Yesterday I sent out a long post contrasting the Shirtwaist Strike with the whole October pink mania.  In Part II we will discuss the Triangle Shirtwaist Factory fire which followed the strike, as it relates to metastatic breast cancer – which is when cancer has spread beyond the breast into other parts of the body, the brain, liver, bone or lungs etc. 

Much of the backlash against the Pinktober efforts are wrapped around the complete lack of attention paid to metastatic breast cancer- the end stage of the “easy” cancer that people die from. The celebration and rituals surrounding “Survivors” are in many ways a look away from the alternative – those non-survivors who are “losing their battle” with breast cancer.

In 1909 when Clara Limlech stood up to call for a general strike, she was joined by over 20,000 garment workers. Clara was a worker at the Triangle Shirtwaist factory, owned by two Russian immigrants, Max Blanck and Isaac Harris. Blanck and Harris used a variety of tactics including hiring thugs to rough up protestors, and then bribing police to arrest the strikers rather than the paid instigators. But bad as they were, working conditions were no better in the nearly 500 other sweatshops making the Gibson Girl style blouses in New York at the time. The strike extended through the bitter cold winter months until it was mostly resolved in February 1910. Notably the largest factory, the Triangle – owned by Shirtwaist Kings Blanck and Harris, made only token improvements, and refused to allow the workers to unionize.

For those who undergo treatment for Breast Cancer the end of treatments can seem like it should be the end of the story. But like the workers returning to their lives after the excitement of the strike, life continues to have its challenges. Life post cancer treatment often brings waves of emotional work to process the experience, and come to terms with the changes to the body rendered by the treatments themselves. From early menopause or cognitive changes, to numbness or pain it is a new world post treatment any way you slice it.

I imagine that the Shirtwaist strikers that were beaten and arrested during the strike,  experienced mixed emotions in the aftermath of the strike. Glad for the wage increase, yet still processing the trauma of being beaten. Likewise post breast cancer treatment women are happy to be “free” of cancer, and yet still have a lot of mixed feelings about the changes to their world.  Specifically the thoughts in the back of the mind that question the chances that the cancer will stay gone. Being a “Survivor” can feel like a joke when every ache and pain needs to be questioned as a sign of metastatic progression.

For many of the 20,000 shirtwaist workers there were modest improvements in working conditions after the strike, but the life of a sweatshop seamstress was still not easy for any of them.  For workers at the Triangle – the safety issues were not addressed. Piles of tissue and fabric scraps were still piled all around, and the fire exits were locked to prevent workers from taking unauthorized breaks. I am guessing that relations between management and workers were at best strained, or more likely abusive at the Triangle.

Just over a year after the end of the strike in March 1911 a fire broke out on the 8th floor of the Triangle factory and rapidly spread upwards to the 10th floor. 146 workers were killed in the blaze. Those piles of scraps, and locked exits contributed to the death toll. It was a shocking spectacle. Fire ladders were not long enough to reach the girls, and firemen looked on hopelessly. The single fire escape collapsed sending workers to their death.

When someone undergoes treatments for cancer – sometimes the fire escape of chemo, radiation and surgery do not lead to the other side – to the fabled cancer free existence that is hoped for. About a 20-30% of the time breast cancer progresses to stage four, Metastatic disease. The kind not offered the option of a cure, the kind people die from. The kind that  the happy pink face of Breast cancer awareness month turns away from.  Some women have an initial diagnosis of stage four, but for most it comes about as a recurrence- sometimes years later. Despite doing everything the women whose disease does not progress do, the gals with metastatic disease find themselves in the middle of an inferno.

Though I believe that in the beginning breast cancer awareness was inspired by those who died, over the years it has been watered down into what is nearly a misinformation campaign. Mammograms do not prevent death via breast cancer. Early diagnosis does not prevent recurrence, or advancement of the disease. The truth is that after all these years we still do not really know why cancer does progress. Historically women with metastatic disease have been used as guinea pigs in clinical trials- but there is woefully little research into actually addressing their situation. For some it is treated as a chronic disease, and they may live many years with cancer as a dread companion. For others death comes swiftly.

