Latest / Just Cut It Out Podcast / Just Cut It Out Podcast | Breast Reconstruction, Finding Your Voice & Changing Healthcare | Dr. Elisabeth Potter

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Just Cut It Out Podcast | Breast Reconstruction, Finding Your Voice & Changing Healthcare | Dr. Elisabeth Potter · Just Cut It Out Podcast

• 0:02
  SPEAKER_01: I'm Dr.
• 0:03
  SPEAKER_01: Kim Brown, and this is Just Cut It Out, where we talk about how the experience of a cancer diagnosis has made people think differently about what it means to them to live a good life.
• 0:17
  SPEAKER_01: Each episode, we cover a little bit of practical wisdom and a little bit of big picture.
• 0:22
  SPEAKER_01: What does this all mean through conversations with patients, their families, and teams who take care of them?
• 0:33
  SPEAKER_01: Welcome.
• 0:33
  SPEAKER_01: I'm Dr.
• 0:34
  SPEAKER_01: Kimberly Brown, and this is Just Cut It Out.
• 0:37
  SPEAKER_01: Today, my guest is Dr.
• 0:39
  SPEAKER_01: Elizabeth Potter, a plastic and reconstructive surgeon here in Austin, Texas.
• 0:44
  SPEAKER_01: She's a colleague and a friend now for going on 10 years or so.
• 0:48
  SPEAKER_01: Yeah, welcome to the podcast, Dr.
• 0:50
  SPEAKER_02: Potter.
• 0:51
  SPEAKER_02: This is so cool to see you in your like natural professional habitat rather than in one of our kitchens.
• 0:56
  SPEAKER_02: So love it.
• 0:58
  SPEAKER_01: Oh, it's great.
• 0:59
  SPEAKER_01: I'm so glad that you came down to visit.
• 1:01
  SPEAKER_01: Well, Dr.
• 1:02
  SPEAKER_01: Potter, let's start with a little bit of background.
• 1:05
  SPEAKER_01: Tell us about your your childhood growing up in Augusta, Georgia.
• 1:10
  SPEAKER_01: Yep.
• 1:11
  SPEAKER_01: And some of the things that shaped you childhood experiences that gosh.
• 1:18
  SPEAKER_02: So yeah, I grew up in Augusta, Georgia.
• 1:20
  SPEAKER_02: I'm one of four kids.
• 1:21
  SPEAKER_02: I'm the third.
• 1:22
  SPEAKER_02: And my dad was a small-town doctor, and that was our family business.
• 1:27
  SPEAKER_02: He was an independent allergy and immunologist, and my mom was a nurse.
• 1:32
  SPEAKER_02: So yeah, I just grew up thinking that my parents' job was to take care of people, and that that was something you could do for your career and be really proud of.
• 1:43
  SPEAKER_02: And I was surrounded by really strong women.
• 1:46
  SPEAKER_02: My grandmother was a nurse anesthetist, and she had been an officer in World War II.
• 1:53
  SPEAKER_02: Oh, I did not know that.
• 1:54
  SPEAKER_02: Yeah, yeah.
• 1:55
  SPEAKER_02: She met, she actually met my grandfather.
• 1:57
  SPEAKER_02: He was enlisted and she was an officer.
• 1:59
  SPEAKER_02: And yeah.
• 2:01
  SPEAKER_02: She was a CRNA, a nurse anesthetist, and she worked at Grady Hospital when it was segregated.
• 2:06
  SPEAKER_02: And they would let her do anesthesia at what they referred to as Black Grady.
• 2:13
  SPEAKER_02: Um, because she was a woman.
• 2:16
  SPEAKER_02: Yeah.
• 2:17
  SPEAKER_02: And so she worked at Grady.
• 2:19
  SPEAKER_02: And then I went to her retirement from desegregated Grady when I was young.
• 2:24
  SPEAKER_02: But I would go to her house and I would ask for hospital stories.
• 2:27
  SPEAKER_02: Same at my house.
• 2:28
  SPEAKER_02: She called me Dr.
• 2:28
  SPEAKER_02: Elizabeth and gave me a stethoscope.
• 2:31
  SPEAKER_02: And um, yeah, I just was around my grandfather, was you know, law enforcement, drove a school bus, was a farmer, really salt-of-the-art people who were always just trying to do the right thing.
• 2:42
  SPEAKER_02: And I was never, I was never afraid of making someone mad if you were doing, if you were for a good reason.
• 2:50
  SPEAKER_02: You know, there were a lot of stories in my family of people getting in a little bit of trouble for a really good reason.
• 2:56
  SPEAKER_02: And those were the kind of stories that that we told each other because we were proud of that, right?
• 3:02
  SPEAKER_02: Right.
• 3:02
  SPEAKER_02: So the stories that you tell.
• 3:04
  SPEAKER_02: The myth of my family was we're good people and we do hard things.
• 3:09
  SPEAKER_02: And so, yeah.
• 3:10
  SPEAKER_01: It's definitely how I have come to know you.
• 3:12
  SPEAKER_01: It's and that makes a lot of sense.
• 3:15
  SPEAKER_01: And I bet then your family was really part of a community.
• 3:19
  SPEAKER_02: You're interesting.
• 3:21
  SPEAKER_02: No, I would say that my parents are both um, you know me, and I'm I refer to myself as a hermit.
• 3:29
  SPEAKER_02: Um, and I think my parents are also really kind of to themselves.
• 3:34
  SPEAKER_02: They're strong family.
• 3:35
  SPEAKER_02: My dad was an only child.
• 3:37
  SPEAKER_02: Um, my mother had a sister who was 18 years younger than her.
• 3:40
  SPEAKER_02: Um, our family was our like our community.
• 3:44
  SPEAKER_02: Okay.
• 3:45
  SPEAKER_02: Yeah.
• 3:45
  SPEAKER_02: So we went to church and I, you know, at school and certainly sports teams.
• 3:50
  SPEAKER_02: Um, and our home became the place where other kids came.
• 3:54
  SPEAKER_02: Right?
• 3:55
  SPEAKER_02: Our our door was always open.
• 3:57
  SPEAKER_02: Um, they called my dad the good doctor in town, and someone would just pull up their car and come in the front door and hang out at our house.
• 4:05
  SPEAKER_02: So I don't we weren't like in any clubs.
• 4:10
  SPEAKER_02: My parents weren't in a country club.
