When I saw an arresting magazine ad for a vaccine that could help prevent cervical cancer in my young daughter, I was intrigued. I ripped it out and stuck it in the page of my daytimer to call our pediatrician.
I had known several people who'd been devastated by cervical cancer, one of whom was my college roommate and the namesake of my daughter. Nora had one young daughter when she got the news. The disease, and the hysterectomy that followed, effectively ended her childbearing years, without her permission or her input.
I'd named one of my twins for her, so that she'd always feel especially connected to another little human being, and I have to smile today when I see them together. Big Nora and Little Nora. They occupy a significant spot in each other's hearts.
Roughly 11,150 cases of invasive cervical cancer will be diagnosed in the US and an estimated 3,670 women will die in 2007, according to The American Cancer Society.
The vaccine, Gardasil, can't prevent against all cancer causing forms of HPV, but the ad claims it is effective in tackling the types which cause 70% of cervical cancer cases, and even 90% of genital warts cases, am image I found I quickly had to stamp out of my head when picturing my baby girl.
So now, here was a way, the ad said, to help rid the possibility from my own daughter's future. At 12, she was still moving slowly, inexorably toward the hormonal vortex of puberty, but had not yet been sucked into its alienating void.
In her eyes I had already gone from somewhat cool Mom to total adult nerd, especially when her friends were around. I was getting eye-rolling and lots of "Moooooooommmmm!" type prostestations when I would do a little dance in the kitchen in front of her girlfriend, or shamelessly sing a radio refrain in the car. To my soon-to be-teenage daughter, in public I was yesterday's bean chili -- old, unappealing and promising only bad gas.
When I called the pediatrician a few weeks later, she told me they were administering the vaccine to the older girls first, the ones closest to being sexually active. Apparently the vaccine was rendered less effective if you had already been having intercourse. In other words, it was recommended for virgins.
When I asked around, chatting with moms of older girls, my sister told me that her own pediatrician was in the three-step process of giving it to his daughter, whom he blithely assured her was not sexually active. My niece, listening in to our conversation, knew differently. "Aunt Lee, she's been sleeping with her boyfriend for two years now," she told me matter-of-factly, with that eye-rolling that telegraphs how incredibly dumb and naive grown-ups can be.
"Well, that's a bummer," I said, wondering absent-mindedly exactly what, as a parent, I didn't know that I thought I did. Oh, I didn't question my kids' current innocence. I had enough spies out there in the mom-hood community to keep me posted on what was happening with the drinking and drug experimentation. I knew who were the suspect kids and whose parents let them party at home. It's just that I hoped, and still do, that I would be a little more clever than my own parents in sussing out just what was happening in the dark underbelly of the teen world. I'd like to think I'm a click more clued in than the bobby-sox and heavy petting generation that hatched my parents.
I remember vividly the summer of '76 when I was snagged for curfew violation. My family spent July and August at an idyllic spot on Lake George in upstate New York, kind of like a scene from the 50s. Everything was within walking distance and at 16, I had my first real boyfriend. It was an innocent, Huck Finn kind of romance about books and sailing and trying to get to every one of the 180 island on our end of the lake.
Yup, I know, I sound hopelessly cheesy and pathetically retro. And yes, it did have strains of the movie Dirty Dancing. It was actually a first love I'd gladly wish on my own kids. To this day, Andrew is a great friend of mine and my husbands. We see him and his family ever summer at the same spot. Our kids play rag-tag on the raft on the lake and we go out for ice cream at night.
My flagrant violations of the 11:00 PM curfew during that summer of puppy love got me grounded. As the eldest child, I was the practice round for my folks, who would later not even impose a curfew on my youngest sister. My flummoxed parents had no idea what to do with their daughter's first rebellious streak. As I sat in our summer cottage, missing a whole night of fun with my friends, I fumed at my mother.
"You are lucky," I snapped at her. "You could have it so much worse!" I could be shooting up drugs or having abortions!" I don't actually recall what my mother's answer was. I just think now what I might say if my own kids came at me with that one. Oh, the glorious payback of parenthood.
