Reshaping the Future with Dr Liz O'riordan

Liz O'Riordan photographed by Alex Kilbee

Reshaping the FUTURE

Dr Liz O’Riordan has the unenviable position of having been a breast surgeon who has delivered many, many cancer diagnoses in her career. She has also experienced being a breast cancer patient herself, not once but twice, and is now helping to care for her mother who has recently undergone surgery following her own cancer diagnosis. For most people this would perhaps slow them down. But if anything she is even more determined to share her experiences and use it as an opportunity to help others facing their own cancer journey, as well as breaking down some of the beliefs held by medical practitioners regarding patient care.

Tbc with Liz O’Riordan

Liz photographed by Alex Kilbee

I always wanted to be a doctor. I LOVED the idea of biology in the human body.

DR LIZ O’RIORDAN

Liz photographed by Alex Kilbee

Liz’s determination has been a driving factor in her career to date.

“I always wanted to be a doctor. I loved the idea of biology in the human body. My dad was a surgeon and a GP, my mum was a nurse and so I grew up surrounded by medicine. They tried to discourage me but I was adamant that I wanted to become a doctor. I studied for five years in medical school and throughout I always knew I wanted to be a surgeon. I was fascinated by the operating table, by what was happening, and I was bored on the wards. It was always about fixing people, helping them and making a difference. Rather than fiddling with drugs and changing the doses, I wanted to get in there. I did my initial five-year training in Cardiff, and I then did three years as a junior doctor and got my first set of exams. I worked incredibly hard, and had to invest thousands of pounds to sit exams, and to jump up each step in the process of becoming a surgeon.” Frustratingly, and despite passing her exams to become a surgeon, she was unable to secure a position because she did not have enough points on her CV, and so she embarked on a PhD in thyroid cancer which took four years. “I was offered a job in East Anglia. So I moved all the way across the country from Cardiff to Suffolk, leaving my friends, my family, everything behind, so it was just me and my two cats looking for accommodation and starting afresh in a new role.”

The price she paid for pursuing the career that she loved was very high. She was a single woman trying to climb the ladder in a very male-dominated sector, and as a senior registrar she spent six years moving every year to a new area. Which of course meant that she had no social life, no support system or any opportunities to meet anyone outside work.

A selfie by Liz

“There was sexual harassment and there was bullying. It was hard as a woman to assert yourself and to be taken seriously. I got used to patients assuming I was a nurse. And to the sexist banter in theatre. It took me until my thirties to realise I did not have to accept all the negativity. It was really, really hard and I was very lonely. At that time a lot of the men I worked with were married, and there were very few opportunities for a single woman in my position to date. It seemed to be completely fine for male consultants to sleep with junior doctors, but if a female consultant slept with a junior doctor that would have been a scandal. There were times when it did become too much, and I considered quitting surgery and going to work in a supermarket where I'd have a social life, no one would criticize me and I would get my hours back. It was such a difficult time and yet it was a career that I wanted so much.”

Liz moved hospitals again, this time she met her future husband, developed a social life and discovered breast surgery. LIVING WITH

“I have always been quite cautious and doubted my abilities. I was not one of those surgeons who would read a book and then feel ready to try something new the next day. With breast surgery it's like dressmaking, it's artistry, it's creating, it's reshaping and I knew I could help women. I fell in love with it.”

Whilst she loved her work she did find the responsibility of constantly having to deliver cancer diagnoses hard. The relationships she developed with her patients were very important, but the difficulty of the news she had to share meant her role had its downsides too.

“It was only when I started working as a consultant, with all the responsibility, that I understood how hard it is to tell someone they have cancer. Most women aren't expecting it, they feel well. I would do that ten times a day. Six before lunch, four or five after lunch, twice a week, every week. You don't get counselling, you don't get coaching, you get a little bit of training, but it's part of the job. You absorb all the negative emotion and there were times when I felt I was being paid to make women cry.”

With breast surgery it's like dressmaking, it's ARTISTRY, it's creating, it's reshaping and I knew I could HELP WOMEN. I fell in love with it."

Liz photographed by Dermot O'Riordan

Time constraints meant that she often found herself delivering a life-changing diagnosis but then having to move on to the next woman, and then the next and the next… There was little time to make sure they had all the information they needed. The mantra used to be ‘don’t google your condition’ yet, with so little information, where else could people turn. Liz acknowledged that as a medic you are not trained in how to deliver this sort of news, or to understand what is needed by the patient. She hoped that she could treat each patient with compassion, and give them the very best medical care but also had to acknowledge that the system does not afford the time needed to meet all of their psychological needs.