In the aftermath of the Shirtwaist Fire there was a public outcry that resulted in Blanck and Harris being tried for murder. They were acquitted because it could not be proven that they knew the doors that trapped the young women were locked. The sheer horror of the situation did result in significant changes to labor law, and the practices for the inspection of workplaces. Their deaths resulted in changes that improved the lives of workers in ways more substantial than the wave of changes that happened in some workplaces post strike in 1910.

I do not believe that there are any breast cancer super villains equivalents to the Shirtwaist Kings. While I doubt that there are dark forces actively contributing to breast cancer deaths, I can not help but wonder if we are missing something that could be done, because we are not looking in the right direction.  I think we need to consider new ways to investigate what is actually going on within cancering cells. Theoretically we should be able to figure out a means of turning off the signals that promote cancering. There is more we can do. If the deaths of 146 seamstresses was enough to spur wide scale changes to labor laws, surely the fact that 40,000 women die of metastatic breast cancer each year is enough to spur us to do what is needed to protect our daughters, and granddaughters from a similar fate. Beyond just calling for more mammograms, which is sort of like installing smoke detectors after the building has burned down.

Though I want to have some magic list of action items to offer for us to take that will address metastatic disease I just don’t. I doubt that taking to the streets in protest will do much at this point in history.  While I was in College my housemates were in the thick of a protest of the first Gulf war that shut down I-5 , the primary west coast freeway from Seattle to LA. Their successful action shut down the freeway for several hours and was completely ignored by national, and even regional news. In these times I am not sure who we can protest to. Donating to ethical organizations like METAvivor that fund research is one option, but beyond that I am not sure how we can influence the situation on a national scale.

The list of things we can do seem to mostly be on the personal scale. Like making an effort to be present to those we know with metastatic disease.  Which means confronting our uncomfortable feelings about death, while remembering that they are still alive, until they aren’t. Metastatic disease can be more painful because it can be isolating. People don’t know what to say so they stay away. Cancer as a chronic illness may be a long game, in which they may need support for years. Some of the most meaningful friendships I have been blessed with have been with people who are dying. I have also made mistakes that destroyed a friendship with someone who is living with metastatic disease.

I personally believe that maintaining a vision of them well can have impact. There are people who have gotten better from even the brink of death. Miracles do happen and have been documented.*  There is a difference between probability and possibility, but from my perspective maintaining a vision of the person being one who has a miracle is much preferred to maintaining a vision of their long slow death.  I vote for possibility over probability every time.  This is a discipline for my own thoughts, not a campaign to talk the person with Mets into having a “better” attitude. Though holding onto hope for someone may be something that may be shared with the person if that is helpful for their particular situation. It may not extend their life, but it may improve their life quality to know that not everyone is just waiting for them to die.

The fire of cancering burns away so much. I want to honor those who have died by finding some way to contribute to the effort to figure out of how to reset a body that has started cancering, so that it may start thriving – regardless of what stage the cancering activity is happening at.  I know that something happens that can change everything in an instant. I believe that it is likely to be some synergistic process that includes a spiritual component.

Finally I have written before about the difference between Heal and Cure that I learned from Bernie Seigel’s books. The greatest gift that we have that the shirtwaist workers did not have, is that with cancer there is usually time to pursue healing prior to death. By cultivating compassion and presence with others we contribute to healing no matter what the circumstances.  Healing may not be the same as cure, but it may in fact ultimately be more important.

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Details from the OSHA site: https://www.osha.gov/oas/trianglefactoryfire.html

There are more useful related links on my prior Post on the shirtwaist strike: Beyond Awareness Month

The Organization METAvivor works to fund research aimed specifically at metastatic disease, and is one avenue for supporting change: http://www.metavivor.org/take-action/

*The Radical Remission Project has stories from people who have gotten well against the odds: http://www.radicalremission.com The excellent book Radical Remission, by Dr. Kelly Turner PhD, gives a variety of actions that have been taken from her research of those who have gotten better. Highly recommended.

Dr. Bernie Seigel’s site: http://berniesiegelmd.com

*The book Dying to Be Me, by  Anita Moorjani is a very moving account of one woman who recovered from stage four cancer after having a spiritual awakening while in a coma. Below is her account given in a TED talk.