What Dr. Jerome Groopman's Patients Have Taught Him About Courage and Endurance.

Show: FRESH AIR
Date: NOVEMBER 18, 1997
Time: 12:00
Tran: 111801NP.217
Type: FEATURE
Head: The Measure of Our Days
Sect: News; Domestic
Time: 12:06

TERRY GROSS, HOST: This is FRESH AIR. I'm Terry Gross.

Dr. Jerome Groopman treats people who have cancer, blood diseases, and AIDS. In fact, he worked on the first AIDS cases diagnosed in 1981. In his new book, "The Measure of Our Days: New Beginnings at Life's End," he profiles some of his patients and shares what they have taught him about courage and endurance.

Dr. Groopman is a professor of Immunology at Harvard Medical School and chief of Experimental Medicine at Beth Israel Deaconess Medical Center. He also conducts lab research into cancer and AIDS.

Dr. Groopman's book begins with the story of Kirk, who had advanced kidney cancer when he asked Groopman to treat him -- so advanced that Groopman was reluctant to take him on until Kirk finally convinced him.

DR. JEROME GROOPMAN, CHIEF OF EXPERIMENTAL MEDICINE, BETH ISRAEL DEACONESS MEDICAL CENTER, AUTHOR, "THE MEASURE OF OUR DAYS: NEW BEGINNINGS AT LIFE'S END," PROFESSOR OF IMMUNOLOGY, HARVARD MEDICAL SCHOOL: It wasn't so much what he told me. It was more what I perceived in him, and that was that despite having widespread kidney cancer, and despite having been turned down at many excellent cancer centers for treatment, and despite not fitting into a formal experimental protocol, I felt within him this determination to live -- this force and will -- and believe that in some way I was obligated, having been touched by that, to respond to him and to treat him, even though I held little hope that we would succeed.

GROSS: You quote him as saying things like: "I don't take 'no' for answer. I'm 54. I'm not ready to pack it up and die. I'm a fighter. I don't buy that nothing can be done. Make me a guinea pig. I take risks all the time. That's my business."

What's your reaction when you see somebody who has this sense of like "I'm a fighter and I'm going to lick this thing?"

GROOPMAN: Well, I think it's a very important stance to take in battling disease, understanding that there are no guarantees and that you well may lose. I think the will to fight, the determination, is very important.

On the other hand, I don't want to be seduced into doing things which have no real rationale or may in the end actually hurt someone, and make his or her situation worse than it already is.

GROSS: Such as?

GROOPMAN: Well, I think there are people who cancer specialists can treat when there really is so little hope or reason, and administer very toxic drugs which will make the last days of their lives marked by terrible side effects, and perhaps even accelerate their death.

So it's a very complicated decision and a very fine balance between wanting to respond and wanting to fight and wanting to save lives. And at the same time, neither indulging yourself -- thinking that you'll be the dramatic cowboy, as I put it in that story, who sort of rides into town with his guns blazing, but really has no chance to hit a target.

Or, to do something which is really possibly against the best interests of the person in front of you.

GROSS: Doesn't that sense of like "I'm a fighter and I'm gonna lick this thing" ever cross over into self-delusion?

GROOPMAN: Well, I think it does. I think that I try to nurture that will and nurture that spirit and feed the energy that the patient is focusing on fighting his disease. At the other -- on the other hand, you have to be honest and you have to lay out the risks and the real chances that despite the best fight that we can muster, we may not succeed -- at least not succeed in a physical context; not succeed in defeating the disease.

GROSS: The person who we were talking about, who you called "Kirk" for the purposes of your book, was, you know, a Wall Street trader dealing mostly in high-risk, short-term investments. What happened psychologically when he went into remission from the cancer and he was let out of the hospital after a long stay there?

GROOPMAN: He couldn't get his bearings. It was as though everything that had structured his life now seemed unimportant and gave him no direction. And for a while, he was in this miraculous, really near-miraculous remission. I had thought he would live a few weeks, and the cancer melted and he lived several months.

But during that time, he was very remote and very much not himself. At first, I thought maybe he was depressed. A lot of people go through a real shock, and then he'd return to life. But it turned out that he wasn't depressed. It turned out that he had realized that he had essentially wasted his life and was filled with profound regret.

GROSS: Did he do anything to try to change his life in the short time he had left to live?

GROOPMAN: I think the really tragic dimension to this is that he didn't know how. He had never really developed the relationships or one can say the mechanisms or the know-how to really act on the realization that came so late in his life. And when the cancer came back, as I write in the story, he presented to me in a very brutal, brutally honest way, his insight that his life essentially had been wasted. He had no time and he really didn't know what to do, and faced the end of his days really a shattered person.

