Drawing on her own struggle with the emotional pain of a cancer diagnosis and treatment, Lee Miller empowers other patients to effectively communicate with their doctors.
Story by Jenny Song & photos by Michael Weschler
Before Lee Miller ever heard her doctor utter the dreaded words, “You have cancer,” he had taken note of the dimpling in her underarm and brusquely proclaimed, “My dear, I’m afraid you will need a radical mastectomy.”
“I didn’t know what radical meant. I thought it was a political party,” recalls Miller, who had gone to the doctor’s office to get a mammogram after finding a worrisome lump in her breast.
After her doctor condescendingly explained to her that she had breast cancer and would need to undergo surgery to remove her breast, Miller did what any normal person might do: She ran to the bathroom and cried. The year was 1975, when the word “cancer” was rarely mentioned in public and the disease was considered a death sentence.
“Women in the waiting room looked at me because they knew I had been given bad news,” recalls Miller, who was a 49-year-old guidance counselor at the time.
She had the radical mastectomy to remove her stage I breast cancer and was spared chemotherapy or radiation. Yet the details of the day she was diagnosed have stayed with Miller for more than 37 years. Not because her story is unique, but because she has come to realize that the insensitive way she learned about her life-changing diagnosis is all-too-common among patients.
Thinking back on her doctor’s unsympathetic tone and uncaring bedside manner, Miller, now 87, says: “That’s no way to tell a woman [she has cancer]. But that’s how I was told, and there are millions of other examples like mine.”
She would know. As one of the founding members of SHARE, a national nonprofit organization that offers peer support for women diagnosed with breast and ovarian cancers, Miller has heard countless stories similar to her own. Whether because they feel rushed or lack understanding, some doctors speak to their patients in ineffective or insensitive ways when discussing difficult subjects, says Miller, who is now the director of special projects at SHARE.
One woman she knows went to see her doctor after being diagnosed with breast cancer. She began to cry because her husband had recently died. But before the doctor even inquired why she was upset, he wrote out a prescription for an antidepressant. “The woman started to yell at him, saying, ‘What kind of understanding is that?’ and she left,” Miller says.
Not all patients are able to communicate with their physicians with such boldness, and so, in 1998, Miller decided to respond with boldness on their behalf, creating SHARE’s Side-by-Side program. The award-winning educational program, which utilizes a handful of volunteer cancer survivors, hosts interactive workshops for doctors, residents and medical students at teaching hospitals and medical schools in New York City. The goal? Helping young doctors understand what it’s like to be a patient—and improving and deepening the conversations with their future patients.
Sending the Right Message
Miller believes that patients can’t feel empowered to take an active role in their care unless they and their doctors are equipped to communicate effectively. Miller’s program also emphasizes to doctors the importance of emotionally supporting patients as they cope with a diagnosis of cancer, says Ivis Febus-Sampayo, the senior director of programs at SHARE.
Warm and approachable, Miller has worked hard to foster an environment where patients and doctors can learn from one another. “Lee brought the groups together and performed her magic,” says Christine Benjamin, the director of SHARE’s breast cancer program, “addressing difficult issues with an openness, kindness, truthfulness and humor.”
Miller has drawn on her traumatic experience as a patient to try to help others, says Richard Shapiro, a surgical oncologist at New York University Langone Medical Center. “She is able to see how doctors view patients through their own eyes and understands why we act and react the way we often do. And she is able to educate patients as to how to engage their physicians in a discussion about their care in an intelligent and nonconfrontational manner.”