Surgeon Puts His Stamp on Breast Cancer | to pdf >>
(Including an interview with Ernie Bodai, MD)
By Judy Lane

You may want to think twice before you say "no" to Balazs (Ernie) Bodai, MD. That's what the United States Postal Service learned after it turned down the 47-year-old surgeon's proposal for a special 33-cent postage stamp, the proceeds from the extra penny to be earmarked for breast cancer research. But the Postal Service hadn't reckoned with the kind of determination that Dr. Bodai brings to his crusade to find a cure for breast cancer. This August, that venerable agency--now a staunch ally of Dr. Bodai and his idea--will issue nationwide a 40-cent semipostal stamp, valid for mailing at the 32-cent first-class rate. Net proceeds (seven or eight cents for each stamp sold) will go for breast cancer research--70% to the National Institutes of Health (NIH) and 30% to the Department of Defense. (A fact not widely known, the Pentagon has spent $500 million on breast cancer research since it was first authorized to do so by Congress in 1992.)

Against the Odds
Dr. Bodai's feat is astonishing when one considers the obstacles. To start, there was resistance, some of it fierce, to an unprecedented fundraising stamp. Objections came from the Postal Service itself, from stamp collectors, and yes, even from national breast cancer organizations. Not surprisingly, the Postal Service was fearful of the precedent a fundraising stamp would set; as it is, the agency gets 40,000 ideas a year for commemorative stamps alone. Postal authorities feared that acquiescing to one request for a fundraising stamp would unleash an avalanche of similar requests from other crusaders for equally worthy causes. More surprising was the opposition by the American Philatelic Society, whose leader argued that the added cost was tantamount to an unfair tax on stamp collectors. And although some may think of stamp collecting as an esoteric pastime pursued by apolitical hobbyists, stamp collectors have considerable lobbying clout, contributing $100 million in annual profits to the Postal Service. Then too, charity or semipostal stamps issued in other countries have been far from successful. For example, a Canadian stamp designed to raise money for the 1976 Olympics was a dismal failure, as was a more recent stamp to raise money to fight illiteracy. Finally, Dr. Bodai had to face the sobering reality that should he pursue legislative action, the chances of getting a bill--any bill--through Congress would never be more than a remote possibility. This year, for example, 10,000 bills were introduced in Congress, but only 40, including the bill to mandate a breast cancer stamp, were passed.

Crusading for the Cause
Still, Dr. Bodai is not a man to be easily dissuaded from a mission, and by now his mission had become a passion. As Chief of Surgery for Kaiser Foundation Hospitals in Sacramento, California, he had grown increasingly frustrated by his inability to save, through surgery, many of his patients with breast cancer. And there is no arguing that breast cancer statistics are sobering:

• Each year, breast cancer affects 900,000 women worldwide, nearly 200,000 of whom are American, including 50,000 who will die from the disease.
• Between one in nine and one in 11 women contracts breast cancer.
• At least 2.6 million US women have breast cancer, an estimated 1.6 million of whom have undiagnosed disease.
• Breast cancer is the most common cause of cancer-related death in women 15 to 45 years of age.

Disturbing as these statistics are, there is still more discouraging news for women. First, mortality rates for breast cancer have not decreased in nearly half a century; a woman who contracts breast cancer in 1998 has no better chance for survival than did her counterpart in 1950. Second, because of the rising costs of research, proportionately fewer research projects are funded now than in past years. The NIH, for example, currently funds only 26% of all proposals it receives.

Rejection of his proposal by US Postmaster General Marvin Runyon only strengthened Dr. Bodai's resolve. That resolve turned positively steely after he wrote to 48 congresswomen and eight women senators without receiving a single response. Recalls Dr. Bodai, his voice still tinged with disbelief, "I got zero response! That's when I got mad. That's when I bought my first plane ticket to Washington." With a crusader's zeal, he determined to lobby Congress to pass legislation mandating that the Postal Service issue the special stamp. Thus began an odyssey that would take him campaigning to Washington 14 more times in the next two years, deplete his personal savings by $100,000, and transform him into an instant lobbyist. At the same time, he knew the importance of gathering grassroots support for his cause. He vowed never to decline an invitation to speak, and speak he did: to more than 200 groups, including audiences as small as two persons and as large as 1,500.

