KELLY MCEVERS, HOST:
We see them everywhere, on billboards and magazines, on TV - ads for hospitals and clinics that talk about miraculous recoveries. Their messages are meant to be uplifting. Many people who are ill, though see them as harmful. From KQED, Sam Harnett reports.
SAM HARNETT, BYLINE: Lori Wallace is sitting on a couch with her 11-year-old son and his new pet snake.
LORI WALLACE: He was terrified, he'd be balled up. See, that's why they're called ball pythons. When they're scared, they turn into a little ball.
HARNETT: Wallace has a pixie haircut and a warm tan. She's vibrant and chatty, and she looks you right in the eyes when she has something to tell you.
WALLACE: My hands are bleeding, and my feet are bleeding.
HARNETT: That's from the chemotherapy pills.
WALLACE: This is Xeloda. You can see the pills right here. I take 4,000 milligrams a day.
HARNETT: Wallace says she used to be a hopeful person, believed she could beat anything. Then a few years ago, she was diagnosed with breast cancer. She was 39. Her son was 4. She couldn't believe it.
WALLACE: I do organic, all the things that you should do to be healthy. I exercise - all the things.
HARNETT: The cancer has spread throughout her body.
WALLACE: The median survival of a woman who is diagnosed with metastatic breast cancer is 33 months. My 33 months would have been December 6 of last year, so I'm on bonus time right now.
HARNETT: When Wallace got sick, she began to notice how much she was being bombarded with stories of how hope and positivity can beat the odds - battle back something like cancer. Wallace says the subtext is that those who are positive, who believe enough, live and those who don't, die. The message came from friends, colleagues, pop culture and, most insidiously, health care ads, like this one that she pulls up on her computer.
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UNIDENTIFIED ACTOR: (As character) Do science and data have the power to lift the human spirit? Amid a thousand maybes and a million no's, we believe in the profound and unstoppable power of yes.
WALLACE: I have tried everything I can. I have done clinical trials. I have said yes to every possible treatment, and the cancer doesn't care.
HARNETT: These kinds of ads are everywhere, testimonies of miraculous recoveries, slogans like Smile Out and Thrive. Thirty or forty years ago, health care providers didn't advertise much at all to customers, says Alex John London. He's a professor of ethics at Carnegie Mellon University.
ALEX JOHN LONDON: The medical profession viewed advertising as commodifying a service that was more noble and that really wasn't the product.
HARNETT: Today, with increasing options and rising costs, patients are more like customers, shopping around for care. Health care providers have to sell themselves says, Tim Calkins a professor of marketing at Northwestern University.
TIM CALKINS: Right now in health care, if you don't have some leverage, if you don't have a brand people care about, if you don't have a reason for people to really pick you over the competitors, well, then you're in a really tough spot.
HARNETT: Calkins says hospitals are spending more than ever on advertising. OK, but this isn't a soda or a car. It's people's lives. In the pharmaceutical industry, the FDA regulates drug ads so companies can't make misleading claims; not so for health care providers, says Calkins.
CALKINS: Hospitals aren't held to any of those standards at all. So a hospital can go out and say, you know, this is where miracles happen. And here's Joe, and Joe was about to die, and now Joe is going to live forever.
HARNETT: Before cancer, Lori Wallace says these ads didn't bother her. She liked that kind of hopeful messaging. Now, she says, she needs realism. She wrote an essay about that for the women in her breast cancer support group.
WALLACE: So it starts with the F-word. So "F Silver Linings And Pink Ribbons" by Lori Wallace - that's me.
HARNETT: And the essay's like her - open, funny and unflinching.
WALLACE: My ovaries are gone, and without them, my skin is aging at hyperspeed. I have hot flashes and cold flashes. My bones ache. My libido is shot, and my vagina is a desert.
HARNETT: Wallace and I are sitting at the kitchen table. Her son is in the other room with his pet snake. Wallace reads me the final paragraph of her essay.
WALLACE: I will try to be thankful for every laugh, hug and kiss and for other things, too. That is, if my chemo brain allows me to remember.
That's what I wrote (laughter).
WALLACE: Brutal honesty.
HARNETT: For NPR News, I'm Sam Harnett in San Jose.
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MCEVERS: This story is part of a reporting partnership with NPR, KQED and Kaiser Health News.
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