Passing the gavel to Dr. Sheldon Feldman

On April 15, 2016, I passed the gavel of the American Society of Breast Surgeons (ASBrS) to our new President, Dr. Sheldon Feldman. The weeks leading up to the meeting were filled with anticipation, anxiety, and a few nightmares. I had dreams that I slept through my Presidential Address, and that I forgot to prepare my slides. My nightmares stopped when 2 weeks before the meeting, I had the opportunity to speak with Dr. Chip Cody, my predecessor. He is a breast surgical oncologist at the Memorial Sloan Cancer Center in New York and a very experienced and polished speaker. He let me know that he also had nightmares before his Presidential Address – it wasn’t just me! The meeting itself brought many emotions, including a bit of last minute panic before the big talk, joy, and pride. Those words don’t do the emotions justice.

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30 December 2015

14 August 2015

It was hard not to get swept up in this one. Anyone who has frequented You Tube knows that certain posts go “viral”. Everyone gets caught up, there is a period of intense conversation and attention, and then it’s gone, replaced by the next trend. While I’ve been amused by some of these “current events”, I’ve never been an active participant. Until now.

A few months ago, This is What We Look Like launched. The purpose:  “Promoting the presence, awareness, and progress of women in traditionally male dominated fields – Filling the web with images of women doing what is usually considered men’s work”. Images of women wearing t-shirts with slogans such as “This is What a [Drummer/CEO/Philosopher/Surgeon] Looks Like” began to fill the internet.

On August 5th 2015, the New York Times reported on the on-line campaign #ILookLikeAnEngineer. Fast forward a few hours, when General Surgery resident Dr. Heather Logghe posted the following on twitter:

A few tweets of support followed:

Next thing you know, the internet was flooded with surgeons posting pictures of themselves, tagged with #ILookLikeASurgeon. All taking part in the celebration of surgical diversity. A Facebook page was started by surgeon Dr. Kathy Hughes.

The images are inspiring. Women from all over the world have participated. Men have joined in, “celebrating the diversity of surgeons and surgery itself”. Breast cancer patient and advocate Terri Coutee wrote about how the images humanize the profession. Even the TODAY Show took notice.

I jumped on board with 3 tweets:

and my favorite:

It is unfortunate that campaigns like this are still necessary. During many of my medical school interviews, I was asked “How can you think about becoming a doctor when you are going to have children?”. Never mind that I didn’t see children in my future even at that young age. On one of my interviews for general surgery residency, I was told by a senior surgeon that women were not generally welcome in the operating rooms at that institution – how would I handle that? I handled it by finishing that interview and skipping out on the lunch and afternoon program to catch an earlier flight home – that was clearly not a program for me.

My medical school class at Georgetown was about 40% women. However, as a general surgery intern at Georgetown in 1990, I was the only woman in the 5-year surgical residency program. There was only one female faculty member, Dr. Colette Magnant. I was one of only a few woman to finish the program as a general surgeon. However, it was a supportive program and I never felt that my gender was a barrier. Throughout my career, I have been mentored by incredible women and men. I owe the many women who came before me in medicine an enormous debt of gratitude, as I feel I’ve had a relatively easy time of things. One of my great pleasures today is working with young women including high school and college students, medical students and surgical trainees, to help show them that “it can be done”.

There are now a growing number of role models for women considering a surgical career. More and more women are filling department chair positions at academic and community institutions and are taking on leadership roles in professional organizations. I am proud to be serving as the current President of the American Society of Breast Surgeons and was happy to respond “no!” when asked if I was their first female president. I am the 19th President, and the 6th woman to hold that position. 52% of our members are women, and 56% of our leadership roles are filled by women, a point raised by Dr. Hiram Cody III during his Presidential Address in April 2015. In Dr. Cody’s words: “We are not an old boy’s club, and there is no glass ceiling at ASBrS”.

With Dr. Hiram Cody III ASBrS Annual Meeting April 2015

With Dr. Hiram Cody III ASBrS Annual Meeting April 2015

Women in surgery and other fields still face many challenges. But the #ILookLikeASurgeon campaign reminds us how many have successfully faced those challenges. My hope is that there will be no need for similar campaigns in the future.

