The vast majority of breast cancer is curable. Why do women jump so quickly to worst-case scenarios? Most women I know, when they have a headache, don’t immediately think they have a brain tumor.
The stories about breast cancer that are most poignant, shocking, and newsworthy tend to end badly. So women’s minds go to the most recent thing they’ve heard, which maybe is Elizabeth Edwards. But she’s not the norm. Stage 0, 1, and 2 cancers are very curable, and Stage 3 is curable, too, but takes a lot more treatment because it can become Stage 4. Everything but 4 is curable. People leap to the worst-case scenarios because they don’t realize that Stage 4 is not the most common. When women present with breast cancer, only 5 percent will be Stage 4; 61 percent will be early stage; 32 percent will be in the middle. The vast majority? I get to walk in the room and say, “I’ve got good news.”
The breast is just so, forgive the description, weighted a body part for women and their self-image.
It’s undeniably connected to femininity and sexuality and body image and womanhood. It takes a strong sense of self, which we hope women strive to achieve, to say, “I am not my breasts,” because breasts are symbolic. If you want to say otherwise, you’re in denial. Also, it is much more devastating to have something external altered unwillingly. People don’t say, “Can you just take a little less of my colon? How much of my colon are you taking? What will it look like?” You don’t have those conversations about colons. I have them all day long about breasts. And I love those conversations. What is the biggest fear when a woman walks in who knows she already has breast cancer? Chemo. What is the fear with chemo? Hair loss. Because it’s external. They can’t hide it. It’s a daily reminder, before they get their wig on and their happy face going, that these are rough days. It’s an unavoidable statement, at least to yourself, that something has gone—I won’t say wrong . . .
Different than planned or than what you had hoped for. But so many men and women emerge stronger from this disease. It can alter their sense of self or even their career path or their relationships for the better. For many it took something as loud as cancer for them to listen. Many women will say, “I don’t regret having gone through that. I’m better having walked through the fire.” They surprise themselves with their resilience. It’s almost like they fall in love with themselves for having endured something so threatening and then emerged victorious from it. That’s what makes me pop out of bed and run into work. It’s just so fun.
Where does your optimism come from?
I was born into an extremely loving family, and I have an unshakable Christian faith. And I’m a blend of my mom’s and dad’s positive attributes. My dad is incredibly kind, can’t think ill of anyone. He’s a stock market analyst, but he grew up poor in Connecticut, as did my mom. As a boy, he’d wake up at 4 a.m. to pick tobacco before school. He treats everyone like family. My mom, who was a dental hygienist, has an inner strength, a determination, and a demand for perfection. When she was 37 and I was one—she had five kids under 13—she had a massive stroke. She was in rehab for three or four years. She couldn’t speak and she didn’t come home. And when she did, she was paralyzed on her right side. But by the time I was five or so, she had perfect speech, she was out of her wheelchair, she walked without a cane. Her right arm didn’t always work and was a little atrophied, but my dad jury-rigged the car with a knob on the steering wheel so she could drive me everywhere I needed to be. She was an amazing mom—she was at every athletic event, every play I ever did. My mom never gives up hope, she never stops fighting. She pushes her body and her mind to that extra limit. She’s 79 now, is back to holding her cane. But at her peak, a long peak of 30 years, she had completely conquered this. So between my father’s quiet, observant, caring compassion and my mom’s vivid determination to be the best, I somehow blended into this person who is determined to make every moment matter. Really, what is life but a long series of moments? So the more moments that are powerful or joyful, the more impactful and wonderful your life.
That’s a beautiful way to say it. The optimistic side of me agrees, but at the same time I worry that those moments can be taken away. I’ve had big losses in my family. You are dealing with that every day: people who are facing the fragility of their own lives. When did you realize you had the capacity to tell people hard news?
When I was in medical school, the first thing I did was trauma. That’s why I’m a surgeon. I loved the immediacy of, Here’s a problem, I can fix it. But I remember when I learned not to make promises you can’t keep. I may cry when I talk about it. There was this old man who came into the ER, and his aorta had burst so he was bleeding out. I was running by the bed as it was being pushed down the hall, doing the intake, and I’m like, “Are you on any medications? Do you have any allergies?” He’s just a stranger, and I’m trying to figure out stuff as we’re racing into the OR and he’s losing consciousness, and he stops and he just says, “Tell my wife I love her.” And I was like, “Um, no, you’re going to tell her when you wake up.” And then he died on the table.
This article was originally published in the September 2013 issue of Los Angeles magazine