Women who had undergone disfiguring surgery for breast cancer, according to one surgeon in the 1970s, needed to “stick an old sock in their bra and get on with their lives.” It was this climate that Betty Rollin, then a television correspondent for NBC, entered when she was diagnosed with the disease in 1975. Rollin, who died of voluntary assisted suicide in Switzerland in November at age 87, became a highly visible activist not only for women with breast cancer but also end-of-life issues, after she helped her mother die and then wrote about it.
It is hard enough to challenge the medical establishment over one issue, but Rollin ably pushed in two controversial areas. Her determined personality and prescient instincts greatly helped.
I first met Rollin in 1997 when I interviewed her for my book “The Breast Cancer Wars.” It was a particularly intense experience for me. Rollin’s 1976 book about her breast cancer, “First, You Cry,” had been a permanent fixture on my mother’s bedstand when she developed breast cancer in 1977. As the book’s title suggested, Rollin believed that it was not only acceptable but therapeutic for women to cry upon learning their breast cancer diagnosis. The stiff upper lip suggested by the “get on with life” breast surgeon, while perhaps effective for some women, ignored the devastating emotional experience that others were going through. “First, You Cry” was also pathbreaking in its use of humor to describe what was a harrowing ordeal.
But what most impressed me about Rollin’s story was her insistence that her surgeon pay attention to what the operation would do to a patient’s appearance. Although perhaps a marker of sexism in society, Rollin, as a prominent television personality, needed to “look good” on the air. Thus, when she discussed her upcoming procedure with her surgeon, she told him, “I am vain. I would like to not be very hideous if that’s possible.” Later, when she first removed the surgical bandages covering her mastectomy scar, Rollin wrote, “I felt ugly and freaky.”
Other women whose impressive stories I told in my book challenged the medical profession’s insistence on still using the very disfiguring radical mastectomy, which was already obsolete, into the 1970s. Not surprisingly, surgeons often treated them with ridicule. But in some sense, Rollin’s stand was even more courageous. Physicians trying to cure breast cancer — with the radical mastectomy or subsequent more limited operations — largely had contempt for women who wanted to discuss their post-operative appearances. It was such a taboo subject that one woman with breast cancer even snuck around Memorial Sloan-Kettering Cancer Center, telling her fellow patients how to get breast forms for their bras and how to talk about sex with their husbands.
Despite the great success of “First, You Cry” and being played by Mary Tyler Moore in a made-for-TV adaptation, Rollin was self-effacing about what she had achieved. In her personal papers, which are housed at the University of Wisconsin, I unearthed a lot of fan mail that she had received, such as one from a woman who wrote, “I still want to walk into a room and have someone think ‘attractive dame.’” But as Rollin later wrote in a journal article that we co-authored, she didn’t remember how much attention she had received, merely preferring to conclude that, after reading her book, “women felt less alone, not only with their disease but with the accompanying feelings about it.”
When I started teaching an undergraduate history of medicine course at New York University about 10 years ago, I looked up Rollin in New York City and asked if she might like to attend the class on breast cancer. She readily agreed and came for several years. The students — especially the women — loved meeting her and hearing her recollections about standing up for her rights in the hospital and at work during the heyday of second-wave feminism.
And I always felt that the same characteristics Rollin had used to challenge the medical system in the 1970s still shined in her in the 2010s. Despite bonding well with the students, she was not what one might call “warm and fuzzy.” But successful activists who need to break down barriers and not take “no” for an answer rarely are.
Even though the focus of the class during her visits was on the history of breast cancer, the discussion would invariably shift at some point to Rollin’s other passion, end-of-life issues. To some degree, much of what Rollin had advocated for in “First, You Cry” had come to pass. Today, concerns about appearance and well-being are a routine part of cancer care. The American Cancer Society helps to fund a program called “Look Good Feel Better.” But the right to die, which Rollin advocated in her 1985 book, “Last Wish,” remains highly controversial.
Rollin first encountered this issue in 1983 as her mother was dying from terminal ovarian cancer and suffering from persistent pain and nausea. Although speeding death was illegal, Rollin worked with a sympathetic doctor to obtain enough pills to help end her mother’s life. “Last Wish” documents these events, for which Rollin conceivably could have been prosecuted. (She never was.)
For the remainder of her life, Rollin advocated for the right of suffering individuals to end their lives. She served on the board of the organization Death With Dignity, whose goal is to “ensure people with terminal illness can decide for themselves what a good death means in accordance with their values and beliefs” as well as the advisory board to Compassion and Choices, which seeks to improve care, expand options and empower everyone on their end-of-life journeys. In a 2018 letter to the New York Times, Rollin approvingly noted that several states had legalized medical aid in dying, which allows terminal patients to obtain and take medications to end their lives, but remarked that such laws are “cruelly slow to change.” My students, many of whom had grandparents or other relatives who had experienced serious illnesses, were very engaged and asked her many questions.
I must confess that when I read that Rollin had traveled to Switzerland to end her life, I immediately looked to see if she had developed a terminal disease, such as cancer or a degenerative neurological disorder. But she had not. According to her New York Times obituary, she had made her decision due to ongoing arthritis, gastrointestinal issues, and sadness over the death of her husband three years earlier.
This set of conditions would not have qualified Rollin for medical aid in dying in the United States, so she had traveled overseas and availed herself of a service — known as Pegasos — that agreed that she had the right to decide when to die. As a physician, I felt sad because she might have had years more to live. But as a historian, I admired Betty Rollin once again for doing what she thought was right.
Barron H. Lerner, professor of medicine and population health at NYU Langone Health, is the author, most recently, of “The Good Doctor: A Father, a Son and the Evolution of Medical Ethics.”