THE BEST MEDICINE: Survivor: Lillie Shockney offers breast cancer patients understanding and humor: She knows firsthand what they are going through.


Early Monday morning, Lillie Shockney bustles around the outpatient clinic of the Johns Hopkins Breast Center, signing up colleagues to enter the Susan G. Komen Race for the Cure for Breast Cancer.

It's the start of a typical 18-hour day for the center's 45-year-old director of education and outreach, a day of juggling media interviews and departmental matters, of hearing about new types of breast prostheses, of agreeing to give lectures that will pour money into breast cancer support groups, of comforting an elderly woman before and after her mastectomy.

But first, before she has time to clear her voice mail, Shockney will meet a family that has flown to Baltimore from Texas. They are in a state of shock, the shock that comes from discovering your healthy 37-year-old wife -- or your healthy 37-year-old daughter -- has advanced breast cancer.

The group awaits Shockney at the center's reception desk. The patient, her husband, parents and best friend all wear the dazed, no-sleep look of refugees who just lost their world to a flash flood and don't know what to do next. They gaze hopefully at Shockney, a small, sturdy, ginger-haired woman, their tired eyes begging her to tell them this is all a big mistake.

Instead, Shockney says they have come to the best possible place for answers. She tells them a loving family support system is crucial to surviving this disease.

She is here to remind the newly diagnosed that their glass is far from empty. As a nurse and patient advocate, Shockney knows what people need to fortify themselves as they prepare to meet the challenges of this disease. As a breast cancer survivor, she knows what it means to discuss your worst nightmare with a doctor you may have never met.

She's adept at finding humor in surreal situations, the ironic, eye-opening humor of been-there survivors.

"You could say that I live and breathe breast cancer," Lillie Shockney says.

October is Breast Cancer Awareness Month, and Shockney feels like Santa Claus on the day after Thanksgiving. There's so much to do: the Race for the Cure -- she and her elves have gathered 900 Hopkins participants -- out-of-town speaking engagements, the first Breast Fest fund-raiser in Canton, a talk about surviving breast cancer with humor at A Woman's Journey, the annual Hopkins-sponsored health symposium on Oct 23.

And there's also her birthday: Shockney is thrilled to be turning 46.

"Last week, a woman said to me, 'I can't imagine getting up each morning, looking down and seeing that my breast is gone.'

"I told her, 'I don't. I get up each morning and see the cancer's gone.' "

Shockney calls herself "a poster child for mammography." Seven years ago, a mammogram revealed a tumor in her left breast that proved to be cancerous. When she read the pathology report on her computer at Hopkins -- she pulled up the results before her physician had a chance to tell her -- she fell right into the abyss of the newly diagnosed: Would she live? Would she lose her breast? What about her sexual desirability? The slightest ache or pain became a potential death threat.

A year after her first mastectomy, Shockney underwent a lumpectomy on her right breast for a benign tumor. Ten months later, when another mammogram revealed precancerous growths, she opted for a second mastectomy.

This time, however, things were different. She had gained hope and confidence from the abundant love of family and friends. And she possessed the sense of humor that could help keep demons at bay. A serious, bookwormish child who grew up on a dairy farm on the Eastern Shore, Shockney says she discovered the potential of laughter in a conversation with her then-11-year-old daughter about her first mastectomy.

"Laura said, 'Will the doctor let you bring your breast home to keep, because, after all, it isn't his, it's yours,' " Shockney chuckles. "She said, 'You can put it downstairs on the mantel in Daddy's pickle jar, and when you're sad, you can go down and look at it.' "

"I told her 'I think I'd feel better if I could leave it at the hospital. Maybe the doctors could do research on it which would prevent someone else's mommy from having to have the same surgery.'

"Laura accepted that. Then she asked, 'Will the doctor take your right breast and move it to the middle?' I said, 'Why do you think he'd do that?' She said, 'Because if he doesn't, Mommy, you're going to lean when you walk.' I was a 44-D. I said, 'I'm going to wear a breast prosthesis.' And I showed her what that looked like and told her a mastectomy bra would hold it in place because it had a pocket in it.

"She said, 'I think having a bra with a pocket in it is a very clever thing. You always worry when you go to the ATM machine that somebody is going to steal your money, you could put it in your pocket and nobody could get it.'

"Out of total innocence, Laura asked the most hysterical things. And I realized that I had only been thinking negative thoughts. I'd forgotten that humor can build the immune system. I told my husband, Al, 'Let's make a commitment that every day for the rest of our lives, no matter what, we will find something funny about the fact I've been diagnosed with breast cancer.'

"And we still do."

Her public lectures and book, "Breast Cancer Survivors' Club: A Nurse's Experience" (Windsor House, $10.95), brim with humorous suggestions about coping with and overcoming such painfully awkward situations as selecting a breast prosthesis.

"I figured getting my prosthesis was like getting a puppy," Shockney says. "Since she was going to be my new bosom buddy, and I was going to take her everywhere, she needed a name. So we selected the name Betty Boob. I sent out adoption notices to my best friends. One sent a ceramic Christmas ornament in the shape of a baby bottle which says Betty Boob's First Xmas, 1992."

Her earthy humor resonates with those survivors who figure they've suffered their share of painful indignities. Laughing with Lillie Shockney is a life-enhancing form of defiance.

"Lillie lets you know that breast cancer is doable, that it's not a death sentence. That we are called breast cancer survivors for a reason," says Celeste Carr, a survivor volunteer at the Breast Center.

"She can read where each woman is coming from and behave accordingly," says Cindy Geoghegan, president of the Maryland Affiliate of the Komen Foundation and a breast cancer survivor. "She pulls what needs to be pulled out of each situation and brings in the right demeanor and vocabulary. She's very warm and will hug and touch, which is important because you can be so frightened.