GROSS: Is it harder to watch somebody die with regret than it is to watch somebody die in pain?

GROOPMAN: Well, I think regret is probably the most acute form of pain. And it's a form of pain that can't be taken away with narcotics, morphine -- the kinds of medications which I believe we can give to people effectively at the end of life to temper the physical pain. It's a spiritual form of pain and it's one that is, for me at least -- having seen it -- terribly frightening and unnerving.

GROSS: What did you think your role was, if any, as the doctor in dealing with this, you know, kind of an existential pain that your patient was going through?

GROOPMAN: Well, I was hard-pressed to come up with a solution. I had no good answer for him. And he wouldn't let me off the hook. At first, I tried to say to him: "well, no, it's really not that way. Your wife, your kids -- they care about you" and so on.

But in the same candor that he lived the rest of his life, he said to me: "that's not true. You know that. You know, I'm a shit," is what he said to me. "I'm an awful person in this dimension and I've wasted my life."

And I looked into my own background and my own experience, and thought about my father who had died a young -- at a young age and whom I loved dearly and was a very, very different person than Kirk. We used to speak a lot about death and about the idea of an afterlife. And my father said that, you know, he didn't really know, of course, if there is an afterlife or not, but what he did know was that there was memory. And memory is the one legacy that we leave to those after we're departed.

And so I offered to Kirk some element related to memory, and I suggested that as hard as it might be, that he should tell his wife and tell his children this awful realization, with the hope that when they remembered him, that this understanding, this insight would protect them or assist them from repeating the mistake, the awful mistake that he had made.

GROSS: And his reaction?

GROOPMAN: I never knew, to be frank. He listened. He was understanding, but he never told me whether he would or not, and as events unfolded, he went back home. He died in the hospice, and I was never in the position to really press or pursue with his wife whether this had occurred.

GROSS: You've seen patients die in terror and other patients die in peace. Have you come to think that one's attitude toward death can be changed? That you can -- you can kind of teach yourself to have, you know, what we'd call a good attitude about death?

GROOPMAN: I think so, and I think a great deal of it comes from my own sense of death and the awful trauma that I experienced when I had just begun medical school, and I write about this in the beginning of the book. I was called in the middle of the night. I was in Manhattan at Columbia PNS and I rushed out to Queens, where my mother stood at the bedside of my father, who was a young man who had had a massive heart attack, rushed to a community hospital.

And my mother and I stood there and actually witnessed my father die. It was not only an untimely death, but probably a unnecessary death, because it was a hospital without an intensive care unit. There was no cardiologist in attendance, and there was no intervention, which really gave him an opportunity to be saved.

But having seen the person who really I loved more than any in the world, and who had centered and guided my life, die -- somehow took away from me the mystery, or some of the mystery; took away the edge of fantasy. It was very concrete. It was very real. And in some way, I just sensed that this had happened to him and I felt so much a part of him, then I knew, yes, it would one day happen to me.

And although I still of course have fears of death and have no desire to die -- I feel I'm very blessed in my life -- I hope that when my time comes I won't be filled with terror; that I'll have witnessed his death and the deaths of others, which in some way will calm my fear and allow me to approach it understanding that it's part of the continuum of life.

GROSS: Do you think that watching your father die what you thought was an unnecessary death, you thought he could have survived with better medical intervention -- has that affected your approach as a doctor?

GROOPMAN: Deeply. I believe in the power of science and the power of technology and I believe that as a physician caring for people, you're absolutely committed to do the best you can; that every detail has to be examined and you have to put yourself into it 100 percent and provide everything that can be provided to them.

I also -- I didn't write about this in the book because frankly it was too painful, and I didn't really have the words to express it, but the doctor who attended my father was a general practitioner who happened to be on call that night in this community hospital.

And there was my father -- he had just died, and my mother and I were standing in shock, just emotionally shattered. And this physician looked at me and said: "it's really tough, kid" and walked away.

I thought many times about those words, and imagine -- you know, could not imagine that that was the most compassion that he could articulate; that that was really the best that he could say.

GROSS: My guest is Dr. Jerome Groopman, author of the new book The Measure of Our Days: New Beginnings at Life's End. We'll talk more after a break.

This is FRESH AIR.

My guest is Dr. Jerome Groopman, professor of Immunology at Harvard Medical School.

You know, you write in your book that when the frustration of dealing with terminal illness gets to you, it's nice to have laboratory work to do and to deal with disease from a completely different point of view. What does laboratory work do for you?

