A Daughter Keeps Her Promise

12/20/17 • 5 min

As a girl, Priscilla Brastianos’s mother told her stories of the grandmother she never knew: a medical student who diagnosed her own fatal breast cancer. The legend of her grandmother, who practiced medicine even in her final days, inspired Brastianos to become an oncologist and physician scientist. The death of Brastianos’s mother from the same disease – and the promise the young doctor made to her in her final days – drives her unwavering commitment to conquer it. The 2012 Conquer Cancer Foundation Young Investigator Award (YIA) recipient talks to mentor Evanthia Galanis about the personal and professional journey that honors her family and patients at every turn.

As a girl, Priscilla Brastianos' mother told her stories of the grandmother she never knew, a medical student who diagnosed her own fatal breast cancer. The legend of her grandmother, who practiced medicine even in her final days, inspired Brastianos to become an oncologist and physician scientist. The death of Brastianos' mother from the same disease and the promise the young doctor made to her in her final days drives her unwavering commitment to conquer it. The 2012 Conquer Cancer Foundation Young Investigator Award recipient talks to mentor Evanthia Galanis about the personal and professional journey that honors her family and patients at every turn.

So Priscilla, tell me about how you got into this line of work.

When I was very young, my mom told us about my grandmother in Greece. When she was 23 years old-- she was in medical school at the time-- they were learning how to palpate breasts on exam. And she palpated a breast mass and had just diagnosed herself with breast cancer. So she went on to graduate from medical school and then, even with metastatic breast cancer, practice medicine.

Years later, my mother had spoken to people from that region. And they all remembered my grandmother, even 20 years later, about the impact that she had on people's lives. So I grew up hearing my grandmother's story and being inspired by her story as a physician, as a mother, and wanting to be like her, wanting to emulate my grandmother. And so that's what got me interested in medicine and also in cancer.

And when I was a third-year medical student, my mother was diagnosed with breast cancer. And there we began the journey of her chemotherapy, her surgeries, her radiation. And I knew that I wanted to change the course of oncology because of the suffering that came with cancer. So that's what got me into cancer and oncology. It was my grandmother's experience and my mother's experience. And ultimately, my mother passed away of metastatic breast cancer recently. And her death is a reminder everyday that we need to do better for cancer. And so that's what drives me and motivates me every day.

So your work is both a personal and professional journey. What do you like most about what you do every day?

Being able to help a patient on any given day is the most rewarding part of what we do. Patients are incredibly selfless and generous. Often, they'll participate in studies that may not necessarily benefit them personally, but they know that they're helping the greater good. The patient's the strongest person in the room when we're seeing patients and their families, and they're stronger than all of us combined. Many patients are heroic in their resilience, in what they teach us. Their strength inspires me.

I would think that the legacy of your mother helps you to push just a little bit further--

Yes.

--That otherwise you would normally have.

One thing that I hadn't appreciated before was-- we had transitioned my mom to hospice. And hospice was actually one of the most beautiful times of our life. And so we had some meaningful moments that I carry with me every day.

The day before she passed away, we were laying next to her in her hospice bed. And she said that those few days in hospice were among the happiest in her life, with us, being surrounded by family. And at that point, she said that she had felt so much love from her family in that setting that she was no longer afraid of death, and that she knew that the love of her family was going to accompany her always in her next journey.

In oncology, talking about end of life, we often feel like we're giving up. But I have a new appreciation for end-of-life care now, that we're not giving up. We're transitioning to a different stage of care. It's made me a better oncologist.

What advice would you give to either young oncologists or medical students who are interested in oncology or interested in the path of combining research with clinical care?

So I always go back to advice that my mom gave, which is don't be afraid to be bold, and don't be afraid to pursue big ideas, and don't be afraid to follow your dreams and passions. So if there's an idea that you'd like to pursue in research or in me...

So Priscilla, tell me about how you got into this line of work.

So your work is both a personal and professional journey. What do you like most about what you do every day?

I would think that the legacy of your mother helps you to push just a little bit further--

Yes.

--That otherwise you would normally have.

