Flat Memoir: “FLAT”

NPOAS sat down with “FLAT” author Catherine Guthrie to learn more about her and her memoir.

FLAT: Reclaiming my body after breast cancer is the cancer memoir you haven’t read — the compelling narrative of a young, queer woman pressed up against a life-threatening illness and cultural expectations of femininity.”


Tell us why you decided to write a book about your experience.

When I was diagnosed in 2009 there were no breast cancer memoirs (that I could find) written by women who chose to go flat. Instead, I found narrators focused on reconstruction and on how their diagnosis impacted their husbands and children. Those books certainly filled a niche, but they didn’t reflect my life. I couldn’t find a narrator unpacking questions about reconstruction and challenging the tacit assumptions about what women want or need to feel whole after breast cancer. My book, FLAT, was my response to what was missing from the breast cancer shelf.

What was it like for you writing the book? Cathartic? Traumatic? Both?

I imagine my experience was different than most folks because I am a health journalist.  Before I was diagnosed with breast cancer, I’d covered it from every angle. How to treat it, how to talk about it, and how to survive it. After being diagnosed, I started a blog called “Pink Is Not Color,” as a way to process the dissonance of being thrust into a hyper-feminine medicalized space where people were showering me with pink tchotchkes and telling me how much I’d love my new breasts. 

Upon finishing treatment, I thought I could shape my blog posts into a memoir, but I soon realized that as a journalist, I knew nothing about writing a memoir. Luckily, we’d just moved to Boston, home to the country’s largest writing nonprofit, Grub Street. I applied to and was accepted into a year-long, MFA-style memoir program and that’s where I learned how to write creative nonfiction, get an agent, and sell my book to a mainstream publisher. But, to answer your question more directly, yes — over the course of the year — I experienced catharsis and revisited many traumatic events. And it was 100 percent worth it because learning how to apply my love of writing to a new genre was one of the most intellectually engaging and satisfying experiences of my life.  

What do you hope people take away from reading your book?

After reading my book, I hope people will have a better send of what breast cancer surgery involves, what kind of decisions you might be asked to make, and how to advocate for yourself or a loved one at the doctor’s office. I also hope that queer couples can see themselves and their lives reflected in the pages of my book.

Can you share your favorite part of the book with us?

My favorite part is the scene when Mary and I elope. Honestly, I was conflicted about ending the book that way. I always hated it when a memoir I was reading ending on marriage or motherhood. And then I did it! I tried to write other endings, but that exercise gave me newfound appreciation for why writers gravitate toward those milestone moments. These events punctuate our lives in meaningful ways. That sweet ceremony at Somerville City Hall bookended a very turbulent few years for me and for Mary. Marriage was something we’d been denied for 14 years. That denial was extraordinarily stressful. I discuss a few of those points in the book. But the precarity of my access to health insurance continued after we moved to Massachusetts. 

As the final shape of the book was falling into place, I kept returning to the marriage scene as a capstone for the book’s emotional arc because, ultimately, the book is a love story. Mary lived through this ordeal just as much as I did. I’d even argue that her job was more difficult in some ways because she had to process her fear without my help. On the other hand, I processed 100 percent of my emotions with her. She is my best friend and my closest confidant. The last scene is less about marriage per se and more about our triumph as a couple. 

Any parting thoughts?

Back in 2009, when I was first diagnosed and the word “flat” wasn’t even a thing in the breast cancer community, I couldn’t have imagined what is so easy to take for granted today: heaps of online support, community, and resources available for folks considering going flat after breast cancer. Not to mention, enough flat memoirs and guidebooks to fill an entire library shelf. I’m honored to have witnessed the progress we’ve made as a community, and I can only imagine where we are going next.


Read reviews & purchase “FLAT” here.

Published by Not Putting on a Shirt

Founder of Not Putting on a Shirt, a mastectomy patients' rights organization that advocates for optimal surgical outcomes for patients going flat.

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