GROOPMAN: Right. Well, I think being engaged in the process of discovery and having a sense that the work you do may help change reality, change the suffering and change the outcome of diseases, which are currently seen as fatal -- that's enormously energizing. And it's real.

I write about, in the prologue to the book, a classmate of mine, Eric Gold (ph), that is his real name, who in fifth grade developed leukemia. In those days, people didn't use words like that. They didn't say "cancer" or "leukemia." We were lied to. We were told in the class that he had blood poisoning.

And Eric withered and ultimately died. Eighty percent of children are cured now with childhood leukemia, and those who aren't have the opportunity for bone marrow transplant, which is still somewhat experimental for them. But there's a reasonable chance Eric would have lived had science advanced to the point to develop drugs and know how to use them.

And I believe that will occur with AIDS. I think there's been important advances made with the protease inhibitors. They're not a cure. They don't work for everyone and there is some slippage now. But they have restored life and functioning to many people. And I believe the same will be true in breast cancer and other diseases that are currently incurable.

GROSS: What are you working on now in the laboratory?

GROOPMAN: We're working on a part of HIV called REV -- R-E-V -- it's a guide that actually moves the virus from the center, from the nucleus of the cell, out into the cytoplasm and then into the bloodstream. And we are making crystals of this REV protein, just like crystals were made of the protease part of HIV.

This is an entirely new technology which is revolutionizing drug development. You can take important proteins that are targets for drugs, and force them to assume a crystal formation in a test tube, and then bounce x-ray beams off them and you get a sense of the topology of the three-dimensional structure of the protein.

And using high-performance computers, you can actually simulate how drugs -- how candidate drugs -- would dock onto the crevices and surfaces of the protein. And this is how the protease inhibitors were developed.

It would have taken decades using older methods of drug development to create these drugs. But using computers that could simulate how the drugs might fit into the protease and prevent that part of HIV from functioning, from working five different drugs were developed, each patented, actually -- therefore very distinct -- which are able to poison that part of the virus.

We're doing the same thing in breast cancer. We discovered a very exciting gene which appears important in breast cancer, called CHK. It opposes the growth of the cancerous cell. It appears that the breast switches it on as it transforms from normal to malignant tissue. And we've begun making crystals of the CHK protein, and studying its structure, and hope to use that information to help develop new and more targeted therapies for breast cancer.

GROSS: Dr. Jerome Groopman is my guest, and he works with people who are stricken with cancer and AIDS. His new book The Measure of Our Days is about working with patients who have what may be terminal illnesses.

Let me ask you, you know, watching so many people dying -- in your years as a doctor, you've seen a lot of people die. Do you ever go around thinking, well, this is the kind of death I want; this isn't the kind of death I want -- do you go around almost like rehearsing for your own death and planning the kind of attitude that you want to have?

GROOPMAN: Well, I do two things. And one is actually one of the motivations of writing the book, is that I look at the experiences of people at this time, not all of whom die in the book, thankfully, but say, you know: what answers do they give me? Or at least what questions to they pose? So that while I'm still healthy and still intact, I can set priorities and develop perspective which hopefully will be more substantial.

And I do think about my own death, particularly now. I'm 45 years old. I'm approaching the age that my father was when he died. And I know, certainly, the kind of end that I don't want. I don't want to end up like Kirk, looking at the end of my days and feeling that I was filled with regret and had wasted them.

And I also don't want to be in pain, and I don't want to enter into a vegetative state or have my life prolonged what seems to be dignified or meaningful. And I think that's really at the core of the whole debate over assisted suicide and when people should be let go.

So I think all of these issues are very prominent in my mind, but I don't live a morbid life...

GROSS: Right.

GROOPMAN: ... I can tell you.

GROSS: Good.

LAUGHTER

(Unintelligible) most of the things you mention you can control -- you know, pain, you say you can control.

GROOPMAN: By and large, yeah.

GROSS: Yeah, you can do a "do not resuscitate"...

GROOPMAN: Right.

GROSS: ... living testament and not, you know -- tell the doctor you don't want to be in a vegetative state. You probably don't have to worry about having -- feeling regret that you've lived a worthless life...

LAUGHTER

GROOPMAN: Oh, thank you.

GROSS: ... having been a doctor working with so many people and helping to save so many of them. So it seems like in some ways the things you're most worried about are things that you can control.

GROOPMAN: I think that's true. But having, you know, the little edge of neurosis that we all have, you -- there are important things in life you don't want to fail at. You don't want to fail at relationships. You don't want to fail in family. You don't want to fail in love.

