Heartfelt Advice

A book details ways to fight the deadliest disease for women.

JOANNA BRODER
Special to the Jewish News

A

sk a woman what her greatest
health risk is and she's likely
to answer breast cancer. Not
true! Heart disease is
the leading cause of death in
women over 35. One of every
two women will die of heart dis-
ease.
There is no one who wants to
get women thinking about heart disease
more than Dr. Nieca Goldberg, chief of
the Women's Heart Program at Lenox
Hill Hospital in' New York City. In her
book, Women are Not Small Men: Life-
Saving Strategies for Preventing and
Healing Heart Disease in Women
(Ballantine Books, $25.95), Dr.
Goldberg has created a well-crafted, fun
to read and very comprehensive guide to
heart disease for women of all ages.

This book is likely to become a valued
guide that the family will refer to again
and again over the years.
Dr. Goldberg's details (over 400 pages
of up-to-the-minute information), her
tailored approach (personal risk assess-
ments and age-specific guide-
lines), her willingness to tackle
tough psychological barriers, such
as a woman's denial that she needs
to make lifestyle changes, and her
real caring are what make this
book stand out.
The comprehensive list of topics
includes descriptions of women's risk
factors, exercise and nutrition recom-
mendations and explorations on stress,
to name just a very few. She describes
how age, menopause and diabetes factor
into a women's heart disease risk with as
much ease as she talks about readiness to
change, confusing food labels and how
to practice meditation.

Recognizing Risks.

But Dr. Goldberg's main goal is to make
women more aware of their risks and
more equipped to prevent and recognize
heart disease. Even young women in
their 20s can take steps now to prevent
heart disease later in life.
Heart disease is not the same in men
and women. Just like Goldberg doesn't
look like the "traditional cardiologist,"
(she is 5 feet 1 1/2 inches and weighs 100
pounds), heart disease in women does
not always present itself like it does in
men. "Women are not small men," Dr.
Goldberg writes. "We have different
symptoms."
Classic symptoms of female heart
attack may include fatigue, back pain
and upper abdominal discomfort, while
the more "classic" male heart attack
symptom involves squeezing pain in the
center of the chest, spreading to the
neck, shoulder or jaw (this can occur in

Thriving With Cancer

A personal memoir with the lifelong threat of cancer running through it.

might think that the narrative to follow
will trace a woman's struggle with breast
cancer. Don't be fooled. This is not a
book about surviving breast cancer. It is a
fthe beginning of Staying
memoir about family relationships and
Alive: A Family Memoir,
how a near-constant threat of death can
author and therapist Janet
change those relationships. In the end,
Reibstein is standing in front
we see that a woman who has lived
of a mirror examining her .breasts for the
much of her life with the fear of
last time.
cancer can ultimately reclaim her
Just prior to getting a prophy-
life.
lactic mastectomy to prevent
The backbone story is that of a
breast cancer, she bids them
woman whose mother and two
farewell. "Well, guys, that's it," she
aunts each are diagnosed with
says unsentimentally, turning
breast cancer over a 20-year peri-
away from the mirror.
od.
Although
always concerned (and at
The question ofwhy Reibstein took -
such a drastic measure is the focus of this times consumed) with her breast health,
it isn't until Reibstein's late 40s --- when
gripping memoir. "Courage has nothing
she discovers that her cousin also has
to do with it," Reibstein explains in her
been diagnosed with breast cancer —
book (Bloomsbury, $24.95). "You sim-
that she decides to take action.
ply arrive at a point when you recoil
In an especially bold move,.Reibstein
from the horror of cancer.... you must
— presuming (but not knowing for
sacrifice your body, in the greater cause
sure) that she carried a genetic mutation
of living."
for breast cancer more common in,
Based on the opening, the reader

JOANNA BRODER
Special to the Jewish News

Ai

11/8
2002.

192

Ashkenazi Jewish women than the gener-
al population — had
her breasts removed.
Soon thereafter, to her
shock, she learned that
she actually had the very
preliminary signs of
breast cancer. It wasn't a
preventive mastectomy
at all.

Family History

Despite the high drama.
of this first story, it is
the second — about
Reibstein's family —
that is really the more
deeply felt one. The
tale begins with the birth of Reibstein's
mother Regina in the old mill town of
Paterson, N.J., in 1920 (Reibstein's
grandmother arrived from Poland at • 15
after being orphaned in a disease-swept
shtetl). The story ends with Reibstein's
present-day life as a psychologist and

women too, but is more likely in
males).
As a reader, you also feel Dr.
Goldberg's genuine sense of caring- and
friendliness. "My goal is to help you rec-
ognize your personal risk factors for
heart disease," she writes.
A heavy reliance on patient anecdotes
makes this book fun and engaging. Dr.
Goldberg contrasts 58-year-old Connie's
tenacity to get a proper heart disease
diagnosis with 57-year-old. Lydia's
roundabout journey to the hospital, in
the face of serious illness. While Connie
demanded that her emergency room
doctors test the electrical activity of her
heart (they wanted to give her Maalox),
Lydia stopped to straighten her house
before even starting out to the emer-
gency room.
"This delay could have been fatal,"
Dr. Goldberg admonishes.
Lack of awareness of heart disease can
delay life-sustaining measures, making a
heart attack all the more devastating if it
does occur.
Meanwhile, she praises Connie's per-
sistence. Connie's only error was that she
took a taxi to the emergency room. If
you are having symptoms of heart dis-
ease you should cull an ambulance, since
there are medications and equipment

university professor in Exeter, England.
In between, we learn about the
important people in Reibstein's life,
including her aunt Fanny who died
young from breast cancer and endured
treatments, some of which would be
seen as barbaric today (fierce, untarget-
ed radiation, masculinising hormones,
etc). There is Mary, Reibstein's oldest
aunt, whose denial of
breast cancer may have
been her downfall. And
then there is Regina,
Reibstein's mother. Regina
is the first in her family to
go to college and also
achieve career success at a
time when most young
middle-class women
were only con-
cerned.about marry-
ing and having chil-
dren.
Reibstein's gifted
storytelling makes
the fear of breast
cancer — cast over
much of Regina and
daughter Reibstein's
lives -- palpable for
her readers.
The memoir is brimming with
warmth, reality and fascinating details,