Despite the odds against him--passage of a revenue-raising bill usually requires $10 million and four to five years--and hoping that a congressional bill would force the Postal Service into action, Dr. Bodai began to prowl the halls of Capitol Hill together with Elizabeth Mullen (a 39-year-old survivor of breast cancer as well as founder and CEO of the Covina, California-based Women's Information Network Against Breast Cancer) to enlist support for the idea of a fundraising stamp. The work was slow and often tedious. "I had a lot of doors slammed in my face, but I never gave up. On the contrary, the cause took over my life," Dr. Bodai says.

Adds Ms. Mullen, "We had no experience, but we quickly learned the game." She believed that lobbying for the stamp was placing her and Dr. Bodai "on the brink of history."

At Last--a Stamp!
Bipartisan support for the stamp grew, and eventually Dr. Bodai and Ms. Mullen obtained commitments from Representative Vic Fazio (D-California) and Senator Diane Feinstein (D-California) to shepherd a bill through Congress. Finally, on July 22, 1997, at 10:30 pm, Dr. Bodai perched in the bleachers of the House of Representatives to watch as the bill flew through the House on a vote of 422-3. On a unanimous vote, Senator Feinstein arranged speedy passage of an identical bill through the Senate. Three weeks later, on August 13, 1997, President Clinton signed the Breast Cancer Research Stamp Act into law.

Rife with symbolism, the new breast cancer stamp is a line drawing against a rainbow-hued background that shows the upper half of the body of Artemis, Greek goddess of the hunt and protector of young women. The stamp bears the legend, "BREAST CANCER" and is the work of Maryland designer (and breast cancer survivor) Ethel Kessler and of illustrator Whitney Sherman. The words "FUND THE FIGHT. FIND A CURE." encircle the woman's missing breast, and her right arm is raised in the correct position for examining one's own breast. She carries a bow and a quiver of arrows: her reach for an arrow suggests her intention to do battle, and there is no mistaking the enemy.

Balazs (Ernie) Bodai, MD

Bright Prospects for More Research
Dr. Bodai is understandably elated with the fundraising potential of the stamp. The Postal Service delivers 180 billion pieces of mail each year, one third of which are sent via first-class mail. Capturing only half that market would net an estimated $210 million a year. The US Postal Service intends to issue 100 million stamps in its first run. Dr. Bodai expects they'll sell in one month. At seven cents a stamp, that's $7 million--and it's only a start. The stamp program will continue for a two-year test period. Bodai hopes to raise between $60 million and $300 million.

Dr. Bodai has, against seemingly impossible odds, turned in a magician's performance by realizing his goal for a postage stamp to fund breast cancer research. If anyone doubts that statement, consider this: The US Postal Service, once so opposed to the fundraising stamp, conducted its own survey, determined that people disposed toward charitable contributions were as likely to spend eight cents as an extra penny, and itself decided to increase the price of the stamp to 40 cents! Still, Dr. Bodai is not without his critics: some fault him for focusing on breast cancer while ignoring other forms of cancer. To those critics, Dr. Bodai responds, "Advances in breast cancer treatment are sure to cross-fertilize into treatment for other forms of cancer." For Dr. Bodai, the ultimate goal is that the threat from cancer--any cancer--will cease to exist.

