Thoughts on Twitter, Community, and Loss

Today I had the privilege of attending a memorial service for a woman that I met only once. I initially got to know her on twitter. I attended the memorial service with 2 women who I also met on twitter.

Yes, twitter.

If you had asked me about twitter 2 years ago, I would have said that it was about celebrities talking about what they had for lunch. I wasn’t interested, and I certainly didn’t have the time. For various reasons I set up an account, started listening, and then started tweeting and interacting. And in doing so I stumbled upon the most remarkable community. Not just a group, and so much more than a chat – a real community. I got to know some incredible people. Online.  A common criticism of online interactions is that they are superficial and not “real”.  My experience has been the complete opposite. We’re drawn to each other on twitter due to common experiences and common goals. Those relationships and bonds are solid, made even more so when we have the opportunity to meet “in real life”. We are there for each other, during good times and bad, for better or worse. We are #FearlessFriends.

Donna Peach passed away due to metastatic breast cancer on March 26, 2013.  I initially got to know Donna her through her blog. She was a gifted writer, as well as a dancer and so much more.  One thing that was clear from her writing was that she loved life and everything about it. When we met approximately 2 months ago, even though she was suffering due to the progression of her disease, we were all struck by her beautiful smile and her incredible spirit. She touched us all – I made the comment after we met that it seemed like Donna had done a little bit of everything – and all of it with a huge smile on her face. Lori wrote about the meetup, capturing Donna’s spirit.  I would never have met Lori if it were not for twitter, and we live less than 10 miles apart. Carmen also accompanied us to the service today – another lovely addition to my life. Jody, Alicia, and too many more to mention. All because of twitter. They have touched me personally and professionally.  I cannot imagine my life without these women.

The tears we cried today at Donna’s service were real. The hugs we shared were real. The sentiments expressed today by those that knew her well were the same that Lori, Carmen and I expressed. Don’t let anyone tell you that online relationships are not real. Some of them are. I only knew Donna for a short time, but I am grateful for the interaction that we had. I will treasure the memories and will remember her spirit.

Rest in peace, Donna Peach.

2012 – Year In Review

Anyone who spends just a few minutes with me knows how important my garden is – it’s my inspiration, my therapist, and my friend. I’m still relatively new to gardening – just 2 years in – but I’m fortunate to be able to take advantage of the mild Southern California climate and a fair amount of beginner’s luck.

I am clearly a very amateur photographer (sorry a lot of the pictures are blurry) and since I changed computers halfway through the year many of them are also out of order. But the video makes me smile and I hope you enjoy it as well.

Happy New Year!

The music is “Celebration” by Jonathan Butler

What Motivates Me

A few weeks ago, I was approached by a contact on Twitter who asked me to participate in an online “blog carnival.” The theme was motivation and how it plays into our roles as patients, providers and caregivers. The deadline for submission (which I just looked at) was September 17^th.

It is obvious to anyone who reads my blog that I am an infrequent writer. I find creative writing very difficult, yet I purposefully avoid using this blog for breast-cancer related posts, which would come easily for me. There are many physicians, patients and advocates who write incredibly moving and well-researched posts related to all aspects of breast cancer. So I started this blog with the intention of writing about “other stuff”. However as I’m known to say, “life gets in the way.” I need a strong smack of inspiration coupled with a large chunk of free time to put together a post. Rarely do free time and inspiration co-exist in my world.

However, the topic of motivation has been rolling around in my head for a few weeks now. And while I missed the deadline for the contest, I’m really not one for competitive writing anyway. So what motivates me?

Being a physician is hard. I’m not complaining – this is my chosen profession – although I think it actually chose me. The responsibility of taking care of patients and performing surgery is physically and mentally draining, the hours are incredibly long, and my life is never my own. I am a surgeon focusing on women (and some men) with breast-related problems, and a large part of that is breast cancer.

We have made much progress in the detection and treatment of breast cancer since I started medical school 26 years ago. However I still see women presenting with advanced and metastatic disease. I am still puzzled and frustrated by the patient who presented with a favorable early-stage cancer, but who then develops metastatic disease. And I still take these and many other stories home with me each and every night.

We have made much progress, but we have a very long way to go. Yet one thing, thankfully, has not changed – what to me is the essence of the physician-patient relationship. One of the reasons that I decided to focus on the care of patients with breast disease was that I recognized early in my career that I actually enjoyed talking to my patients. Getting to know them and their families. Having a kinship with them in addition to a professional relationship. And this came much more naturally with my breast patients than with patients who were seeing me for a limited time, for example to have their gallbladder removed or hernia repaired. I noticed, as did my staff, that I spent more time with my patients than did my colleagues. And my patients recognized this as well. 

So I put up with the increasing financial and administrative pressures. The challenges of running a small business that is being increasingly legislated and regulated. The frustration that we’re not where I would like us to be in terms of our science.

What motivates me? It’s simple really – I can’t always cure, but I can always care. 

My 3 Words – An Update

Or maybe this should be titled “life gets in the way”…

With the first day of Spring just past and Easter just around the corner, it’s time to finally shake off winter (or what we call winter here in Southern California) and move forward. But I don’t think you can properly move forward without reflecting – note I said reflecting, not dwelling – on the past. So I went back to my New Year’s Day post, and came across Resilience, Rejuvenation, and Serenity. How am I doing?

Well, life gets in the way, and things have been hardly what I would call serene. I am being pulled in multiple different directions; all things I want to do but as I get older I realize that I can’t continue to do it all.  Getting older is fine. For me, the difficult part is trying to accept my limitations while at the same time balancing all that I still want to accomplish with the expectations that I and others place on me.