Everything changed for Liz when she herself was diagnosed with breast cancer. “I had a normal mammogram six months previously and then overnight a lump came up. As a breast surgeon, I was not worried. I’d had cysts previously and expected this to be the same. My mammogram was normal and then I went for an ultrasound. The radiologist put the probe on the lump and I turned to look at the screen because I do ultrasounds myself, and I saw cancer. I knew it was cancer. In that split second everything went through my head; the fact I was 40, that I'd need a mastectomy. I'd need chemo, and I had a good idea about my chance of being alive in 10 years - I knew too much. A part of me was in denial, it was like looking at it happening to someone else..."

“...My husband, who is a surgeon, was trying to reassure me because even though he knew it was bad, he just wanted it to all be ok. We both knew every word that was coming. I listened to the consultant talk through all the treatment options, and inside I'm still going, ‘oh my god, oh my god, oh my god.’ All I could think was ‘how much do I tell my parents?’ Because there's so much they don't want to know, they never need to know, but I can't not know it. I've looked after women younger than me who have died with a better cancer prognosis than I had. I'm about to have every treatment that I give my patients. I'm about to find out what it's really like, and realised how little I knew about how to cope with the treatment I give my patients. About how I make decisions, or where I go for answers, or how will I cope with chemo? With my body image and menopause, all that kind of stuff? I had no idea." Up to that point everything Liz had done in her career had been as a surgeon. She admits that she had not even been on a breast cancer website or looked at the information available to those newly diagnosed. Social media played an important role following her diagnosis, as she decided early on to share her cancer journey with her followers, having felt it was better to be honest and open about her journey. Immediately she was flooded with messages from people giving advice, sharing information and providing valuable insights into what they had been through. No matter what time of the day or night it was, she knew that there was always someone she could reach out to. Liz also took part in a photo shoot, something she initially was reluctant to do, but felt was cathartic.

“I think for me, it was stripping away the mask. I could just be. I didn't know how I was going to feel. I didn't need to pretend, I didn't need to be brave. I could be scared or upset. It was real. So much of my cancer journey felt almost fake. Fake is the wrong word, but it felt like it wasn't happening to me. I knew too much. It couldn't be happening. It was a way of thinking, that no, this is real and you will need to come to terms with it. Life will be different.”

I didn't know how I was going to feel. I didn't need to pretend, I didn't need to be brave. I could be scared or upset. It was real."

Liz photographed by Alex Kilbee

In a way I'm a happier, STRONGER person having had breast cancer twice."

Recently Liz has faced the role of becoming a carer, as her mother has been diagnosed with an extremely rare bone cancer after breaking her arm. Travelling through this journey now as a surgeon, patient and carer she has learned and experienced so much. Not least has been the full realisation that the delivery of a diagnosis can be done better, with more time given, and better understanding of the patient’s needs. “When mum was given her initial diagnosis I just wanted to hug her and to take all her pain away. Being a doctor, I realise I cannot make her better. I have to help her go through this and I have to help her go through this the way she wants to. Not the way I think she should.” As her mother’s cancer is extremely rare, she was referred to one of only five centres that treat this type of cancer. They had to wait for three weeks, knowing the diagnosis, whilst living with a broken arm that cannot be fixed, until they find out what could be done.

“I did that very thing I had spent years telling people not to do, I turned to google, but, as it is so rare there was little or no information. To watch someone go through it is horrific. When I was having chemo in some ways I think it was easy for me, but my husband said he felt impotent, leaving me on the sofa looking terrible whilst he had to go to work, and knowing he could not make me better. Now I am in that position with my mum.” When they saw her mother’s orthopaedic surgeon he spent an hour with the family, talking through all of the options, and Liz felt she’d witnessed a masterclass almost, in how this type of news could and should be delivered. She was so moved that she even wrote a card thanking him for making what was a difficult experience for her mum as good as it could be. Liz said she realised how the luxury of time gave the ability to explain patients choices to them.

“When my cancer came back I was forced to retire, I couldn't move my arm because of the side effects of surgery and radiotherapy. The psychological impact was huge. I couldn’t remember the last operation and it was then that I suddenly realized that I’d lost what I’d spent twenty years of my life training to do. I'd lost my purpose. I was a surgeon who helps people, what did I do now?” Reflecting on, and sharing her unique and unusual experience of knowing not only how it feels to deliver a diagnosis, and to receive a diagnosis but also to care for the person getting that diagnosis has helped Liz to gradually find her voice in this new community. By educating people online, by writing books and speaking at conferences she is finding a new, different way to help people. “In a way I'm a happier, stronger person having had breast cancer twice. There are still things that are hard. I live in chronic pain and I still regret that cancer stopped me from becoming a mum. That is always hard, it never goes away. When you're very ‘out there’ on social media, you feel you have to be strong and positive, but it is equally important to show the hard stuff. I'm not superhuman, and yes there will be times I don’t exercise for three months because I have felt bad, and it is important to show that too.”

FIND OUT MORE Liz is working on documenting her journey, and you can read her full story when she releases her autobiography next summer. Click on the links below to find out more.

• Visit Liz' website & blog or pre-order

her memoir

Liz photographed by Alex Kilbee