And I think that's really at the core...

GROSS: Right.

GROOPMAN: ... of concern. Not that I feel I am, per se, but the future unfolds.

GROSS: Yeah, you're getting into the part that is out of control.

LAUGHTER

GROOPMAN: Exactly.

LAUGHTER

Would that it were so easy, huh?

GROSS: Oh, yeah. Well, Dr. Jerome Groopman, thank you very much for talking with us.

GROOPMAN: Thank you.

GROSS: Dr. Jerome Groopman is the author of the new book The Measure of Our Days. He's a professor of Immunology at Harvard Medical School and chief of Experimental Medicine at Beth Israel Deaconess Medical Center.

I'm Terry Gross and this is FRESH AIR.

Dateline: Terry Gross, Philadelphia
Guest: Dr. Jerome Groopman
High: Dr. Jerome Groopman. Since the discovery of AIDS, he's treated patients and done extensive cancer and AIDS research. He's written a book titled "The Measure of Our Days: New Beginnings at Life's End." It borrows stories from some of his patients in Boston and aims to give support, hope, and comfort to those suffering with life threatening illness. Dr. Groopman is Chief of Experimental Medicine at Beth Israel Deaconess Medical Center in Boston and is also a professor of medicine at Harvard.
Spec: Health and Medicine; AIDS; Politics; Government
Please note, this is not the final feed of record
Copy: Content and programming copyright 1997 WHYY, Inc. All rights reserved. Transcribed by FDCH, Inc. under license from WHYY, Inc. Formatting copyright 1997 FDCH, Inc. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to WHYY, Inc. This transcript may not be reproduced in whole or in part without prior written permission.
End-Story: The Measure of Our Days
Show: FRESH AIR
Date: NOVEMBER 18, 1997
Time: 12:00
Tran: 111802NP.217
Type: FEATURE
Head: Fifty Years of Fashion
Sect: News; Domestic
Time: 12:40

TERRY GROSS, HOST: This is FRESH AIR. I'm Terry Gross.

It wasn't so long ago that the well-dressed woman was expected to wear a long, flared skirt, white gloves, high heels, and a hat. Each look, whether it comes from Paris couture or youth culture, has something to say about changing ideas of beauty and the role of women.

My guest Valerie Steele is chief curator of the Museum at the Fashion Institute of Technology in New York. She's curated their new show on changing fashion since World War II called "Fifty Years of Fashion." She also wrote the companion book.

Steele says the function of couture has changed over the years.

VALERIE STEELE, FASHION HISTORIAN, AUTHOR AND CHIEF CURATOR, "FIFTY YEARS OF FASHION: NEW LOOK TO NOW," MUSEUM AT THE FASHION INSTITUTE OF TECHNOLOGY: Well, it used to be much more to dress individual wealthy women. But beginning in the 1950s, the couture sort of switched from the atelier to the global corporate conglomerate. It switched to selling patterns and materials to be manufactured by department stores or manufacturers in America.

So in the book and in the exhibition at the Museum at FIT, we have for example a Christian Dior dress from the 1950s, and then also a Christian Dior New York, made on license in New York. In the last 10 years, it's become even more of a kind of advertising area. So in the couture, you can have it be a kind of laboratory for experiments, and it can also function simply as a very expensive advertisement for the name.

So, you'll hundreds of thousands of dollars producing the couture shows, having the couture show, and hardly any of these clothes may be sold, and you may even lose money selling them 'cause they're so expensive to produce, but it gets your name out there, and the name, you know, Galiano, Dior -- is very, very hip. And so you start to sell a lot of, say, lipstick.

GROSS: And that's where they make the money, is on...

STEELE: They'll make the money on less...

GROSS: ... cosmetics?

STEELE: ... expensive items, absolutely.

GROSS: Mm-hmm.

STEELE: They'll sell many more of lipsticks or bluejeans or pairs of underpants than they will the expensive dresses.

GROSS: The show that you curated and the book that you've written is about 50 years of fashion, beginning in the mid-'40s at about the time of the end of World War II. Describe what was called the "New Look" after the war.

STEELE: The New Look was a tremendously radical break in fashion. During the war years, women tended to wear fairly short skirts -- short and narrow, 'cause you were conserving fabric, and jackets which were boxy and with broad shoulders. Then Dior brought in a look which had soft shoulders, an hour-glass figure, cinched waist, and a long, long full skirt.

As he said, during the war, he thought women looked like soldiers or boxers, and he dreamed of having women who looked like flowers. It was a very controversial look. A lot of people...

