I felt the need to send this letter as I was a patient of Dr. Karen Barbosa. Let me rephrase that, I AM a patient of Dr. Barbosa. I refuse to accept that a doctor of her caliber was unceremoniously dismissed.
I began my journey when my sister was diagnosed with breast cancer just under three years ago. Her cancer was found early, or so we thought. What we did not know at the time is that she was BRCA 2 positive which means her breast cancer was aggressive. Within one month, she went from a tumor the size of a sesame seed to lymph node involvement. This led her to chemotherapy, where she lost her hair, developed neuropathy in her hands and feet and then on to radiation.
She elected to have a double mastectomy, but because of her cancer diagnosis, could not have that done until treatment was over. When they removed the breast with cancer, there were suspicious cells. She is now on a regimen of medication to prevent metathesis that make her so nauseous some days, she cannot get out of bed.
Because my sister was positive, I was tested. I am also BRCA 2 positive. I elected to do a full hysterectomy within months of finding out. Because of this, I was required to find a doctor that specialized in breasts as I now must have a mammogram each year and a breast MRI six months after that. I saw Dr. Amanda Biro in the Beebe Center for Breast Health in Milford. I really liked her and asked for a consult with a breast surgeon to weigh my options. She left before that happened.
I was then referred to the Lewes office as the Milford office closed. The doctor who I saw was Dr. Barbosa. Instantly, I felt at ease with her. I told her I wanted to be referred to a surgeon, and she said with a big smile “I am a surgeon.” So, I told her I wanted to talk about the possibility of a preventative mastectomy. Now, let me explain something. I remember thinking women who did not have cancer who went that far were crazy. “Breast cancer is easy to catch and treat, WHY would you do that.” And then I watched my little sister suffer with the treatment for a cancer that was “caught” early. So, I just wanted to weight my options.
Dr. Barbosa suggested that I continue on my regimen for now and sent me for my MRI and mammogram. I went back to see her about two months after the tests. I was relieved that they were clear. When the medical assistant came in, she looked at my chart and said “Wow! Your risk has increased!” What I did not know is that my breasts had gotten significantly denser, the normal process of aging, but that meant that a tumor could hide in the denseness, even with an MRI or mammogram.
What I was told was that I had gone from a 50 percent risk of cancer to an almost 80 percent risk. In one year. I came home and told my husband. I told my children. And as a family, the decision was made that I would do a preventative mastectomy. The comment was “if your boobs are going to kill you, they have to go.” I made the appointment with Dr. Barbosa the next day.
At the first appointment, she told me that there were some politics in the office and that she was required to send me to a specific plastic surgeon. I won’t use his name, but will call him Dr. A. No, his last name does not begin with an A, so don’t try to figure it out. Anyway, Dr. Barbosa told me that I was a candidate for direct-to-implant surgery. That meant just one surgery, but she would need a plastic surgeon to assist.
I went to Dr. A. He was very nice but didn’t listen to me. I told him I wanted direct-to-implant, and he basically told me “no.” His reason: “I have only done four of them and they did not go well.” He then proceeded to tell me I would have to lose my nipples as my breasts were too “saggy.” Yes, he used the proper term, but that was what he meant. I just didn’t feel as if he listened to me and the fact he had only done four of the surgeries I wanted, told me he was inexperienced.
I returned to Dr. Barbosa, and she asked what I thought. I was honest. I told her he seemed very inexperienced. She laughed and said “He is. He is good, and he will get there, but right now he needs some more experience. Now, let me send you to the surgeon I know can help you.” She sent me to Dr. B. Again, his name is completely different.
I went to see Dr. B. He was amazing. He was thorough, listened to me, and told me that I was a perfect candidate for a direct-to-implant with nipple sparing. He told me I would likely have to go smaller in size, but I was okay with that. I felt so much more comfortable. It was early December and I knew I could not do the surgery until after the first of the year due to the holiday.
I had an appointment with Dr. Barbosa soon after I met with Dr. B. I told her I was happy with him. I told her I felt he knew what he was doing. She took her surgery marker and actually marked where the incisions would be. She said, “since we are waiting until January, make an appointment after the first of the year and we will set the surgery date.” She also know I had a short window to get the surgery in and recovery as I would be traveling for my job in late March. My appointment was January 14.
That morning, I got a call from the office informing me “Dr. Barbosa is no longer here.” The day I was to schedule surgery within the next two weeks. I was offered to see Dr. C in the practice. I was not pleased, but felt I had no choice. Dr. Barbosa had given me her personal cell phone number so I could reach her if I ever had a question. I sent her a message to ask where she was. It was then she informed me they had not renewed her contract and refused to allow her to see patients for the six months she had left.
I was devastated. I knew of the politics in that office but never thought it would get to the point my surgeon would be dismissed. So, I decided to go to the appointment with the other doctor in the office.