"But she can also make you laugh."

It was one of the most memorable moments of her career: Working in Easton Memorial Hospital's recovery room for the first time, the young student nurse was taking the blood pressure of a woman who had just had a mastectomy when suddenly, the patient awoke.

"She said: 'Please, please tell me my breast isn't off! Please, please tell me he didn't take it off!' " Shockney remembers. "And I froze because he did take it off. I just stared at her and she stared at me. My silence told her it was gone. She started crying and I started crying. I had no idea how to console this woman."

It was the early 1970s, a time when most women entering the operating room for a biopsy did not know whether or not they would leave with two breasts. Shockney still shudders at the bleakness of facing surgery under such terms.

In her five years at the Breast Center, initially as a volunteer, Shockney has worked toward making the experience of losing a breast into a transformation of a new life without cancer. And she constantly seeks suggestions about how to make this process more dignifying and nurturing.

After Shockney rallied support for changing the type of anesthesia used in breast cancer operations, for instance, the Hopkins medical team was able to reduce post-surgery nausea from 85 percent of the women to less than 2 percent. Now, she's fond of saying that 92 percent of the patients having lumpectomy and mastectomy without reconstruction choose to go home straight from the recovery room. And that half of them go right out to dinner to celebrate their survivorship.

"Lillie is very helpful at keeping the medical staff focused on the patient's needs," says surgical oncologist William Dooley, medical director of the breast center. "We have dealt well with the big issues of survival: Probably 75 percent of the women who are diagnosed with breast cancer today will live out their lives and die of something else. But we have not done as well with the smaller issues [such as fatigue, weakness and other effects of chemotherapy]."

Before she falls into bed at 1 o'clock on Tuesday morning, Shockney will match up eight newly diagnosed women with survivor volunteers. She will call the family from Texas to learn how their day went. She will answer 58 e-mails: She and her mother, Charmayne Dierker, created the nation's first online support group for mothers whose daughters have breast cancer. In the past four years, they have helped more than 10,000 women.

But nothing that day has been more important than helping a recently widowed woman prepare for her mastectomy. As they wait together for the summons to the operating room, Shockney hugs the elderly woman. They make jokes about the hospital gown fashions, laugh about medications, talk about anything that can ward off apprehension.

Then Shockney takes the woman's hand and looks into her eyes as if they were the only two people in this hospital, the only two who know what it is to have breast cancer.

She whispers to her to have faith, to believe that her husband is watching over her.

The patient's expression changes. She knows he's there, she nods, her eyes filling, her voice trembling, yes, thank you. She knows he will be with her in the operating room during her surgery. She knows he will be in the recovery room after she wakes up.

So will Lillie Shockney.

Breast Cancer Awareness Month

October is Breast Cancer Awareness Month, and many events and efforts are in the works to help raise money to find a cure. Among them are:

* Maryland Race for the Cure, with two 5-kilometer run/walks and a 1-mile fun walk, takes place today at Rash Field in the Inner Harbor. More than 10,000 Maryland runners and walkers are expected to participate in the events, which raise money for breasst cancer research and education. The entry fee is $20 a person. Race number pickup and onsite registration start at 6:30 a.m.; the fun walk is at 8:30 a.m.; the 5K run/walk for women is at 8:40 a.m.; and the 5K run/walk for all is at 9:25 a.m. Race for the Cure is presented nationally by the Susan G. Komen Breast Cancer Foundation. Call: 410-433-RACE.

* The first-ever Breast Fest, to benefit the Johns Hopkins Breast Center, will take place Oct. 16 from 3 p.m. to 8 p.m. at the Gin Mill in the Canton area of East Baltimore. A celebration of life and a good-humored effort to promote breast cancer prevention and awareness, the event will feature food, drink and entertainment, including mwsic and door prizes. Tickets cost $25 in advance, $35 at the door. All proceeds from ticket sales and other event fund-raising will benefit patient care at the center. Call 410-356-8853.

* A kit containing everything needed to make a 9-inch, heart-shaped, handmade, pink-and-white gingham pillow is the latest Sew for the Cure project to raise money for breast cancer research and education programs. Sew for the Cure is a joint venture of the Home Sewing Association and the Komen foundation. The kit costs $9.95, plus shipping and handling, and can be ordered by calling 877-SEW-CURE or visiting the Home Sewing Association's Web site, Ninety-five percent of the proceeds will be donated to the American Cancer Society, the National Alliance of Breast Cancer Organizations and the Komen foundation.

* The American Physical Therapy Association is sponsoring the Walk for Hope Against Breast Cancer in 10 cities nationwide. The walks will raise money for the City of Hope National Medical Center and Beckman Research Institute, a comprehensive cancer center. For more information, call 800-266-7920 or visit the Web site.

Lillie Shockney : The voice of experience

* Once you've been diagnosed with breast cancer, your life is forever changed. It is up to you if it changes for the better.

* When I look down, I don't see that my breasts are gone, I see that the cancer is gone.

* My husband told me that the mission of the surgeon is to perform transformation surgery. My mastectomy transformed me from a victim into a survivor, so I'm exchanging my breasts for another chance at life -- a very fair trade.

* On the anniversary of your diagnosis or surgery or however you have chosen to mark the event of having been diagnosed with breast cancer, make it a point of celebrating. Consider it a new birthday. Your life has started anew. Acknowledge it, be thankful for it, experience the joy in it.

* This is not the time to keep your emotions bottled up. Share your feelings, no matter how scary they may seem, with your spouse, other family members or your best friend. Your immune system will benefit and thank you later for it.

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