30 December 2020

30 December 2019

10 October 2019

I am beyond honored to be profiled by SheWarriors as an example of a strong woman and a leader.

11 June 2019

July 1st is almost here, and a new class of surgical interns will soon be in place. It’s an exciting and at the same time unsettling period. Many who are well past the trainee phase have been sharing suggestions on making the successful transition from student to doctor via social media using the hashtag #TipsForNewDocs.

I’ve had the opportunity to participate in panel discussions and “mixers” over the past several years, organized for medical students interested in a career in surgery. I always find these sessions stimulating. The faculty share stories of how we came to choose surgery, and convey to the next generation of surgeons what we love about our profession. The students always have many thought-provoking questions.

At a session a few months ago, a student asked a question that I had not heard before. Medical school and residency, especially for surgery, are grueling. There are some who become very hardened during that training period, and unfortunately a few do not “soften up” (return to being human) once their residency and fellowship are over. As these individuals advance into leadership roles, they can be challenging to work with, and even more so to train under. A student asked: “What do you think went wrong?” And the implication was “How can I keep that from happening to me?”

The faculty shared examples of some of the tools we use to cope with stress: create and nurture a strong circle of friends and confidants within and outside of medicine; maintain outside interests and hobbies; exercise; fight for the ever-elusive sleep. But we also acknowledged the importance of being honest with yourself if you are truly unhappy. Many described complete U-turns (made by themselves or colleagues) during training or even later in a career to get to a place where they felt comfortable. There is no shame is saying “I was wrong – this is not for me.”

Whether it’s taking time to go for a walk or re-thinking your career path, you owe it to your patients, your colleagues, your support staff, and most of all to yourself to pay attention to what feeds you. Life is short and too much is at stake.

30 December 2018

19 March 2018

I am often asked why I take the time to post on social media sites, and the answer is simple – it’s a way to reach patients and others who are interested in the content. As physicians, one of our primary roles is patient education, and there is a limit to how many we can reach in our daily interactions. With more and more patients searching online for health information, I feel that it is important that credible and accurate information is readily available. Online patient communities not only benefit from a physician presence, but physicians also benefit from being exposed to different perspectives and points of view.

Today’s Health News Review podcast features several physician bloggers (including me!) discussing why they blog.

30 December 2017

8 November 2017

I was just featured in the “Observations” section of the British Medical Journal. For those who are not able to access “Operation Chocolate” on the BMJ site, I have posted it here.

Biography: Deanna Attai, 53, is a breast surgeon in Los Angeles who puts patient empowerment high on her priority list. Born to a New York medical family, she was educated at Vassar College and Georgetown University and practised in Virginia for five years before moving west in 1999. She was president of the American Society of Breast Surgeons during 2015-16 and is assistant clinical professor of surgery at the University of California, Los Angeles. Patient communication, she says, is “one of the joys of breast surgery and part of what drew me to the field.” She co-moderates Breast Cancer Social Media, a Twitter based breast cancer support group.

WHAT WAS YOUR EARLIEST AMBITION? I thought that the best job in the world was professional athlete. Unfortunately, I wasn’t good enough at any sport. However, I was good at science, and I was drawn to medicine probably because of my father’s influence. Once I got to medical school, surgery was the only specialty that really captivated me.

WHAT WAS YOUR BEST CAREER MOVE? After four years at a large group practice in Washington, DC, I moved across the country to Los Angeles to join a small group general surgery practice. I didn’t know anyone in LA, and I moved out there alone. After 18 months I left that practice, went out on my own, and then transitioned from general surgery to a breast-only practice. Looking back, I don’t know how I took those leaps—I was pretty fearless back then.

WHAT WAS THE WORST MISTAKE IN YOUR CAREER? Not focusing enough on my own health, especially after I went into solo practice.

HOW IS YOUR WORK-LIFE BALANCE? “Balance” implies that everything is moving along smoothly. In reality it’s a very active process, requiring constant adjustments. I learned, the hard way, to respect my limits. I’m now fiercely protective of my free time: I say “no” more often, and I say it without guilt.

HOW DO YOU KEEP FIT AND HEALTHY? Moderate exercise, gardening, and playing with my kittens. I’m in bed by 9 pm most nights. I follow a (mostly) healthy, balanced, plant based diet. I do consider regular doses of chocolate critical to my health, although this makes it harder to stay fit.

WHAT DO YOU WISH THAT YOU HAD KNOWN WHEN YOU WERE YOUNGER? That it would all work out in the end. I shouldn’t have stressed so much.

DO DOCTORS GET PAID ENOUGH? It very much depends on specialty and practice setting. On balance, yes, but those in private practice can struggle.

TO WHOM WOULD YOU MOST LIKE TO APOLOGISE? My staff. They bend over backwards for me and for our patients, and I don’t always let them know how appreciated they are. Shout out to Maggie, Ana, and Laura!

WHAT DO YOU USUALLY WEAR TO WORK? Scrubs. I like to be comfortable.

WHICH LIVING DOCTOR DO YOU MOST ADMIRE, AND WHY? My father, who is a retired cardiac surgeon. As a high school student I accompanied him to the operating room, my first exposure to surgery. Tagging along with him on hospital rounds showed me a completely different side of him, and his gentle way with patients has been an inspiration.

