A Letter to Dr. #&*@

Please insert your own expletive in the title above.

I had a visit with the plastic surgeon later today. He didn't really give me a chance to respond or explain, so I'm writing this letter to him. He may never see it. But I have half a mind to send the link to his office staff so they can show him. Writing this letter is passive-aggressive, I know, but warranted. I won't use his name, but he and probably others in town will know of whom I speak.

Dr. #&*@,
This morning, you were condescending and dismissive to me. I cried a bit, not because you said that I wouldn't be cured but because you didn't seem to care.

I understand that the amount of tissue that will be removed is quite large. I understand, too, that this will require more tissue, which means a "free flap" procedure (one in which they have to do microsurgery to connect the blood vessels) rather than a LAT flap (in which the tissue is still attached to its own blood supply). I am okay with being referred to OHSU where they could do a free flap procedure. This email is not about your decision or about what you can or can't do. I understand the reasons why - I have a PhD, after all, and am fairly well read about my disease, the treatments, and how to cope with my disease.

This letter is meant to chastise you and to ask you to be more empathetic and caring to your next patients.

I have lived with metastatic disease for three years. I know that I will never be "cured". I know that I will be in some form of treatment for the rest of my life, which I hope is a long one. I have faith that I will enter into "stable disease" status in the next six months or so.

If I were you, I would be careful about characterizing the surgery to remove the diseased and dying tissue in my armpit as a "toilet job". I fully understand that the purpose of doing this surgery is to help me get rid of this open wound. I also think that by getting rid of the diseased tissue in the armpit, we give my body a better chance of containing the disease that's left elsewhere in my body because we remove the biggest source of growing cancerous cells. Less cancer means that we give my immune system and whatever chemo I have a better chance - it's like getting rid of 2/3 or 3/4 of the enemy forces.

As I mentioned, I believe I will achieve stable disease soon.

I am also single.

I am interested in dating again.

To that end, I would like to have as normal a looking body as possible. I don't think it's too much to ask, while I'm having plastic surgery anyway, to keep the implant and to fix the "dog ears" (i.e., what's left of the fat tissue at my waist).

Your attitude and your words, however, made me feel that since I will never be "cured", that I should be happy with the reconstructed armpit, that I should aim instead for quality of life and just move on. You implied that I should give up on the idea of having an implant and that, in the end, it doesn't matter about the dog ears. To some extent, you acted as if I wouldn't be around very much longer and therefore why worry about the cosmetics?

You said (and rightly so) that the bigger concern is my armpit. I agree completely.

But that doesn't mean that the implant or the other plastic surgery fixes are trivial to me.

As I said earlier in the post, I want to look normal.

Today, you acted as if what I wanted (to keep the implant) was not possible and you seemed surprised that I would even ask to keep it.

In terms of "quality of life", I would like to look and feel normal in my clothes. Who knows how many years I have left? I fully expect to be alive for a long time. Therefore, my quality of life would be improved if I felt more normal.

I cried because I was disappointed that you didn't seem to care about me and what I might want. You were dismissive and condescending - you talked to me as if I didn't know that I would never be cured. I know that better than anyone else - you didn't have to tell me that.

I am glad that you won't be my doctor any longer. It's best that we part ways. But for any future unsuspecting patient of yours, get off your high horse and treat them like human beings. There are a lot of smart women like me out there. Don't be threatened by us. Take the time to ask what we want and tell us what's possible in a sympathetic, caring manner. Don't dismiss us. Don't be condescending. Please. We deserve more than that.

Sincerely,
Deanna Kingston