• 4:13
  SPEAKER_02: They weren't, it it was just a real we were just really close as a family, and we're all really busy um playing sports and trying to, you know, decide what we're gonna do with our lives, and um just so no, I wouldn't say we felt like I never felt like we had a really big circle.
• 4:35
  SPEAKER_02: I felt like we had a small circle, but we invited people in.
• 4:39
  SPEAKER_01: Interesting.
• 4:40
  SPEAKER_01: Okay.
• 4:40
  SPEAKER_01: Well, and growing up, sports was important to you?
• 4:44
  SPEAKER_01: Very yeah.
• 4:45
  SPEAKER_01: I I identify you as an athlete, yeah, even even now.
• 4:49
  SPEAKER_01: Um and so you went off to college and you played sports in college.
• 4:54
  SPEAKER_02: I rode at Princeton, and that was one of those I played basketball and soccer.
• 4:58
  SPEAKER_02: I ran track because I had to because my brother ran.
• 5:00
  SPEAKER_02: He was really fast, and he drove the car.
• 5:03
  SPEAKER_02: And so it was either I was gonna sit around and wait for track practice to be done, or I was gonna run the 400.
• 5:08
  SPEAKER_02: And so I probably should have sat around because the 400 is a miserable race to run.
• 5:13
  SPEAKER_02: But um, yeah, I played sports, and then my brother played soccer in college, and I I went to Princeton where he was playing, and that did have a big played a big role in me going to Princeton.
• 5:24
  SPEAKER_02: I did want to continue to be around my brother.
• 5:26
  SPEAKER_02: Oh, he was just a really great guy.
• 5:28
  SPEAKER_02: And um so when I was choosing schools, I I wanted to be with him.
• 5:32
  SPEAKER_02: And then I was on campus like before school started, and the rowing coach saw me working out and was like, hey, come on down to the boathouse.
• 5:40
  SPEAKER_02: And so I did, and I got to row at Princeton.
• 5:44
  SPEAKER_02: And um, yeah, for me, like I'm I've always had like the mind of an athlete, and I like having a task, being really focused on it, completing it, thinking about what I could have done better, um, and resting.
• 5:59
  SPEAKER_02: I like to feel like I earned my rest.
• 6:02
  SPEAKER_02: Sure.
• 6:02
  SPEAKER_02: Um that all sounds a lot like your approach to surgery, but we'll get to that later.
• 6:07
  SPEAKER_02: Okay.
• 6:07
  SPEAKER_02: And it was through your brother that you met, Jeff, your husband?
• 6:10
  SPEAKER_02: Yes.
• 6:11
  SPEAKER_02: So my brother, actually, when I was a senior in high school, my brother was, so we were just one year apart.
• 6:17
  SPEAKER_02: He was a freshman at Princeton, and he came home at Christmas, and we're outside in Augusta, Georgia shooting baskets at our, you know, at the hoop.
• 6:25
  SPEAKER_02: And John said, I met somebody that I would be okay with you dating.
• 6:30
  SPEAKER_01: Which is about as good of a recommendation as a brother can give, right?
• 6:32
  SPEAKER_02: Yeah, I mean, he was just like, I'd be okay with that.
• 6:35
  SPEAKER_02: And I was just kind of like, and I wasn't really like boy crazy.
• 6:38
  SPEAKER_02: Um, but I think John anticipated that I was gonna find someone at some point, and he wanted to weigh in, and so he pre-screened Jeff.
• 6:46
  SPEAKER_02: So sweet.
• 6:47
  SPEAKER_02: And uh they played intramural basketball together and um we're in like the youth group together.
• 6:52
  SPEAKER_02: Um, and I remembered the name, and then when I saw, I was on campus my first week, I saw somebody walk through a door with another girl at it.
• 7:00
  SPEAKER_02: We were at Princetonian Diner, and he walked in with another girl that was definitely his girlfriend.
• 7:04
  SPEAKER_02: Oh and I said to the woman sitting next to me, Who is that?
• 7:07
  SPEAKER_02: And she said, That's Jeff Potter.
• 7:08
  SPEAKER_02: And I was like, That's the guy.
• 7:12
  SPEAKER_02: That's my guy.
• 7:13
  SPEAKER_01: What is he doing with her?
• 7:15
  SPEAKER_01: How long did that take to unravel?
• 7:17
  SPEAKER_01: Like a year and a half.
• 7:18
  SPEAKER_01: Okay, oh yeah, yeah, yeah, amazing.
• 7:21
  SPEAKER_01: What made you choose plastic surgery?
• 7:23
  SPEAKER_01: Well, sort of fast-forward med school, and you have all these options, and that wasn't something in your family, you were medicine family, right?
• 7:32
  SPEAKER_01: Yeah, totally.
• 7:33
  SPEAKER_01: Yeah.
• 7:33
  SPEAKER_01: Or the CRNA, I guess.
• 7:36
  SPEAKER_02: Right.
• 7:36
  SPEAKER_02: I knew uh I knew myself really well, and I've always like realized that I I do want to feel happy, and I I want to feel fulfilled, and there's like specific things that make me happy.
• 7:49
  SPEAKER_02: Um, we've already talked about being tired.
• 7:51
  SPEAKER_02: I like to work with my hands.
• 7:52
  SPEAKER_02: So I had already sort of known I think it's gonna be procedural, you know, because every day I wanted have a task.
• 7:59
  SPEAKER_02: I don't like to talk a lot.
• 8:01
  SPEAKER_02: This is fun, but like, you know what I mean?
• 8:03
  SPEAKER_02: Yes, um, so surgery was on my mind, and I actually I saw a mastectomy in my third year of medical school, and I had never thought of doing plastic surgery before my third year.
• 8:18
  SPEAKER_02: And if anyone's ever been through medical school, they're like, then that's pretty late.
• 8:23
  SPEAKER_02: Right for a very competitive specialty, right?
• 8:26
  SPEAKER_02: So, so so my advice is just work hard until you find what you want to do, you know, because I was set up because I'd worked hard.
• 8:35
  SPEAKER_02: Sure, you know, yes, um, but I saw mastectomy, and then um the surgical oncologists were like, we're done for the day.
• 8:43
  SPEAKER_02: And the plastic surgeons came in the room, and they just were like, Hey, you want to hold hook for us?
• 8:48
  SPEAKER_02: Hold a retractor, do you want to stick around and help us?
