Pink Ribbons, Inc.

I’m a definite contrarian/devil’s advocate/cynic/non-conformist type. Always have been. If there’s something that’s popular in a dogmatic kind of “you better not question this or look too closely at it or we’ll know you’re the enemy” way, then it’s a major red flag to my critical thinking tendencies. That’s one reason I hate political correctness as much as I do.

If anything, I have to guard against being too biased against the “this is what all of us good people believe in now, so you better also” stuff. I mean, what’s objectionable about treating such things as dogma isn’t that they’re always wrong, but that they’re being treated as dogma where people are discouraged from inquiring into their merits.

So when I saw that there was a documentary debunking the whole breast cancer cause with its pink ribbons, celebrities, corporate sponsors, etc., my natural reaction wasn’t, “How dare any nasty cynics attack such a self-evidently wonderful cause and disrespect heroic breast cancer survivors of all people?!” but more like, “Good, I’d be quite surprised if there wasn’t a great deal of bullshit, corruption, and muddled thinking in that movement.”

Not that I had any specific criticisms in mind, beyond just the general sleaze factor of there being an awful lot of evil corporate types trying to profit off of being on the right side of a trendy issue. It was more just my rule of thumb to assume that anything where pretty much all mainstream figures line up on one side is likely either false or trivial.

I do remember, though, an oncologist friend of mine mentioning in passing that while he’d be more than willing to address publicly almost any issue in medicine if people wanted to know what he thought, he would never speak openly about the current dogmas concerning breast cancer, which were far more political than medical, as it would mean the end of his career. Like questioning if more research dollars for breast cancer is more urgent than for prostate or other cancers, for instance. Or questioning whether mammograms are overrated. You’d immediately be shunned as anti-breast cancer survivor and anti-woman if you suggested such things were even up for debate.

Maybe as a doctor he couldn’t get away with opposing the current dogma on breast cancer, but that’s exactly what the documentary Pink Ribbons, Inc. (based on a book by the same name) does.

This is a good to very good documentary. My only complaint—and this is true of virtually any documentary, so I’m not going to come down on it too hard for this—is the organization. It’s the nature of the art that advocacy documentaries make their case in impressionistic more than logical ways.

As someone who values logic and critical thinking, I crave a presentation that is cogent and logically organized. You know, something where the conclusion or conclusions are made clear, where the premises are presented in an order that makes sense and are well articulated and defended with potential opposing points addressed, and it’s explained how the conclusion or conclusions allegedly follow from these premises. But of course that’s not typically going to be the most effective approach in a visual medium with very limited time available, addressed to a general audience rather than a few academics or logic buffs.

I’m not saying Pink Ribbons, Inc. is completely random. But to me at least it has a scattershot quality. There are a few general themes I can identify, but they come and go throughout the film. So, some fact, scene, quote, etc. concerning theme A will be followed by one concerning theme B, then one concerning theme C, then back to A, then C, then D, then C, then another C, then E, then back to A, etc.

The film spends a significant amount of time—and again this is weaved throughout rather than being covered in one specific section—giving the background of the breast cancer awareness phenomenon or cause or whatever you want to call it, showing many of its various events, etc.

So there are a lot of clips of people participating in walk-a-thons, running for “the Cure,” giving speeches to fire up the volunteers, illuminating famous monuments with pink lights, and so on. We certainly see plenty of people whooping it up at these event, excitedly carrying on for the camera to show their spirit. Many, many, many examples are shown of the various products—invariably recolored as pink—that corporations have chosen to associate with the fight against breast cancer.

The background stuff is worthwhile. Especially with the footage from the various fundraisers, you get a sense of just how caught up people get in this, just how much meaning it has for them to be an active participant in a cause that is close to their heart, and to come together in the process with countless other good, likeminded people. I’m sure it’s exhilarating to experience.

I’m also sure that many, many people like that would respond negatively and defensively to this critical documentary, but in so doing I think they’d be missing the point. The documentary is not at all critical of people like them; the documentary is critical of those they contend are exploiting people like them.

I know documentaries desperately try to avoid relying on talking heads for fear of putting viewers to sleep, but the clips with the talking heads in this film are among the high points, especially since they include the great Barbara Ehrenreich. I only wish there wasn’t so little of her. (I’m one of the 1% of viewers who would actually prefer a film of the same length consisting of Ehrenreich simply lecturing to the camera the whole time, presenting a logically coherent, cogent case for taking a critical stance toward this pop culture breast cancer movement.)

