It’s now a week on from this first Reconstruction Revelation blog being (slightly) edited and repeated in the Guardian’s CiF, where I know the comments section so often attracts anger and where I was still, stunned, to read so much anger directed at me – much of it telling me I am not grateful enough, others thinking it was rude to have brought it up in public rather than in the privacy of the consulting room – it’s possible they’re right about that, though ever-aware of the long queue of people waiting, bringing up a both personal and political discussion with a doctor I have only just met for the first time feels like a big ask.(Mind you, I also appreciate that many commentators are drawn by the headline – written by a sub, obviously, not the writer of the piece, and the one that have there is fairly incendiary.)
I am still surprised that many of the commentators appear to think cancer-related breast reconstruction is ONLY about looks, that they might think I chose to have a reconstruction in order to look a certain way. And while the anger directed at my piece was upsetting, it has helped me clarify something :
My reconstruction was NOT to do with what other people see. Not doctors, not surgeons, not people in the street, not the friends who have (kindly, since the first days after surgery, all said ‘it looks great’, because clearly, they too think that’s why I did it), not even me, when I look in the mirror, or look down.
I had a reconstruction because I wanted to feel physically like ‘me’. I mean feel in a physical sense, not emotionally, having already had cancer once I knew I wouldn’t feel emotionally ok for a long long time. And that when – if – I did feel emotionally ok, it would be a new me who felt this. Disease, facing mortality, changes us. It has certainly changed me. I think it’s meant to.
I had an idea that a reconstruction would feel – physically – similar to my own breast. And it doesn’t. Not at all. This particular reconstruction, with a fairly large amount of fat necrosis, doesn’t. And I didn’t expect it to feel so very different (or to be painful, solid in places – the solid being something we think can be corrected by further surgery), and THAT is why it feels odd to have a doctor only want to look at my breast, that is why it is odd when they don’t ask how it FEELS, because I simply didn’t have a reconstruction to look ‘finished’ to other people. I had it hoping I would feel like me.
nb, I’ve seen three different doctors in the past few months, a new one at each appointment. The ones who did the original surgery ALWAYS asked about feel as well as looks. As I said in the original piece, these new ones have been younger, so my guess is they are being newly taught that look matters more than feel.
Anyway … Saying yes to the Guardian sharing it brought lots of great response from people who’ve had body-changing surgeries (due to illness, not cosmetic), and from several breast care groups, as well as individuals who said this was exactly how they also felt (emotionally and physically!). So hopefully it was worthwhile.
And it started an email dialogue with a Plastic, Reconstructive and Aesthetic Surgeon, Dr Marco Romeo from Madrid, which I share here, with his permission. I think he offers an interesting perspective and I’m glad to have had the conversation with him. I can’t quite picture myself addressing anyone as ‘hey kid’ (while fully dressed or bare-breasted) but I do rather like the image of myself as the kind of woman who might. Here’s the link too, to Marco’s blog.
I am a Plastic Surgeon, I read your article and I find your story relevant to me but it left me with some questions. Would you start an open or private discussion with me about that?
I’m leaving London for Nigeria tomorrow for a week, back briefly before a week working in rural Devon, neither place I’m going to has great Internet reception but I’ll get back to you as soon as I can.
I do hope you read my own, longer blog, rather than the edited Guardian version. My main concern is that it appears the younger doctors (none yet consultants) have obviously been trained that symmetry/shape are of premier importance, whereas the older professionals and consultants are interested in what I feel (physically) – so there appears to be a disconnect between what the older ones and what the younger ones have been taught in how to deal with patients’ concerns.
I’m on my second breast cancer, I don’t expect miracles, or to be entirely pain-free, but it is odd that the younger drs are approaching it very differently, and (in my opinion) less generously, than the slightly older ones.
thank you for your reply, I really appreciate it especially because you seem very busy. With your reply you perfectly explained the point, I understand your concerns and I may try to explain them later in this email. Unfortunately, the message that comes from your article (not sure if is the Guardian edited or not) it seems that young male doctors may let you feel uncomfortable for a cold approach and probably the difference of age and sex may have worsen the situation.
I understand that empathy and “having the touch” is something very personal, difficult to teach in our career, young doctors live the the “anxiety” of getting more and more knowledge, they feel the rush to express perfectly their technical skills and they are not probably ready to handle with warm approach at the same time, most of them will learn, some not. I worked in the UK, I know my colleagues over there, great professionals, maybe just colder sometimes. I do breast reconstruction myself in Madrid, for a coincidence I correspond to the young male profile you cited. We are in a clinic with many young professionals and I dare to say that our patients love us (most of them at least!) because we received a thorough ethical and emphatic education. Whether there is a different approach between of the two countries is not the core of this letter, anyway.
My concern, is that what we felt reading the article is that all the good and difficult part behind reconstruction process is vanished for a young and quick doctor that made you feel uncomfortable.
I also thought that sometimes there is lack of communication or misunderstanding.
A nice message to give, that would be useful for both us surgeons and the patients is to speak to your doctor, something like: Hey kid, you must be a good doctor but here is a real woman in front of you, treat me as you’d like your sister or mother to be treated. Sometimes speak just as straight, lower any barrier and bring us back from medicine planet down to earth.
I read some of the comments in your blog, some women reacted just as bad as I feared.
don’t underestimate the power of a blog, when we suggest to lift up the other breast we don’t wish to say: you old woman! We try to give symmetry and harmony to allow you to wear a nice bikini in the beach and smile, again.
Thank you for your time,