I never thought much about breast cancer when I was younger.
My mom died of ovarian cancer when she was 52.
My grandmother was diagnosed with breast cancer but she was old and had Alzheimer’s. I wasn’t worried.
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But then in 2010, my first cousin once removed - also a college professor, coincidentally - died of metastatic breast cancer. Melanie was 44 years old. I was 38 at the time.
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Early that year, I’d had a minor scare: a mammogram and ultrasound of a teeny tiny but palpable lump had been flagged as concerning. I had a stereotactic biopsy. All good.
Months later, another lump, another round of tests. All good.
But the seeds of worry had been planted.
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When Melanie died, those seeds were watered and grew.
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2011 rolled around and I had another lump. Ultrasound, MRI, biopsy, and then a lumpectomy.
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The pathology report came back and things looked....good-ish. The mass was benign but it had some odd features and they were unable to get clear margins. My surgeon said not to worry.
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But I was worried. I kept thinking about Melanie. And my son. And my wife.
I asked my surgeon if she could send the tissue samples to another pathology lab for a second opinion. She was kind and patient and said absolutely.
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The second pathology report was different.
The pathologist thought the mass had features of a phyllodes tumor. Not malignant but “borderline”
Neither pathologist made a mistake - pathology is both art and science and sometimes opinions differ.
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I was worried. My surgeon suggested a second lumpectomy to try to get clear margins. We talked about risks and benefits.I was BRCA negative but the geneticist the surgeon sent me to had concerns about my family’s patterns of breast and ovarian cancer.
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Intellectually I understood that another lumpectomy followed by watching and waiting would probably be fine. But emotionally, I was a wreck. For me, “watching and waiting” meant living with the crushing weight of worry.
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My surgeon listened to me and talked to me about options. I told her I’d rather have a prophylactic mastectomy than deal with the anxiety associated with an annual mammogram-ultrasound-biopsy merry-go-round.
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She more than listened to me - she *heard* me.
Exceptional surgeons don't just cut. They care.
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I had a prophylactic mastectomy without reconstruction in October 2011. No hospital stay - I went home the same day.
Never once have I regretted my decision.
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I'm sharing this story because it's important to recognize that there isn't a "right" way to navigate decisions when it comes to your own breasts.
They are *your* breasts.
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If someone wants to make their breasts bigger, it's easy to find a surgeon willing to do it.
If someone wants to remove their breasts -- whether to reduce their risk of breast cancer or to bring their body into alignment with their gender identity - it's not so easy.
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I was fortunate to find a surgeon who understood that my need to avoid breast cancer was infinitely greater than my desire to have breasts.
1⃣ Anyone with breast tissue -- regardless of sex assigned at birth or gender identity -- can get breast cancer.
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2⃣We need more research on metastatic breast cancer.
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3⃣Breasts mean different things to different people. If a person with breast cancer wants reconstruction, that's great. If they don't, that's great too.
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4⃣The absence of breasts on someone who identifies as a woman doesn't make them less of a woman.
Similarly, the presence of breasts on someone who identifies as a man doesn't make them less of a man.
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Thank you for coming to my TED talk. 😊
/end thread
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If you’re white, you know someone who empathizes with the mob at the Capitol.
You know someone who *supports* the actions taken by that mob.
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You know someone who thinks Trump won the election but it was “stolen” from him.
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You know someone who called it a “riot” when Black people took to the streets to protest racism in policing, broke windows, and burned buildings, but...
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In the J-term class I'm teaching, the topic of "faking it" came up yesterday. I don't know who needs to hear this today but I thought it was worth sharing.
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Some women and non-binary people with vaginas feel pressured to "perform" pleasure for the benefit of a partner. In movies and on TV, sex rarely takes a long time -- it's done quickly and both parties act as though they had an orgasm through penis-in-vagina sex.
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In reality, reaching orgasm for people with vaginas is generally more complicated than that. It can be difficult for someone to feel confident enough to say to a penis-having partner that they need more than PIV in order to have an orgasm.
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I've worked as a volunteer at the past three inaugurations: twice with the American Red Cross (Obama 2009, Trump 2017) and once with the Boy Scouts of America (Obama 2013).
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I was proud to serve at all three events. Crowds in 2009 and 2013 were massive but I felt safe. Crowds were tiny in 2017 and there was more discord but I still felt safe.
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I'm sad to say I won't be volunteering to serve at Biden's inauguration because after this week, I have zero confidence in the ability of the Capitol Police to handle anything other than maybe defending the body wash aisle in CVS.
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Like the author of the piece, I've been on the "patient side of the stethoscope" before -- through hospitalizations with Greyson, my (compulsively early but) late wife, and myself.
I empathize with how frightening it can be when a loved one is in the hospital. I also empathize with how difficult it can be to be a healthcare professional taking care of someone - someone who is usually cared for by a loved one who, at that moment, feels helpless.
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The concerns raised by physicians on Twitter about the medical inaccuracies in the article are valid ones.
I feel more conflicted about the comments re: the author "hissing" at a resident who tried to examine her daughter in the middle of the night.
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Thank you to my @UVA, @UVASON, and @uvamedicine colleagues who have been speaking out loudly, clearly, and consistently on Twitter over the past year (and long before that) about the ways in which politics, policy, racism, and health are inextricably intertwined.
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For my colleagues at UVA who *haven't* dipped their toe into using Twitter to speak truth to power, here are a few tips for getting started.
1. Decide what kind of world you want to live in.
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2. Decide whether you're willing to say hard truths out loud, in public, even if that means the people you work with -- or for -- may not like what you have to say.
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