Nancy Brinker is the founder of Susan G. Komen for the Cure. Nancy served as Ambassador to Hungary and as Chief of Protocol of the United States under President George W. Bush.
Nancy Brinker was interviewed for the Gerald R. Ford Oral History Project on November 19, 2010 by Richard Norton Smith.
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Smith: Thank you very much for doing this. You obviously have a remarkable story in your own right. How did your path cross with that of Betty Ford.
Brinker: Well, you know, after my sister died, or as we went through the journey of her very unsuccessful end with breast cancer—
Smith: How long was she ill?
Brinker: She was diagnosed in 1977 at the end of the year, I think it was, and she died in 1980 at the age of 36. I’ll never forget it. In a lot of ways, it was as if it were yesterday. In fact, I just wrote a book about it, Promise Me, which _________ a picture of Mrs. Ford in it. So, you know, in those days, cancer was “The Big C,” it was spoken of in whispers. People crossed the streets sometimes when they saw my sister. We lived in Peoria, Illinois and we know there was cancer there, being in hospitals. Still it was nothing like it is today. People were much less willing to address these issues out loud.
Smith: Was there even more of the stigma, if that’s the word, attached to breast cancer?
Brinker: Yes, of course, even though it was “The Big C,” that was usually lung cancer or maybe an intestinal cancer. But when it came to breast cancer, it was even worse. It was more hidden in the shadows. You couldn’t print the word ‘breast’ in most newspapers or magazines and certainly couldn’t use the words on TV or radio. So, in fact, when we started Susan G. Komen for the Cure a few years after my sister died, many people advised me to make it be Susan G. Komen Foundation for Women’s Cancers. But, aside from that, when Susan was going through her care and treatment, and we finally got her to M.D. Anderson, it was far too late. But, she used to always say, “If Betty Ford could take her chemotherapy and have it and be like she was, so brave and always looked good and always had a very positive demeanor, so can I.” So, she was a role model for untold hundreds and thousands of people who didn’t have a voice.
Smith: Did she know Mrs. Ford?
Brinker: No.
Smith: Was it just that Betty Ford was a public figure?
Brinker: That Betty Ford was a public figure. She was the First Lady and she talked about it, so Susie knew that she had chemotherapy and, therefore, if she could do it, it was like it was alright. It was like what you should do. And when I think of those pictures of Betty, they’re apocryphal now, throwing the football, the President talking about her disease – we just went through all those videos the other day because we’re doing some archival work at Susan G. Komen – and the pictures of him at the press conference announcing that Betty had breast cancer. Then everything about it changed. You know, everything about the disease and the acculturation of it began to change and I think people know it. But I think that the full credit for what Betty did in those days will have a voice itself for hundreds and hundreds of years, because it just wasn’t done. People didn’t talk about disease. Look at President Franklin Roosevelt. He couldn’t even talk about the infantile paralysis he had and there was a great staging going on in the films. You didn’t discuss disease because you knew you’d be disadvantaged. You knew you could lose your job. It usually meant death. People were more afraid of cancer than they were of the treatment because, or maybe it was both. They thought if you had cancer, you die.
Smith: Let me ask you to try to take people in this culture back thirty or forty years and make them understand what, on the surface, seems incredible. Did women discuss it among themselves? Was it something that they talked about, shared their fears, their concerns?
Brinker: You know, no. There was no patient support or there were very few. Maybe there was one patient support group, but it wasn’t really entrenched where women were. It was more for aftercare. So there wasn’t really an opportunity. There was no patient advocacy. There were no 1-800 numbers. No cell phones. No internet. No outreach to people. Certainly you didn’t talk about this at school. And, in your doctor’s office, when you walked in, you never saw a breast self-exam card, or ‘Have you had a mammogram?’ even after they developed mammography. So, you were beginning to see some discussion of it in doctors’ offices. Maybe your gynecologist did a breast self-exam, but honestly it was not discussed openly like it is today. Not even close.
Smith: Is it logical to assume that it is part of a general relaxation of popular attitudes about sex and sexual attractiveness?
