Surgeons and Egos

Back in the early eighties, the dark ages of breast cancer research and information, I had yet another cyst and this one could not be aspirated, so I was referred to a general surgeon. I had a LOT of questions. The normal procedure then was to do the biopsy under full anesthesia, rush the sample to the lab and if suspicious, do a radical mastectomy which meant taking practically everything except the heart and lungs leaving a crater where there had been a good-sized hill.

Well, no. I wanted to make this a two step (now standard procedure) and discuss my options if the biopsy was positive. No radical mastectomy until I had a chance to review it myself. And I wanted to see pictures post-op radical mastectomy. And I wanted to be awake and have him just use a local anesthesia for the biopsy. Both ideas affronted my surgeon. At first he used the fatherly approach....”it would be better for you...” Then he got downright angry when I said I would refuse to sign the consent form for the mastectomy. So we parted ways.

I approached the American Cancer Society. Today, if you have a history of cancer in the family, or if you are facing the possibility of mastectomy, the information is overwhelming. In my day, they guarded it, what there was of it, as if it were the Fort Knox gold. The American Cancer Society REFUSED to talk to me UNTIL I had a positive diagnosis! Awareness and Preparedness???? I think not. “It’s better not to know,” they patronizingly cooed at me. “Come back if you really have cancer.”

It’s almost 30 years later and my blood still rises, remembering.

And Tess is discovering the Surgeon’s Ego is still aware and awake.

Her Dr. B. has refused to do the prophylactic mastectomy, the removal of the other breast for safety’s sake. He is also the one who really questioned her decision not to use his plastic surgeon recommendation. You know, the one with the teeth and expensive shoes. Instead she chose Dr. Levy who showed real interest in the patient. This is also, looking back, the same doctor who had a false negative on the biopsy, a false positive on lymph node involvement, said she could not have more children, left unclear margins and initially found the tumor to be estrogen positive. (Maybe it is a GOOD thing that he bowed out of her life.) Disconcertingly, he did it by not returning her phone calls, nor through his right hand contact Mary, but instead had a scheduler tell her that she might be better off going to Dr. Crowe. End of story.

Tess was shocked, disbelieving, hurt and then furious at this dismissal. “If he wants that boob so bad, I’ll wrap it up and send it to him! He can have it if he’s so attached to keeping it!”

Dr. Crowe and the geneticist at Cleveland Clinic were both supportive of Tess’s decision. Since Dr. Crowe is the head surgeon in the Cancer part, I guess this too is a GOOD thing. Also (since Dr. Levy does not work on main campus where Dr. Crowe is) the plastic surgeon (#3!) only does breast surgery. That, too, is probably a GOOD thing!

(Maybe a little GODincidences here. Keep those prayers going!)

So those dates are being scheduled......for the second mastectomy and implants on both sides. November 8th she sees Dr. Crowe again and on November 29th she meets with Plastic Surgeon #3.

OK......a lot has changed over the course of this journey. Now they CAN have children and depending upon who you talk to, the advice has been to wait anywhere from 6 months after chemo to 5 years. Tess says “I’ll just follow my gut.” And even at the Cleveland Clinic you have to be aware and prepared and proactive.