As the day came for my children's annual check-ups, Cathryn, always a little nervous about needles, asked me if they were due for any shots. I hadn't really thought a lot more about the vaccine or about prepping Cath for it. But she was an inveterate interrogator when it came to new situations. I have no doubt she will grow up to be a reporter or a consumer advocate; a mini- Ralph Nader.
"It's a shot that will prevent cervical cancer," I said, reminding her we'd spoken about it briefly weeks before. My son Mack was at the dinner table with his two cents and more info than I would have thought. It occurred to me later that he had read the ad by my purse.
"It's for people who have sex, Cath" he said smugly, enjoying his superior knowledge and teasing in a way only big brothers can.
"What? Mom?" she said appalled, jaw dropping in an exaggerated look of confusion and betrayal. She glanced back and forth between the two of us. There was a HUGE eeewwwwwwwww factor in all of this for her. "I am SO not having sex!" Her face went beet red in front of her brother and she left the room.
I'd been very upfront with my kids about the birds and the bees years earlier. I'd bought a bunch of zippy books with cartoons, one actually had a bird and a bee narrating the details. We had always spoken openly about how babies were made. And I constantly told my kids that no questions were too stupid or too intimate to ask me. Anything was fair game. And I meant it.
But now I was suggesting to my daughter that her Mom was already contemplating, even if she wasn't, the possibility of her someday having a sexual partner. For just a moment I was reminded of the tradition of Chinese foot-binding. The mother broke the bones in her young, malleable daughters feet, bending them back and binding them to produce the perfect shaped "lotus" to excite her husband. The smaller the foot, the more marriageable the girl. Now that was the height of maternal devotion.
At the check-up that afternoon, I brought up the issue of the vaccine with the doctor and we agreed we could start the series of shots in the fall in order to be finished by the school year. We both spoke sort of over Cathryn's head, including her, but texting each other with a bunch of exaggerated eye motions just to make sure we were singing off the same songsheet. We didn't want to be laying things out like we were preparing her for a future as the village bicycle -- you know the line -- everybody gets a turn?
As I looked at my daughter's sweet, milky skin, and her still doe-eyed innocence, I felt a little bit guilty about all of this, but vastly wise and realistic as well. Cathryn was just on the cusp of going from awkward but unaware beautiful girl to beautiful teenager, and she mostly sweetness with flashes of joy and the occasional grumps. The kid was simply born happy. She might pretend I represented the ancient age of crones or one big old nerd, but there were still wonderful, gratifying moments when she would come up to me with a probing question about life, give me a giant hug or tell me spontaneously that she loved me. Often times, however, those expressions of love were followed by a request to go to the mall, or buy that dress for the dance.
I think about my own moments in college and beyond, contemplating my sexual boundaries as I got older and met men with whom I would decide just how much of myself to hold in reserve. In so many ways things were simpler. AIDS hadn't broken out, we didn't think much about sexually transmitted diseases, those were things for hookers or in Henry VIII movies. The biggest consequence of fooling around was unwanted pregnancy. And in the days following Roe v. Wade, we all knew that there were options.
The official ethical edicts as a culture have loosened over time. In my mother's era, you waited for marriage or risked being branded the town whore. Somewhere after that, good girls still didn't do it or at least talk about it if they did. Now there are youth groups advocating and proclaiming sexual abstinence and others who are certainly experimenting at a far earlier age than I care to know.
But I know what I'll tell my daughter if she ever asks my opinion. Don't make the decision lightly, or in haste, I'll say. Don't undersell yourself or bow to pressure. Wait for that person who makes you feel wonderful, with whom you feel protected and loved and most like yourself. Always remember that you are the one in control. And lastly, your mother hopes she has given you the best protection she can; far beyond a vaccine to guard against cancer. She's given you respect and love for yourself, a set of values and confidence in your own judgment. And she loves you more than the solar system.