GROSS: What was controversial about it?

STEELE: Well, a lot of people thought it was retrograde; that it -- mostly they interpreted it in class terms. Nowadays we look back and think of it as being part of the feminine mystique -- longer skirts and girdles. But at the time, more people were saying: this is an old-fashioned look that only applies to upper-class woman. How can secretaries and housewives wear this kind of a look?

But in fact, it was also tremendously popular and very rapidly people started buying knock-offs of it or even making copies themselves -- sort of ripping apart dresses and adding hemlines to the skirts; and ripping out shoulder pads and modifying the clothes, to create their version of this very, very radically different look.

GROSS: You know, doesn't the look kind of say, in a way, that women went from working during the war to just looking -- to being expected to look fashionable after the war; to be expected to look like a beautiful object?

STEELE: Well, I think it's natural that we would interpret it in these terms now, but at the time there was a tremendous longing for luxury and beauty. People had been really scrimping and saving and didn't get new clothes for years. And so there was a tremendous sort of surge of excitement on most people's feelings. I mean, people said: "thank God there are new, becoming clothes that we can wear."

It was -- people felt deprived as though they'd been forced to eat, you know, just sort of chicken sandwiches for five years, and suddenly they had a big steak.

GROSS: What underclothes were required for the New Look, and how did the New Look change women's bras and girdles, stockings?

STEELE: Well, basically it wasn't that it changed it that much, except you had more in the way of underclothes built into the clothes, and a sort of wasp-waist girdle effect. You had considerable padding over the hips.

I think this is something we don't realize now when we're interested in having sort of flat, boyish hips. But at the time, the jackets and the skirts were often padded out over the hips to create this sort of hour-glass figure.

So it wasn't just cinching the waist or padding the bosom, but also padding the hips out.

GROSS: I grew up in the 1950s watching, of course, a lot of television. And women on TV in the '50s were always wearing dresses, even if they were doing housework.

STEELE: Mm-hmm.

GROSS: And I'm wondering: when did pants become acceptable for women, not just in high fashion, but just, you know, in general?

STEELE: Well, you start to see women wearing -- breaking this big taboo against wearing men's pants -- gradually in the early part of the 20th century. So in the '20s and '30s, you find women wearing sort of pajama-like trousers for internal evening parties; or for lounging on the beach; or for going horseback riding; or for working in the garden.

And this kind of casual kinds of trouser-wearing continued during the '40s and even in the '50s, although increasingly sort of rules about being lady-like implied that bluejeans and pants were more for college girls and bachelorettes than for wives.

There was a really egregious book called "Wife Dressing" published by a woman fashion designer Ann Fogarty (ph) in the '50s, which suggested that not -- you should never wear bluejeans 'cause you weren't a kind of car mechanic. What you were was a wife and you should be wearing not just a dress, but a girdle, even when you were cleaning the floor.

GROSS: I think of the '50s also as the evening gown and the cocktail dress era. What were the guidelines then for what a woman was supposed to wear in the evening?

STEELE: There were lots and lots of rules, and it was very much what was occasion-specifically appropriate dress. So it had nothing to do with expense. For example, crocodile shoes might be very expensive, but you couldn't wear them after 5:00 because they were afternoon shoes. Generally speaking, as it got later in the evening and got more formal, the dress got longer in the hemline and lower in the bosom.

So, cocktail dresses tended to be at the knee. Then, if you're going out in the evening, the dress was dropping to the ankle. If it was a really formal ball, you might have a train. And again, more and more of the bosom was showing, the decolletage dropped.

We had a lot of fun with the show in putting together a section on cocktail dresses, where the little black cocktail dress and the little black cocktail hat were there. The man in the gray flannel suit in the afternoon switched into his tuxedo. So you had this -- everybody wearing black at the cocktail party, except we had one woman in a black and white Balenciaga dress who was kind of the outcast 'cause she didn't fit in.

And we had another section -- dress "think pink" -- where we had a variety of evening dresses of different styles -- things like a formal evening ball gown or a regular evening gown -- the kind of early evening party dress, all in pink, because a lot of the rules that had to do with dress were related to gender stereotypes.

GROSS: Give me some of those rules.

STEELE: Well for example, the idea that color -- certain colors were masculine and certain colors were feminine; that as you mentioned before, pants were essentially either masculine or informal, so they were more appropriate for younger girls, and not appropriate for married women; things like the kind of accessories that you wore would determine, you know, how appropriately dressed you were.

