In a dramatic monologue, Joanne traces the devastation of a familial proclivity to breast cancer through four generations of women: her grandmother Sarah; her mother; Joanne herself and her two daughters, one of whom is also Sarah.

Joanne’s mother and grandmother both died very young of breast cancer; however, many other family members vanished in the Holocaust and the number of familial cancer deaths is insufficient for her to qualify for genetic testing. Her friend Linda, also a mother of two daughters, learns too late that she carries the BRCA gene; she urges Joanne to be tested.

Tormented by not knowing and equally tormented by what should be done if the test is positive—both for herself and her daughters, she convinces a doctor to lie so that the test can be performed. It is positive; Joanne opts for bilateral preventative mastectomies. During a visit to the gravesite of her mother and grandmother, she begins to explain the genetic risk to her daughters. 


The ethical implications of a screening test are beautifully explored. Deciding factors over who is entitled to have a test and who is not rarely take into account historical events. Nor can they “measure” psychic torment.

Looming over the story, Joanne’s recollection of the suffering of her beloved parents through her mother’s illness adds to her fear and strengthens her conviction to avoid cancer at all cost. She wants to spare her daughters the pain of watching her die of cancer too, and she realizes that preventative mastectomies may keep her cancer free, but they will not protect her daughters from having to confront the threat of a genetic cancer themselves even before their breasts are fully formed.

Jeff Nisker has been writing plays since the early 1990s…. aiming to promote humanity in health policy development. Like all Nisker’s plays, this text could be used as a reading assignment or as reader’s theatre.


Portions of this play appeared in Ars Medica 2004 1.1: 75-80

Primary Source

From Calcedonies to Orchids: Plays Promoting Humanity in Health Policy



Place Published





Nisker, Jeffrey A.

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