Jessica Queller
Pretty Is What Changes
Reviewed by: Rick Kleffel © 2008

Spiegel & Grau / Random House
US First Edition Hardcover
ISBN 978-0-385-52040-9
248 Pages; $24.95
Publication Date: 04-08-2008
Date Reviewed: 05-05-2008

Index: Non-Fiction  Science Fiction

We generally count on those who dispense technology to guide us with regards to the choices we're presented. This is particularly true with regards to medicine. We go to the doctor, get a diagnosis and a treatment is prescribed. We follow the prescription, and expect a cure. But we're enmeshed in technology that is moving faster than our ability to know precisely how to use it. The decisions are no longer the province of the experts; the patient may be called upon to choose the cure.

Jessica Queller found herself in the most extreme example of this conundrum imaginable. Distraught and distracted by the deaths of both her grandmother and her mother, she decided to submit her blood for a genetic test to determine if she had the BRCA gene, a marker that indicates an almost certain disposition to develop breast and / or ovarian cancer. She was pretty certain that there would be no problem. There was no extensive history of cancer in her family. She'd check the box off, be fine and go about the rest of her life as a young woman, working as a writer for television dramas in Hollywood. She never heard back and managed to get a doctor on the phone, who told her that she did indeed have the BRCA gene; she had an 87% chance of developing breast cancer.

'Pretty Is What Changes' is Queller's compelling memoir of death, disease and ultimately, life. She juggles the order a bit, starting when she received the news that she possessed the BRCA gene, and then backtracking to her grandmother's and eventually, her mother's death. From there on, she takes the reader step by step through a harrowing journey past the borders of science and society. There are no easy answers; there are lots of difficult questions. Her journey is thrilling, terrorizing, poignant and powerfully well-written without ever slipping into sentiment or bathos. Crisp prose brings the reader face to face with decisions beyond the safety net.

'Pretty Is What Changes' has many strengths, but everything arises from Queller's prose. She writes with straightforward clarity and lacerating honesty. Reading this book, I never felt as if I were being hit up for sympathy, or beseeched for understanding. Queller earns sympathy by writing well, not by virtue of what she's writing about. She makes the decisions she faces understandable to the lay reader because she herself was very much a layperson before being immersed in the world of cancer. Where readers are doubtful she is as well, and as her doubts are resolved, so are ours. It's a difficult line to tread. Some of the material requires that she reveal emotion, and she manages to convey powerful feelings without sliding into sentiment. Clean, stripped down prose does the trick, and makes this book a joy to read.

Queller is also a skilled storyteller, structuring her work to provide tension, humor and all the aspects of a good novel without writing fiction. There's a driving pace here that makes reading the book enjoyable even when the events are traumatic. The humor is dark and plentiful. You'll find yourself laughing a lot more than you might suspect given the frightening subject.

Faced with a life-changing problem, Queller is a resourceful researcher, and much of the joy in the book lies in following her journey along the edges of science. She knows how to convey the raw information we desire in an entertaining manner, always helped by her skills as a prose writer. The dilemma at the heart of the book — whether or not to get a prophylactic double mastectomy — could easily be made to seem overwrought. By taking us through her learning process, a learning process she herself sort of resisted, the resistant reader finds an ally in the writer. We're in this together, and we care.

'Pretty Is What Changes' takes readers into lives that make the science-fictional nature of our world startlingly clear. We have technology that strides well beyond the established moral boundaries, that makes the impossible possible. We're inclined to accept that the impossible is indeed that, and as such it provides a natural moral boundary. But when those natural boundaries are dissolved by advanced science, we must manufacture our own morals. Jessica Queller's story is an example of one woman stepping past science to embrace and create the world beyond.