WHAT IS THE WORST JOB YOU HAVE DONE? During a college summer break I worked as a waitress at an all-night restaurant—the type of place people go when they’re drunk and need food at 2 am. That was interesting.

WHAT SINGLE UNHERALDED CHANGE HAS MADE THE MOST DIFFERENCE IN YOUR FIELD IN YOUR LIFETIME? The field of breast surgery and breast oncology has progressed thanks to researchers who design innovative and forward thinking clinical trials and the courageous patients who participate in these studies. Clinical trial participants don’t get nearly enough thanks.

WHAT NEW TECHNOLOGY OR DEVELOPMENT ARE YOU MOST LOOKING FORWARD TO? Non-operative ablative therapy shows promise for selected patients. Ongoing studies are evaluating whether surgery can be eliminated in patients who exhibit an apparent complete response to neoadjuvant therapy. It may sound strange for a surgeon to look forward to the day when we operate less, but there you have it.

WHAT BOOK SHOULD EVERY DOCTOR READ? It’s very important that physicians know the history of the disease they’re treating: you can’t have a good appreciation of where we are until you understand how we got here. One of the best books I’ve read about the history of breast cancer is Bathsheba’s Breast: Women, Cancer and History by James S Olson. Find the book that captures the history of your specialty.

WHAT IS YOUR GUILTIEST PLEASURE? Chocolate and sleep. And I’ve learned not to feel guilty about either of them: they’re necessities.

WHERE ARE OR WHEN WERE YOU HAPPIEST? Where I am right now. I’m very content with my current life and situation.

WHAT TELEVISION PROGRAMMES DO YOU LIKE? As kids we weren’t allowed to watch typical sitcoms or other mindless shows, so I never developed a taste for those. I’m an NBA basketball fan, so I love the halftime and post-game shows. And I do watch House Hunters (that one should probably go under “guilty pleasure”).

WHAT PERSONAL AMBITION DO YOU STILL HAVE? I go back and forth about writing a book: right now it’s a low priority, but that could change overnight. I’d like to learn to cook well—what I do every night is pretty basic. But I’m catching my breath after some major professional milestones and changes over the past few years. The next adventure will come when I’m ready, and that could be tomorrow.

SUMMARISE YOUR PERSONALITY IN THREE WORDS: Practical, focused, and empathetic, with a healthy side of New York sarcasm.

WHAT IS YOUR PET HATE? People who don’t keep their word or who have hidden agendas. Just be honest.

WHAT WOULD BE ON THE MENU FOR YOUR LAST SUPPER? Chocolate fudge brownies with vanilla ice cream.

WHAT POEM, SONG, OR PASSAGE OF PROSE WOULD YOU LIKE MOURNERS AT YOUR FUNERAL TO HEAR? I don’t think that I want a funeral. People may or may not want to mourn, but I don’t want a big show. Go out with some friends for wine and chocolate. Plant something. Adopt a kitten or a puppy.

IS THE THOUGHT OF RETIREMENT A DREAM OR A NIGHTMARE? A dream, but I’m not ready for it just yet.

IF YOU WEREN’T IN YOUR PRESENT POSITION WHAT WOULD YOU BE DOING INSTEAD? Rescuing stray kittens and tending to an organic vegetable farm.

3 August 2017

Alicia Staley and Jody Schoger met on Twitter in 2009. After a series of online interactions, they were inspired to create the #bcsm community. The first #bcsm tweetchat took place on July 4th, 2011.

Alicia and Jody brought together patients, physicians, researchers and others who shared an interest in providing education and support for all impacted by breast cancer. Without Alicia, Jody and the #bcsm community, I would have never met Lori Marx-Rubiner, who died yesterday due to metastatic breast cancer.

Lori and I crossed paths during one of the early #bcsm tweetchats. She was the driving force behind the early LA tweetups, and in 2013 she wrote about one of our get togethers, noting that “it is at once an uneventful and deeply powerful few hours.” Her caption next to our group photo says it all: “How fabulous is this group??”

Shortly after we met online, Lori and I discovered that we lived fairly close to one another. We started meeting every few months for lunch or dinner. She was always very matter of fact and had a great way of breaking down problems or challenging situations.  She was a great listener, and had a wicked sense of humor. After her diagnosis of metastatic breast cancer, we continued to meet, and our conversations delved deeper into issues of life, death and our own mortality. After my close friend and colleague was killed in a freeway accident, she was the first person I turned to when I was ready to open up and talk. As an “expert patient”, she volunteered her time to come to my office for a “lunch and learn” with my staff to discuss some common frustrations that patients experience when trying to navigate the healthcare system, so that they could better understand the patient’s point of view. She was an incredible and inspiring woman and I am so thankful that she was in my life.

When Donna Peach died in 2013, I posted some thoughts about how incredible it was that something like Twitter could bring people together in such a meaningful way. The connections that we make online translate into something very special when we meet “in real life”, or IRL.  The virtual “group hugs” are wonderful, but the IRL hugs are truly magical. Lori and I shared many of those magical hugs.

Rest in peace, Lori. Rest in peace Jody, Donna, and all of the other women and men taken from this world way too soon. You are remembered with love. Thank you to the Universe for bringing Alicia and Jody together online. And thank you to Alicia and Jody, who had the vision to create such a special place for all of us – the fabulous online community that is #bcsm.

30 December 2016