15 July 2015

I’m not an active non-medical blogger. However, when Jackie Fox tagged me in a tweet on Sunday, I gave in to peer pressure, and put together a few “fun facts” that you might not know about me.

Here you go – 15 Random Things About Me:

1. I was born in the Bronx, NY.

2. Deep down I am very shy. My mother used to tell me not to be a “scared rabbit” when I was around other people.

3. I have been the shortest one in my class since kindergarten. I didn’t go to pre-school otherwise I would have been the shortest one there, too. I used to be called Tiny Mighty Mo in elementary school. That stupid song still gets stuck in my head sometimes.

4. I still ask my sister, the English major, for grammar advice. I’d be lost without spellcheck.

5. I used to wonder about people who lived in California, given all the earthquakes. I moved to LA in 1999, and I wouldn’t live on the east coast again – I’m not a fan of winter. But I do get annoyed when it’s still 90 degrees in November.

6. I love NBA Basketball. Anyone who has seen me (all 4’11” of me) knows I could never play. I was a serious Michael Jordan fan. I saw his IMAX movie. 3 times. I still have the Sports Illustrated from his final championship. And a commemorative book. I’ve watched all of the Dream Team documentaries. I wish the Fun Police were still around.

7. Since 1999 I’ve been an LA Clippers fan. I usually pull for the underdog, which they were at that time. I had season tickets for a few years. It’s rare that I miss an episode of the NBA on TNT. I only like watching the games on TNT. The commentators on the other stations irritate me.

8. With the exception of the NBA I don’t watch TV. Except the occasional episode of House Hunters.

9. I love living on the west coast because I can stay up for the late basketball games, and still get to bed at a decent time.

10. Ideally I’m in bed by 9pm, 10 at the very latest. I eat about 5 times per day, at very regular intervals. Lack of sleep or food makes me incredibly cranky – ask my staff.

11. I have a serious chocolate problem.

12. My biggest influence and mentor during my surgical career has been my father.

13. I used to hate gardening. My mother grew all sorts of things. She would drag us to nurseries on the weekends and we’d be there for what seemed like hours. So how do I currently spend my weekends? I tend to my garden, read gardening books and seed catalogs, and go to nurseries.

14. While I enjoy traveling to new places, there’s no where I’d rather be than my vegetable garden. It feeds me in so many ways. Thanks to the milkweed, I have plenty of monarch butterflies.

15. My cat has no name, but after 14 years, she actually responds (when she feels like it) to “Sweetie” or “Good Girl”. She’s a scaredy-cat that I got from a shelter when she was barely 3 months old. She’s gotten much bolder in her old age. Here she is eating my breakfast when I got up to make some tea. As she gets older I let her indulge. Life is too short.

There you have it. 15 random things about me.

30 December 2014

30 December 2013

27 December 2013

I was recently featured in the December 2013  issue of Oncology Times, in the Profiles in Social Media section. I was interviewed by Lola Butcher, and in case you are not able to access the article, I have re-posted it here. This explains how I became involved in social media and how this involvement has impacted both my professional and personal life.

Oncology Times:
doi: 10.1097/01.COT.0000441837.24257.46
Lola Butcher

Twitter Bio: Breast Surgeon, #BCSM Co-Moderator, Teacher, Advocate, Author, Organic Vegetable Gardener, and Gluten-Free
Facebook Bio: Dr. Deanna J. Attai is a breast surgeon dedicated to state-of-the-art minimally invasive care for women with benign and malignant breast disease. Areas of expertise include ultrasound, minimally invasive breast biopsy, cryoablation for benign and malignant tumors, and accelerated partial breast irradiation. Dr. Attai is actively involved in research and patient and physician education in addition to her busy clinical practice.

Deanna Attai, MD, a private-practice surgeon in Burbank, Calif., is best known in the social media world for her leadership in the Breast Cancer Social Media community, including her role as co-moderator of the BCSM TweetChat every Monday evening. She is featured in 25-and-counting videos on her YouTube channel. She blogs regularly about breast cancer topics on her website; shares personal reflections on her wellness blog; and promotes breast cancer awareness and knowledge on her Facebook page.

Like many physicians, she initially was dubious about the benefits of social media and waded in only to support a professional organization. A lot has changed since then.

“If you had told me a few years ago that not only would I be on Twitter, but I would be driving an hour and a half to the funeral of a woman I got to know through Twitter and that I would have this huge following on social media, I would have never believed it because this is so far removed from anything I have done previously,” she said.

