Angelina Jolie: let’s talk about her “Diary of a Surgery”

Angelina Jolie: Inspirational role model. Special Envoy of UNHCR. Mother. Wife. Hollywood actress and now director. Questionable affair with Brad Pitt (was he married?) and Inherited the BRCA1 gene mutation.

Love or loathe her, she always invokes a stampede of press who follow her around the world, documenting her meteoric career and goodwill work. Although I am constantly baffled by the amount of reverence the media gives entertainers, I read with awe her revealing op-ed in The New York Times titled “My Medical Choice“, describing her decision for surgery for a preventative double mastectomy in 2013.

By sharing her intimate journey of familial cancer and diagnosis of the BRCA1 gene mutation, Angelina Jolie raised public awareness of risk reduction for family members with hereditary cancer. The publicity generated saw an increase in screening and conversations by women across the world called the “Angelina Jolie Effect”. The public health consequence of her disclosure was phenomenal.

With this increased awareness for those living with the BRCA1 or BRCA2 gene mutations, what is the reality of the decision to undergo surgery and why did she really do it?

A journey of grief

Angelina Jolie inherited the BRCA1 gene mutation giving her an 87% chance of developing breast cancer in her lifetime. She lost her mother who passed away from ovarian cancer in 2007, her grandmother and her aunt. Jolie recently had an oophorectomy (surgical removal of in this case both her ovaries), and her fallopian tubes due to the associated increased risk of fallopian tube cancer.

Given her family history of grief and bad news, it seems clear why she made her decision for surgery. Both of these surgeries reduce her risks for breast and ovarian cancer, but come at a cost. But what is it?

Jolie has repeatedly written she feels more empowered and her decision did not diminish her femininity. But did her decision rekindle feelings of grief and loss for her mother who passed away? The closeness to cancer can absurdly blur feelings of connectedness to the loss of her mother from the disease.

She may have recalled what it felt as a child to lose her mother to cancer, and not wanting the same fate for her children, her perceived grief could have accelerated her thought process and decision-making.

Did she mourn the effect of her decision on her unborn children?

In her self written op-ed “Diary of a Surgery” published a few days ago in The New York Times she says,”I feel deeply for women for whom this decision comes very early in life, before they have had their children. Their situation is far harder than mine.”

Why did she do it?

The surgery has put her body into menopause, changing her body physically and irreversibly. She has to take hormone supplements, and continues to have surveillance for the minor possibility of developing breast or ovarian cancer in the future. So, was it worth it?

In one word, yes. The sacrifice was worth it – for her children.

In her 2015  New York Times op-ed “Diary of a Surgery“, Jolie says of her decision to see the surgeon came with a moment of clarity. “You know what you live for and what matters. It is polarising, and it is peaceful,” she says.

Angelina Jolie looking healthy and happy hugging her two daughters at the 2015 Kids Choice Awards.

Angelina Jolie looking healthy and happy hugging her two daughters at the 2015 Kids’ Choice Awards.

No doubt Angelina Jolie’s decision was made for her family.

I made a physical sacrifice to continue to live with hereditary disease and would make it again for my family. Have you had a similar experience? I would love to hear your stories.


About Dinethra Menon

Dinethra Menon is a freelance medical writer based in Sydney with over a decade of medical communications expertise. She has a Bachelor of Science from the University of Melbourne and a post graduate diploma in genetic counselling.

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