Joey Wahler (Host): It's the most common female cancer globally, so we're discussing breast cancer. Our guests are Dr. Steven Barrett, he's a general surgeon with Southeast Georgia Health System, and his patient, Dicy Peppers.

This is Health Matters from Southeast Georgia Health System. Thanks so much for joining us. I'm Joey Wahler. Hi there, Dr. Barrett, Dicy. Welcome.

Stephen G. Barrett, MD: Thank you.

Dicy A. Peppers: Thank you. Hi, Joey.

Host: Hi there. Great to have you both. We appreciate the time. So first for you, Dr. Barrett, what motivated you to pursue healthcare and your specific field in the first place? Where did it all start for you?

Stephen G. Barrett, MD: When I was 13 years old, I watched a TV show on NPR. And it was about a surgeon named Tessier, who was a French surgeon, who treated patients that had terrible congenital facial abnormalities. And I thought that was the most amazing thing that I've ever seen in my life. And so, that led me down the healthcare pathway. And I know I don't do that particular surgery now, but it certainly had me very interested in performing surgery. And so, I'd say that that was sort of divine intervention, because I wasn't really sure what I was going to do other than that.

Host: It's interesting how many of those either doctors or others involved in healthcare, they got the itch very young, right?

Stephen G. Barrett, MD: Yes, sir. I mean, I had no family members that were physicians. I did have some nursing providers in the family, but no doctors. So, my dad was an electrical engineer, so that was very far removed from that.

Host: Interesting. So, Dicy, we've got to ask you before we go any further, tell us about your first name, rather unique, beautiful name. Where did you get it from?

Dicy A. Peppers: Well, Joey, it is funny because I've always enjoyed the name. And at first, I didn't like it because it was a teasing aspect at first. However, my mother, she was in college and she had a friend, her name was Dicy and she just thought it was so beautiful. And so, she named me after her friend. And I don't know much more of the story other than that.

Host: Okay. But you've come to appreciate and love the name, yes?

Dicy A. Peppers: Yes, I do. I think it fits my personality.

Host: That's great. And what first brought you to the area?

Dicy A. Peppers: Well, I work for the Transportation Security Administration. And our academy is at FLETC, the Federal Law Enforcement Training Center. So, I came as an instructor in 2016 to the academy for TSA. And that's where the story started, and I've been here ever since.

Host: So Dicy, you were expecting a routine mammogram when first referred to Dr. Barrett, when was that and what were you feeling at the time?

Dicy A. Peppers: Well, at that time, I've never missed my mammograms. So every year, I would always go and get the mammogram done. However, this particular January, I went in and I was called back and I have never been called back before. So, it was a little bit upsetting or, I guess, confusing as to why. And so, after I was called back, then I took an ultrasound. And from the ultrasound, the ultrasound doctor said that it looks a little abnormal. And it was just a blessing that I was able to get with Dr. Barrett the actual day of hearing that news without having to wait to get on his roster or get an appointment with him.

Host: And what wound up being your diagnosis?

Dicy A. Peppers: Well, Dr. Barrett told me that-- and what I loved about him was that he was very caring and understanding, but he was very direct-- and he told me to prepare myself. And what it was was it was the breast cancer. At that time, I don't believe that he said the triple-negative, I'm not sure. But when you get that type of diagnosis, you hear maybe every fourth, fifth word that is said. You don't really hone in on everything that is told to you at that time because you're still trying to process what you just heard.

Host: I can imagine that. And so, how did you react to that news, Dicy, and keep things focused and grounded under the circumstances?

Dicy A. Peppers: At that point, the way I reacted was I remained calm. I do believe that my eyes welled up. I began to form tears, but I didn't go hysterical. Because at that time, I needed to tap into my faith and allow the Lord to remind me that he's going to be there with me. So, I just took what I know my faith is and I know how strong I am in my faith. And I just took it and said, "Lord, you walk with me through this because this is going to be a journey."

Host: Sounds like a levelheaded, positive mindset to have in that situation, Dicy. So, Dr. Barrett, as a general surgeon, what are those first conversations like with a patient like Dicy receiving a new breast cancer diagnosis? Obviously, medical school and your training aside, it involves a human touch, doesn't it?

