Lifelines
A breast cancer survivor describes her treatment at St. Francis Hospital
Story by Jane Gordon | Photography by Michael Fiedler
 
Kathy Jollie, 56, of Farmington, rolled over in bed one Sunday morning and felt a hard lump under her arm, above her rib cage. Her story could have taken any number of paths, particularly if she had been passive about her discovery, as many patients might have been 30 years ago. But Jollie is one of a new generation of patients who engage in decision-making with their doctors and try a range of treatments that include but are not limited to surgery, radiation, and chemotherapy.
Though Jollie had a sparkling clean record of health and no family history of breast cancer, the lump was malignant. She talked with doctors and weighed her options. Her decision: to be treated at the Comprehensive Breast Health Center at St. Francis Hospital and Medical Center in Hartford. It was a pivotal choice for her: St. Francis is now home to Dr. Kristen Zarfos, who stumbled into the political spotlight in 1997 when she
vigorously protested insurance companies that insisted upon “drive-through mastectomies,” in which patients were sent home within 24 hours of their surgeries, woozy from medication and often with drainage tubes still attached. Zarfos’s battle became a national issue, prompting an invitation to the White House where then-President Bill Clinton publicly applauded her efforts.
Zarfos—known fondly as “Dr. Z” to some of her patients—became nationally recognized as an energetic and passionate advocate for women’s health and for patients’ participation in their own healthcare decisions. “Those of us who were a product of the ‘70s embraced the concept of women being more involved with their health,” she says. “We said, ‘Gee, let’s have people be a part of this, let’s encourage them to take more ownership.’ It’s been an evolution, a process with the patient, the doctors, the hospitals.”
Treated at St. Francis, Jollie felt a mix of relief and hope. “Dr. Zarfos is a very gracious, intelligent, informed woman and surgeon. She understands that it’s important for me as a person to understand what the options were and what the ramifications were,” Jollie says. “But she also made it very clear that the decisions need to be mine.”
Zarfos, along with other groundbreaking physicians, were already taking St. Francis to a new level of cancer care. Beyond the newest treatments, the leading-edge drugs, and all else that was new in modern-day care, the staff at St. Francis began to listen carefully to patients, embracing treatments that were “ages old,” according to Dr. Kathleen Mueller, medical director for the Center for Integrative Medicine at St. Francis.
“Can my massage therapist come into the hospital?” one patient after another asked, so administrators set up massage therapy spaces in conference rooms, in the gym, and wherever else there was space. “This approach goes back to some of the wisdom we had from thousands of years ago,” Mueller says. “Using our body’s natural healing ability, really working to combine both worlds with the best science behind it; that’s what we try to do. Part of my job is to make sure that physicians get people to me so I can help them choose their path. I do not think there is one integrative approach. Some people like meditation, some like yoga, some choose acupuncture.”
The combined approach, known as integrative medicine, became so popular that a few years ago St. Francis embraced it fully, creating dedicated space for it. Neither “complementary” nor “alternative,” Mueller says, “integrative care is a combination of both worlds, incorporating both medical approaches. There is good science and growing research behind what we do.” For example, she says, “We’re finding that massage therapy may support the function of the immune system and that acupuncture can be effective for chemotherapy-induced nausea and vomiting that may not respond to prescription medications.”
Equipped with a menu of choices and supported by a medical team who believed in her ability to make good decisions, Jollie met with Zarfos and a medical oncologist at St. Francis, Dr. Zia U. Rahman, to discuss her options. “I had just about every diagnostic test you could do,” she says, “and it was actually really interesting. I had an opportunity to be exposed to so many different people who were tremendous in helping me understand what was going on.”
Jollie was no neophyte: in her first job, she paid medical claims for a large insurer. “I learned that people had to stand up for themselves,” she says. “Working in the insurance industry, talking with people on the phone, helping people to understand what their rights were as far as their coverage went, encouraging them to question doctors—that helped me to take responsibility for my own decisions and to ask questions and challenge. One of the things Dr. Zarfos made very clear from the start was that all of the decisions were really mine. My approach—because of paying medical claims starting at the age of twenty-one—helped me to understand just how important that was.”
Breast health has three primary components, Zarfos says: a regular breast self-exam accompanied by self-awareness; an annual exam by a physician or nurse practitioner; and an annual mammogram and possibly an ultrasound.
At St. Francis, if an abnormality appears in a mammogram, a clinician sees the patient immediately and a radiologist provides a report. When additional X-rays are needed, they are scheduled on the spot. “You have your answers before you leave,” Zarfos says. “I can walk a patient right down the corridor and say ‘Let’s do an ultrasound, or let’s do a mammogram.’ We are comprehensive in terms of women’s breast health issues.”
Jollie’s treatment incorporated radiation, a lumpectomy and node dissection, massage therapy, and continuing her normal work life and cardio and weight training exercises at the gym. Cancer-free for five years, she says she is grateful to have the care she needed at St. Francis. “To meet such tremendous people—Dr. Z, Dr. Rahman, Dr. [Eric] van Rooy, my incredible oncology nurse Debbie Konopka—and to have such a tremendous team—in addition to my family and friends—was incredible,” she says.
“I think that whether it’s doctors, nutritionists, dietitians, massage therapists, music therapists—and all the other aspects of care that are available to patients while they are going through treatment—St. Francis is trying to be on the leading edge of the scientific perspective as well as other types of healing,” Jollie says. “It really is an entire picture. I feel very fortunate to live in an area where that approach is available. I didn’t have to drive to Boston. I didn’t have to drive to New York. I was working with people who are continuing to investigate options using integrative care—that whole picture that helps someone deal with cancer and so many other diseases.”
Jane Gordon, a longtime contributor to The New York Times and a former editor
at The Hartford Courant, can be reached
at jane-gordon@cox.net.
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