You always were supposed to wear white gloves when you went into the city, and carry an extra pair in your purse because you know, it might get dirty and so you'd have to have these sort of fresh, crisp gloves, and the right hat and so on, for every occasion.

GROSS: Are you as happy as I am that you don't have to dress this way?

LAUGHTER

STEELE: It's almost inconceivable for people nowadays, and yet it was only in the late '60s that all these rules broke down. In the early '60s, the game changed and the new rules became youth-quake. You're supposed to wear mini-dresses and the rules started to come up from the kids in the street. But these were still being promulgated as rules. It's very funny if you look at fashion magazines from '65, you know, they're giving adult women the sort of vocabulary -- "look, a 'chick' is a girl...

LAUGHTER

... 'bread' is money. This -- I remember my favorite was an article -- you can "frug that fat away," so you could use contemporary dancing as a form of aerobic exercise. It's only with the hippie era that people finally throw up their hands and say, you know, "the end -- enough with this kind of fashion fascism. We're not going to obey any more of these rules, and people should try and figure out for themselves what they want to wear."

And really, it's never gone back.

GROSS: As you pointed out, the hippies in the '60s kind of destroyed or set about destroying a lot of fashion rules. And that had a big impact on the fashion industry. How did the fashion industry try to use what was coming out of youth culture with the hippies -- this kind of anti-fashion look? How did the fashion industry try to market that?

STEELE: Well, the hippies had the sort of utopian idea that you could dress to express your own individual personality, and they looked for inspiration to long ago and far away. So, you had clothes which were inspired by Moroccan and Indian clothes. Thrift stores were pillaged for Edwardian petticoats and 1930s slip dresses.

And all of these things were immediately able to be picked up by designers. Basically, it moved from sort of hippies themselves creating tie-dyed T-shirts and going to thrift stores and coming back from North Africa. And then designers started picking this up, so you had Halston doing a tie-dyed caftan for example, on silk. Or, you had Giorgio St. Angelo making a beautiful king of gypsy/American Indian-inspired clothing with, you know, slashed suede for example.

You had ultimately St. Laurent creating, with the famous Russian collection, the whole sort of rich peasant extravaganza of costumy dressing, which all drew on the sort of the hippies costume-party approach to style.

GROSS: Let's look at the 1970s. Do you think that that decade holds up to the nickname "the decade that taste forgot?"

LAUGHTER

STEELE: Well, one thing that happens when you have a lot of people who stop obeying the arbiters of fashion. The arbiters may have been dictatorial, but they did at least have a coherent view of what they thought style should look like. And when people are all deciding for themselves, the fact is that a lot of people make some pretty, perhaps egregious choices. And you have fashion moving very rapidly to various extremes.

So that the early '70s are characterized by things like hot pants, platform shoes, very, very, very wide lapels, strange color combinations -- and we've got a sort of a lime green man's suit, for example, from the early 1970s; velvet patchwork bell bottom trousers. Things like -- we've got a pair of fur hotpants in the show, and a sort of see-throughish chiffon blouse.

All of these things -- really sort of outrageous wild styles -- were a part of the '70s look. And a lot of what we think of as '60s style really only began to appear for most people in the '70s. You had to be sort of ahead of the game to be a mod or a hippie in the '60s, but by the '70s, as you can see from contemporary movies, I mean everybody out in the suburbs and everywhere was getting into the sexual revolution and the drug revolution and the freedom to wear whatever they wanted.

GROSS: If you're just joining us, my guest is Valerie Steele, and she's chief curator for the Fashion Institute of Technology in New York. She curated their new show Fifty Years of Fashion and wrote the companion book.

Let's take a short break and then we'll talk some more.

This is FRESH AIR.

Back with Valerie Steele, chief curator of the Fashion Institute of Technology in New York. She curated their new show Fifty Years of Fashion and wrote the new companion book.

You wrote an earlier book called "Fetish: Fashion, Sex and Power," and I'm wondering where you see, kind of, fetish clothing most now?

STEELE: Well, I think that it's definitely one of the style tribes that you see. Lots of kids are wearing sort of pervy clothes to...

GROSS: Excuse me -- oh, as in "perverse."

STEELE: As in pervert -- or perverse. And sort of perv style as it's known in England, continues to be a big part of night life style. In fact, to considerable extent, their quite kinky clothes have become just sort of mainstream as sexy-looking clothes.

So materials like rubber, which a few years ago were never seen outside, you know, sort of surgical gloves or kind of fetish magazines -- fetish pornography. Now, you have quite openly various kinds of latex and rubberized surfaces being used in mainstream fashion.