Stephen G. Barrett, MD: Oh, certainly. So from the standpoint of how I personally do it, we generally try to do it in two visits. As Dicy sort of alluded to, that first visit is generally very shocking for the patient. So a lot of times, I'll say that they hear they had breast cancer. And hopefully, when they leave, they hear also that it's very treatable. So, we have a brief overview of how the treatment options will be sort of laid out. We also have some educational materials that the patient leaves with that are very helpful. I send them home with a little bit of homework as I call it. And typically, they do some research at home and then sort of figure out questions they need to ask me. And so, we typically see them back several days to possibly a week later, generally try to resolve all those questions, and then figure out our treatment plan at that time.

Host: And speaking of which, Doctor, what factors led you to recommend surgery for Dicy's case? And what actually did you do surgically?

Stephen G. Barrett, MD: So, she actually did not have surgery first off. So, most ladies that get diagnosed with breast cancer in America probably do have diagnosis surgery, then possibly chemotherapy and possibly radiation. Hers was a little bit different. She had a variant called triple-negative breast cancer, which typically would be considered more aggressive. So at that point in time, we elected to get her evaluated by Oncology. She had a workup and actually did chemotherapy prior to having any surgery done.

Host: And then, what eventually was the surgical procedure?

Stephen G. Barrett, MD: Well, she elected to have her breast saved. So, she had breast-conserving surgery with, I believe, a reshaping of the breast. So, she had a what's called an oncoplastic lumpectomy, and we also did a lymph node sampling, which is a standard treatment.

Host: And so, Dicy, leading up to that surgery, what was your experience like with Dr. Barrett and his staff in terms of the support, in terms of the education that you needed in order to make decisions along the way that really were affecting your life?

Dicy A. Peppers: Well, like I said, Dr. Barrett was very direct and very transparent. His staff, they were so supportive in the way of answering any type of questions, making sure that he was advised or informed of anything that I did have a question on that he would probably need to answer. They were willing to see me at a drop of a dime. I was concerned about certain things, but the book that he talked about was a lot, it had a lot of information. And if you did your homework, as he said, you would be able to be more informed so you can make a more informed decision on what's best for you moving forward.

Host: And speaking of moving forward, how would you describe your recovery since?

Dicy A. Peppers: I can say it was awesome. It has been a journey that I can't even believe that it's been a year already. And Dr. Barrett, along with all the information from all the doctors that I have had come in contact with, I can say that it's been an educational thing and it's definitely been a point to where I can be able to now have my testimony help others to be able to understand what's important about getting your mammogram, and understanding what your body is trying to tell you. Listen to your body because it is the first to know.

Host: That's very well put. Very true and very well put Indeed, right, Dr. Barrett? So, tell us, Doctor, from your standpoint, obviously this is a great success story, fortunately, and so what do you want people joining us to know about Dicy's recovery and the results here?

Stephen G. Barrett, MD: I think just the fact that, number one, she's such a powerfully positive person, so her mindset-- and I know she sort of said she had a tear sort of coming out, and it was amazing, she handled the bad information just like a champ. I mean, she never let it get her down. She was determined from the beginning that, "Okay, this is the hand up and dealt. This is what I'm going to do. I'm going to get all the information. I'm going to make the best decision for myself, but remain extraordinarily positive throughout that entire journey." And I think that's such an important thing for people to understand. There's such an emotional part of this, and that positive outlook only just improves things tremendously for the patient.

Host: And regarding that positive outlook of yours, Dicy, let's talk about that a little bit more because, thank goodness, you're now in remission, which is naturally such a significant milestone in and of itself. How has that fact shaped your outlook moving forward, the fact that you tried to remain positive and it seems to have paid off, right?

Dicy A. Peppers: Yes. I think that, from the beginning, like Dr. Barrett said, once you hear something as devastating as cancer of any sort, your mind automatically goes to, "Is this the end? Will I overcome this?" And you have to put in perspective what's important. And my children and my family were very important to me and I was going to overcome that. So, the thing that I had to do was put that in my mind to know that that's the end result. And the end result is that I'm going to be here with my family. So when I believed and held onto my faith, as I said before, a scripture came to mind, Joshua 1:9, where the Lord reminded me :Do not be afraid, be courageous, be strong and know that I'll be with you wherever you go." So, not only where I go, but what I go through, and I was going to go through this and I was not going to let this beat me. So, you have to be mentally strong. Because if you allow it-- and I never did, let me say this, I never I said I had cancer. I always said that I was diagnosed with cancer, because the diagnosis is something that I can beat. But if I allow it to become a part of me and say that I have it, then that's something that has control over me and I was not going to allow that to happen.

