VO: Welcome to Extraordinary People, a podcast series from UK HealthCare. The stories you'll hear are from patients who've overcome the most challenging moments of their lives, and our providers who've helped thousands of patients navigate those moments.

Debra Faulk: All I know is when I was told that I had cancer, all I heard was death. And immediately, I started planning my funeral, because I know a lot of people that didn't make it.

Host: In January 2021, Debra Faulk was diagnosed with breast cancer, a disease she was uncomfortably familiar with. A grandmother and aunt on her mother's side battled breast cancer. Her sister died from it at age 33. Debra had triple-positive breast cancer, which is an aggressive form of the disease, characterized by tumor cells that have estrogen receptors, progesterone receptors and a larger than normal number of HER2 receptors. If caught early enough, it's also highly treatable through targeted therapies available at the UK Markey Cancer Center. That's where Debra received care from a team of doctors led by Emily Marcinkowski.

Dr. Emily Marcinkowski: Patients, sometimes they come in and they're really stoic. Sometimes they come in and they are scared, just like so anxiety-ridden. It's like the first thing I have to tell them is this is beatable, treatable, curable breast cancer to even get them to allow me to see them.

Host: Debra was unlike many patients who enter Dr. Marcinkowski's care. A lifelong performing artist and comedienne, Debra is accustomed to reckoning with grief and channeling it for her routines. "Comedy at its core is just a bunch of pain," she says. Debra accepted the possibility of the worst outcome when she received her diagnosis, but had no intention of throwing in the towel.

Dr. Emily Marcinkowski: I remember her being laid back. She was kind of, you know, "We have this situation. Now, what are we going to go forward with it?" Like, she was ready to move. She was decisive in her decision-making. She wasn't somebody that waffled back and forth. So, she was very focused and accepting and determined to move on, like she had already accepted her diagnosis. Some women come in and it's like, "Why is this happening? Why is this happening to me?" And almost don't want to accept it. And so, sometimes they'll put off decision-making. She was ready. She was like, "Okay. This is here. This is what it is. Let's find a plan and let's move on."

Host: Debra's judiciousness was cultivated through 16 years of caregiving for her father who had dementia.

Debra Faulk: I understood health and I knew how to be an advocate for my father, being that he was a military vet. So, I learned from taking care of my dad how to take care of myself. And so, I was able to ask a lot of questions. And even though I had no idea what they were saying, they knew that I had some questions and I wanted people to be responsive as well as responsible for me. So, I just started asking a lot of questions and I started talking to other women that were in the waiting room because I wanted to know how you felt and how did you know and what does this mean to you. And so, that was part of my process, was just talking through it.

Host: The same month she received her diagnosis, Debra underwent a lumpectomy to remove the cancerous tissue from her breast.

Debra Faulk: As soon as I was given the option to have a mastectomy or a lumpectomy, I thought immediately, "Just take out what you need. Don't take all my goods."

Dr. Emily Marcinkowski: she truly had all of the power in her, which makes the patient feel more powerful. In breast cancer, it's like this total loss of control thing. And so whenever they get some of that power back, it's such a wonderful thing for the patient, because they feel like they're in control of the way, you know, that they're treated. And so, it makes them able to accept the diagnosis a little bit better.

Host: Following that procedure, Debra was considered cancer-free, but had to undergo chemotherapy and radiation therapy to discourage recurrence. One of Debra's therapy drugs, Herceptin, targets the HER2 protein, but can also produce bad side effects on the heart. Her initial echocardiogram revealed no cause for concern. But when Debra developed abnormalities in her breathing pattern and blood pressure, followups were ordered. Subsequent echoes showed that the squeezing capacity of her heart had been reduced. Chemotherapy was paused until experts at the UK Gill Heart and Vascular Institute could put her on a treatment plan that would protect her heart while continuing chemotherapy.

Because of the relationship between Markey and Gill, UK HealthCare is one of only 27 hospitals in the United States recognized as a Gold Class Center of Excellence by the International Cardio-Oncology Society. It is the only hospital in Kentucky with that distinction, which is an indicator of the highest quality of care for patients who experience heart problems as a result of their cancer treatment. Amit Arbune, Director of UK HealthCare's Cardio-Oncology Program, led the treatment plan for Debra's heart.

Dr. Amit Arbune: Being in that situation, having one deadly disease, cancer, and on top of that, the life-saving chemotherapy being interrupted, she was still very calm and composed. And then, once I explained to her what my role was and what my expertise was, that I deal with patients with cancer therapy-related cardiovascular side effects and how we treat them, that we are able to get these patients back, she was relieved with that. And even in our first meeting, I remember she told me that she was a standup comedienne, and how lately after having been diagnosed with cancer, she had been using this avenue to educate people, which was really interesting because, despite going through such a terrible condition herself, like having been diagnosed with cancer, going through the treatment, she was still using that avenue of connecting with people to educate them.

Host: Dr. Arbune was able to identify medications that improved Debra's heart function, allowing her chemotherapy treatment to continue. Amid her body's toughest fight, Debra's spirit never wavered, nor did her self-advocacy, a crucial element to her not just beating breast cancer, but doing so on her terms.

Debra Faulk: The hardest part for me was going in every week because I didn't have a PIC or a port. I didn't want any more scars on my body because we've been doing quite well throughout the years. I still wanted to be able to show my legs and my arms. So, that was a big part for me not to be scarred up anymore after having a lumpectomy, as well as having lymph nodes removed. So, I decided, "You're not going to put in a PIC or a port." So every week, my greatest fear was being stuck with this needle. But all I kept thinking was, "I won't have any scars." So, you've got to find the something that helps get you through. And man, I tell you, every week, they knew. And I was questioning everybody. I'm reading names because I want to know who's sticking me. Like I said, I'm a control freak. So, you have to be your own best advocate. And I need to know how many times do you stick in one day, because my veins are small and they move, and I need somebody who can get it one time. I need you to send me somebody who's got a gold medal in sticking people with needles.

