture, and Cultural Sniping, a verbal one) over thatcreated bycultural stereotypes of the patient as lacking consciousness and/oragency, andgenerally, the "text" of social myths such as perpetual health andhappinesswhich family and portrait photography create. I find Spence's image more self-reflexive in the context ofher overallwork on class identity, family history, health issues andphototherapy.Ironically, again, given my intersection with experiences of breastcancer, Ifind something more affirming in her representation than Metzger's.WhileMetzger used her tattoo and her photograph to help and invite theviewer to gazeat the shocking sight of a one-breasted woman, and to bring herinto the realmof the "aesthetic" Spence directly challenges the gaze and subvertsitsexpectations and manipulates the dynamic of the camera eye.Marianne Hirsch haswritten that "Spence is turning the look back at the medicalestablishment andgaining some small control over an institution that can decide herfuture"(Hirsch, 139). So Spence consciously grapples with the question ofrepresentingthe desire to be a victim or a heroine as a choice. "Spence stepsout of arepresentational tradition which depicts the ailing person as onewho copes andsuffers; in her images the ill person acts" (Hirsch, 139). WhileMetzger shows arecovered ill person, Spence documents the effects of illness whileit ishappening, over and over again. Breast cancer photography seeks to raise awareness of thedisease ashaving serious effects on individuals, and on culture and culturalproducts.Especially when it is accompanied by the words of the subject orphotographer,photography of breast cancer bodies creates texts which rewrite oroverwritehistory--medical history, and the history of the construction offemale bodyimages. Such work interrogates not only the ideology of moderncultureþs gaze,but the priorities of modern cultureþs problem solving modes. WhileMetzgerþsand Spence's portraits are the most obvious examples in which womentransformthe body affected by breast cancer into a surface to write on, theysuggest afurther inquiry into other more subtle ways artists and writersinscribe newvoices and philosophies in the history of perception of bodies anddisease.
For a more extensive breastcancerbibliography, contact the author at
For poster and postcardreproductions of "TheWarrior," contact Donnelly/Colt Catalog, P.O. Box 188, Hampton, CT06247, (860)455-9621. ***
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