A Medical Historian Confronts Her Own DiagnosisRoundup
tags: medical history
Dr. Fitzharris, a medical historian, is the author of The Facemaker: A Visionary Surgeon’s Battle to Mend the Disfigured Soldiers of World War I.
“Do you see the puckering around this white mass?” The radiologist pointed to a white blur on the monochrome scan. To my untrained eye, it resembled a comet throwing out plumes of dust in the blackness of space. “That’s a tell-tale sign.”
I had just turned 40, and until this point I had never even had a mammogram. Now I was being told I had breast cancer.
The radiologist explained that she needed to perform a needle biopsy next. While she prepared to take a tissue sample, I lay on the examination table in the kind of shock that generations of women before me have experienced.
Later, I came to feel like the luckiest of unlucky people. I had asked to see a specialist after finding a lump in my breast. As it turned out, it was just a benign cyst. But during the investigation, the radiologist found a cancerous tumor far from the original site. It was so small, in fact, that it could not yet be felt. Since women aren’t given routine mammograms until the age of 50 in the U.K., it’s unlikely the tumor would have been noticed for some time had I not insisted on a referral.
As a medical historian, I’ve spent years writing about other people’s experiences of illness. So, after the bad news came, I felt I had to be publicly transparent about my own situation. I was only diagnosed a few weeks ago, but I’ve already traveled a very bumpy stretch of road, rutted with tests, results, second opinions and a crash course in oncology. I’ve asked myself several times, why me? But then again, why not me?
My surgery, which took place last month, combined a lumpectomy with therapeutic mammoplasty. I met with a variety of experts who helped me through this difficult process, including oncologists, oncoplastic surgeons, radiologists, nurse practitioners, anesthesiologists, pain consultants and physiotherapists.
The experience has got me thinking about the women who came before me and how their pain and suffering accelerated medical advancements from which I am benefiting. My mother underwent a bilateral mastectomy 10 years ago, but things have changed markedly, even in that short span of time.
Before the discovery of anesthesia in the mid-19th century, most surgery of any kind was painful and dangerous. Because of this, many surgeons refused to operate altogether, choosing instead to limit their practice to the treatment of external ailments like skin conditions and superficial wounds. Invasive procedures such as mastectomies were rarities, especially as they had poor long-term results.
Historical accounts of breast surgeries will make even the most seasoned medical historian wince, let alone one about to go under the knife herself. In 1855, a Protestant missionary named Lucy Thurston described in a letter to her daughter the horror of a mastectomy without anesthesia. “I myself fully intended to have seen the thing done. But on recollection, every glimpse I happened to have, was the doctor’s right hand completely covered with blood, up to the very wrist…It was nearly an hour and a half that I was beneath his hand.” Thurston survived the shock and blood loss from the operation, but many did not.
Editor's note: for an interview with Dr. Fitzharris about her book The Facemaker, see here.