• 8:51
  SPEAKER_02: And I was I said, Of course.
• 8:52
  SPEAKER_02: I was, what is this about?
• 8:54
  SPEAKER_02: Yeah, yeah.
• 8:54
  SPEAKER_02: And I saw a version, the old school version of a deep flap that day.
• 8:59
  SPEAKER_02: And it was like the you know, the C's parted, and I just had to do that thing.
• 9:07
  SPEAKER_02: And it was just so very clear.
• 9:09
  SPEAKER_02: So I didn't have this sort of like rational decision-making algorithm for getting to plastic surgery.
• 9:15
  SPEAKER_02: Like so many things in my life, I knew it and I did it.
• 9:19
  SPEAKER_02: I knew it that day, and I just said, that's what I'm gonna do.
• 9:23
  SPEAKER_02: And you know, I called my dad and I said, I'm gonna do plastic surgery, and he said no, ma'am.
• 9:30
  SPEAKER_02: Why did he say no?
• 9:32
  SPEAKER_02: This is the second time in my life where he'd done something like that.
• 9:34
  SPEAKER_02: Because when I was in at Princeton, and dad did not have he was not able to go to college right away.
• 9:40
  SPEAKER_02: He had to he drove a garbage truck for the city of Atlanta and he took yearbook pictures.
• 9:44
  SPEAKER_02: He didn't have a dad, and he had the gift of being able to go to college given to him several years after he had graduated high school when someone, a distant relative, died and gave him money.
• 9:54
  SPEAKER_02: So so he told us as kids, we love, I love Georgia where we grew up, but you have to leave.
• 10:01
  SPEAKER_02: You have to leave and you can bring something back.
• 10:03
  SPEAKER_02: Okay, but you have to leave.
• 10:04
  SPEAKER_02: You have to see a little bit of something outside.
• 10:06
  SPEAKER_02: Yeah, and he he paid for all of his kids to go to college.
• 10:10
  SPEAKER_02: Like that was a big deal for him, right?
• 10:13
  SPEAKER_02: So I'm in Princeton and I call him up my sophomore year, and I went to Princeton having watched this great documentary called And the Band Played On, which everyone should watch, about HIV.
• 10:23
  SPEAKER_02: It's like, I mean, it really, as a child, really landed with me.
• 10:26
  SPEAKER_02: It's great.
• 10:28
  SPEAKER_02: Um, and I was like, I'm gonna do molecular biology and immunology, and I chose a program because my brother was there and because of molecular biology.
• 10:35
  SPEAKER_02: But I called my dad and I said, Dad, you know, I'm thinking, I'm thinking I want to do art history.
• 10:42
  SPEAKER_02: Was that a no ma'am?
• 10:44
  SPEAKER_02: He what this is what happened.
• 10:45
  SPEAKER_02: That was Thursday.
• 10:46
  SPEAKER_02: And my dad was in clinic, right?
• 10:48
  SPEAKER_02: He has his own practice, and on Friday afternoon, somebody knocked on my door.
• 10:53
  SPEAKER_02: In Princeton.
• 10:54
  SPEAKER_02: In Princeton.
• 10:55
  SPEAKER_02: Okay.
• 10:55
  SPEAKER_02: And he had closed his clinic and driven up I 95, 12 hours, to have this conversation with me in person, where he said, We are not that kind of people.
• 11:06
  SPEAKER_02: Wow.
• 11:07
  SPEAKER_02: I have I will put you through school and you will have a, what did he say?
• 11:11
  SPEAKER_02: Um, it was like a marketable skill.
• 11:16
  SPEAKER_02: You must have a marketable skill.
• 11:18
  SPEAKER_02: And he said, I don't think you're gonna get married.
• 11:20
  SPEAKER_02: I need you to be independent enough to provide for yourself.
• 11:24
  SPEAKER_02: And I'm we're not sacrificing all this for art history.
• 11:26
  SPEAKER_01: He's like, you can minor all you want, but you will be doing all the sense in the world from where he came from, right?
• 11:34
  SPEAKER_02: A thousand percent.
• 11:35
  SPEAKER_02: And I and I so value him.
• 11:36
  SPEAKER_02: I mean, he's just very consistently about hard work.
• 11:39
  SPEAKER_02: And you can fit the fun in, but you do your thing.
• 11:42
  SPEAKER_02: Sure.
• 11:42
  SPEAKER_02: And so that me too.
• 11:43
  SPEAKER_02: I'm like, I fit all the other stuff in, but I'm always doing the job.
• 11:46
  SPEAKER_02: Yeah, right, super dependable.
• 11:48
  SPEAKER_02: Um, and so yeah, in medical school, he said no, ma'am, when I said up plastic surgery.
• 11:53
  SPEAKER_02: And then I explained to him what I'd seen, the mastectomy.
• 11:56
  SPEAKER_02: And he was thinking, like, you know, cosmetic surgery.
• 11:58
  SPEAKER_02: And he was like, it's just not.
• 12:00
  SPEAKER_02: He he literally said to me, You're you are worth more than that.
• 12:03
  SPEAKER_02: And and I'm not, that is what my dad said to me.
• 12:05
  SPEAKER_02: Right.
• 12:06
  SPEAKER_02: That's a fact.
• 12:07
  SPEAKER_02: And I knew what he meant.
• 12:10
  SPEAKER_02: And I knew what I that I was supposed to do it, like that the universe was telling me that I needed to be a plastic surgeon, and now I know why.
• 12:17
  SPEAKER_02: Yeah.
• 12:17
  SPEAKER_02: Right?
• 12:18
  SPEAKER_02: But um he listened and he's like, Okay, I understand.
• 12:21
  SPEAKER_02: I trust you.
• 12:23
  SPEAKER_02: And um, and now he's like super proud.
• 12:26
  SPEAKER_01: Of course.
• 12:26
  SPEAKER_01: But yeah.
• 12:28
  SPEAKER_01: Wow.
• 12:28
  SPEAKER_01: So now you're a plastic surgeon, and you and I see patients both at the beginning of their journey, um, as they're finding out about the diagnosis, understanding the options, and then um you carry actually a longer relationship because frequently your reconstruction happens after the rest of the treatments are are done.
• 12:48
  SPEAKER_01: But I'm I'm super curious.
• 12:50
  SPEAKER_01: Um, when a patient comes to you at the beginning and they're overwhelmed, they just got this diagnosis.
