Pretty Is What Changes: Impossible Choices, the Breast Cancer Gene, and How I Defied My Destiny

By Jessica Queller

“If genes can map our fates and their dark knowledge is offered to us, will we willingly trade innocence for the information that could save our lives?”

In this powerful memoir, the author describes her mother’s painful battle with ovarian cancer and her own struggle to accept that she has inherited the breast cancer gene. Jessica Queller was a beautiful 34 year old television writer living a glamorous life in LA and Manhattan when she endured the loss of her mother, and months later learned that she would likely face her own fight against cancer someday, with an 87% chance of developing breast cancer and a 44% chance for ovarian cancer.

Women like Jessica who test positive for the BRCA gene mutation must make an agonizing decision: frequent surveillance to check for cancer while living in a state of constant fear or a preventative double mastectomy and oophorectomy to reduce the risk. Queller writes, “Hard decision? Deciding whether to go to law school or take one’s chances as a writer is a hard decision. Deciding whether to have amniocentesis when you’re your pregnant is a hard decision. Deciding to cut off your breasts when you don’t have cancer and possibly never will? To me, that was insanity. At the same time, passively waiting for cancer to strike, relying on inexact surveillance machines, hoping to catch it before it spread – that didn’t sound reasonable either.”

Once she recovers from the initial shock of testing positive, and after many grueling and emotional months filled with research and soul searching, Jessica shocks her friends and family members by opting for the mastectomy, a decision she never regrets for one moment. While the surgery and reconstruction are both painful and difficult, she realizes that her double mastactomy is not the end of the world, but a cancer diagnosis might have been.

Queller is witty, smart and utterly relatable. Her book is completely absorbing; I couldn’t put it down. She somehow manages to take the most tragic circumstances and transform them into a story of amazing courage. I found her strength heroic and inspirational, and I’m so grateful that she chose to share her very personal story with millions of readers, like myself. This book completely changed my opinion about what I would do in Jessica’s shoes. Before reading Pretty Is What Changes, I was completely against taking the BRCA test and a preventative double mastectomy seemed like an extremely rash decision. It is an extremely personal choice and maybe I can't know for certain how I would feel unless it happened to me, but at least now I understand that this knowledge could save my life. Thanks to this book, I don’t feel so afraid of the future anymore and I hope that I would have the grace and courage that Jessica Queller had. She writes, “We are living in an age in which scientific advances give us new opportunities to live. Seize them.”