"The night before brain surgery, I thought about death. I searched out my larger values, and I asked myself, if I was going to die, did I want to do it fighting and clawing or in peaceful surrender? What sort of character did I hope to show? Was I content with myself and what I had done with my life so far? I decided that I was essentially a good person, although I could have been better--but at the same time I understood that the cancer didn't care.

It would be my guess that Madonna is not a very happy woman. From my own experience having gone through persona changes like that that kind of clawing need to be the center of attention is not a pleasant place to be.