Elizabeth Wurtzel’s tragic death should be a wakeup call for Ashkenazi Jewish women
If ever there were a Gen X Jewish woman writer who made meaning out of the intimate details and dark forces that wreaked havoc on her life, it was Elizabeth Wurtzel. The author of “Prozac Nation” and “More, Now, Again: A Memoir of Addiction”, Wurtzel died, far too young, on Tuesday from metastatic breast cancer; she was just 52.
I didn’t know Wurtzel personally, but I knew her deeply personal struggles. Time and again, Wurtzel used her writing to confront her own vulnerabilities head-on, honing an intimate and detailed form of personal memoir which changed the conversations around mental illness and addiction in the U.S. What she accomplished was new and brave and important. With her visceral approach, Wurtzel helped many understand their own struggles, and slay their own demons.
Wurtzel’s life had many revolutions, from music writer to memoirist to provocateur to lawyer (with a JD from Yale). Finally, she was a patient, and being who she was, Wurtzel brought the same unflinching honesty to her own cancer, writing a deeply disquieting Sunday op-ed in The New York Times: “The Breast Cancer Gene and Me.”
“I did not know I have the BRCA mutation,” she wrote then, in 2015. “I did not know I would likely get breast cancer when I was still young, when the disease is a wild animal. I caught it fast and I acted fast, but I must have looked away: By the time of my double mastectomy, the cancer had spread to five lymph nodes.”
In the wake of her death this week, those of us who are — or love — Ahskenazi Jewish women should follow Wurtzel’s lead and face up to the facts of breast cancer and BRCA — without flinching.
Let’s start with the numbers, as staggering and scary as they may be. Beyond some kinds of skin cancer, breast cancer is the most common cancer in women, regardless of race or ethnicity. It’s the second most deadly cancer for women in the US, causing 40,000 deaths each year.
One in eight women will receive a breast cancer diagnosis in her lifetime. One in 400 women are BRCA-positive, having a mutation that increases their lifetime risk of developing breast and/or ovarian cancer up to 84%. And for women of Ashkenazi heritage, there’s a one in 40 chance of having a BRCA genetic mutation.
“I could have avoided all this,” Wurtzel wrote, “if I had been tested for the BRCA mutation. All Ashkenazi Jewish women should be tested, because we have it at least 10 times the rate of the rest of the population.”
It seems extremely likely she’s right. A preventative double mastectomy decreases the risk of breast cancer by 95% for women who have a disease-causing BRCA mutation, according to the National Institutes of Health.
Right after her Times op-ed on BRCA came out, I spent the better part of a week interviewing geneticists, doctors, scientists and advocates — from New York’s Mount Sinai to Hadassah Hospital in Jerusalem — to better understand the different schools of thought on breast cancer, specifically on when and which Jewish women should get genetic counseling and testing.
What I came away with is this: Ashkenazi Jewish women — even those who are unaware of breast cancer or BRCA in their families (especially when carried by the father) should talk to a genetic counselor. Even those who opt not to go for genetic testing will better understand their risks — and what they can do to mitigate them. Because, yes, our choices absolutely impact our health. So do our laws.
Like Wurtzel, we can all fight to ensure that we don’t lose the mandatory health insurance coverage for breast cancer screenings and some preventative treatments we gained through the Affordable Care Act — and to gain coverage for genetic counseling and testing.
There are also tests you can order online to take at home, but it’s not recommended. The counsel of professionals who can help you understand the implications of your results for you and your family are crucial; if you were to get a positive result, you’d want to hear the news from a genetic counselor who can talk you through what your next steps should be. And if you were to get a negative result, you’d want to understand just what’s been ruled out — and what hasn’t.
Most people aren’t brave and bold and public about the things that hurt and scare them most, like Elizabeth Wurtizel was. But maybe thanks to her, more women will be catalyzed into action, at the very least to get a mammogram, and if Ashkenazi or otherwise at higher risk, to talk to a genetic counselor. I did. And I hope the Ashkenazi women in your life will too.
I’m not someone who says hella, but here it is: Elizabeth Wurtzel had hella chutzpah.
“Everyone else can hate cancer. I don’t,” she wrote in the Guardian in 2018. “Everyone else can be afraid of cancer. I am not.”
And while most of us absolutely are, we can be afraid even as we face it head-on.
Erica Brody is a writer, editor and strategist who lives in Brooklyn. The views represented here are her own.