So anyway, what are some of the main themes, the criticisms, that Pink Ribbons, Inc. advances? (Many of these are interrelated of course.)

• Some of the corporations associating themselves with the fight against breast cancer are corporate bad actors simply engaged in public relations to improve their reputation. Worse yet, some of them represent industries that actually expose people to greater risks of cancer, thus making their PR stunts especially ironic and disgusting.
• Comparatively little of the money raised goes into research and other efforts aimed at prevention, versus the search for “the Cure.” What little does get directed that way almost all goes toward prevention and early detection on the individual level, like urging dietary changes, breast self-examinations, etc., and not on the public health environmental factors that affect the incidence of cancer. This is no coincidence, but stems from the fact that the movement wants to continue to get the money and support of corporations that would suffer if more were known and publicized about the links between environmental factors and cancer, and legal or regulatory action were taken against the industries giving us cancer.
• In general, there’s enormously more emphasis on raising as much money as possible, than on how this money is spent. The philosophy is to throw as much publicity and money at the problem of breast cancer as possible and assume that that’ll get the job done. No one seems to have a global view of all the spending, but it appears there is considerable inefficiency in it, with some areas neglected and others unnecessarily duplicated. Plus this isn’t just random inefficiency, but reflects factors such as the aforementioned advantages to industry of avoiding delving into environmental causes of cancer, and a bias in favor of efforts that will generate corporate profits (like finding expensive new treatment drugs).
• Some of the fundraising gimmicks themselves are stupid, at least as far as doing anything about breast cancer as opposed to furthering the public relations goals of their sponsors.
• In general, any impulse in the movement toward any kind of activism that could be threatening to the corporate status quo has been actively suppressed in order to keep the movement as uncontroversial, popular, feel-good, and capable of raising money from any and all sources as possible. Protest marches on corporate polluters releasing carcinogens into the air and water have been replaced by women dressed in pink jumping out of airplanes to raise money and raise awareness.
• The “raising awareness” messages of the movement are sometimes dubious or mislead plenty of people. For example, the heavy emphasis on mammograms, what age to start getting them, how often to get them, etc. ignores the fact that the research is far from conclusive on all this, and so generates more money for those who sell certain medical services, including the mammograms themselves, while providing less certain benefits to patients. In addition, polls indicate that a surprisingly high percentage of women think mammograms prevent breast cancer—as if they do something to the breasts that makes them invulnerable or less vulnerable to cancer—when of course they’re just a method of detecting signs of breast cancer. Furthermore, while that potential early detection helps some women, it harms or does nothing for others. So even insofar as their messages have merit—which to some extent is arguable—they aren’t doing a very effective job communicating them.
• The movement’s emphasis on the determined women who are standing strong and defeating cancer by undergoing all the recommended treatments and such—the “survivors”—leaves out all the women who are at a stage of the cancer for which there is no treatment, or who fight in the recommended ways and don’t win the battle. They’re made to feel like losers, like they’re dying of cancer because they didn’t do enough to stop that from happening.
• Related to that, all the happy talk, positive thinking stuff about the movement leaves out all the women who don’t want their breast cancer to be presented as all warm and fuzzy, and who feel judged for not maintaining a chipper, upbeat attitude throughout their illness, where again it feels like they’re being told that dying of cancer is their own fault, as if it wouldn’t have happened if only they had kept up a better attitude.

That’s just off the top of my head after watching the movie; I’m sure if I watched it again I’d be reminded of additional significant points that don’t fit neatly into any of these categories.

On the first point, the film points out that among the most prominent sponsors of the movement are cosmetics companies that use known or suspected carcinogens in their products, and companies like Ford that are associated with the use of fossil fuels.

I think they’re on a little shakier ground when they ridicule a sponsor company like KFC. “You actively market and sell products that causes cancer, so it’s hypocritical of you to act like you care about the fight against breast cancer” makes more sense to me than “You actively market and sell products that are criticizable (e.g., can contribute to obesity, aren’t vegan and so violate animal rights, or whatever), so it’s hypocritical of you to act like you care about the fight against breast cancer” sounds more like generic social justice warrior posturing.

Not that I’m defending KFC, et al. I suppose what I’d say is that it’s especially odious for the corporations that cause cancer to seek to boost their reputations by associating themselves with the fight against breast cancer, but really there’s something scummy about philanthropy for marketing purposes in general, whether your corporation’s goods and services are good, bad, or indifferent.