Brinker: I honestly think that, in those days, there was the great fear of being mutilated because the surgery was so huge. If there was a discussion of it, there was so much fear and almost running away. Remember how teenage girls ran away when they were pregnant and they were hidden. It was almost like that. However, I think as you went farther down the demographic chain, the sexual part and the mutilation and the fear about all that got worse in any event.
But what most people began to realize is that it was happening a lot more often. A) People were aging, but b) it was just happening more often. People were living longer and many people died of this without ever knowing what they died of years and years and years ago and centuries ago. So, you had to be very brave to confront a disease like breast cancer and to be public about it. I don’t know of anyone else like that that was that public about it. I really don’t. I grew up in a rather empowered household and was very aware that President Nixon signed the national cancer act. Very aware of people who led the cancer movement in this county. But there was no talk about breast cancer and certainly no actresses, no public spokesperson, because it would ruin your career. You know, they would a) think you were going to die and b) you would be considered mutilated and not fit for prime time.
So, it was more, I think with women, than even a sexual concern. It was a fear of life and everything about it and the very, very severe treatment. You know, the Halstead radical mastectomy was the only option offered. Most people from after the turn of the century until about 1960, in the late 60s, and in some places in the country earlier than that – my aunt had had that terribly debilitating [procedure] where, literally, half of your body was removed from your waist up.
Smith: And you did not know necessarily going into the operating room?
Brinker: No, you did not know and you were not given a choice. So, you could wake up and have half your body missing, practically, and not know what you were waking up to and all the adjustment that went with it. It was terrible. And if you were given a cobalt therapy or rather rudimentary therapy, it was burning all over. I mean, it was really brutal. But, to have Betty talk about it, Betty Ford, our First Lady, talk about it the way she did. It was her spirit more than anything that enlightened people and the rate of mammography, of course, went up significantly after that. It then dipped a little bit, but she was always in the forefront of this movement. Always. And I sought to meet her immediately. I had married a man from Texas called Norm Brinker, who was a wonderful man, since passed away. And he was friendly with Trammell Crow, who was one of his very good friends. When I started the foundation, we were going to do a big luncheon and I thought in my mind, “Who could we give an award to?” And these are the days before there were award luncheons for every disease and every body part. Ours was really one of the first. So, I said to Norman one night, “I would do anything if I could get even a phone call to Mrs. Ford because I have a feeling that maybe she would understand how important this would be”, especially in Texas, to do this in Dallas, Texas, at that time, where possibly women were even a little more unempowered about things in those days. So, he said, “Well, let me call Trammell Crow.” I knew they were great friends. I went to see Trammell and he picked up the phone and I’ll never forget it – she took the call. She was fabulous about it and I said to her, “You know, Mrs. Ford, we really need you here because I don’t have anyone to speak on my sister’s behalf. I don’t have anyone to speak on behalf of this disease and I feel we can do something important here. We can begin to really amplify this issue, but we really need you here. We need you to come.” And she sort of joked – the first event we were going to do was going to be at Norman’s polo club and we were going to have a little dinner out there and a little demonstration – and she says, “Well, I’ll be happy to come as long as I don’t have to ride a horse.” And she just said that and she has that great sense of humor. I said, “No, no, you won’t have to ride a horse.”
Smith: And this was your first contact with her?
Brinker: Yes, it was my first contact. And when she came, in fact, there’s a picture of her arriving for the very first event in my new book, Promise Me. My son, who now is thirty-five, he was just a little boy, he was only eight years old, standing there with a bouquet of roses to hand her as she got off the plane. And she came every single year as long as we had that event for years. I think it must’ve been fifteen or twenty years and then [she] came to Washington when we had other events. But, she spoke out about this. And then, of course, right shortly after that, her position on substance abuse – again, leading edge – who does that? You know, at the time, you thought, “Who does that? Who would talk about that?” We were all hiding. Everybody was hiding whether they had a drink too many or whether they were taking pills or whatever. And she was the vanguard of that sort of ability to be frank and to be open and it set people free. It literally was an emancipation of people who were completely bound by secrecy, shame, and fear. And that’s why I think she probably was one of the greatest First Ladies that this country has ever known.
Smith: She’s unique in that her real historical impact is probably greater after she left the White House. It’s interesting. If you think about how ordinary people live their lives, she’s probably had more impact than many presidents.