An Interview with Balazs Bodai, MD By Judy Lane Dr. Balazs (Ernie) Bodai exudes the kind of energy that brings to mind a tornado or tidal wave. The force of his personality, his enthusiasm, the sheer rush of his words in conversation, leave the listener breathless. What, exactly, makes a man as inexhaustibly driven as Dr. Bodai--a man who nearly single-handedly sought and got passage of an unprecedented bill for a special fundraising breast cancer stamp? In response to the question, Dr. Bodai laughs self-deprecatingly and cheerfully attributes his turbo-drive energy to hyperactivity. "I've got A.D.D.!", he laughingly exclaims. Then, pausing momentarily, he adds, "I'm like a dog with a bone!" and laughs again. Dr. Bodai's achievements are, however, no laughing matter. In addition to his duties as Chief of General Surgery for Kaiser Permanente's medical center in Sacramento, he holds patents on at least 13 medical devices and is part owner in three biomedical companies. Of his inventions, he cites the Bodai neonatal suction valve as the one he is most proud of. Patented in 1990, the neonatal suction valve is routinely used in hospitals to suction infants without necessitating the temporary removal of the ventilator. Although he is modest in his depiction of the valve as a remarkably uncomplicated device, he does not shy away from crediting it with having already saved hundreds of neonatal lives. Unable to relax in ways that most of the world understands, Dr. Bodai uses time that others might call "spare" to contemplate and immerse himself in new ventures. A prolific writer since the days of his residency, he has authored or coauthored nearly 200 articles for publication. He is, in addition, the author of a 1994 surgical text book, Synopsis of Common Surgical Procedures. Having successfully campaigned to get Congress and the US Postal Service to issue a stamp whose proceeds will fund breast cancer research, Dr. Bodai has lately focused his attention and energies on a new Breast Health Center. Largely through his efforts, Kaiser Permanente-Sacramento will dramatically improve services to patients receiving treatment or services related to breast cancer. Where before, patients were required to scramble from one location to another to receive their care, they will now receive coordinated care in one setting where various components of 15 to 20 disciplines are assembled under a single roof. And what a roof it is! Dr. Bodai has managed to obtain space for his project in the Region's newest medical office. He is optimistic that with time, the office will be devoted exclusively to breast cancer services. Development of such a center has particular significance, says Dr. Bodai. Within the Northern California Division, Sacramento as the flagship hospital sees 330 breast cancer patients and does 1,000 biopsies annually--more than the combined number performed throughout the rest of the Division. And by 1999 Dr. Bodai anticipates that the number of Sacramento cases will climb to 500 and biopsies to 1,500. Equally noteworthy, says Bodai, but little known--even among other Kaiser Permanente Divisions--the Northern California Division enrolls more participants in NIH research trials than any of the other 211 participating clinical outreach groups (those private hospitals with a university affiliation). Lest anyone think that his extra activities detract from his surgical productivity, Dr. Bodai, as if anticipating this question, is quick to point to statistics that show that he is as busy as any other Kaiser Permanente clinician in Sacramento--both in surgical cases and new consults. In the physician world, where over-achievers are commonplace, Dr. Bodai is a phenomenon. Asked to explain his fierce drive, he grows momentarily reflective. His tone suddenly serious, he recalls having fled Hungary at age six with his parents and two brothers after the Soviet takeover in 1956. After arriving in the United States, penniless and unable to speak English, the family took temporary refuge with strangers before settling in permanent quarters. Home, says Dr. Bodai, was a hovel. His most searing recollection is that of his physicist father, a brilliant man who was reduced to laboring as a bricklayer, because having lived behind the Iron Curtain, he was considered a security risk. Perhaps the son's ambition may come from a wish to redeem the father's failed hopes. What motivates for a man like Dr. Bodai? Certainly not material things; his only adornment is a 15-dollar Casio watch. He professes to be notoriously indifferent to his attire, preferring the comfort of surgical scrubs during the work day. Home is a comfortable but unremarkable home in a pleasant area of Sacramento. His one luxury, he admits somewhat sheepishly, is a new black Mercedes, which he says his wife encouraged him to buy. As if in apology for his indulgence in a rare luxury, he points out that the model--a 230--is Mercedes' least expensive. What he likes best about the car is its license plate--PL105-41--the title of the public law that made official the breast cancer fundraising stamp.