• 12:56
  SPEAKER_01: All these options, do I have a lumbectomy, do I have a mastectomy, do I have a bilateral mastoctomy, do I get reconstruction, do I not?
• 13:03
  SPEAKER_01: How do you help them think through the trade-offs of each of those options?
• 13:09
  SPEAKER_01: Because there are there's financial trade-offs, which is sad reality.
• 13:14
  SPEAKER_01: There's time, there's how much time till they're done with treatments, there's body image, there's thinking about risk, like how do you help them come uh to clarity about what matters most to them in in thinking through these treatments?
• 13:30
  SPEAKER_02: I I think I just listen a lot, and every patient's different.
• 13:35
  SPEAKER_02: And I try to slow it down and not get too far ahead.
• 13:40
  SPEAKER_02: Right.
• 13:40
  SPEAKER_02: So I often say, like, what are our priorities?
• 13:44
  SPEAKER_02: You know, and you know, cancer treatment number one.
• 13:48
  SPEAKER_02: And I reassure them that I'm able to do reconstruction in a way that prioritizes cancer treatment, and it doesn't mean that they have to know everything right now.
• 13:55
  SPEAKER_02: Like I talk about a way of doing it where they can change course later, they can make a decision that sets up the framework for reconstruction and preserves options for later.
• 14:05
  SPEAKER_02: So it's not such a pressured decision.
• 14:08
  SPEAKER_02: Um and I see so many pressured decisions, right?
• 14:12
  SPEAKER_02: I am not a salesman for surgery, and I will take all the time in the world, right, to get to what feels right for that patient.
• 14:23
  SPEAKER_02: And and I think it is really listening.
• 14:25
  SPEAKER_02: I think that the answer is in the patient.
• 14:27
  SPEAKER_02: I need to give them enough information so that they can start to go, like, okay, well, my priority is getting back to my life sooner.
• 14:34
  SPEAKER_02: Right.
• 14:34
  SPEAKER_02: Okay, got it.
• 14:35
  SPEAKER_02: Well, then is let's and then every time we talk, we say, is that still the priority?
• 14:39
  SPEAKER_02: You know, okay, well, it's maybe it's tissue expander implant reconstruction, or maybe it's flat closure.
• 14:44
  SPEAKER_02: Right?
• 14:45
  SPEAKER_02: Like you there's so many ways to find yourself in such a dark time by making choices that reflect your your your priorities.
• 14:56
  SPEAKER_01: And sometimes they make choices, patients make choices reflecting their fears, and then as they get further along, get more clarity on their priorities.
• 15:05
  SPEAKER_01: Yeah, and that's valid.
• 15:06
  SPEAKER_01: It's it's totally valid.
• 15:07
  SPEAKER_01: I mean it's cancer.
• 15:08
  SPEAKER_01: And yes.
• 15:09
  SPEAKER_01: And when you're in that moment of like, I just want to live.
• 15:14
  SPEAKER_01: Right, and I get it.
• 15:15
  SPEAKER_01: And that's um it's hard to see beyond that.
• 15:17
  SPEAKER_01: And even though you and I see like there's a great chance that you're gonna live for the rest of your life without this coming back.
• 15:25
  SPEAKER_02: Yeah.
• 15:25
  SPEAKER_01: But it's hard to see, it's hard to help someone see that longer term view sometimes.
• 15:30
  SPEAKER_02: I also think people bring such different perspectives.
• 15:34
  SPEAKER_02: So I listen to the words they're saying.
• 15:36
  SPEAKER_02: Some people are like, you know, I I really need to start restricted construction right now because I can't imagine not really going after it right now.
• 15:44
  SPEAKER_02: And I hear them saying that's really important to them.
• 15:46
  SPEAKER_02: And some people say, this just isn't that important to me.
• 15:48
  SPEAKER_02: This feels like, you know, like I shouldn't be worried about this right now.
• 15:52
  SPEAKER_02: I don't want to be thinking about it.
• 15:54
  SPEAKER_02: Um, so I I think everybody is different, and I try to take my cues from the patient.
• 16:02
  SPEAKER_01: Yeah.
• 16:04
  SPEAKER_01: Do you have a have you had experiences where the patient and the family have sort of differing kind of perspectives about what to do or what might be done, and how do you help navigate that situation?
• 16:17
  SPEAKER_02: I would say two kind of perspectives, two instances in general come to mind.
• 16:22
  SPEAKER_02: One is, so we're talking about breasts, and a lot of people come in with their partner.
• 16:28
  SPEAKER_02: And um, some partners are supportive and some aren't.
• 16:32
  SPEAKER_02: And uh, you know, having done this for 14 years, I've kind of seen that dynamic, and I try really hard to navigate that thoughtfully, but really clearly on the side of the patient, and to step in when I need to step in.
• 16:45
  SPEAKER_02: But I've had patients' partners say what they want in a breast reconstruction, and I just I just stop that.
• 16:54
  SPEAKER_02: Like you're not my patient, right?
• 16:57
  SPEAKER_02: You're I really want you to be a part of the support system here, but you know, perhaps we need to step out of the room for a while, right?
• 17:05
  SPEAKER_02: I've seen really hard pressures applied to women facing mastectomy by their partners and blatantly, right?
• 17:14
  SPEAKER_02: Yeah I've also seen amazing support, like the most beautiful statements of like, I just want you to be healthy and like your spirit is all I'm you know, like your I will love you and we will have an an amazing sex life regardless of all the things.
• 17:29
  SPEAKER_02: Like I see all of it, but I'd I would say that the the dynamic of the partner who is worried about how they are going to process having having a change to that appearance.
• 17:45
  SPEAKER_02: Yeah, yeah.
• 17:46
  SPEAKER_02: And then I would say the other thing is like the the children of an older patient, you know, that's always a delicate situation.
• 17:58
  SPEAKER_02: Um, because age is just a number.
• 18:01
  unknown: Yeah.
• 18:01
  SPEAKER_02: And this is about quality of life.
• 18:03
  SPEAKER_02: And some people are identity.
• 18:04
  SPEAKER_02: Totally.
• 18:05
  SPEAKER_02: And some some people are 70 and they really want, you know, to go off completely after breast reconstruction.
• 18:11
  SPEAKER_02: And if it's medically safe, I mean, I think it's a re I I do that often.
• 18:16
  SPEAKER_02: And I see some children coming in, adult children, you know, wanting their parents to do as little as possible.