Host: How about this, Dicy? You've actually mentored women through your organization called Wonders of Womanhood. So, how has this journey shaped or strengthened that mission of yours?

Dicy A. Peppers: Well, in my organization, I tried to get the women to understand more on a professional level, so it was more like leadership and getting them prepared for supervisory training and stuff like that. But once I became diagnosed with this, it took another turn and it added on a level of understanding that you not only need to take care of yourself and take charge of yourself at work, but you also need to take charge of yourself, your mind, your body, your soul, spiritually and mentally. So, it added a level of understanding that you're not just who you are at work, you're who you are as a whole.

Host: Also, Dicy, you touched on this somewhat earlier, but to pick up on it a bit, what do you want other women joining us, especially those who may not get annual screenings or checkups, as you have, to take away from your story, those who may be fearful or may be procrastinating or whatever the case may be?

Dicy A. Peppers: What I would like for all women to understand whether they get their annual screenings or not, is to understand that if you go in with a positive mind and you go in early. Early detection is very important. And whether they get it early or they get it sometimes a little bit later than what they would like to, just know that you can beat it if you can remain positive. Just remain positive. But mostly get it done because your help is with those that know how to give you the treatment, know how to give you that support because what you are thinking is fear, and fear is false evidence that appears real. So, take charge of your health and take control of it by going and getting your screenings as soon as possible every year.

Host: I love all these philosophical phrases that you're hitting us with, Dicy. I wish I had something to write these down. I'm going to have to go back and revisit them.

Dicy A. Peppers: Thank you.

Host: Absolutely. Just a couple more things here for both of you. Doctor, what's one thing you wish more people understood about that early detection and breast cancer treatment? What's the takeaway here today?

Stephen G. Barrett, MD: I think the basic gist is that you leave all options available to yourself if you find it early. So, the analogy of if you find something that's the size of a green pea, then that obviously is going to allow a woman to save her breast. If you find something the size of a softball in your breast, that may very severely limit your options to save your breast. So, you may have eliminated that possibility for yourself. So, early detection, in addition to what I just mentioned was that the chances of needing chemotherapy probably go way down if you find it at a much smaller state than well further along.

Host: As a woman that obviously brought a lot of faith and positivity to this experience. How has this journey strengthened that on your part?

Dicy A. Peppers: For sure. I think that what doesn't kill you will make you stronger. And this right here has strengthened me in more ways than I can even imagine. It strengthened me to be able to be a model for others to see that I went through it and I made it so you can do that same thing.

If I can be a model for someone else's journey, I could be a testimony to someone else just to strengthen them, support them, and let them know that you can overcome them, then the impact, the journey, it was not void. And I don't believe that the Lord allowed anything-- he won't put more on you than what you can bear. And sometimes you just have to have each other. You have to be strong for each other and just let everybody know it's not just family. It's a circle, a circle of love between everyone and whoever is going through it, if they just know that they can overcome it, if they just believe.

Host: Perfect words indeed, under the circumstances. Finally, for you, Dr. Barrett, how rewarding for you to be able to help a woman like Dicy in this situation? This is what it's all about, right?

Stephen G. Barrett, MD: Exactly. I mean, I couldn't say it any better than she just did. I mean, from the standpoint, you meet lots of different people in your practice and you meet some really special ones, and she's certainly a real special one. Just the way she handled the diagnosis, how, as we said, positive she was throughout the entire experience, how she's willing to come on this podcast and help other women sacrifice her time for others is very endearing.

Host: People can learn a lot from your experience, Dicy, and the way you've handled it in more ways than one. That's for sure. Well, folks, we trust you are now more familiar with breast cancer. Dr. Barrett, please keep up all your great work. And Dicy, congratulations on your remission. Continued good health and thanks so much for sharing your very inspirational story.

Dicy A. Peppers: Thank you so much for having me.

Host: Absolutely. And for more information, folks, please visit sghs.org/breasthealth. If you found this podcast helpful, please do share it on your social media. Thanks so much again for being part of Health Matters from Southeast Georgia Health System.