I’m certainly not going to think better of some pizza chain just because it pats itself on the back for “raising awareness” about breast cancer by using pink carryout boxes one month per year and donates money to breast cancer charities. After all, “Thus, when you give to the needy, sound no trumpet before you, as the hypocrites do in the synagogues and in the streets, that they may be praised by others. Truly, I say to you, they have received their reward. But when you give to the needy, do not let your left hand know what your right hand is doing, so that your giving may be in secret.”

I mean, I’m sure people will say that given the nature of capitalism, you can’t really hope for any better than that corporate philanthropy will be for self-interested motives. And isn’t it better to exploit corporations’ craving for good public relations so as to raise money for good causes like curing breast cancer? (Reagan is shown making a point like that in a speech, though of course not worded in a way that highlights the selfishness of the corporations.) Perhaps, but really I think that’s more of a condemnation of capitalism and how it has warped people’s motivations and judgments than a defense of public relations-based philanthropy.

My favorite of the dubious fundraising ploys is from Yoplait. If you send in a lid from your used Yoplait container, they’ll donate 10 cents to the fight against breast cancer. But as a commentator in the film notes, even leaving aside the labor and time, you’ve paid 45 cents for a stamp to send in the lid, resulting in a 10 cent donation. You’re out 45 cents, the breast cancer charities gain 10 cents, maybe the government gets some slight benefit from selling you the postage, and Yoplait gains whatever it gains from this marketing maneuver to make it look like good guys. Wouldn’t it make more sense just to give your 45 cents directly to a breast cancer charity or some other good cause?

I suppose the only response would be that people aren’t rational. Like if the same amount of marketing money were spent to urge people to give 45 cents to breast cancer as is spent to urge people to send a yogurt lid to Yoplait so they’ll give 10 cents to breast cancer, very few people would give the 45 cents. So maybe breast cancer ends up getting more money if you choose the irrational route, because people are dumb.

I mentioned that mammograms are a mixed blessing. Let’s talk about that a little more, with the understanding that the film is not at all taking an anti-mammogram position, but is merely pointing out that there are costs to go along with the benefits.

There is one clear type of case where mammograms are a definite good: A person gets a mammogram, the results reveal a treatable cancer, she gets treatment that makes her better to some degree, and had she not gotten that mammogram she wouldn’t have known to get the treatment and would have fared worse.

That’s the best case scenario, but of course it’s also a small minority of cases. Most cases instead will fall into one of these categories:

• The mammogram shows nothing, so you’re in the exact same position as if you hadn’t gotten it. The only difference is you (or your insurance company or the government or someone) are out the cost of the mammogram, so in that sense it’s slightly worse than if you hadn’t gotten it.
• The mammogram reveals that you have a cancer that can’t be treated, or that can be treated no more effectively than if you hadn’t found out until whenever you would have found out in the absence of getting the mammogram. Again you’re basically in the same position, with that slight difference that you (or someone) paid for a mammogram. In this case there’s the additional psychological difference that you knew about the cancer sooner. Because that knowledge provides no treatment benefit, for most people it would be a clear negative (you would very likely be happier living your life not realizing you had cancer), though perhaps there are a few people who have a preference to know such bad news, even in a case like this where they can’t do anything about it, as soon as possible.
• The mammogram reveals enough that you end up getting treatment when really you shouldn’t have, either because it’s a false positive (i.e., what it revealed was never cancer), the cancer it revealed would never have developed into anything harmful if left untreated, or it revealed a cancer that treatment sometimes helps and sometimes doesn’t and this happened to be one of the times it doesn’t. This is the worst type of case because not only does the treatment cost you or someone money, often a great deal of money, but it also can be difficult and painful to go through and in some cases can damage or even kill you. I mean, cancer treatments have improved greatly over the years, but they are still not something you undergo for kicks; about the best thing that can be said for them is that they’re better than dying of cancer.

Again, this is not to say that these cons (all these types of cases where you would have been better off not getting the mammogram) deserve more weight than the pro (the type of case where lives are saved by early detection). Even when you take all the evidence into account mammograms do more good than harm.

But that can be true, and yet it also be true that mammograms are overrated, or that there can be reasonable disagreement over who should get them and how often.