One of the main reasons I am writing this is because of the comments on the article in this paper. The people who think there was anything other than politics never saw her as a patient. They also likely never saw the doctor in that practice I was referred to after Dr. Barbosa left.
I was to have a direct-to-implant with nipple sparing surgery. When the doctor walked in, she seemed nice enough. But it was clear she had not even read my chart. She asked me what Dr. B and I had discussed. Note she did NOT ask what Dr. Barbosa and I discussed. I said, “Dr. Barbosa and I had discussed one surgery with nipple sparing.” She responded, “What did Dr. B tell you.” I was a bit confused, and I told her he said the same thing.
“Well, I am waiting for his notes. However, it is more advisable to remove the tissue and then we use spacers…” before she could say anything else, I said “No. I was told I could do one surgery.” She then pointed out that the flaps on my breast would be very large and that could cause difficulty healing. I told her I was well aware of the risks as both Dr. Barbosa and Dr. B told me that. I also told her I did not want to go into surgery with breasts and come out with nothing.
“Oh, it isn’t nothing. You have the spacers and then a few weeks later we do a small incision…” This time I had heard enough. “I am really confused. Dr. Barbosa told me I was an excellent candidate for this, so I am simply not understanding why you are telling me something different.” Her response was “I have not worked with Dr. B (again completely dismissing Dr. Barbosa) and I don’t know what he told you, but I am telling you with my 40 years’ experience….” I interrupted again and said I wanted ONE surgery.
She then says, “If you do one surgery, you will have to go MUCH larger than you are now.” Again, I pointed out that Dr. Barbosa and Dr. B had told me the opposite. Every single time I said Dr. Barbosa’s name, she clenched her lips and rolled her eyes.
Then she did an exam and leaned back. “I think you could manage the one surgery if we don’t do the nipple saving.” I instantly said “NO! Dr. Barbosa was adamant that I could keep them and so did Dr. B.”
Her response was “He can make you a nipple.” I again said no. She said, “Have you seen the tattoos they do now.” At that point I had enough. I told her “Yes. I have. But MY doctor told me I could keep them.” She sat back in her seat, snapped her little notebook closed, stood up and said in a very snippy tone “Okay.” Then she walked out the door.
This woman had NO respect for Dr. Barbosa and that appointment showed me just how toxic that office must have been. It is clear Dr. C cannot do direct to implant surgeries or simply doesn’t want to. She parroted what the “chosen” plastic surgeon, Dr. A, said. Since that time, I have learned that doctor has botched surgeries, took a trip to California when she was on call and refused to come to the hospital when she was on call because she had jet lag. She was rude, condescending and simply did not listen. She also clearly had no respect for Dr. Barbosa.
I tell this for the people who think Dr. Barbosa did something wrong. This was one of the most difficult decisions my family and I have had to make. I have to feel comfortable with my surgeon. I will never let Dr. C touch me. I am sad because I truly did like Dr. B, but after this, I don’t care if I ever use a Beebe Healthcare office again. They clearly do not care about the patient, but about the politics, the bottom line and the added surgeries they can bill insurance for that are unnecessary.
Before you think hospitals don’t do this, know that three other progressive doctors at Beebe have been terminated in the past year. It absolutely does happen and it happened here. I know it is highly unlikely Dr. Barbosa will get her job back and if she does, her life will be miserable. My only hope is that she finds another practice in the area so I can go to her again. If you think this was something she did, you are correct. She was talented, progressive and able to do things in one surgery other surgeons have to take two or three to complete. She traveled the world to learn the latest techniques. She was the type of physician we need in this area instead of doctors who think the “old way” is the only way.
I also feel the need to address the OR nurse who said, “it isn’t like there aren’t other surgeons.” I get that you work with these surgeons every day. But have you been one of their patients? Have you been told a week before you were to go into surgery the doctor you trust not to butcher you is no longer there? Have you been told you have to lose your nipples as if they are just a fingernail? Have you been told you have to undergo two separate surgeries for something that can be done in one? Have you been dismissed as if you are a child after making one of the most difficult decisions you will ever make?
Many of the women who are angry have not only had to face losing their breasts, but also the fact they have cancer. This isn’t just a case of the flu or a cut that needs stitching. This is traumatic, devastating and frightening. To even say “it is not like there are not other surgeons” is disrespectful and shows a lack of empathy for what we are going through that is unbelievable from a nurse. I am making a decision to alter my body, and I simply cannot let just anyone do it. I can guarantee you it will NOT be Dr. C. Your statement has made me even less likely to use Beebe Healthcare.
I hope Beebe reconsiders or that someone out there who is hiring a good oncoplastic surgeon snaps her up and gives us all back the surgeon we trust.
Sincerely,
Linda F.
Ellendale