Brinker: Right. Oh, yes. And actually, I think, besides all of the patients and women and people through her activism, she opened their hearts and minds. Also, would say that the whole discussion of disease in this society changed or evolved. Disease became more personalized. People used to talk about disease like it was a control science project or someone landing on the moon. It was never personalized. She put a name and a face on issues that opened up an entire dialogue for forever more.
Smith: I’ve often wondered – actually I mentioned this in the eulogy – most of us, as we get older, the cliché is that we tend to become more conservative. And, they seemed more open, more compassionate. I’ve often wondered how much of it was her influence on him or having kids who were still relatively young, and grandchildren.
Brinker: Great children.
Smith: And maybe most nebulous was the experience of going through the intervention and the continuing work with the Betty Ford Center where they saw people who you might not at first blush ever expect to see there. To see good people, decent people, accomplished people, who had a problem, a weakness, and whether all of that came together. Obviously, they were quite outspoken in their views about choice, but, you know, he signed a gay rights petition. I mean, he did a lot of things that you don’t ordinarily associate with a conservative Republican president.
Brinker: Right. And I think that he was, in a way, the quintessential moderate. I really don’t think of him as a dyed in the wool conservative, because, though he was fiscally conservative in his beliefs, I think if you took an honest poll in America, you’d find their beliefs lined up pretty much with what most people thought. And I think that’s why they’re so revered as a couple and as a presidency. You know, I mean, I think it was very, very important that they spoke out on the issues they did. It resonated and it continues to resonate. And she was very outspoken about all that. You know, going to the Republican meetings and endorsing candidates that the rest of the Republican Party didn’t feel were acceptable. And the truth will out. That’s how a lot of people feel, that they don’t want those kinds of issues to become part of a political dialogue.
There are a lot of people in this country who feel that gender orientation has no place or gender preference doesn’t have any place in a political discussion in America. So, I think they led with such dignity and such a wise and credible set of beliefs that I think, again, the respect for them will grow and grow and grow as times move on. And particularly, if we elect people who are highly partisan, I think that it shows what it should be rather than exercising every bit of your partisanship. I think President Ford understood and was a master negotiator himself and a leader. You know what he did in the Republican Party alone and in Congress, and all of the jobs that he held before then prepared him for that kind of public presence and persona, I think.
Smith: You saw them together. Tell us about your sense of their relationship.
Brinker: Yeah. You know what? They were really, really loving, attractive, and I hate to use the word ‘cute’ together, but they were. They were easy. They could joke with each other. He used to tease, “Well, you know Betty did this,” or “Betty said that.” He always quoted her all the time and she always quoted him all the time. You know, she was a wonderful dancer and loved to dance when she was young. And they loved to dance together, as you know. So, I used to love to watch the pictures of them dancing at the White House because they were so in step with each other. It was like they were in harmony with each other.
Smith: In some ways it’s a case of opposites attracting. He was famously punctual.
Brinker: Right.
Smith: And she never made a deadline probably in her life. And, with some couples, that would be an issue.—
Brinker: I think he just adored her and I think she was, you know, even with her substance issues later that came to bear, I think she was a wonderful mother and he knew that. And he also knew that she loved him very much.
Smith: I’ve often wondered- we’re talking with the kids now – whether he felt any kind of guilt. The fact is, like lots of men in his generation and lots of men in this town, when he was climbing the professional ladder, he’d been away a lot on the road.
Brinker: Yeah, sure. And so, she was left with the burden of the children and the public persona and everything. I’m sure the gratitude for that grew more and more. You know, I didn’t observe them so much in public, but kind of remember just seeing pictures. You could get a sense of people’s chemistry. And they just seemed so comfortable with each other.
Smith: Yeah. I think that’s part of the problem now. She says she misses her boyfriend.
Brinker: Oh, yeah, sure. I mean, it has to be really hard. They were together so many years. Their best years, probably they would’ve both said, were after he left the White House, after getting out of all that. They loved their house in Vail and they loved wherever they were. They really enjoyed it in California. They really loved that. I can remember visiting them in the desert and how much they loved that experience and his golf. And, you know, when he was younger and skiing, how much they loved that. Norman and I visited them several times in their house in Vail and we used to go skiing there. And we would see them in the summer if we came to the desert and they just always were the same. Hospitable, charismatic, and very comfortable.