• 18:23
  SPEAKER_02: And and so I just think again it's important, it's important that you know who your patient is.
• 18:31
  SPEAKER_01: Yes.
• 18:32
  SPEAKER_01: Yes.
• 18:33
  SPEAKER_02: I that is my patient is that woman who's 75.
• 18:39
  SPEAKER_02: And she values the opinion of her children.
• 18:42
  SPEAKER_02: And so I'm approaching this conversation to help her like weigh that valuable opinion, but she is my patient.
• 18:53
  SPEAKER_00: Yes.
• 18:53
  SPEAKER_02: Yeah.
• 18:54
  SPEAKER_02: So I often find that women, and I I just love women.
• 18:58
  SPEAKER_02: I just I love taking care of women, I love, I love women finding their strength as they go through their life.
• 19:03
  SPEAKER_02: I love that, you know, you don't peek at 25 and like you can be just constantly improving and feeling more like yourself.
• 19:10
  SPEAKER_02: And I love that even through the hardest times that I see women find strength they didn't know they had.
• 19:16
  SPEAKER_02: And I mean that in the most real sense.
• 19:20
  SPEAKER_02: They often tell me, I had no idea I would feel okay again.
• 19:25
  SPEAKER_02: I had no idea I was this strong.
• 19:27
  SPEAKER_02: Like I can do anything.
• 19:28
  SPEAKER_02: And some women, you know, make huge life changes after going through breast cancer and reconstruction.
• 19:33
  SPEAKER_02: And it's it's all just like it's so beautiful.
• 19:38
  SPEAKER_02: It's so, it's just life lifing, you know.
• 19:42
  SPEAKER_01: Yeah.
• 19:43
  SPEAKER_01: Yeah, that through something so hard, so scary in the moment that just like I didn't think I could get through this day, and then they do.
• 19:51
  SPEAKER_01: And then you get through another day, and then you start to build this sense of like I can do hard things that I can.
• 19:56
  SPEAKER_01: Yeah, just one day at a time.
• 19:57
  SPEAKER_02: And the anxiety of it is often worse than the doing of it.
• 20:00
  SPEAKER_02: And so it's just like I'm here and I'm gonna help you do this next thing.
• 20:03
  SPEAKER_02: So just we'll do this next thing together, and then check in and go, look what you did.
• 20:08
  SPEAKER_03: Yeah.
• 20:08
  SPEAKER_02: And yeah.
• 20:10
  SPEAKER_01: Do you do you find there's any common either misperceptions or or uh uh misunderstandings that you would want someone watching this podcast who maybe doesn't get to come and see you to to think about with breast reconstruction, something that you find you uh uh talk over with patients that makes a difference in how they're thinking about it?
• 20:32
  SPEAKER_02: Yeah, I would say, you know, that you should feel good with your reconstruction team.
• 20:40
  SPEAKER_02: You should feel good with the plan.
• 20:42
  SPEAKER_02: You shouldn't feel like you're being forced into a certain kind of a pathway.
• 20:46
  SPEAKER_02: And I think broadly around the United States, um implant-based reconstruction is certainly the most common and most available type of reconstruction, and that a lot of women aren't counseled about other options, either flat closure or using their own tissue.
• 21:02
  SPEAKER_02: Um so I would just say that if you're in front of somebody talking and you're talking about breast reconstruction, ask what they do, what types of breast reconstruction they do.
• 21:13
  SPEAKER_02: And if they don't do the type of reconstruction you're interested in, ask who they would refer you to to discuss that with an expert.
• 21:20
  SPEAKER_02: Right?
• 21:20
  SPEAKER_02: I think it's really important to have that conversation with someone who does it all the time because the biases are real and this is your body.
• 21:29
  SPEAKER_01: Sure, right.
• 21:30
  SPEAKER_02: If all I have is a hammer, then it's a nail.
• 21:33
  SPEAKER_02: And people will say to me, like, oh, you just do flaps, that's all you do.
• 21:36
  SPEAKER_02: And it's not actually.
• 21:37
  SPEAKER_02: I'm like 50-50.
• 21:38
  SPEAKER_02: I do 500 surgeries a year.
• 21:40
  SPEAKER_02: I just do a ton of flaps because I'm really good at it, and there's not that many people out there doing it through insurance.
• 21:46
  SPEAKER_02: But I'm just trying to do the right thing for the patient in front of me.
• 21:49
  SPEAKER_02: Sure.
• 21:49
  SPEAKER_02: So I think that being able to ask for that second opinion, ask specifically about what the doctor in front of you actually does, like what are they good at?
• 21:58
  SPEAKER_01: That that's hard for me.
• 22:00
  SPEAKER_01: For a lot of patients to do to question their doctor.
• 22:02
  SPEAKER_02: Yeah, we have to do that though.
• 22:04
  SPEAKER_02: I mean, I do that with my doctors and with my parents' doctors.
• 22:07
  SPEAKER_01: Bring someone in the room who is willing to ask that question, right?
• 22:09
  SPEAKER_01: If you're like it's always better, I think, when patients come in with a with a support person.
• 22:14
  SPEAKER_01: Totally.
• 22:14
  SPEAKER_02: Yeah.
• 22:15
  SPEAKER_02: Yeah, but just expect maybe also expect it to go well.
• 22:18
  SPEAKER_02: And then maybe be a little surprised when they don't take it well and be like, oh, I didn't I thought that you'd be okay with that.
• 22:22
  SPEAKER_02: I mean, I'm just saying, like, there are ways to hack being a patient.
• 22:25
  SPEAKER_01: Sure.
• 22:26
  SPEAKER_02: And expecting your doctors to show up for you and be adults is, you know, one of them.
• 22:31
  SPEAKER_01: And the doctor should be should be discussing all the options, not just saying, here, here's what you should do.
• 22:37
  SPEAKER_02: It's so plastic surgery is so funny because there are like a lot of options.
• 22:44
  SPEAKER_02: But you can't undo a surgery.
• 22:46
  SPEAKER_02: Right, for sure.
• 22:48
  SPEAKER_02: Right?
• 22:48
  SPEAKER_02: And there are pressures, there's a lot of pressures applied to the system that drive people towards performing a surgery or receiving a surgery.
• 22:57
  SPEAKER_02: And so just acknowledging that the geographic differences in the training, the reimbursement differences, like just I think it's better to be honest about it, to recognize that there are forces out there, and to really see, am I being offered everything?
