Thursday, May 28, 2009
Happy birthday BRCA
I read somewhere (a blog, actually, and we all know how trustworthy those can be -- never trust anything you read on the internets) that yesterday was the 15th anniversary of the discovery of the BRCA gene.(What? You didn't get an invitation to the birthday bash? Yeah, me neither.)
Oh, to harken back to the halcyon days of May 1994! Pearl Jam topped the charts, the salacious backbiting on Melrose Place had us glued to our televisions on Wednesday nights, and Kurt Cobain was newly dead. I was 15, finishing up my sophomore year of high school, preparing for another summer at the beach, learning to drive. I was completely unaware that scientists were racing to decode the human genome and, with it, the genes that cause hereditary cancers. I had missed this issue of Newsweek, published the previous December (my family, to be fair, were always, and are still to this day, Time magazine subscribers. We also buy Ford cars and Crest toothpaste. We're brand-loyal like that). And aside from my maternal grandmother's bout with breast cancer in the 1980s, my life was gloriously free from concerns about disease, death, and genetic destiny.
But even then, even before they has a test for it, even before they knew what they were looking for, I unknowingly carried the breast cancer gene. (This is mind-blowing to consider: when I learned about my status, my first instinct was to think back to a happy moment before I had the gene, just like someone who gets sick might look back longingly at a time before he or she surrendered to disease. But there is no moment in my life when I wasn't a gene carrier: I was born one and I'll die one, but for the first thirty years of my life, I didn't know I was one. And that's astonishing. So when I think back to happy times, like my wedding last summer, I don't think of those memories as snapshots from a time "before I got BRCA" but as stills from a film about my life "before I knew.") And now 15 years after the discovery of the gene, I have been tested for it, I've confirmed I'm a carrier, and I've started to consider my options to reduce my risk of cancer. I'm living proof of the impact of the inexorable march of scientific progress: in my short lifetime, I've already benefited from genomic advances that probably sounded like mere science fiction way back when I was born.
And what more is to come? It's dizzying to imagine the gene therapies and the DNA repair agents (not to mention the futuristic clothes we'll wear and the moving sidewalks we'll walk on) of the future. I feel lucky to be alive during this era of exponential discovery, but I worry that the choices I make today, like having a prophylactic mastectomy or making use of preimplantation genetic diagnosis, will seem barbaric and medieval just 15 years hence. But belief in better future hardly resolves the conundrums of an uncertain present. I'm thankful for the knowledge I have about my genetic predisposition toward breast cancer, but I'm also grateful for those many years of blissful ignorance. I can't imagine what my teenage self would have done with this knowledge. (I probably would have slammed my bedroom door and turned up the volume on the Reality Bites soundtrack -- oh, how I loved that movie. Having a moment here realizing it's 15 years old. Give me a sec. OK. Deep breath. I still love you, Troy Dyer!)
So here's to you, BRCA, and the talented scientists who discovered you. You've turned my life upside down, but I don't fault you. I'm just glad I found out about you before you started causing malignancies in my mammaries. And because of what happened 15 years ago, I can make better choices about how to coexist peacefully with you, just like I did all that time before we were introduced.