Or it could even be the case that mammograms with certain equipment are justified in cases where they wouldn’t be justified with other equipment. One of the interesting tidbits the film mentions (and there are analogues to this with drugs) is that when the United States and some countries determined that certain types of mammogram machines gave the patient a high enough shot of radiation that they actually did more harm than good overall and mandated that only lower radiation machines could henceforth be used, the companies that had all those old mammogram machines didn’t simply put them out to the curb with the trash. Many of those machines went to Third World or other countries that hadn’t made that same determination.

Moving on, I don’t know that I’m fully on board with the criticism that the movement—with its purposeful choice of a color that tests happy and positive with focus groups, its celebration of how incredibly awesome all women with breast cancer are, and its incessant upbeatness and positive thinking philosophy in general—is saying that breast cancer itself is something happy and fun. (For example, Ehrenreich notes that when she was in a waiting room at an appointment to get treatment for her breast cancer, she saw an ad in some magazine she picked up for a pink breast cancer teddy bear, and it thoroughly disgusted her, like, how dare you tell me cancer, or having cancer, is something cute and cuddly and lovable.) I mean, I think the obvious interpretation of the message of all the positivity and pink is that the opposition to breast cancer is a positive thing, not that the cancer itself is a positive thing.

But that’s not to say I agree with the happy talk approach, merely that I’m dubious that the specific thing wrong with it is that it makes cancer itself out to be something fun and happy.

Maybe the best you can say about the approach is that it works for some people. But that leaves open the possibility that it doesn’t work for others. Seemingly a lot of the women with untreatable breast cancer, Ehrenreich-style curmudgeons, and maybe some other types of breast cancer patients aren’t helped by that approach and a mass movement shouldn’t pressure them with a “one-size-fits-all” philosophy.

A lot of the happy talk just strikes me as benevolently-intended bullshit (and of course people will differ on whether benevolently-intended bullshit in general is good or bad, with I suspect the vast majority favoring it).

For example, one of the speakers at one of the rallies in the film speaks with great emotion about how women with breast cancer are the most courageous of all people, or words to that effect (which of course elicits the intended enthusiastic applause of agreement from the assembled crowd).

OK, how so? Note that she isn’t claiming that certain breast cancer patients—for instance, those who deal with their disease in this way rather than that way—are superlatively courageous. She’s saying that they all are, that evidently just having the disease itself constitutes being highly courageous.

But if you’re awesomely courageous whether you get treatment or not, whether you follow doctor’s orders or not, whether you maintain a positive attitude or not, whether you reach out to help fellow sufferers of the disease or not, whether you get depressed or not, whether you let a charlatan dupe you into paying for a quack treatment or not, whether you kill yourself or not, then does the compliment even have any substance to it?

Ehrenreich mentions, by the way, that she hates the “survivor” terminology, that instead of “breast cancer patients,” “breast cancer victims,” “breast cancer sufferers,” whatever, it’s now politically mandatory to say “breast cancer survivors.” For one thing, it’s kind of an indirect knock on the people who have died of (i.e., not survived) breast cancer. Do they not exist? Are they losers for not having survived?

I hate it more just on the general principle that I hate euphemisms. I roll my eyes at such linguistic manipulation tactics just as much in other contexts.

The “survivor” thing obviously isn’t exclusive to breast cancer. There are incest “survivors,” rape “survivors,” sexual harassment “survivors,” and on and on (though oddly enough no murder “survivors” so far). I mean, it makes sense if you really are making a distinction between those who survived something and those who didn’t. Like the (fatal) victims of some school shooting versus the survivors of it. But otherwise it’s a euphemism, like saying “defense” spending instead of “war” or “military” spending, or like Richard Simmons trying to change “diet” to “live it.”

I’d actually like to have seen more in the film on the social issues, the kinds of things Ehrenreich addresses. They’re brought up here and there, but generally dropped pretty quickly. There’s much more emphasis on the sleazy corporate stuff. Which I agree is important—I’m not saying there’s too much of that—but more on the pros and cons of the feel-good approach to dealing with cancer would have been good.

As a final note, I should mention that Pink Ribbons, Inc. is now quite a few years old. (It’s from 2012.) So keep in mind that the claims it makes apply to the movement as it was at that time, as do my remarks. It’s possible the movement has changed significantly since then, for the better or for the worse.

Relatedly, obviously relevant specific events from the last few years aren’t addressed in this film. For example, the dust-up concerning the Susan G. Komen group’s withdrawing (and then under fire restoring) its support for Planned Parenthood does not come up in the film, as that occurred shortly after (actually later the same year) the film was completed.