THE BEAUTIFUL DEFECT

A young mother considers having major elective surgery after finding out that she’s at elevated risk for breast cancer in this debut memoir.

Technological advances in medicine continue to place finding cures for diseases like cancer on the forefront. Noting these advances, Lilith Costa, a wife and pregnant mother of a toddler, decided to take a test to determine whether she’d inherited the gene that caused cancer in her father, uncle, and several other family members. The test result causes her to contemplate whether to have a prophylactic double mastectomy that will significantly cut her chances of falling prey to the disease. Lilith’s decision will affect her immediate family and friends in surprising ways. She’s already dealing with two autoimmune disorders that have impacts on her daily living and caused high-risk pregnancies, and the new surgical procedures will put further pressure on an already strained relationship with her husband; the book plays up whether the author’s marriage will survive. The author, who’s Black, also discusses how colorism and others’ lack of acceptance of her interracial marriage affected her own self-image, which was shaken by her impending surgery: “My looks and behavior would always be up for debate. Too dark, too ethnic. She sounds too white…. And marrying someone of a different race?!...After surgery I would need to look in the mirror and find acceptance. Though I accepted my body, and knew I’d have to accept the outcome of surgery, I didn’t know if I wanted to share it with the world.” However, other than in this passage, she doesn’t address these complex issues in depth. Ultimately, though, her endeavors as a fiction writer give her memoir a novelesque quality. Punchy exchanges, especially between the author and her husband, are balanced with thoughtful observations and probing self-questioning that provides an honest, unflinching view of a woman grappling with not just physical health related changes, but also personal and marital shifts.

An often engagingly written work in which hard choices unearth meaningful revelations.