Smith: When was the last time you saw or talked to her?
Brinker: You know what? I’ve tried to call several times but we couldn’t connect. I do talk to Vaden and I talk to Susan. Susan did a wonderful piece for our thirtieth year honoring the promise and she did a video on behalf of her mother. And I’ve sent several messages to her and I saw her, of course, at the funeral, which, you know, was quite awhile ago, but I was just stunned.
Smith: Were you surprised by the amount of reaction? Because, you know, he’d been out of the public eye a while. I was with ABC the first half of the week and then with the family the second half. I can tell you, journalists, particularly younger journalists, were surprised. There was a whole generation that was being introduced to him for the first time. They were seeing these clippings and they were contrasting it with the ugliness of our current politics. And he looked awfully good.
Brinker: Well, this is what I mean. I think that their image and their ease on the dance floor, so to speak, is something in their leadership style – because he always reached out. He was always friendly. He had an ability to talk to anyone and so did she. And that’s just not what you see today. We seem to have people who are in corners, you know, who don’t reach out to each other easily, who don’t go out and have dinner together, who don’t live here, really. So, as a result, you have such a fractured political system now. And I’m sad about it. We just don’t have the style and the outreach for people to feel included and inclusive. Times have been very difficult the last few years and I think that’s created even more distance between people and their politicians.
Smith: He and Hale Boggs, his Democratic counterpart, would have debates at the National Press Club. They would drive down together to the club and decide what they were going to debate that day. They’d go to the club and they’d have their debate and go have a drink and lunch and then go back to the Hill. It’s not as if the ‘60s were an era of good feelings, but institutionally, you had people who were rewarded for getting things done. Now they’re rewarded for keeping things from getting done.
Brinker: From getting done and also, you know, we don’t have a political class anymore. It used to be that a lot of politicians had a gravitas, a sort of respect, and now it’s as if we just dislike all of them. The civility has just gone out of it. And I think all of those fellows and, you know, Tip O’Neill and Ronald Reagan, when you look at the camaraderie there, I feel like we’ll never see that again. I hope that’s not true.
Smith: I understand your feelings. I think the media had a lot to do with it.
Brinker: Yeah, of course, on every issue.
Smith: Cable TV and the internet have coarsened and polarized—
Brinker: And scripted.
Smith: And scripted.
Brinker: So that no one can really say how they feel. No one’s free to say anything and there’s so much media that, you know, if someone blinks a certain way, it’s a story and it’s so sensational and tabloid. So, that’s a problem.
Smith: How do you think she should be remembered?
Brinker: I think she should be remembered as a woman who really did it all. You know, she not only was a great wife and a great mother and figured out how to do it all, even with the steps along the way and the difficulty she personally had, but she was a leader in a time that wasn’t easy to be a leader. In other words, she didn’t have the option, as many people do today, to act almost any way you want to as a woman. Things were very scripted and prescribed for women. And Betty had a way of transitioning from the classic First Lady role into the role of a leader. And that kind of leadership, as you said, will go on for generations and generations because she broke ceilings and walls in the nicest possible way and by example – other than preaching, teaching, shouting. It was always by example. And I think she will be seen as a very important First Lady as time goes on who served at a difficult juncture of history.
Smith: I also wonder if you look at her in the ‘60s, she’s almost representative of a generation of women. She was a dancer. She was an accomplished, creative individual who was very happily married and who loved being a mother, but who also sensed that there was more potentially to life than that. She saw a psychiatrist at one point, which she was very candid about. You get a sense of a whole generation of women who were on the cusp of great change.
Brinker: Exactly.
Smith: They were unknowingly, in some ways, they were pioneers.
Brinker: Unknowingly evolutionary. She was evolutionary in being able to do the things that she did. And, you know, it isn’t just so much the disease part, it’s the living your life in public. Because even after that, she had to become much more public in a way and people were watching very carefully all the time, watching for signs.
Smith: That’s interesting because she typically made a joke about the first state dinner – “everyone was watching, which one.” But I assume, as often is the case, humor hides something very serious.