Spring is a beautiful, promising time of the year – to me even more so than January 1. My garden is doing wonderfully. The daffodils are in bloom. I’ve already harvested some baby beets and kale, and have enough sugar snap peas to make lunch for my entire office building – all started from seed! Summer crops are going in this weekend and next. The nice thing about gardening here is that there is always something growing – you don’t have to wait until after the snow melts. It’s a reminder to me that we are also constantly growing – changing with the seasons and wiith the events that occur in our day-to-day lives.

So while life has gotten in the way, and I have not started the New Year in the zen-like state that I envisioned, all is good. I’m not looking back, frustrated that I am struggling to keep my “resolutions”. I’m looking back to remember what I started out to accomplish and am looking forward, knowing that I will get there.

My 3 Words

Happy New Year!

To me, those words always carry such hope and optimism – out with the old, in with the new; a time to develop and cultivate new (healthy) habits, make better decisions, and live a better life. We’ve all had experience with resolutions, and while I’m not a big fan of formal ones, it is tempting to make at least a mental list of the things that I want to do better, and the things I want to accomplish personally and professionally in the New Year.

During 2011 I had the good fortune to get to know – through her writing – Philippa, who blogs as FeistyBlueGecko on matters of breast cancer and life. During one of the weekly tweetchats, she mentioned that she does not make resolutions for the New Year, but she chooses 3 words, and uses those words to guide and inspire her. How difficult but amazing to distill things down to 3 words! And how incredible to have just 3 words running around in your head to guide your every move during the year. 3 words – easy to remember, easy to call upon when needed. So it got me thinking – what would my words be, and why?

My 3 words for 2012 are Resilience, Rejuvenation, and Serenity. I borrowed resilience from Philippa, but it works for me as well, and there’s no reason we can’t all share.

Resilience: a – the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress; b – an ability to recover from or adjust easily to misfortune or change.

I can handle anything. Personally or professionally, emotionally or physically– I’ve been through some major tests and have come through them all. Not necessarily with flying colors, but I’ve always been able to make it through to the other side. I need to keep reminding myself of that, and remember to learn from past hardships. That’s how we improve and grow. Not just thinking “oh no, how much more can I take”, but rather “I’ve been through so much and made it through, and I know I can do it again”. Over the years I have improved my innate tools or have acquired new ones that enable me to bounce back from adversity, stronger than before. This is different than hard-headed stubbornness – hopefully the wisdom of age has sunk in and allowed me to realize when I just need to walk away from a situation, rather than try to plow through it. But however I decide to handle a difficult situation, I know I will be fine in the end.

Rejuvenation: a – to make young or youthful again, give new vigor to; b – to restore to an original or new state

I am taking only part of definition “b” above – to restore to a new state – it is my word after all, and I can use what definition suits me….  I had initially thought of restoration, but to me, that means going back to the original. I am not who or what I was one year, 5 years, or 10 years ago. Time and circumstances make it impossible to go back. And I don’t necessarily want to go back. Rather, rejuvenation –  re-injecting life and vitality to get to a new state – that’s what I’m aiming for. How will this happen? By reinforcing my commitment to self-care and health. By eliminating or avoiding people and situations that sap my energy and strength. By concentrating on what I love to do and putting myself in situations where I can focus on just that.

Serenity: The quality or state of being serene

Serene:  a – clear and free of storms or unpleasant change; b – shining bright and steady; c – marked by or suggestive of utter calm and unruffled repose or quietude

If one is truly happy and at peace with who they are, with what they are doing, and with who they are surrounded by, serenity follows. There is no way that we can control the chaos in our lives, but our response to the chaos and uncertainty can be controlled. Keep the internalization to a minimum, keep the mind and body quiet and still. It does not mean that I will not worry (and even obsess) over problems, situations, and issues, but I will try to maintain a proper perspective, and to be a calming influence on all that I encounter.

Those are my 3 words. I really liked Philippa’s 3^rd word, “wonder”,  but for me, it falls under serenity as well as rejuvenation – reminding myself that nature and other miracles exist everywhere, and taking the time to savor them and smile will lead to rejuvenation and serenity.

I do reserve the right to come up with more words, switch words, or develop another plan completely, but for now, this seems to be a good way to start 2012. Happy New Year, everyone!

All definitions from Merriam-Webster.

Why I Tweet

An Introduction

Welcome to my blog!  A little about me – I am a Breast Surgeon – that is not only my profession, but it defines much of me as well. I provide care to women (and men) with both benign and malignant breast disease. While I am a surgeon, many breast conditions can be treated without an operation, and areas of interest include minimally-invasive treatment, especially cryoblation and partial-breast irradiation. I was introduced to Chinese and Ayurvedic medicine when I developed a personal health condition that was actually worsened by traditional Western medicine and these disciplines remain an area of personal and professional fascination for me. I believe that we have a lot to learn from these ancient traditions regarding disease prevention and treatment.

I get a tremendous amount  of satisfaction and enjoyment from teaching regardless of the circumstances – one-on-one with a patient, in front of large community groups, or with other physicians who are learning new techniques and procedures. I am also fortunate to be involved with the American Society of Breast Surgeons as a member of the Board of Directors – involvement with this organization allows me to interact with some of the leaders in the field of Breast Surgery on a regular basis, which helps me stay current in my practice and recommendations.

In my spare time, I have started growing vegetables and some fruits in my backyard, and have found that without really trying, I am pretty good at it! I had a steady supply of kale, chard, and broccoli during the winter, and strawberries and blueberries this spring (blueberries are still going strong!). Still waiting for tomatoes, eggplant and sweet peppers but I was a little late getting the seeds in the ground – next year I’ll start them earlier.

I do not expect to post regularly, and this might be the last post for some time, but you never know.