“But this has changed me personally, it has definitely changed me professionally, and all for the better. And I can’t imagine practicing without it at this point.”

How did you get involved in social media?
“It’s all the fault of the American Society of Breast Surgeons [ASBS]. I am chair of the communications committee, and in 2011, the staff person I work with and I thought that we might be able to use social media to increase the visibility of our organization and also offer patient education.

“I had to go before the board of directors and explain why, as an organization, we need to be involved in social media. And I can tell you, I got a lot of blank stares at that meeting.

“Before I went to the board meeting, I set up a Facebook page for my practice. And then I opened a Twitter account, and I just started following and listening. I followed a lot of cancer organizations, I followed a lot of news media organizations. I started following some professional organizations. And then, I started noticing the conversations that were going on specifically related to breast cancer among patients and advocates.

“The first time I realized that I really have a role on Twitter was one night when two women on Twitter were discussing one of their friends who had just been diagnosed with Paget’s disease. One said, ‘Her doctor told her she needs a mastectomy, but I also read that maybe she could get an MRI.’ And I just sort of watched these women with a little bit of horror, thinking, why are doctors not answering these questions? So I kind of butted in and said, ‘I’m a breast surgeon, can I give you any guidance?’

“And I ended up doing the same thing that I do day in and day out if a colleague or friend calls me and says, ‘My mother was just diagnosed—what do I need to do?’ I explained the usual workup for Paget’s disease and the surgical options, depending on what the MRI showed. I found out where in the country she was located, and I got on the American Society of Breast Surgeons website to find a couple of ASBrS members in the area in case she wanted a second opinion.

“I got an email from that woman about a month later, saying the patient had the MRI, the cancer was localized, she had a lumpectomy—and thanking me for my help. That was when I realized there are so many patients who are just not getting the information they need from their physician, and they are going online to look for information whether we are there or not.

“So I think it’s part of our responsibility as physicians to make sure that the information is accurate, and that people are getting the answers they need. And even if we just raise a couple of questions that they can take back to their own physicians, then we’ve done our job.”

The #bcsmchat on Twitter is the envy of every medical community that is interested in social media. What makes it so successful?
“Two breast cancer survivors who are very active on Twitter—Jody Schoger [@jodyms] and Alicia Staley [@stales]—started the breast cancer social media weekly chat in July 2011. I missed the first one, but I joined the second, and basically have participated ever since. I came on as an official co-moderator in October 2011.

“The success is due to the integrity and the vision of Jody and Alicia. When they first found each other on Twitter, they realized that no one was really talking about breast cancer in a constructive way. A lot of times the people who are online looking for information about cancer have not had a pleasant experience with their diagnosis and treatment and they need to discuss issues or problems. So Jody and Alicia sought to provide a supportive environment and evidence-based information and avoid perpetuating media hysteria and misinformation.

“The community essentially polices itself. Some people come on to the chat trying to promote their specific agenda and companies come on to promote their products, and that gets shut down very quickly.

“We are having docs join in left and right, and it’s fantastic. The patients absolutely love it because they have this whole network of specialists that are available to them, even outside of chat hours. Patients sometimes send out a tweet asking a question about a study or something they have read, and they will tag a couple of us and we all respond. It provides us a good opportunity to help empower and educate patients.

“Jody, Alicia, and I come up with weekly topics. I tend to take the lead when we are talking about medical things. For example, when we did a chat based on the American Society of Breast Surgeons’ meeting in May and the American Society of Clinical Oncology Breast Cancer Symposium in September, I basically rounded up the docs who were going to be involved, came up with the topics, and I moderated.

“If Jody is leading the discussion on a certain topic, I’ll be the one in the background, fielding the side questions or the things that may not be exactly pertinent. So we often have multiple conversations going on at once. It often takes the three of us to keep it under control.

“One week we had a topic scheduled, and two of the group members, both with end-stage metastatic disease, died that morning, within hours of each other. So, that night we spent most of the chat talking about them—the issues of death and dying, but also honoring our members.

