In this post, Lindsay Hardley, DO, breast oncology surgeon, Breast Care Team, Parkview Cancer Institute, shares the motivation behind her decision to move into a specialty in breast surgery.
I believe that, throughout your life, things happen. And when those things happen, they plant seeds that eventually form and grow into who you are.
Early seeds
My grandmother was diagnosed with bilateral breast cancer two years apart; on one side when she was 49 and on the other when she was 51. At the time, the treatment was mastectomies. She couldn’t tell you the complexities of her case, just that she felt a lump and the doctors chose to treat it that way. It was just what they did.
As I got older and noticed the physical differences of her body and learned about her cancer battle, another seed was planted. She had breast cancer, but it didn’t define her. It was part of her journey but it didn’t consume her. She was happy to support others, but she didn’t make it her life mission to focus on the fact that she’d had breast cancer. I think it’s so important to empower people who have this disease, but it doesn’t have to define you. Everyone has a story and it will affect everyone in a different way. The way my grandmother handled it had a huge impact on me.
Certainly, I was that kid in kindergarten who always said I wanted to be a doctor. I was naïve, as most kids are, about the variety within medicine. I had a very simplified view of the profession. I always gravitated toward math and science – they just came easier to me. Those were the gifts I was given and I wanted to use them.
Becoming a surgeon
I went to medical school at Lake Erie College of Medicine in Florida. It was a new school and they had a different learning model. It was case-based learning in small groups, rather than in large lecture halls. There was a focus on independent learning. I gained a lot of confidence there and proved to myself that I could really do hard things.
I actually came to Fort Wayne to do all of my third and fourth year clinicals through Fort Wayne Medical Education, which was also fairly new. They didn’t have a lot of medical students at the time.
I went to Columbus, Ohio, for my residency, which was five years of general surgery. During that time, I had a fantastic mentor in breast surgery and there was a lot of the specialty incorporated into the general surgery residency. That’s when I realized that I had the capacity to absorb a deep understanding of breast oncology and breast surgery. I was really intrigued by the oncology part of it. I loved the complexity, and how it wasn’t black and white. Every case started as a blank slate, and then, based on tumor markers, pathology, etc. it began to take shape through an algorithm of sorts. But in the end, each woman could be totally different. It could be intimidating for some, but I loved it. Another seed had been planted.
At the time, I was afraid to commit to one single specialty. I thought it would narrow down my future opportunities. I didn’t want to do academic; I wanted to be more community based. I was doing abdominal surgeries, endoscopy, whatever came through the ER in that community setting, and also getting referrals for breast surgery patients. I wasn’t bored with general surgery by any means, but I did have inclinations to explore something else. The fear of staying in the same role was worse than that of taking a leap. I was terrified of never trying. I didn’t want the regret of always wondering, which is what led me to surgery in the first place. I never wanted to stop changing or doing better. And then all the pieces fell into place.
A new challenge
In 2017, God moved mountains in ways that I can’t explain. Throughout my five years working in general surgery, I’d been getting those nudges. Did I want to do this for my entire career? I loved all of my patients, but I was being pulled toward my breast oncology patients. I’m a person of connection and community. I started having curiosities.
Given the complexities of breast cancer, you have to be two feet in. You can’t dabble at it and do it well. I had conflicting feelings about offering both breast services and general surgery. I wanted to have a good reputation and provide the best experience possible. It was weighing heavy on my heart, but I didn’t know how to make a change happen. I was also seeing the impact of, what I call “broken medicine.” When a patient’s care is fractured and they are being referred to different providers in different locations and trying to keep it all straight and feeling so overwhelmed. I knew there had to be a better way.
Around that time, “Private Practice” was popular on TV. The drama series featured a handful of physicians, all of different disciplines, working out of one office. I remember thinking how awesome that would be. The concept of that type of care model was another seed, planted in my mind. But how could I make that multidisciplinary approach happen?
One day, in 2017, a flier showed up on my desk for an open house showcasing the new Parkview Cancer Institute. I will never forget how I felt. I was having heart palpitations. I’d worked with Neil Sharma, MD, president, Parkview Cancer Institute, before. I’d referred patients to him, but we’d never talked about the new cancer institute. I knew the second I saw the flier that I was going to do it, I just had to figure out the timing. Parkview had to build the building for me to say, “OK, make it happen.”
Watching the seeds grow
In October of 2018, the year the cancer institute opened, I started with Parkview. And I never looked back.
It was an easy transition, really. I already had the passion for breast surgery and was knowledgeable about breast oncology. I had Linda Han, MD, breast oncology surgeon,Breast Care Team, Parkview Cancer Institute, as my mentor and she wasn’t going to let me fail. I got to start molding my practice to the vision of the Parkview Cancer Institute, which was already in place. It felt like I was home.
Colleagues and loved ones would ask if I was going to miss general surgery or get bored being focused on just breast. But this specialty is so colorful; every patient is different, every family is different, every experience is different. The complexity of breast isn’t going away and it’s only going to get better the more research we do.
What I love most about my position at the cancer institute is the teamwork. I recently had a patient who came for a second opinion. She was so overwhelmed by that brokenness I’d seen earlier in my career. The system she’d worked with previously wasn’t communicating. She knew she needed help and reached out to a nurse navigator. From there, the teamwork began. She needed chemotherapy, so I reached out to Ellen Szwed, DO, , medical oncologist, Breast Care Team, Parkview Cancer Institute, and she fit her in the next day. I spoke to radiology and they showed me films for the patient while she was actively in the office. We have a system in place where we can provide everything for the patient in terms of breast cancer care.
I try to do things in the same way and create a routine for my patients. When I see a new patient on my schedule, I write down notes, I look at their imaging before I read the radiologist’s report, I look at the pathology because that’s what starts to make it complex. I ask if they need oncology at the same time they see me. I develop a soft plan based on the information I have and then when I see the patient I get to know them and make a plan that’s best for their situation. I do an exam and look at the area of concern with ultrasound to begin mapping out their surgery, if we’re doing surgery first. We talk about my recommendations and come to a plan together. When we get to surgery, everyone’s on the same page and everyone feels really good about the decisions made.
When I think about where I am now and where I was even just two years ago, it reminds me how important it is to be brave. We can’t be afraid to make those hard changes because they can lead to our best adventures. Don’t be afraid to keep learning. When you feel stuck, there’s usually a reason and something better on the other side. You just have to work through the fear.
