Why Him, Why Now and Why Me
The surgeon who changed cancer care forever and why you've never heard of him
In God we trust. All others must bring data.
– Dr. Bernard Fisher
By now, breast cancer seems to be everywhere–in our family, friends, social media feeds, and even the freezer aisle. In fact, the pink ribbon is so ubiquitous that some use the term “pinkwashing,” to describe how companies use breast cancer to influence consumer behavior. Pink, it turns out, sells. Whether the money garnered actually ever helps patients is less clear.
Breast cancer survivors are also a growing and vocal community. Thanks in large part to early detection efforts, greater than 80% of breast cancers are now curable. Treatment over the past fifty years has also become less radical and more personalized.
And yet, a quarter century after President Nixon declared a “War on Cancer” so many patients ask me: why aren’t we closer to finding a cure for everyone?
This fall I will be releasing a podcast to answer that question. I have been sharing this story with my patients for almost a decade. During the summer of 2020, I realized that I needed to speak to a bigger audience. And during a trip to New York last fall, I realized how to share the story with you.
To those of you already subscribing, thank you for being here. For those new to the table, welcome.
North Carolina, June 2020
As another wave of COVID peaked and the racial justice movement surged, I was seeing cancer patients in the cold, windowless basement of a hospital in North Carolina. On the floors above my head, overwhelmed ICU nurses taped gloves filled with warm water to the hands of intubated patients dying alone.
Unlike colleagues who were shifted to COVID units or were sent home, oncology providers like me trudged forward. Cancer hadn’t gotten the memo to stay home, so neither did we.
One day, outside an exam room, I reviewed the chart of my next patient and listened to an update from my nurse. Like thousands of previous follow-up visits, I opened the door, shook his hand, and sat down on a rolling stool. After an unremarkable back and forth about his cancer, he said, “Can I tell you something, doc?” I nodded.
“You remember my son?” I nodded again.
“Well, I’m so proud of him. He’s hooked up with a white supremacy group online and goddamnit he’s doing something to get our country back. He’s going to make sure these *expletive* get what they deserve.”
As words of hate, xenophobia and antisemitism spewed from his mouth, I was taken aback. My brain raced as I wondered how:
I had given the impression that I might agree
to push back, balancing my personal beliefs and responsibility as his treating physician
to inform him that the surgeon to which he just gave rave reviews was Jewish
When he stopped talking, our eyes met over my mask. I realized that he was waiting for me to speak.
Nothing had prepared me for that moment.
As the pandemic wore on and the temperature in my exam rooms continued to rise, I thought about stories that I had heard from older physicians of a pugnacious surgeon named Bernard Fisher. I wondered what he was saying about COVID.
To my dismay, when I finally searched his name online, I found his New York Times obituary from 2019.
Listening to the news and watching scientists under attack, I read more about Fisher and was dismayed at the similarities between then and now.
What would have happened if years ago, this son of Jewish immigrants had not found a way around the antisemitism of the late 1930s to enter medical school? Or had his ancestors been killed in a pogrom?
Would we see more women walking around today with the concave chests and debilitating lymphedema from the brutal surgeries prevalent in the 1970’s? Probably.
Would we be using the life-saving medications that Fisher studied? Common cancer treatments like tamoxifen, Herceptin, and Taxol? Maybe not.
Would women have a choice to undergo a lumpectomy rather than a mastectomy, assured by her doctor that either surgery was reasonable? I’m not sure.
History demonstrates how the impulse to punish “others” is not new. And yet ignorant people still argue this is what must be done. Any scientist who dares to speak up now risks their personal safety.
This story is also the story of politics. Of the elevation of doctors to “healthcare heroes” and their inevitable fall from grace. Propelled by grievance and personal agendas, members of the US government attacked Dr. Fisher and tried to destroy a lifetime of research that forms the backbone of breast cancer care today.
Dr. Fisher’s story is the beautiful story of science. And of a political attack so brutal that it still serves as a warning to mavericks who consider sticking their necks out.
New York City, 2023
On a recent visit to Manhattan, my husband and I found ourselves in Rockefeller Center. Overseeing the long lines of sweaty parents waiting to get into the Lego store floats the Greek god, Prometheus. His muscular figure sits atop circles of gold, one arm extended, the other holding a ball of fire. This is allegedly the most photographed statue in New York City, and I obligingly raised my phone to capture the moment.
According to Greek mythology, Prometheus stole fire from Zeus and gave it to humankind. Using fire (which some scholars feel stands for knowledge), humans evolved from their animal-like existence to cook food, develop culture, and manipulate the environment around them.
Zeus punished Prometheus by chaining him to a mountain for eternity, tortured by an eagle that eats his liver which regenerates each night. Apollodorus, a Greek historian, suggests that Prometheus was originally human. If true, he is one of the first superheroes, stealing knowledge from the gods to help his fellow man.
As I pondered the gold figure in front of me, I thought back to something former NCI director Dr. Vincent DeVita told me once: “Women in the US should erect a statue to Bernie Fisher.”
A statue of a Greek god stands in one of the most prominent places in the United States, representing the good that comes when we share science, knowledge, and stories. Like Prometheus, Fisher’s contributions enraged those in power, resulting in the destruction of his decades long career and his scientific legacy. Due to this targeted campaign, he has not, until now, received the recognition that he deserves.
Dr. Fisher is present in the room of every woman diagnosed with breast cancer. Yet no statue stands in his honor, and few know his name.
At the end of September, I will not build a statue, but I will correct this omission by sharing the story of this remarkable man with you. It’s a great story and I promise you will not be disappointed.
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On my mind…
I’m a Medical Technologist working in Oncology. We saw during the pandemic what happens to the few who don’t go along with the medical big shots. We stayed open during the lockdown and I never got sick.
Thank you for NOT staying home during the pandemic. I went through treatment for Stage 4, TP, Grade 3 BC from pandemic inception. I am eternally grateful to all the cancer docs out there who bravely chose patients during that tumultuous time. TU! Looking forward to reading more about Dr. Fisher!