• 23:11
  SPEAKER_02: And if I'm not, then do a virtual visit with somebody, you know, explore your options.
• 23:17
  SPEAKER_02: Yeah.
• 23:17
  SPEAKER_01: Well, thank you.
• 23:18
  SPEAKER_01: Yeah.
• 23:19
  SPEAKER_01: Um in your walk with all of these patients with cancer diagnoses, you know, you've you've seen young women, old women, you've seen so many late diagnoses sometimes.
• 23:34
  SPEAKER_01: And um how is that through through that lens, how has that made you think differently about what matters most to you, like in or out of work?
• 23:44
  SPEAKER_02: Hmm.
• 23:45
  SPEAKER_02: Seeing the different I would say that like a lot of people who work around cancer, that I just have a very the veil is thin.
• 23:57
  SPEAKER_02: I just think that, you know, life is fleeting and I want to live every day to its fullest.
• 24:03
  SPEAKER_02: And I out of out of the presence that I have with my patients, out of respect for them, out of the reality that I see around me, um, you know, I could be diagnosed with breast cancer tomorrow.
• 24:16
  SPEAKER_02: I think about that a lot.
• 24:17
  SPEAKER_02: Right.
• 24:17
  SPEAKER_02: And I think that when you're when you're we're around this all the time, we we dwell with that.
• 24:23
  SPEAKER_02: Um and I'm okay with it.
• 24:26
  SPEAKER_02: Like I literally, I'm okay with it.
• 24:29
  unknown: Yeah.
• 24:30
  SPEAKER_01: I try to do my best.
• 24:31
  SPEAKER_01: When you happen, it's gonna happen, and you just try to live today so that if it happened tomorrow, I I feel like I don't want to have regrets.
• 24:38
  SPEAKER_01: Right.
• 24:39
  SPEAKER_02: So I don't know that I'm that yeah, I am changed by by being around so many people facing cancer, but I'm also hopeful.
• 24:52
  SPEAKER_02: I'm also um committed to like it's not like a death sentence, right?
• 24:57
  SPEAKER_02: And so many, so many people feel like, oh, it would be no, it's not.
• 25:00
  SPEAKER_02: We can cure this.
• 25:01
  SPEAKER_02: Let's just get after it.
• 25:03
  SPEAKER_02: It's the being scared of it and the waiting that's the hard thing.
• 25:06
  SPEAKER_02: Um so I don't, I don't really, I think that sits with me.
• 25:11
  SPEAKER_02: I don't think about it a lot, but I think more about like the changes in me because of my patients are that's like advocacy.
• 25:19
  SPEAKER_02: Sure.
• 25:19
  SPEAKER_02: You know what I'm saying?
• 25:20
  SPEAKER_02: Like that's where I channel that.
• 25:22
  SPEAKER_02: Um, I'm like, we gotta fix the bigger picture.
• 25:24
  SPEAKER_02: Absolutely.
• 25:25
  SPEAKER_01: Yeah.
• 25:26
  SPEAKER_01: And and that's something that is so uniquely beautiful about you, is there's there's so many things to be mad about right now.
• 25:33
  SPEAKER_01: There's so many things that are that you can look at and just shake your fist or make some angry social media post.
• 25:40
  SPEAKER_01: You can be against things, but you are so uniquely for things.
• 25:44
  SPEAKER_01: Like you channel that energy into something constructive and and it's intentional.
• 25:49
  SPEAKER_02: Thank you for saying that.
• 25:50
  SPEAKER_02: I actually do think about that exact thing.
• 25:53
  SPEAKER_02: I I really am not interested in listening to people who are against things.
• 25:57
  SPEAKER_02: I almost I'm old enough where I like tune it out.
• 26:00
  SPEAKER_02: I want to know what you're for.
• 26:01
  SPEAKER_02: And if you don't know what you're for, I don't think you know who you are.
• 26:04
  SPEAKER_02: Yeah, and you may not even know what you're against.
• 26:06
  SPEAKER_02: Yeah.
• 26:07
  SPEAKER_02: So I'm like, what are you for?
• 26:08
  SPEAKER_02: Like, I'm for healthcare, right?
• 26:11
  SPEAKER_02: So it's not a partisan issue.
• 26:12
  SPEAKER_02: I'll sit down with anyone, I'll talk about it with anyone, Republican, Democrat, independent, whatever.
• 26:18
  SPEAKER_02: It's healthcare.
• 26:19
  SPEAKER_02: Yeah, I mean, so yeah, I think um we waste a lot of time um spinning our wheels with anger and fear and all the things.
• 26:29
  SPEAKER_02: And those are all valid responses to a lot of hard things that happen in life.
• 26:33
  SPEAKER_02: I get it, and I've been there.
• 26:35
  SPEAKER_02: But I at some point I thought this feels really bad.
• 26:40
  SPEAKER_02: Like healthcare feels really bad.
• 26:43
  SPEAKER_02: True.
• 26:45
  SPEAKER_02: And I can do something about that.
• 26:49
  SPEAKER_02: And I'm I'm going to, and I'm gonna that's gonna be part of me being a doctor.
• 26:54
  SPEAKER_02: And so it's every day, you know?
• 26:57
  SPEAKER_02: And it's not just me, it's my whole team.
• 26:59
  SPEAKER_02: Like every day they're like, what's up?
• 27:00
  SPEAKER_02: What's the new thing?
• 27:01
  SPEAKER_02: What's how's that bill going?
• 27:03
  SPEAKER_02: What are you, you know, it's part of taking care of our patients, is moving the needle.
• 27:07
  SPEAKER_02: So yeah.
• 27:12
  SPEAKER_01: Some of the things that you've done include advocacy and also you've you've built your own surgery center.
• 27:18
  SPEAKER_01: You you are showing like what it is that healthcare needs to be.
• 27:24
  SPEAKER_01: I think that's amazing.
• 27:26
  SPEAKER_01: Um, do you want to talk at all about how you do things at Red Bud?
• 27:30
  SPEAKER_01: Sure.
• 27:30
  SPEAKER_02: Yeah, I mean it's a, you know, again, I think, you know, it's about how I live my life.
• 27:38
  SPEAKER_02: And I want, if I'm if I say I'm about something, like look at how look at what I'm doing.
• 27:45
  SPEAKER_02: And if if my life doesn't look like I care about healthcare workers, then I probably don't.