Brinker: Right, it does. And also you learn to live with it. And once you’re a breast cancer survivor, it doesn’t matter who you are, you always wonder, “Is it going to come back?”, “Is it going to?”, “When?”, “How?”, “If.” She had a husband in the White House. She was still fairly on the young side.
Smith: But she had a relatively advanced case.
Brinker: Yeah, and she did chemotherapy and I’m sure she had doubts and fears in her own mind which also one didn’t deal with openly. Yet she managed to always be able to talk about it, even if somebody asked her. I do know that. Friends of mine in the cancer community would ask her “Are you okay?” and “Have you had any fears about it?” and she was always open about it. And that, in itself, is a whole other set of issues that survivors deal with aside from the diagnosis. And the now you’re in public and this isn’t spoken about and now everyone’s looking at you to see if you’re sick and you’re going to die or how you’re going to look or how you’re going to act or if you act different or if there’s something about you that’s different. Especially a disease like breast cancer in those days.
Smith: And there’s not a more visible position in the world than the one she was in.
Brinker: No, every garment inspected, every image looked at carefully. “Does she fit in her clothes?” “How does that look?” “How must that be?” “What’s her husband thinking about all that?” “Are they going to break up over it?” I mean, there’s lots of that.
Smith: That’s a large issue. She obviously was a leader. He, less obviously, it seems to me, was a leader. I mean, leading by example. Showing other men this is how you’re supposed to react.
Brinker: This is how you do it. And you go to the press conference and you speak out loud about it. “My Betty has been diagnosed” to the public. And then resuming your playful life right afterwards. That was the cue that was so important to people. Another cue that was very important to people, because, you know, I keep saying about the throwing the football, that may be one of the most important pictures ever in history, that and out on the White House lawn. Because it’s a resumption of a life. It’s a presumption that you can live with cancer and that you live beyond these things.
Smith: And it’s a loving life.
Brinker: And it’s a loving one. And in those days, you have to remember, Richard, you were dealing with a subject that was as taboo as almost anything I can think of and they got through this. And I just loved him because there was just a certain masculinity about him that was not macho at all. He was a very gentle person inside. He was a kind person. And you could tell that. And, so, his kindness helped her and together they even grew more as a couple. And he is a leader. You know, when he had his political issues, I think they just really sailed through a lot of those kinds of things because they were so in tune and they had such a great afterlife. You know, he loved golf. They loved being in that house in Vail. They loved having their children there. They loved living that kind of life. They were doing sports.
Smith: Time was good to the Fords.
Brinker: Yeah, very good. And they were invited everywhere and they were admired and then she did her Betty Ford work.
Smith: He lived long enough to know that most people had come around to his way of thinking on the pardon.
Brinker: That’s right.
Smith: And he said when the Kennedys gave him the Profiles in Courage award it was just an extraordinary turning point. He said, “People don’t ask the question anymore. For twenty-five years, people asked the pardon question.”
Brinker: That’s right. And he took such a strong position on that and I think history would’ve judged him right at that point. It was very, very interesting, all that, but he did the right thing and he lived, as you say, long enough to see it, which was a great blessing for both of them, I think, and for their children. You know, it was nice that their children have a legacy in the rest of the world that sometimes, you see, today, people don’t understand how long things take to do. People always think that things should happen instantly. And if you do something, you should be immediately rewarded for it or it should immediately turn around. Young people, particularly, don’t understand that. So, this was a man who lived with a set of principles, did what he thought was right, and lived through it. Didn’t whine. Didn’t complain. Didn’t say, “Oh, gee, I was hounded.” And that’s a difference today that you see a lot of. People playing the blame game, blaming someone else.
Smith: And Susan now has stepped into her mother’s shoes?
Brinker: Yeah, she stepped into her shoes and I owe her a call because I want to keep up with what she’s doing. She’s such a great woman and she’s worked very hard. She’s had some of her own challenges, you know, and she’s just great. She’ll do a great job there. Susan’s a hard worker and she knew what her mom wanted to accomplish and that’s really important to keep the Center the way it is. And she cares a lot about her brothers. They’re very close. So, that’s very nice and it’s nice for everybody to keep in touch with them, too.
Smith: That’s perfect.