“Jody and Alicia and I all kind of patrol the hashtag (#bcsm) during the week. People will send out tweets using the hashtag—maybe it’s someone who has written a blog post, maybe it’s somebody posting an article, sometimes it’s someone saying, ‘First day of chemo today; I’m scared.’ We call it our ‘bat signal,’ and we tell people if they have any questions or issues during the week, just send out a tweet with #BCSM and we’ll all come running.”

How has social media affected your practice?
“You don’t use social media to get patients. I don’t think anyone will come to me just because I have a good Facebook page or because I’m on Twitter. But Twitter gives me a huge network—just like it does for the patients—of specialists all across the country that I draw from, personally and professionally, for my own education and for what I can provide to my patients. And these are some of the leaders in their field. So I have access to the best and the brightest in medical oncology and surgery and other specialties.

“Also, the interactions I have with patients on Twitter have made me realize just how difficult our treatments really are for them. Of course, we see the patients who come to our offices and we ask them questions, but when we hear these women talking online, it lets us see what happens behind closed doors. It gives us a window into what really is going on with our patients and how our treatments and our words really affect them.

“This has changed the way I interact with my patients. I am much more aware that they are putting on their happy face when they come into the office. The reality is I just have to dig a little deeper to get to the issues that are concerning them.”

What is the #bcsm-LATweetup?
“There are several of us who are in southern California, and one of the #bcsm members came up with the idea that we should all get together. So maybe five or six of us met—that’s a Tweetup—and it was like we were all long-lost high school friends.

“When we scheduled the next one, another member, Donna Peach (@danceswithpens), said she wanted to come. She was a writer by trade and a dancer and such an incredibly warm and loving person that we all really gravitated towards her.

“By the time our TweetUp was scheduled, it was clear from Donna’s blog and her tweets that she was not well and probably towards the end stage. While we were sitting at the restaurant waiting for her, one of our group, Lori Marx-Rubiner (@regrounding) got a text saying Donna’s husband couldn’t find a handicap ramp—Donna was in a wheelchair by now—and they were going to turn around and go home. And Lori got up from the table, ran out, and basically stopped traffic to help get Donna out of the vehicle and wheel her up to the table. And we were all together for about an hour.

“Donna made such an impression on us that when she passed, it was like we had known her all our lives. Three of us drove down to the funeral. We had known her for only a little while, but she was a family member.”

What advice do you have for physicians who have not yet tried social media?
“When I started using Twitter, one of the first things I did was look at organizations like the American Cancer Society and check who is following them and I would start following some of those people. That led me to a few patients and advocates who seemed to have a prominent voice, and I looked to see who was following them and who they were following. And that is how I started figuring how who I need to listen to. There were many I started following initially whom I later un-followed because their voice wasn’t anything I wanted to hear.

“The best way to start is just to go in and look and listen. And you will figure out where your community or where your niche is. Or you may never say a word. You may just use it to soak in the information, and that’s perfectly fine. The whole world is open to anyone, which is incredible.

“Also, don’t be afraid as a physician in social media to humanize yourself. I put a lot of my garden stuff on my blog and on my Facebook page. I’ll get more ‘likes’ when I post vegetables from my garden than any breast cancer story that I post. And the feedback that I get, both from my patients and from the people that I haven’t met but who follow me online, is ‘Oh, my gosh, the doctor is a real person.’”

06 April 2013

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 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, 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.

30 December 2012

Anyone who spends just a few minutes with me knows how important my garden is – it’s my inspiration, my therapist, and my friend. Here is the first of what I hope will be an annual posting of the garden year-in-review. Enjoy!

26 September 2012

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 17th.

I find non-medical writing very difficult – I need a large chunk of free time combined with a strong dose of inspiration to put together a more creative 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. Many of my patients have been diagnosed with breast cancer – the anxiety and stress in the consultation room is often palpable. Despite our advances, and modern medicine’s best efforts, patients do not always survive. I take many patient stories home with me each and every night.

One of the reasons that I decided to specialize in breast surgery was that I recognized early in my career that I actually liked talking to my patients – not the stereotypical general surgeon. I enjoyed getting to know them and their families, and to have a more personal type of professional relationship.

So despite many personal and professional challenges, and the frustration that our science is not exactly where it needs to be, I continue to love what I do and could not imagine another career. There are ways that I can help that do not involve the operating room or a scalpel. What motivates me? It’s simple really – I can’t always cure, but I can always care.