TEDx Talk excerpt: Daddy, I cleaned the bathroom all by myself. Can you please give me my allowance?

Host: You're listening to an excerpt from a TEDx Talk that Debra gave at Transylvania University in 2018, about three years before her breast cancer diagnosis.

TEDx Talk excerpt: You said you cleaned the bathroom all by yourself. Sure enough. You sure you done it all by yourself? Yes, daddy. I cleaned the bathroom all by myself and didn't nobody help me. And they was all outside playing, even though they were supposed to be helping, but they didn't. And I cleaned the bathroom all by myself. Sure enough. Well, let me ask you something. When you turn on the light, did the light work? Yes, daddy. Of course, daddy works. You ain't done nothing by yourself. You understand what daddy's trying to learn you? Yes, daddy. Let me ask you something else. When you turn on the water, did the water come out the spigot? Yes, daddy. Of course, your mama works. Your mama paid that water bill. You ain't done nothing by yourself. Let me ask you somethin else. When you went to get the Ajax and the White Claw, was it underneath the sink for you? Yes, daddy. Because your brother worked. I've been learning him how to be a man. He been out there shoveling snow all winter and raking leaves during the summer. You think you done it all by yourself. I know you think you done it all. But can't nobody do nothing by they self. You understand? Hell, I helped Barack Obama get in the office. My one vote counts! Ha! Now, what I done, I helped that man get in the office. He ain't get in there by his self. You understand what daddy trying to learn you? Trying to learn you right here in this house before you get out there in that real world and they learn you in a different way. There's folks that been dangling from trees from where they been hung, swinging like strange fruit. There's people that had to sit in the back of the bus so you could sit in the front of the classroom. And you're going to tell me you done it all by yourself. Whether you know about it or not, somebody helped you, because we all need help.

Host: Debra practices her father's wisdom in her performances and her demeanor. Throughout her treatment, Even. Amid the setbacks involving her heart, she took it upon herself to be a source of joy for other patients going through cancer therapy.

Debra Faulk: You see these car commercials, and they're all like, "Oh, it's just like home!" And I'm like, "It can't be!" But I did find that at Markey Cancer Center. And I spoke to people. I got to know them. I know their names. I know what they're going through, because there are a lot of different people that come through that waiting room. And for me to see people sitting there and not conversing and not talking to each other, you don't try to act like you don't see me and we're both sitting here, wrapped up, with this tiny little robe on. Come on, talk to me.

So, I think I was able to help some women loosen up, open up and widen their mind to some possibilities. Because, yeah, we're sick. We're not dead. We still got jobs to do. We still have a mission. You still got to go to work. You still have to be a school teacher. You still have to be this example. And just because you see me crying doesn't mean that I'm weak. That shows strength in being vulnerable. So, I had to be there to be a voice to these women, to let them know what strength looks like, because everybody's vision is not the same. Some people's vision are blurred and they can't see the finish line, and I couldn't see it either.

Host: Debra left a lasting impression on her doctors too.

Dr. Emily Marcinkowski: She understood that cancer doesn't define you. Like, cancer doesn't define me. Like, I am more than, you know, a diagnosis. And it was not going to interrupt her life. And I love that, because she didn't stop living. She never stopped living. Sure, she had like some speed bumps along the way, but she was still Debra. She was still going to perform, and she was still going to come back and be as sassy as she was.

Dr. Amit Arbune: We always had jokes, I can't remember any one of them specifically, but we have had great interactions. My nurse practitioner and her one time, they were talking and they were talking about jewelry and I walked in. And they were like, "This is girls talk. You don't need to be here." So, yeah, it's been a pleasure working with her, so various interactions. She's a great patient.

Host: In the midst of her treatment, genetic testing revealed that Debra did not have BRCA or BRCA gene mutations, which increased the risk of cancer recurrence. It also indicated that her cancer was not hereditary as she feared. A born artist who's entertained on stages from Lexington to Las Vegas, Debra has long channeled personal pain into her performances. Surviving breast cancer is something she could not have done alone, and she intends to do what she can to make sure no one else feels alone in their own cancer journey. That's especially true for black women, who, despite similar incident rates compared to other women, are 40% more likely to die from breast cancer.

Debra Faulk: And I made the best of it, and I came out not only as a Winburn Warrior and as a Bryan Station Defender, but I'm no longer a Cougar, I'm a Kentucky Wildcat. Roar! Hear me roar, honey. Hear me roar, because I fought the good fight. And even though I'm a declawed wildcat, I still fought, you know? Never give up on yourself, because everybody else is doing that. So if I can be a beacon of light, then allow me to be that. Even in my standup comedy routine, when I get off stage, I always let the audience know, "Thank you so much. I got the light." That's double entendre. I don't just have the light because my time is up. Baby, I'm just getting started. So, let your light shine, and do things that matter. Chemo helps you love better and harder. I forgive people. I ain't forgot nothing, but I forgive. And with that same heart that we were able to save at the Gill Heart Institute, I can still love and laugh and live. And that's what cancer did for me.

VO: This episode of Extraordinary People was brought to you by the UK HealthCare Brand Strategy Team. If you were a patient at UK HealthCare and would like to share your story, please visit ukhealthcare.com/stories. We would love to help you tell it. Thank you for listening.