On the Other Side of Care

After years of working in healthcare, Tangela Q. Parker knew why mammograms mattered. Then a routine screening found a mass in her breast, placing her in the position she had spent much of her career thinking about professionally: the patient waiting for answers.

I had just finished my tennis lesson at the Sandy Springs Tennis Center when my phone rang. I did not recognize the number, but I answered. The caller was from Emory, where I had recently had my mammogram. She told me they wanted me to come back for additional images. I had been getting mammograms since I was 35 years old, and I had never received a call like that. When we hung up, I stayed in my truck for a few minutes before leaving. I was not afraid at that point. I was trying to process what I had heard and what it could mean.

I have worked in healthcare long enough to know that a callback after a mammogram is not a cancer diagnosis. It means something on the images needs a closer look. I knew that, but my mind still went places it had never needed to go after a mammogram. I did not call anyone. I am usually the person people call when something has happened, and I know myself well enough to recognize why I stayed quiet. Once you share uncertain medical news with people who love you, their concern becomes part of what you are dealing with. They want answers because they care, and you can find yourself reassuring them before you have had time to process your own reaction. That afternoon, I needed time before I invited anyone else into the conversation. It also made me think differently about medical privacy. People should be able to decide whom they tell about their health, when they tell them and how much they choose to share. They may still be trying to make sense of incomplete medical information themselves. A person’s decision to keep that information private should be respected and should never be used against them later.

The additional imaging showed a mass in my breast, and a biopsy was recommended. During the procedure, six tissue samples were removed. My professional background helped me understand why the biopsy was necessary. I knew a mass could be benign and that pathology could answer questions the imaging could not. What I could not know was what the laboratory would find in my tissue. Waiting for the pathology report was harder than receiving the original callback. By then, my mind had enough information to consider possibilities I did not want to consider. I could remind myself of what I knew medically, but eventually there was nothing left for me to reason through. I had to wait. My faith became especially important during those days. I have believed in God for as long as I can remember, so prayer was already part of my life. I prayed for a benign result while knowing that faith did not give me control over what the report would say. My relationship with God could not depend upon receiving the answer I wanted.

The biopsy was benign, and I was deeply relieved. My medical care, however, did not end there. Further assessment showed that my breast cancer risk requires closer surveillance. I now undergo breast screening every six months as well as MRI, and genetic testing has become part of my care. I am also meeting with a geneticist who has reviewed my family history with me in greater detail than I had ever considered before. We have looked at where cancer has occurred in my family and what that history may mean for my own risk. Seeing my family mapped in a medical history was sobering. I was looking at people I knew and loved, while my geneticist was helping me understand how their histories might inform my own care. I do not yet know everything genetic testing or future screening may reveal. The biopsy answered the immediate question about the mass, other questions remain. Therapy has been valuable while I work through those questions. Having a good therapist gives me a place to talk openly about what concerns me without worrying about how someone close to me is reacting to the same news. Faith remains part of that process as well. I cannot know what every future screening will show, and trusting God cannot depend upon already knowing the outcome.

For much of my career, I have worked with health plans, government programs and healthcare organizations. I have spent years thinking about preventive care and patient experience professionally. In September, I became the patient waiting for the result. My experience has also made me look more closely at access. I was able to have regular mammograms, return for additional imaging, undergo the biopsy and see the specialists now evaluating my risk. Every woman does not have those same options. Cost, insurance, transportation, work and family responsibilities can affect whether an appointment gets made or kept. Money and professional status can make access easier. Neither can determine what an imaging study or pathology report will show.

This is the first Breast Cancer Awareness Month I have entered while actively undergoing breast surveillance. What began with a routine mammogram in September is still unfolding. My biopsy was benign, but there are appointments ahead and questions I am still discussing with my doctors.

I cannot know what another woman’s screening will show, and I would never tell her there is nothing to worry about. I can only tell her what happened to me. I went for a routine mammogram without feeling a lump or believing anything was wrong, and it identified a mass that needed further evaluation.

If your mammogram is due, I hope you will make the appointment.

I am grateful that I made mine.