In fact, there was a big -- big wall painting in New York, said "no glove, no love" -- showed a woman in a rubberized outfit, which explicitly assimilated this kind of latex style to safe-sex practices.

GROSS: Where would you say we are now in the, well, in the beginning of the late '90s? What's happening in the fashion and in the street fashion world?

STEELE: I think at the end of this millennium, sort of on the edge of the new one, we are seeing a lot of retro fashions, but we're also seeing a lot of ethnic-inspired fashions as the world gets more multicultural and global. I think that's going to become a bigger and bigger trend.

And I think along with retro and ethno-styles, techno-styles are very important -- styles that are drawing on new technologies so that you have smart fabrics that will sort of change their capabilities as you need them to get you warmer or cooler or to sort of wick sweat away from your body.

I think that all three of these trends are very important now.

GROSS: Athletics and working out have had a huge impact on fashion -- people wearing jogging suits and stretch fabrics that show off, you know, your muscles, and elaborate sneakers and so on. Do you think that this is continuing?

STEELE: I think so. I think that athletic and sports attire has had, and will continue to have a really big impact on fashion. Even though, realistically, many of the people who are wearing the high-tech sneakers and so on get no more exercise than just sort of jogging to the refrigerator.

Nevertheless, because sports are so prestigious in our society, and because sort of the look of athletics is so coveted, people are drawing more and more on this style.

In another way, though, I think that it's very imp -- the body's becoming a more and more important part of fashion. In the past, you know, girdles or padded bras or various things would kind of push your fat around. But increasingly, that kind of corsetry has -- is -- demands to be internalized through diet and exercise.

So increasingly, you're supposed to be working on having a hard body because the clothes themselves are becoming, in a sense, more minimal and in order to look right, you have to have the body that the clothes require.

GROSS: Mm-hmm. You know, I think a lot of women really hate designers, because designers create really outlandish fashion trends that are unflattering to mere mortals.

LAUGHTER

And I wonder if you've found that to be true -- I mean, that response.

STEELE: Oh, yes. The anti-fashion sentiment is very, very strong particularly in America and to a lesser extent in England. It's really not very evident in other parts of the world like Europe and Asia or Latin America.

And I think that, although I recognize there's some validity to it, some designers in fact are not at all interested in dressing, you know, sort of a range of ordinary people, but only want to dress people who are sort of six feet tall and weigh 95 pounds.

But on the whole, I think that the sort of feminist critique of fashion is misconceived. Fashion, for example, doesn't cause bad feelings about your body. It certainly doesn't cause anorexia or eating disorders any more than, you know, country and Western music causes alcoholism or adultery.

I think that a lot of times, people's feelings about themselves are heightened when they compare their -- their ideal body with how they actually look, but it's not really the fault of the clothes -- you see what I mean? -- any more than a bathing suit designer is at fault when a lot of people feel very unhappy when they're trying on new bathing suits.

GROSS: Well, but you -- so you don't think that fashion designers kind of -- I'll tell you my big frustration.

STEELE: Fashion designers -- I think fashion designers want to sell clothes.

GROSS: Right.

STEELE: And they recognize, or their business partners recognize, that you have to sell them to a particular -- to particular markets. On the other hand, see, people who tend to be more fashion forward do tend to be younger and often thinner than the average person. So the designers, if they're trying to sell to a kind of young, hip market, they're going to be selling the kind of clothes that won't appeal, necessarily, to everyone.

GROSS: I want to thank you for talking with us about Fifty Years of Fashion.

STEELE: OK. Thank you.

GROSS: Valerie Steele is chief curator of the Museum at the Fashion Institute of Technology in New York. She curated the show Fifty Years of Fashion and wrote the companion book.

Dateline: Terry Gross, Philadelphia
Guest: Valerie Steele
High: Fashion historian Valerie Steele. Her new book outlines changes in the fashion world through the past half century, noting how the economy, global climate, and sexual politics affected designers' creations as well as the styles we wore. The book is called "Fifty Years of Fashion: New Look to Now." Steele is Chief Curator at the Museum at the Fashion Institute of Technology in New York.
Spec: Fashion; History; Women; Books; Authors; Fifty Years of Fashion
Please note, this is not the final feed of record
Copy: Content and programming copyright 1997 WHYY, Inc. All rights reserved. Transcribed by FDCH, Inc. under license from WHYY, Inc. Formatting copyright 1997 FDCH, Inc. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to WHYY, Inc. This transcript may not be reproduced in whole or in part without prior written permission.
End-Story: Fifty Years of Fashion
Show: FRESH AIR
Date: NOVEMBER 18, 1997
Time: 12:00
Tran: 111803NP.217
Type: FEATURE
Head: Madredeus
Sect: News; International
Time: 12:55

TERRY GROSS, HOST: Music critic Milo Miles has discovered a singer whose voice is thrilling, but it's been a puzzling experience.