What advice would you give to either young oncologists or medical students who are interested in oncology or interested in the path of combining research with clinical care?

Next Episode

Lessons in Loss

When grief is an occupational hazard, it’s hard not to bring work home. Lidia Schapira teaches doctors how to help patients approach the end of their lives. What kind of lessons did her children learn from a parent who regularly cares for and loses seriously ill patients? Lauren Goldstein talks to Dr. Schapira, her mother, the current Editor in Chief of Cancer.Net, and a Conquer Cancer donor about growing up in the shadows of cancer.

Lidia Schapira, an oncologist specializing in quality of life, talks candidly with her daughter, Lauren Goldstein, about how she managed work-life balance while caring for seriously ill patients and raising young children. We learn that she approaches the care of patients with the same dedication and attention she has for her family, and how at times, that was incredibly difficult.

Ms. Goldstein is a doctoral student in psychology at UCLA. Dr. Schapira is the director of the Cancer Survivorship Program at Stanford, a generous donor to the Conquer Cancer Foundation, and acts as the editor in chief for cancer.net, ASCO's patient information website, supported in part by the Conquer Cancer Foundation. Dr. Schapira begins this segment by sharing why she became a doctor.

I think I fell into being a doctor, in part, through identification with my dad, who was a wonderful, kind, compassionate doctor, and also because of my real desire to do something that would help people. But there was this inevitability of things spilling over, and the boundaries, I think, become very porous between work life and home life, especially when the work is so emotionally intense.

And specifically, I remember one holiday we had as a family in Prince Edward Island, when I was very heavily involved in grieving the anticipated loss of a very, very dear patient who was in the final weeks of life. And I just was so careful, I thought, not to have this spill over. And I just wondered if you remember back to that holiday, and if you could sense that something was going on?

I do remember that vacation. I remember it very well. I got the new NSYNC CD, and I listened to it probably 70 times in a week. And I did not know what was going on with you at all. When you were grieving, I honestly didn't see it.

That's reassuring for me in so many ways. It really is a balm to hear that. Do you remember any of the fun events, like the famous lunch in East Boston with a family that made the best meatballs?

Yes. This was a patient who, I think, was quite sick at the time.

Very ill, a lady who did not want to know her diagnosis, didn't speak a word of English--

Spoke no English.

--wanted to have us over for Sunday dinner.

Yep. And she made the best meatballs I've ever had. It was like an all-day meatball affair, the way that she prepared those. This was a moment that was presumably sad for you and some sort of goodbye in some way, a way to incorporate that personal relationship into the goodbye, maybe. I don't know how sick she was in that moment. But I know now that that was near the end of her life, and I missed it, because the meatballs were so good. [CHUCKLES] So I'm curious what you would say you're most proud of.

Most importantly and meaningful to me are the moments when I felt that my presence made a change in a situation that by my own ability to be there, either by connecting to somebody, by giving solace to a family, by making the right diagnosis, by providing access to a therapy that profoundly impacted on somebody's life, or just by accompanying and witnessing what was happening, that my being there actually helped. That is absolutely and by far the stuff that gives me the greatest sense of peace and purpose.

And then on a perhaps more intellectual level, when I felt that by virtue of a conversation or a talk or my modeling my behavior, a young physician got it, that they got something that was important that they had not seen before that perhaps had remained theoretical or abstract. But they got it, so perhaps my feeling is that mentoring is almost like an extension of parenting. It's almost as joyful as when your kids somehow get something that is so enormously important to you, and that they show you that they really understood it at a deep and lasting level.

I'm also curious what you would say you were least proud of.

It was when I had a meeting in Washington. We were living in Boston at the time. And it was 7:00 in the morning, and I was about to go out to the airport. And I remember Karen, Timmy's mom called and said she couldn't do carpool that afternoon. And I said, oh, yeah, yeah, that's fine. Mark was in third grade.

And I rushed out the door thinking that I would make alternate pickup arrangements for Mark. And I forgot. Then I went on to my lovely meeting and everything. And it wasn't until I was on the shuttle on my way home, and they said, we're about to take off, and ...