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Interview with Acclaimed Reconstructive Surgeon, Dr. Babak J. Mehrara, at Memorial Sloan-Kettering Cancer Center, New York

Interview with Acclaimed Reconstructive Surgeon, Dr. Babak J. Mehrara, at Memorial Sloan-Kettering Cancer Center, New York

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Published by Cheri Laser
Back in July of 2011, when my breast cancer was only the second of my now four primary cancers, Dr. Mehrara very graciously gave time to me for this interview. The original plan was to incude the interview in a book I was writing for newly diagnosed breast cancer patients. In the interim, two additional primary cancers intervened, and I'm still being treated for the fourth. So plans for the book were put on hold.

But Dr. Mehrara gave me permission to publish the interview however I wished, and since the information and perspective he provided are, in my opinion, so important for women who are newly diagnosed with breast cancer, I feel compelled to get this conversation out there for viewing.
Back in July of 2011, when my breast cancer was only the second of my now four primary cancers, Dr. Mehrara very graciously gave time to me for this interview. The original plan was to incude the interview in a book I was writing for newly diagnosed breast cancer patients. In the interim, two additional primary cancers intervened, and I'm still being treated for the fourth. So plans for the book were put on hold.

But Dr. Mehrara gave me permission to publish the interview however I wished, and since the information and perspective he provided are, in my opinion, so important for women who are newly diagnosed with breast cancer, I feel compelled to get this conversation out there for viewing.

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Published by: Cheri Laser on May 23, 2012
Copyright:Attribution Non-commercial

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July 27, 2011Interview with Babak Mehrara, M.D.Plastic & Reconstructive SurgeonMemorial Sloan-Kettering Cancer CenterNew York, New York (CL= Cheri Laser, Author/Interviewer; BM=Dr. Babak Mehrara)
CL: The purpose of the book I’m writing— 
Under Construction: A Body & Soul after  Mastectomy
 — 
is to target newly diagnosed breast cancer patients, to give them a source they canreference that has humor, information, sort of a respite from the fear
 —something that’s not too
technical, a place for them to get started. So, given that target audience, I was wondering
 — 
 just tostart this conversation
 — 
if you had one thing to say to a brand new breast cancer patient, whatwould that be? What would be the first thing you would say?BM:
Well, they’re going to be overwhelmed. But there are l
ots of resources out there to helpthem
 —lots of things available to get them through it. They’ll get through it with support from
their health care professionals, families, friends, and online communities. So they should notdespair.CL: Great. Thank you.
That’s the kind of thing people want to hear, because in the beginning,when you first hear you have breast cancer, it’s very frightening. My situation was a little dilutedin that I’d already had cancer. So it wasn’t the first time I’d
heard it. But even so, it was really
terrifying. Now … I’ve kind of divided these questions into two segments. One is about you, and
one is about the technical parts of the reconstruction and other pieces of information that I wantto include, to help people with their decisions. And then any closing comments.BM: Okay.CL: Do you mind if I read these questions? I tried to memorize them, but I was unsuccessful.BM: Sure.CL: Other than offering your technical skills, how do you approach those first meetings with newbreast cancer patients? And you may have already answered this with your first answer, so if you
don’t have anything to add, let me know. What do you do to reassure them and help reduce the
anxiety that every woman brings into that first meeting with you?BM
: Well, I spend a lot of time with them during the first visit trying to gauge … to get an idea
of what they are, what their life is about and their social situation, and what the context of thebreast cancer is,
so it’s not in isolation.
So, we do that
 — 
and then we go through the various
options for reconstruction, then we try and figure out what’s the best method for that particular 
person. And then I show them lots of different pictures of various options for reconstruction and
how they can … what they ca
n expect from them. Then we go through questions, if they haveany. So really, just a lot of time trying to tailor the type of reconstruction that we do for the
 
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person, depending on their life circumstances, their oncological issues, and as best as I can glean,their desires for reconstruction.CL: Okay. When women come in for that first meeting, how many have already decided to do amastectomy and reconstruction versus how many are coming to talk to you to get information tomake that decision?BM: I think most people who come to see me have already made that decision.CL: They have. Okay. Thinking back on those first meetings again, was there a particularlychallenging first meeting you had that produced lessons you think would be useful to new breastcancer patients?BM: I think breast cancer patients continuously teach
me
new things. People come up with
questions I didn’t expect—things that didn’t worry … that I wouldn’t have thought were issues
but were issues to them. And I think I continuously try to figure out ways to get my message out
 better so that it’s more understandable and less technical, less scary. So
,
I don’t think there areany specific examples. It’s a continuous process
where I can continue to learn.CL: Did they teach you about that first meeting in medical school, or is that something you kindof have to learn as you go?BM: No, they never did
that 
. They never taught me anything about that in medical school. We dohave a resource here at Memorial for how to communicate better with patients. I did that,actually, my seventh or eighth year into practice, and it actually did help. I found that I had
learned a lot of those techniques by myself through trial and error, but you know there’s actuallya fair bit of research that’s done on th
is. So that was helpful.CL: On the first meeting? Or on that
 BM:
That’s in general … on talking to patients
. On giving them bad news, or giving them good
news, conveying information, and trying to get them to remember a particular point that you’re
trying to make.
CL: Through the fog … the fog of fear.
 BM: Make the message memorable.CL: Right. Are there usually people in the room with them
 — 
family members or somebody whocan help them remember those things?BM: Sometimes.CL: Or is the woman more often than not by herself? Trying to hear all of this?
 
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BM: It’s probably 50
-50.CL: Okay.
BM: Yeah, I’d say 50
-50.CL: So, in your opinion, is it helpful to have a family member in the room to help remember allthese things?BM: Well, you know, coming
from a big family, I always think it’s good to have people around.
Sometimes it can be disruptive, though. Sometimes, if a family member is too vocal, they canend up taking some of the attention away from the patient. They can end up confusing the issuesometimes, or interrupting, and I forget things or they forget things. So I think it can be good andbad. Most of the time,
it’s good.
 CL: Okay, good. Switching gears a little bit, to
 you
 
… of course, for me, you’re a star. But what
led you to the reconstructive specialty in the first place? Was there one motivating moment?BM: Well, I always liked plastic surgery because I thought it was very creative and fun. I
thought it was interesting because it was … you don’t sort of do the same thing over and ove
ragain. Plastic surgeons are really the last general surgeons left other than maybe pediatricsurgeons. We operate on everyone, you know, from babies to ninety-year-olds. We operate from
head to toe. So, we don’t just do breast reconstruction. We do all
inds of other reconstruction.So that really is interesting and challenging. So, on a given day, I could do a breastreconstruction, a head and neck reconstruction. Lots of different things. So I like that. I like thechallenge. I thought it was better tha
n … to me
, it was better than just cosmetic surgery because Ithought it was more challenging to
repair 
something as opposed to just sort of tweak something.So those are the things that I like.
CL: So that’s what led you into the cancer reconstruction ve
rsus the regular cosmetic practice?BM: Yeah, I suppose. I also did additional training in microsurgery, where we transfer tissue
from one part of the body to another. And that’s typically used in cancer reconstruction
. S
o that’s
the other thing that sort of pushed me in this direction.CL: Okay. How many years have you been here doing that now?BM: This is the beginning of my tenth year.CL: Actually, you answered one of my questions, because I had a question about whatpercentage of your time is spent
on breast reconstruction versus other …
 BM: Ninety percent.CL: Ninety percent! So ten percent covers the rest of the body?

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