MILO MILES, FRESH AIR COMMENTATOR: I have never been sympathetic to the cult of the voice. For me, it's the singer and the song. I hear how the cult of the voice works in opera sometimes, but it resolutely does not carry over into pop.

Yes, Whitney Houston has a terrific set of pipes. So what? But no matter which way you listen, there's no denying that voices can cut across cultures; no denying they can defeat rational resistance and tickle the subconscious.

Performers that become international stars are almost invariably potent singers. A recent example was Nusrat Fateh Ali Khan. His swirling voice gripped Western audiences who knew nothing about his Quali (ph) music, and less about his Sufi mysticism.

Speaking of mysticism, people think voices have spooky powers, and they're right. As a declared disbeliever in voice cults, I was shocked to find myself sucked into one during the past year. It happened with the Portuguese group Madredeus. Never have I found a singer so captivating attached to a band I found so boring.

Madredeus began in 1987, after a couple of pop bass players got together to concoct a new style of music to reflect Sadad (ph), the fragile, melancholy Portuguese equivalent of soul.

Apparently liking things mild, pretty, and other-worldly, they rounded up a bit of traditional Fado (ph) from Portugal; a bit of melodious pop from Brazil; a bit of tango from Argentina; and a bit of New Age fuzz from everywhere and nowhere.

You wouldn't be hearing about any of this from me if they hadn't also rounded up a 17-year-old they found singing in a bar. Her name is Teresa Salgueiro. There's nothing quite like it when her voice comes sailing into the innocuous mixture of Madredeus' music. It follows you around like perfume on your collar.

(BEGIN AUDIO CLIP, PORTUGUESE SINGER TERESA SALGUEIRO WITH BAND "MADREDEUS")

SALGUEIRO SINGING IN PORTUGUESE

MILES: I deliberately haven't named the instrumentalists in Madredeus because, well, they don't matter a whole lot. This point was underscored at a recent Madredeus concert I attended at Boston's Berkeley Performance Center. One of the founding musicians left a couple of years ago, and the other, Pedro Magales (ph) has returned the group to its earliest lineup: out with the cello and the accordion; in with the bass guitar and the synthesizer.

But no difference. Salgueiro steps up to the microphone and the spell is cast again. The crowd was more mature and conservative that ones I'm used to, and I worry that affection for New Age is a sign of old age. Or perhaps it's just a modern version of 101 Strings, since handholding couples abounded.

All the music came from an unreleased new album called "El Pariso" -- The Paradise. Salgueiro is dignified and lovely, though I'm glad I don't understand Portuguese when she explains in English that this song is about the swallow that brings the spring, and that song is about after a storm is over.

Madredeus uses dry ice smoke for that dreamy mood enhancement. They use purple lights for ballads that are even slower than their other numbers. Salgueiro twirls and sashays for one song that's based on a folk tune, and that's as active as things get.

Every moment she isn't singing or dancing is a waste. Every moment she sings is rapture. My ears and mind can't reach any qualities in her voice to explain why, exactly. Perhaps she is filled with Sadade. Perhaps I am simply one of the beguiled.

GROSS: Milo Miles is a music writer living in Cambridge, Massachusetts.

Dateline: Milo Miles, Cambridge, MA; Terry Gross, Philadelphia
Guest:
High: World music critic Milo Miles on the Portuguese group Madredeus and 17-year old singer Teresa Salgueiro who is a newer member of the group. The complete Madredeus catalog is on the Metro Blue label.
Spec: Music Industry; World Music; Europe; Portugal; Teresa Salgueiro; Madredeus
Please note, this is not the final feed of record
Copy: Content and programming copyright 1997 WHYY, Inc. All rights reserved. Transcribed by FDCH, Inc. under license from WHYY, Inc. Formatting copyright 1997 FDCH, Inc. All rights reserved. No quotes from the materials contained herein may be used in any media without attribution to WHYY, Inc. This transcript may not be reproduced in whole or in part without prior written permission.
End-Story: Madredeus
Transcripts are created on a rush deadline, and accuracy and availability may vary. This text may not be in its final form and may be updated or revised in the future. Please be aware that the authoritative record of Fresh Air interviews and reviews are the audio recordings of each segment.