Going into PA school 5 years ago, I already couldn’t wait to be on my surgery rotation. While nervous at the complexity of operations and the prospect of fainting, I’ve always liked to be hands-on. At that point, I had no idea the impact that those four weeks would make on the way I practice medicine today.
When I received my assignment, I was thrilled to be with a surgeon who is constantly requested by students. Dr. Randy Cooper. While a general surgeon, over the years, his focus has developed into diagnosing and surgically treating breast cancer. I’d heard how amazing this rotation was, and also what would be expected of me, but I really didn’t know anything about breast cancer.
I suppose I can say that I’m lucky that no one in my family has had a breast cancer diagnosis, but I have plenty of friends who have walked through this with their grandmothers, moms, sisters, and colleagues. Walking into my rotation on the first day, I was eager to learn about breast cancer from a medical standpoint.
The first few days were a whirlwind of adjusting to a new EMR, deciphering terms like “ductal carcinoma” and “ER positive.” But then we had our first new diagnosis of breast cancer, and I started putting faces and stories to these terms. A 35-year-old woman with two children who found a strange lump in her breast while on vacation.
I watched as Dr. Cooper worked her into his already slammed schedule to do an ultrasound guided core biopsy of the mass. While she cried, partly from pain, but mostly from fear, I noticed the biopsy float to the bottom of the specimen cup. From my short time with Dr. Cooper, I learned that was typically an ominous sign.
The results confirmed breast cancer, and it was time to break the news. I learned so much about communicating with patients from Dr. Cooper’s bedside manner. It was refreshing to me to see a doctor who is honest with his patients, and willing to cry and pray with them over a life-changing diagnosis. A surgeon who walks his patients through every step of the process.
Two days later we were scrubbing into the OR to do a double masectomy, on a Thursday when Dr. Cooper is supposed to be “off.” (That didn’t happen one Thursday out of the four I was with him.) After reassuring the patient, I assisted in making the incisions and removing the tumor that was present. This was only the first step followed by months of radiation and chemotherapy. This was one of many new breast cancer diagnoses we made that month, and each one left a lasting impression on me.
From this experience, I took away a few things. Everyone responds to bad news differently, and it’s important to be there for patients through their reactions. There were tears and questions, and then sometimes just a practical need to know the next steps. While I haven’t been in this position personally, I can’t predict what my response would be. Working in dermatology, I’ve been able to continue to do this when I break the news of melanoma to my patients. I’ve actually had three different diagnoses of inflammatory breast cancer that simply came to see their dermatology PA because of a “rash” on their breast that wouldn’t go away.
On the first day of my rotation, after seeing our first patient, Dr. Cooper stopped in his tracks, looked me in the eye, and said, “Before you leave a patient’s room, make sure you lay a hand on them.” He didn’t mean while doing a physical exam, but he was speaking to the importance of physical touch in helping people feel connected and loved. Whenever I leave a patient’s room, I remember his words, and I’m thankful for the perspective a month in breast surgery gave me.
About the author
Savanna Perry PA-C is a practicing dermotology physician assistant living and working in Augusta, GA. In her free time, Savanna enjoys exploring her town and traveling with her husband, who is currently an internal medicine resident. She is also the founder of The PA Platform, a popular website for Pre-PA and current PA students.