A women’s right to choose an alternative to radical surgery
by Rosalind Campion (1972)
This little volume, only 96 pages, is a gem. It’s the story of a woman in the early 1970s who discovers a lump in her breast and her surgeon in New York City recommends a radical mastectomy if it turns out to be cancer. By serendipity, she learns of an article by Dr. William Nolan is going to be published within a week or so recommending a simple lumpectomy for early breast cancer. When she discusses this with her New York surgeon it is clear that he didn’t want to hear any of this.
She gets the feeling that there is not really much emotional difference between prisons and hospitals. The New York surgeon tells her “Now, you are being a very silly and stubborn woman. You ask too many questions.” “It took me a while to figure out that there really wasn’t anything else he could’ve said. He had spent most of his working life performing these operations and, often, saving lives. How could he possibly admit that at times there might be a better and simpler way without denying his skill and his entire career?“
She makes an appointment to be seen at the Mayo Clinic. It turns out that. The Clinic is much more open-minded. They listen to her concerns and she has a simple lumpectomy and does not even need radiation, based on pathology. The Clinic doctor told her, “The trouble with most surgeons is that they won’t take the time to look into every possible method of treatment applicable to each patient’s case.“ He was talking about patient – centered care which in 1970 was not a term that had been used.
She writes, “My feeling, as he talked calmly and pleasantly at his paper-strewn desk, was that in addition to the obvious blessing of local excision, severe trauma, both physical and emotional, is spared the patient who has been thoroughly informed.” She continues, “It had occurred to me that the attitude of most surgeons in defending mutilation so wholeheartedly was like that of the Serengeti tribe in Africa who practice female circumcision. There is a mysterious element of punishment involved, and perhaps guilt as well.”
That was a prevailing attitude of medicine and those days with regards to a woman’s choice for breast surgery. We’ve come a long way, but still there are areas where chauvinism plays a role in medicine today. She writes, “It is doubtful that cancer occurs psychologically, but resistance to it may somehow be tied up with the nature of the spirit.” [I’m not sure how one can unpack that statement, but there may be a kernel of truth there.]
Towards the end, she writes “Are women really so timid that they think it immoral to question authority?” She ends wit,“I’d like to be a living tribute to the belief that a surgeon and his patient owe each other mutual respect. Each avenue of cure for each individual must be considered.“ That’s a good a protocol for physicians wanting to provide patient-centered care.
