Catherine, Princess of Wales, asked for space after her cancer diagnosis. But true privacy is impossible with cancer — and for the wife of a future king.
To be clear, there is nothing private about having cancer. A diagnosis requires referrals and a bewildering number of scans and tests. There are ultrasounds, MRIs, PET scans; colonoscopies, bronchoscopies, endoscopies. There are needle biopsies, razor biopsies, or liquid biopsies. Most of the tests require getting naked, or mostly naked, beneath a robe, sometimes waiting in a large room full of other terrified strangers also in robes, before presenting oneself to strangers who push, jab, thread and insert tools into or onto body parts that are not normally explored. Frequently, these tests have to be repeated, or different tests ordered, to rule something out.
“I’ve been naked in front of so many people in my life at this point. You sort of lose some of that sense of, ‘My body is private,’” said Isabel Blumberg, who is my gynecologist. When I was diagnosed with breast cancer in 2019, Blumberg was the first person to call me. She told me that she’d had cancer, too.
In the video Kensington Palace released on Friday, Catherine, Princess of Wales, revealed her cancer status after more than six weeks of silence and pleaded for privacy. “We hope that you will understand that, as a family, we now need some time, space and privacy while I complete my treatment,” she said while wringing her thin hands. A princess no doubt bypasses the waiting rooms and receives a level of medical care inaccessible to most. But she cannot evade the intrusions and indignities of cancer — the anxious waiting for pathology reports, the shock of the news, the series of treatment decisions that no young, healthy person has ever imagined having to make. The treatment can feel like a grueling, interminable invasion.
And because Catherine is a princess, the violations went further: the wild and incessant speculation about what had gone wrong with her body, the alleged unauthorized infiltrations of her medical files, which the London Clinic, where she underwent “major abdominal surgery,” is investigating. “There is no place at our hospital for those who intentionally breach the trust of any of our patients or colleagues,” Al Russell, the clinic’s CEO, said in a statement.
Even in health, privacy is difficult for a public figure to attain, and since she married Prince William in 2011, Kate Middleton has lived under a microscope. Her physical body — her legs, her hair, her behind, her clothing — has been scrutinized in the way of every female celebrity but also because of her royal function and role.
Long ago, she traded her independence for rank, and her most important job has been to perpetuate the monarchy by bearing its heirs. In a very real way, her body is under inspection because it belongs to her nation, and to its future.
In becoming royal, a person secures a lifetime of luxury and comfort. But also, “you become a public body, the site of enormous projection, everything from longing to disdain. People pick you apart,” Susie Orbach, a psychoanalyst in London and New York who treated Princess Diana, said in an interview. “There are so many different aspects of what it means to be a royal body — which obviously no one understands when they start going out with a prince.”
Guarding against incursions into privacy — controlling who has an interest in and access to the female royal body (for certainly no one is as obsessed with King Charles III’s health as they are with Catherine’s) — is at least four centuries old. Elizabeth I “spent an enormous amount of time authorizing images of her body,” strategically projecting an image of potent virginity to avoid marriage in order to amass and preserve power, explained Jean Howard, a Renaissance scholar at Columbia University. “She had to produce a body that people would accept,” Howard said.
Working with court painters, the image makers of the time, Elizabeth I created “a virginity that everyone fetishized,” both sexual and unattainable. “She adorned herself with pearls of purity. She was painted in dresses that had a pearl right where the clitoris would be,” Howard said. When she passed childbearing age and could no longer wear virginity as armor, Elizabeth I instructed her portrait makers to render her as godlike — in Howard’s words, “the bride of Christ, married to her job, and married to the country.”
