I get the feeling Angelina Jolie and my friend Aurora would like each other. Both are successful, busy working moms who go out of their way to help others. While Angelina shines on the red carpet, Aurora is more the person who’d be styling her hair. She runs one of the most popular hair salons in our neck of the woods.
Both women opted recently to strip to a hospital jonnie, allowing a surgeon to grab a scalpel and whittle away and discard their breasts. Breasts that fed their children, gave them pleasure, and were part of them for decades…until the day they weren’t.
By now, you know about Angelina, how she watched her mother die young from ovarian cancer. Angelina shared a gene with mom that could make history repeat itself; or even more likely, attack her through her breasts. It was no contest, decided Angelina. Her kids needed their mom. The breasts would have to go.
Aurora has no idea if she has the breast cancer gene. She was nine years old, living in
Puerto Rico, when
her mom put her and her three sisters on a plane and sent them to New York to
live with their father. But apparently she’d never arranged it with him. The
girls were settled in a state orphanage. Foster homes followed. Some acting out
followed. (Both Angelina and Aurora have come a long way since then.) But
Aurora, like Angelina, figured things out, and worked her butt off to succeed.
I know Aurora’s story not just because we’re friends, but because we women chat the whole time while we’re getting clipped and coiffed. Who’s the best doctor, babysitter, carpenter? It’s a “grooming circle”, where we share stories and exchange wisdom. It probably has its cousins in the Amazon and the Outback.
A while back Aurora told me she was going to get her eyes done. “Just this saggy skin”, she said, tugging at her upper eyelid, working way too hard, I thought, to find loose skin anywhere on her 115-pound frame. At least, I knew, she would have the benefit of knowing which plastic surgeon to go to. She’d been seeing, touching and evaluating their work for decades. In the confessional of the grooming circle, Aurora has probably amassed enough insider knowledge of plastic surgeons to start a consulting business.
|Patrick Sullivan, MD|
So off she went to Dr. Patrick Sullivan of Providence, who’s won accolades as one of the top plastic surgeons in the United States. Dr. Sullivan met with Aurora and learned what she wanted. Then, he sent her away. First, she would have to get a full physical including a mammogram. Working 12-hour days left Aurora little room to squeeze in an appointment, but there was no choice: no physical exam, no eyelids. Aurora wasn’t worried…she’s active and athletic, eats mostly fish and vegetables, and doesn’t drink or smoke. How could anything be wrong?
Only it was. Cancer in both breasts. Plunged abruptly into a blur of big next steps. Telling the kids. More biopsies. A salon to run, clients to re-arrange. A will. The lumpectomy comes back with bad margins. Try it again? Her children are terrified. How many times will she have to go under the knife before she can wake up without the dark horse of cancer stalking her? Surgeries that chip away at her body and mind, and shape the cadence of her life?
An agony of choice, made alone, a husband long out of the picture. The surgery is brutal. I visit her days later and she’s a tearful mess. She raises her shirt. I see smooth skin ending in puckered scarlet crescents. Drains carry fluids into plastic bags. Reconstruction will have to wait until she heals. I want to hug her, but can’t.
But she is strong. Three weeks later she’s back at her salon, taking clients. Her surgeon
says they got
all the cancer…no need for chemo and radiation.
|Aurora 3 weeks post-surgery|
And she is grateful. “Thank God I got that mammogram.” Most plastic surgeons, she says, would just take your money. “They don’t care”, she says. “But Doctor Sullivan saved my life.”
A Booming Business
2012 saw a record number of people undergoing cosmetic procedures. More than 14.6 million procedures were performed in total, five percent more than the year before. How many plastic surgeons insist on a full physical before raising their scalpel? Not enough, apparently. For all those people pondering a surgical route to greater beauty, I asked Dr. Sullivan some key questions you might ask as well.
Pat: Why do you ask clients to get a full physical?
Dr. Sullivan: I want my patients to have a very safe experience with their surgical treatment. We have managed to find and uncover a number of medical problems with this approach. It has caused us to have to cancel or postpone a number of surgeries, as we did with Aurora; it leaves us with sudden holes in our surgery schedule but that is always very secondary to the patient's well-being.
Pat: How often do clients not come back when you say you require that?
Dr. Sullivan: We have lost a number of patients because they don't want to comply for a variety of reasons. We try to explain to them how it is for THEIR benefit but some do not want to invest the time and effort.
Pat: How many have had the exam and learned they have underlying health problems?
Dr. Sullivan: A larger number than we ever expected. It is very gratifying to find important problems like Aurora's that are asymptomatic (showing no obvious signs). Catching things early saves lives and helps people be on top of their game. And this is what our type of care and treatment is all about as well.
Pat: Do plastic surgeons have latitude in this regard? Is it dictated just by personal ethics, or regulated in any way?
Dr. Sullivan: Unfortunately there is very little regulation out there. We now have oral surgeons, ear nose and throat doctors, eye doctors, and ob/gyn docs performing cosmetic surgeries, sometimes calling themselves plastic surgeons, and getting away with it. This state (Rhode Island) does not control this and protect patients and consumers as they should. For example, these oral surgeons send out mailers to unsuspecting people inviting them in for free consults. Aggressive marketing and low prices frequently fool people into having treatments that turn out horribly. The patients end up in my office with post-operative problems that can't be fixed. They tell me they want to sue the doctor because of their bad result but that can't change the problems they have. I could show you pictures of scary results that can't be fixed and could have been prevented. So…do you think these doctors who are doing unsafe surgery are going to do what we feel is appropriate in the pre-operative analysis?
Pat: What kind of anecdotes can you share about this?
Dr. Sullivan: Though we have many life threatening examples, we had one of these doctor's patients end up in the emergency room bleeding and needing blood transfusions and emergency surgery. She nearly died. The doctor did not have privileges to do the surgery in a hospital (he did it in a surgery center that was not adequately monitored by our state) and could not take care of his patient's complications. And when she tried to reach him when she was having her bleeding problems he was out of state and had no coverage in-state. She had no one to help her so I agreed to come to the emergency room that night and care for her. Interestingly she had consulted with me first for her problems but chose to have her surgery done by the person who was not a plastic surgeon. He does have a beautiful office and told her what she wanted to hear rather than give her the type of surgery she really needed.
Pat: How does this make you feel?
Dr. Sullivan: It makes me feel sick.
Pat: What is your philosophy about treating "the whole person"?
Dr. Sullivan: It's not just my philosophy, it is our team's philosophy. Our entire team is devoted to treating the whole person. People don't suddenly become like that. When I choose people to join our team I want them to be the type of people who always put the patient and the patient's well-being first.
Pat: Do you also screen for emotional stability prior to booking a procedure?
Dr. Sullivan: We try to get to know our patients well. They meet with a number of people on our team before we do the surgery. We put our heads together and the team can usually tell if a person has appropriate motivation for cosmetic surgery or non-surgical cosmetic treatments.
Pat: How often do you turn clients away?
Dr. Sullivan: We turn patients away frequently, each time we feel that plastic surgery or cosmetic surgery treatments are not in their best interest. We wish there were more ways to educate people about the high price they can pay for seemingly cheaper surgery.
Your Turn Now
Angelina Jolie is a champ for going public with her choice to have a preventative double mastectomy, because it’s sparked important conversation that might save lives. She’s done her job. Now here’s yours: next time you’re in the “grooming circle”, getting your hair or nails done, swapping stories and reading slick magazines with pretty bodies on the cover, consider passing along Aurora’s story, too. As for Aurora, she’s seeing things pretty clearly now. Turns out, her eyes are just fine.