• 27:52
  SPEAKER_02: Right?
• 27:53
  SPEAKER_02: But I really do.
• 27:54
  SPEAKER_02: And I really have built a place where people are valued and they're paid well and they're not overworked, and the staffing ratios are bonkers ridiculous in the other direction.
• 28:05
  SPEAKER_02: And we're so encouraging, and it's not a caste system.
• 28:09
  SPEAKER_02: And yeah, I just I'm proud of it.
• 28:12
  SPEAKER_02: I'm proud of making people feel good about their work and proud when they go home.
• 28:19
  SPEAKER_02: I'm proud that the their kids say, I want to be a doctor, and they know who Dr.
• 28:23
  SPEAKER_02: Potter is and they they love their moms.
• 28:25
  SPEAKER_02: I mean, I just all of it's really good.
• 28:27
  SPEAKER_02: Like you can create energy, good or bad.
• 28:31
  SPEAKER_02: And Red Bud is about, you know, when I open the practice, like the sort of like the clinic side of the practice, I really threw myself into doing that the best possible way, regardless of reimbursement and funding or whatever.
• 28:48
  SPEAKER_02: How do I want to treat every patient?
• 28:51
  SPEAKER_02: And from the get-go, that's what we have done.
• 28:53
  SPEAKER_02: And that whole team is set up to just care for the patient and do whatever they need.
• 29:01
  SPEAKER_02: Like, we'll we'll have we're so good at that.
• 29:04
  SPEAKER_02: We'll have a patient call us from another doctor's office and say, my ride was canceled.
• 29:09
  SPEAKER_02: And my team will get them a ride.
• 29:13
  SPEAKER_02: Because we are about the patient.
• 29:15
  SPEAKER_02: And they that's they received the message.
• 29:18
  SPEAKER_02: And when I hear that, and my team is like, guess what we did?
• 29:21
  SPEAKER_02: And they're so proud.
• 29:22
  SPEAKER_02: And I'm like, you go.
• 29:23
  SPEAKER_02: Those are the stories that you tell yourself.
• 29:25
  SPEAKER_02: Exactly.
• 29:26
  SPEAKER_02: That's the culture, that's the myth.
• 29:28
  SPEAKER_02: The myth is like throw it at us, watch us, and then we're gonna be like, We're the team who'll get your ride to and from your radiation oncology appointment when they won't.
• 29:38
  SPEAKER_02: And also, they won't.
• 29:40
  SPEAKER_02: And I'm not afraid to say that either.
• 29:42
  SPEAKER_02: Right?
• 29:42
  SPEAKER_02: And I'll call them up and be like, hey, why was I the one?
• 29:46
  SPEAKER_02: Right, yeah, with your big fancy office.
• 29:49
  SPEAKER_02: Why am I the one?
• 29:51
  SPEAKER_02: So, yeah.
• 29:53
  SPEAKER_02: So I wanted it to be great like that, but I knew that I could build something better myself and control the things, and that the people who work there would be happier and the outcomes would be better.
• 30:07
  SPEAKER_02: Um, and so I did that.
• 30:09
  SPEAKER_02: I just said, I can do this too.
• 30:12
  SPEAKER_02: And it's really important, it's really important to protect that that spark that doctors have.
• 30:21
  SPEAKER_02: The spark to do the right thing.
• 30:25
  SPEAKER_02: And to like, when the wind is blowing, to like put your hand around that flame and protect that thing.
• 30:31
  SPEAKER_02: And that's the spark that made me build Red Bud.
• 30:34
  SPEAKER_02: I can I can build something small and better, and I can tell a story about that.
• 30:38
  SPEAKER_02: And so it really has been about protecting that spark.
• 30:44
  SPEAKER_02: And that's so important because you have like children like who want to say, I want to be like Dr.
• 30:49
  SPEAKER_02: Potter, and then they go to school and they work an author, they do all these hard things, and they're thinking, I'm gonna just take care of people, I'm gonna do the right thing.
• 30:55
  SPEAKER_02: And then they need this system with just kind of like sometimes crushing that that spirit, right?
• 31:06
  SPEAKER_02: So for me, preserving options for independent doctors and options to have different kinds of environments is so important because we need to protect the heart of medicine, the heart of health care, ethic care.
• 31:24
  SPEAKER_02: Yeah, it's not a business.
• 31:27
  SPEAKER_02: It really is it's about how you treat the human being next to you.
• 31:34
  SPEAKER_02: You know?
• 31:35
  SPEAKER_02: Yeah.
• 31:36
  SPEAKER_00: And to keep your spark going, what what are the things that you do that allow you to be this powerhouse of just amazing patient care, but also systemic change?
• 31:48
  SPEAKER_02: Well, I mean, so you know me.
• 31:49
  SPEAKER_02: And um dogs.
• 31:52
  SPEAKER_02: I mean, I'm really connected to to animals.
• 31:58
  SPEAKER_02: And um, and I think like just energy in general and honesty, and I think that if you I think everyone should rescue a dog, I'm serious, and your life will have purpose immediately.
• 32:14
  unknown: Yeah.
• 32:14
  SPEAKER_01: I will I will commit to rescuing my next dog not from a breeder.
• 32:19
  SPEAKER_02: But I just dogs don't change changed my life too.
• 32:23
  SPEAKER_02: Right, and just you know, even when I see even like a young person who's going through a hard time sit down and pet a dog in my house in my home or something, it's like you see their blood pressure go down and you see them realize what's real and they're loved and valued.
• 32:40
  SPEAKER_02: So every I have right now four dogs, about to have five.
• 32:44
  SPEAKER_02: And um when I yeah, that's the story.
• 32:48
  SPEAKER_02: When I every day I get that, and it's they don't think I'm Dr.
• 32:53
  SPEAKER_02: Potter, they just think I'm that lady, you know, and they're like, are you doing the things you said you'd do for me?
• 32:58
  SPEAKER_02: And I'm gonna love you.
• 32:59
  SPEAKER_02: And so I would say dogs exercise.
• 33:01
  SPEAKER_02: I work out a lot and I love it.
• 33:03
  SPEAKER_02: And it's not just to for like physical health, it's I like who I am, I like showing myself who I am.
• 33:12
  SPEAKER_02: Um, I like growing and challenging myself and um I try to get good sleep.
• 33:21
  SPEAKER_02: Um, and I try to be honest with myself.