But the monarchy has undergone the same cultural shift as everyone else — from bright lines between public and private selves to blurred ones, “from believing in privacy to believing you share everything,” Orbach said. When Queen Elizabeth II was pregnant in 1948 and 1950, with Prince Charles and Princess Anne, respectively, “the Queen was merely said to be in ‘an interesting condition’ and all photographs of that ‘condition’ were prohibited,” wrote Tina Brown in “The Diana Chronicles.” And in 1966, when the queen’s mother, Elizabeth, was admitted to the hospital, the communications team at Clarence House referenced “abdominal surgery,” and nothing further. More than 40 years passed before the Queen Mother’s biographer, William Shawcross, revealed that a cancerous tumor had been removed from her colon.
“I hope they’re looking after you well,” Prince Charles, who was 18 at the time, wrote to his grandmother. “Mummy said that you had difficulty getting around two gi-normous policemen wedged into the corridor outside your room.” By the time Charles was expecting his first child, the tabloids were full of stories about Diana’s morning sickness.
Cancer is not just an intrusive, malignant replication of cells that “lives desperately, inventively, fiercely, territorially, casually, and defensively” in the body, as Siddhartha Mukherjee wrote in “The Emperor of All Maladies,” but it always carries with it a whiff of death. At its best, cancer is something to be vigilant about and to contain. At its worst, it destroys. In any person, a diagnosis of cancer comes with a recognition of mortality. In many people, especially young healthy people, it feels like betrayal.
“I had the easiest breast cancer I could have had,” Dr. Blumberg told me, “and it brought me up short.” She was diagnosed at 46 and is now 52. “It creates a sense of embarrassment that your body let you down at this age. I do remember feeling kind of stunned. Like, weak. Like embarrassed that my body had shown a vulnerability that I didn’t think I was going to have.” I felt the same way. We both also understood exactly how lucky we were to have small cancers, health insurance and doctors we could reach on the phone.
Still, for Catherine, whose royal image is one of lithe and capable athleticism, who has been photographed running, boating, mountain biking, and playing rugby, the news must be unbalancing. To process the reality of cancer — and the possibility of desiccation, weakness, and ugliness — when the public stakes in her vibrant health and beauty are so high, in the midst of the malign social media torrent, must feel outrageous.
With every cancer diagnosis comes the question of whom to tell, and when. And because cancer still carries with it such a deep sense of failure and shame, this telling is freighted with fear of judgment. When Susan Sontag wrote “Illness as Metaphor” in 1978, doctors in Italy and France did not tell any but “the most mature and intelligent” patients of their cancer diagnoses, fearing “the truth will be intolerable.” And “patients who know what they have tend themselves to be extremely prudish, if not outright secretive, about their disease,” she wrote. When, 40 years later, it was suggested, in a previous job, that I tell the HR manager about my breast cancer, I recoiled. I tell my friends everything, yet felt I did not know this man well enough to admit to a sickness in my left breast.
The desire to disclose the details of one’s cancer varies widely, depending on the nature and severity of the diagnosis, the patient’s support systems and responsibilities, and, of course, gender. “Cancer management, like all of life, does not occur within a vacuum. It occurs within a system of relationships,” wrote the authors of a 2003 paper on cancer management. A 2009 analysis affirmed the convention that young men tend to be stoical, but it noted that women can also feel responsible for how others receive the news. “Women described trying to ‘protect’ or ‘distance’ their families from their diagnosis, and several talked explicitly about their efforts to remain upbeat,” the researchers wrote.
Six weeks is not a long time in cancer world. Information reveals itself slowly, in stages, as do treatment options, and decisions are made accordingly. Now that Catherine has revealed her condition — broadly, without specifics — the world has another opportunity for projection. “Do we recoil?” Orbach asked. “Do we hurt? Do we identify? Do we fear?” Everyone will have some response, “including people who are anti-royalists, triumphalists.” But it’s not all negative, she pointed out. “People are fearful, but they also really care about you.”
The royals, Orbach said, have lost their privacy along with everyone else — and to a higher degree because of the public’s magnified focus on them. But at the same time, their position affords them protection, and retreat. For Catherine, “I think there are enough private spaces, and one doesn’t need to worry about that.”
https://www.nytimes.com/2024/03/23/well/princess-catherine-cancer-privacy.html
