A True Crime

by Lisa R. Cohen

Talk about a crime related news week! Sunday night we heard that one of the biggest criminal masterminds in the world has just left this earth. I'm sure for days, maybe weeks, we'll hear more of the story, unraveling bit by bit, stringing along the news cycle. But for me, personally, Sunday marked a milestone in a different fight against crime.

This past Sunday, as Navy Seals were locked in mortal combat with Osama Bin Laden, a film I produced premiered at the Tribeca Film festival. (I still have a hard time saying or writing that line.) I was part of a small team of talented producers, directors of photography, editors, and a director who have all worked, off and on, over the last four years on The Education of Dee Dee Ricks, which will continue to garner attention when it airs on HBO this October.

Luckily, Dee Dee herself is not a victim of this crime. She's a smart, beautiful, tough-talking, wise-cracking woman of means, who was diagnosed with breast cancer in 2007.

For two years after that, she had me follow her around with a camera crew, documenting her life. Through a double mastectomy, a brutal round of chemotherapy, and the havoc it all wrought on her personal life, her finances, and her body, Dee Dee fought hard, kicking, screaming, and sometimes cursing like a dockworker.

Eventually she won.

But that was only part of how she spent her time and resources. Arguably she spent the better part taking on the inequities of cancer care in this country. In plain terms, Dee Dee set out to learn why a rich, white woman who can afford whatever she needs can win her fight, but a poor, underinsured black woman can't - and often doesn't.

And then she set out to tell the world, or at least anyone who would listen to her, and eventually, anyone who would watch our documentary. She interviewed doctors and advocates, and women who weren't as fortunate as she. She met and befriended Cynthia, another funny, outspoken breast cancer patient, who seemed like Dee Dee in many ways, except the critical one that placed her in so much more jeopardy. And she met a man who has worked for decades to change all that.

Dr. Harold P. Freeman is a renowned, elegant, soft-spoken, Harvard educated, African-American cancer surgeon (that's a LOT of impressive qualifiers). As a young man, he watched his own father die of cancer, which inspired his life's work. In his lifetime, he's seen amazing strides in cancer research, seen science transform the odds, as people today beat cancer. From when he started, to where things are now, miracles are now commonplace.

What makes him shake his head in dismay, then, is how many people are still dying. They're not dying because nothing can be done, or because their disease baffles the doctors. They're dying because they're poor. And that, says Dr. Freeman, is what is truly criminal.

"It's not a scientific issue," he says. "It's a moral issue. People should not die simply because they're poor." He's talking about the women he has seen with no insurance and no other means to get treatment until they find their way to the cancer center he runs in Harlem. By that time, he chillingly describes, they sometimes have no breast tissue left in the affected area. Just tumor. By that time, it's too late.

Why didn't they go in sooner? Well, as Dr. Freeman told a captive audience after the Tribeca screening, if you have no insurance and you go to an emergency room because you have a little lump in your breast, you'll sit there for hours. When you're finally examined, you'll be told you're in the wrong place. You have to go get a Medicaid card first, then appear somewhere a hundred blocks south to get examined.

"At that point," Dr. Freeman explained, "the effort to get help is so much more painful than the painless lump in your breast, you'll throw up your arms and go home."

Dr. Freeman then told the audience about something he has developed over the years to counter that sense of helplessness, something that is now growing in practice all over the country. It's a concept called Patient Navigation. First, it's outreach and education - to help bring women (and men) to places like the Ralph Lauren Cancer Center, which Freeman heads up. There, an often panic stricken or numbed patient in denial is turned over to an actual human being, someone looks like them, speaks their cultural language, and will hold their hand every step of the treatment way, steering them around the myriad hurdles that cause even the hardiest to give up.

No insurance? Your navigator will take you through every step to get it, then line up tests, procedures, surgical options, chemo, etc, etc. No support at home? Your navigator's latched on, as are the doctors, nurses, social workers - even the in-house pharmacist. No one to prod you to make appointments and then keep them? You'll get the call from your patient navigator. As Dr. Freeman says, it's a low tech approach, but it literally saves lives. But so much more needs to be done.

I was with Dee Dee the day she met Dr. Freeman and, as she likes to say, fell in love. That day, he made her cry, and then she did the same to him. You'll have to watch the film to see why. Since that day, she has championed him and his cause, raised millions of dollars for it, and quite literally bared her soul and every other part of herself to get people to look... and listen. A hot blond who can also make you laugh while she moves you to tears is a powerful tool.

I have great hope for this team, and I'm proud to have been able to help tell their story. And after Sunday night, instead of the tired refrain, "If they can put a man on the moon..." I'm going to try a fresh tack. If we can track down and take out Osama Bin Laden... we should be able to win this war on crime too.

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