• 33:23
  SPEAKER_02: I try to be honest and um and take the take what the time that I need in the way that I need.
• 33:35
  SPEAKER_02: I am a hermit.
• 33:37
  SPEAKER_02: Yeah, right?
• 33:38
  SPEAKER_02: Yes.
• 33:38
  SPEAKER_02: And that's okay.
• 33:39
  SPEAKER_02: Yes.
• 33:40
  SPEAKER_02: Right?
• 33:40
  SPEAKER_02: And and it's I can for all of those for anyone out there who is the person that you know needs more time to recharge, it's okay if that's you.
• 33:51
  SPEAKER_02: That's me, but look how much I do.
• 33:53
  SPEAKER_02: Right?
• 33:54
  SPEAKER_02: Right?
• 33:54
  SPEAKER_02: Yes, they're related.
• 33:55
  SPEAKER_01: If you don't give yourself that time, then it's eventually it catches up, and you can't be the person having all this impact.
• 34:03
  SPEAKER_02: Yeah, and that's when I listen.
• 34:06
  SPEAKER_02: That's when I I hear myself, you know?
• 34:09
  SPEAKER_02: I need to hear myself.
• 34:10
  SPEAKER_02: When you when it's quiet, yeah.
• 34:12
  SPEAKER_01: It's really powerful.
• 34:13
  SPEAKER_01: That can be a whole episode in itself.
• 34:15
  SPEAKER_01: And if you can't be quiet with your own thoughts, if you have to have distractions because you can't be present with your own thoughts, I think that's I think it means you got some work to do.
• 34:25
  SPEAKER_02: But also, like, I'm I didn't know what it was.
• 34:29
  SPEAKER_02: When I was a kid, I thought I heard the phrase the life of the mind.
• 34:32
  SPEAKER_02: And I what I heard was that I could see my own thoughts.
• 34:37
  SPEAKER_02: Like I have always been able to reflect on my thoughts, and that is a really valuable thing for every day for me to like step back and think about my patterns of thinking and what I'm doing and take stock.
• 34:55
  SPEAKER_02: It's very meta, but it's really core to who I am, and I can only do that on my own when you're quiet.
• 35:05
  SPEAKER_01: Yeah, yeah, that might be analogy that I've heard is like you're you're on the dance floor, you know, when you're like doing the thing, and then sometimes you have to get up on the balcony.
• 35:14
  SPEAKER_01: Right.
• 35:14
  SPEAKER_01: Yeah, and kind of look around and and take stock.
• 35:17
  SPEAKER_01: Yeah.
• 35:19
  SPEAKER_01: Um, well, I could literally talk to you forever about totally things, but um, I do want to give you a chance to ask me a question.
• 35:27
  SPEAKER_02: I had so my question for you is where will you be in five years?
• 35:32
  SPEAKER_01: Oh, that's such a hard question.
• 35:34
  SPEAKER_01: I know it is right now.
• 35:35
  SPEAKER_02: I know.
• 35:36
  SPEAKER_02: And I want an actual answer.
• 35:38
  SPEAKER_01: An actual answer.
• 35:40
  SPEAKER_01: I I don't have a lot of clarity in that.
• 35:43
  SPEAKER_01: There's a lot of things changing right now in Austin, and I hope that in five years I will be part of a powerful, unique, meaningful, patient-centered oncology practice where I'm able to deliver excellent care, the kind I would want my family members to get.
• 36:03
  SPEAKER_01: And I hope that in the next five years I get to be a part of building that in a meaningful way.
• 36:09
  SPEAKER_01: Um I am navigating my parents who live in Austin, their health care.
• 36:15
  SPEAKER_01: Now one of my children is having medical issues, and I feel the pain of the patient experience, even as somebody who's so on the inside that I have doctors' cell phone numbers, and it's still incredibly hard to be a patient in that system you described that is literally not designed for the patient's experience.
• 36:38
  SPEAKER_01: It's designed for throughput for other things that that could be another episode.
• 36:44
  SPEAKER_01: So I hope to be practicing in a model that makes me proud to come to work every day.
• 36:52
  SPEAKER_01: And and to also have been part of building that and the educational system around it so that our bright-eyed, excited students who come into that system don't get crushed.
• 37:06
  SPEAKER_01: They see an example of how they want to practice and and can be a part of that.
• 37:11
  SPEAKER_02: I think that you even just having these conversations with people, you're doing that.
• 37:16
  SPEAKER_02: And I would really lean into having the conversations because what I have found is that we know things that other people don't know.
• 37:24
  SPEAKER_02: And bringing them to light and letting other people who aren't on the inside of healthcare hear about them, even when it feels like I'm just talking about a problem, you're not.
• 37:35
  SPEAKER_02: You're giving information that helps people make change.
• 37:38
  SPEAKER_02: And so I would say really lean into the these conversations.
• 37:43
  SPEAKER_02: And I yeah, the universe is at your back.
• 37:49
  SPEAKER_02: And my hope for you is that you feel even closer to your purpose, whatever that is.
• 37:56
  SPEAKER_01: Yeah.
• 37:56
  SPEAKER_01: This podcast has certainly uh brought me closer to that, to being able to put out into the universe a message of hope, of again, paying attention to what you're for, not your what you're against.
• 38:10
  SPEAKER_02: Um that's so you're so good at it.
• 38:13
  SPEAKER_02: And having known you for a long time, it feels like you're supposed to be doing this.
• 38:17
  SPEAKER_01: Well, thank you.
• 38:18
  SPEAKER_01: Yeah, I appreciate that so much.
• 38:19
  SPEAKER_02: It's the honest truth.
• 38:20
  SPEAKER_02: Um I I can't not be honest.
• 38:23
  SPEAKER_02: That's all so you can't not work hard.
• 38:26
  SPEAKER_02: I can't be honest.
• 38:27
  SPEAKER_02: Yeah, I wouldn't tell you, but I think like I feel the energy of that.
• 38:30
  unknown: Thank you.
• 38:31
  SPEAKER_02: You're where you should be.
• 38:32
  SPEAKER_01: All right.
• 38:32
  SPEAKER_01: Well, it has been a pleasure talking to you here on Just Cut It Out, and I look forward to hearing the story of the fifth dog.
• 38:39
  SPEAKER_01: I'm sure it's a good one.
• 38:40
  SPEAKER_01: Um, thank you very much for joining us for today's episode of Just Cut It Out.