Dr. H.M. Pennypacker is one of the few men you'll meet who has had a mammogram. Pennypacker had a mammogram for the same reason millions of women have mammograms: He found a lump while examining his breasts. (Like other humans with very small breasts, he found his mammogram quite uncomfortable. "Now I know why women bitch about it," said Pennypacker, and then he apologized for his language.)
Why was Pennypacker examining his breasts? Because he knows that men get breast cancer too, though not very often. (One in 1,000 men, over the course of a lifetime, develops it, as opposed to one in eight women.) The more telling reason is that Pennypacker's life, for the past 17 years, has revolved around breast lumps. Pennypacker is the inventor of a line of patented silicone Breast Models with Simulated Lumps, which are sold, along with videotapes and booklets, under the brand name MammaCare. At first, only medical and nursing schools bought the breasts. And they needed them: In a 1985 Journal of the American Medical Association study, 80 physicians were only able to find an average of 44 percent of the lumps hidden in a Pennypacker-designed breast model.
"The press picked up on it, and all hell broke loose," Pennypacker recalls. "Women said, 'What's going on here? We trust our lives to you guys, and you can't even find a Ping-Pong ball!'" (Actually, the biggest lump was one centimeter.) In 1988, Pennypacker came out with a self-examination breast model and video for home use.
The UPS man delivered my breast this morning. It is of average size and flesh toned, that is to say, Caucasian flesh tone (a "Breast Model of Color" is also available). It weighs about a pound and is squishy in the addictive way of those balls you squeeze in your palm when you're stressed.
I took out the video and opened the instruction booklet. "Position yourself in front of your television so that you are lying on your back," it said. I glanced at the sofa, which was occupied by the husband, lying on his back. On the television screen, race cars were circling a track. I explained what I needed to do. "Maybe you could drive to the 101 overpass and watch those cars go by," I said cheerfully. Ed would have none of it. "Can I watch the video with you?"
The tape began with an attractive woman in a purple dress, explaining the importance of breast self-examinations and early detection. Ed listened thoughtfully. I was touched that he wanted to be involved in my health this way. He took my hand in his and smiled. "Think we'll see hers?"
After the woman in the purple dress finished, there was an "interlude while you get completely and comfortably prepared."
"This is where you go get some snacks," said Ed, but he didn't, because the interlude is actually when you take off your shirt. "You use that one," he said, pointing to the Pennypacker breast, "and I'll practice on these."
In fact, there used to be a group of nurses in Marin County, Calif., who taught a MammaCare breast examination class for couples. Pennypacker himself supervised a doctoral dissertation on the topic of men examining their wives' breasts. "The problem is that men wind up confusing palpation with fondling," he told me. "First thing you know, it turns into foreplay."
Ed suddenly lost interest in my breast tissue, because it was around this point in the video that "Kate the Trainee" took off her blouse. Kate placed the breast model on her chest, so that it sat in between her own breasts like a third eye. She laid one hand on her forehead, giving her a distraught, Scarlett O'Hara-
I was having a hard time finding the Simulated Lumps. They were down at the bottom of the silicone and required a great deal of pressure to get to. This is, according to Pennypacker, the amount of pressure it would take to press your fingers through to the ribcage beneath "a good D-cup breast."
The alternative, Pennypacker said, would have been to make a "five-gallon breast model." He mused that his decision may have hurt sales, though not, I would surmise, the sort of sales you want to brag about.
The lumps could be viewed by peeling off a piece of cloth stuck to the back of the model. Viewed from the back, the breast was clear, like a Lucite paperweight, and embedded in it were what appeared to be two pencil erasers, a bite of Slim Jim, a birth control pill and a piece of pimento.
"Oh no, no, no, no," said Pennypacker when I called him the next day and told him what I thought he'd used. Pennypacker had hired a material sciences engineer who lent him a Durometer, which is a machine that measures the firmness of objects. "We had a person standing outside the operating room and when a lump was on its way from the O.R. to pathology, we took a reading. In there are plastic representatives of all types of lumps coming out of the operating room." Including Pennypacker's lump (the pimento variety).
His lump, by the by, turned out to be benign and remains inside his breast. "Sometimes when we train nurses and we have one whose feel is questionable, I get on the table and say, 'OK, I've got one. You find it.'"
Meanwhile, back on the video, it was time to practice on myself. Using Kate's chest as a model, the video highlighted the area to be examined, which extended in a pointy-topped square from the "bra line" up to the collarbone.
Here again, we caught Ed's attention.
"Look," he said. "It's like home plate."
I was instructed to move along doing little dime-sized circles, up and back and up and back, in rows, as though my breast were a United Airlines check-in line on the Friday before Labor Day. An A-cup is supposed to take a couple of minutes. It was going on 10. Ed offered to help.
I would have to agree with the conclusions of Pennypacker's doctoral student as to the effectiveness of husbands doing exams on wives. Let us just say Ed's Durometer reading went up a few points. I sent him away and finished my self-exam myself. When he came back, Kate the Trainee had returned to the screen and was showing the "nine positions for visual inspection." When it came time for home viewers to try this, the screen showed butterflies while pretty guitar music played. Ed put the race back on. The announcer said that Andretti was in the sixth position, which is hard to do inside one of those cramped little cars.
So now I am one of the few women who actually knows what they're feeling for when they examine their breasts. Not, I admit, as special a thing as a man who's had a mammogram, but neat nonetheless.