Full Episode Transcript

Season 2 | Episode 2: What We Do for Our Bodies (with Dr. Kavita Jackson, M.D.)

Transcribed by: Eryn Strong, Hannah Rosentreter, Gina Marioni, Sonia Montejano, Elizabeth Jarvie, Kisa Nishimoto, Leina Megurikami and Jamie Fischer. 

Running Time: 1:32:49

Dr. Kavita Jackson: Every day you wake up, you show up for your treatments, you show up for all the visits, you know, my body is there showing up and now it's time for my mind to get on board. I'm going to support you. You supported me in so many ways in the past. You, I'm going to believe, did not choose cancer, cancer chose you, cancer chose us, ‘cause we would not have made that decision. So I'm here for you. I'm going to nourish you. I'm going to take care of you however you need because we're doing this together
[Theme Music Begins]

Jodi-Ann Burey, as host: Welcome to Black Cancer. I'm your host, Jodi-Ann Burey. Our guest on today's episode is Dr. Kavita Jackson, breast cancer warrior MD. We talk about her experiences from launching her career as an emergency room physician to facing stage two invasive ductal carcinoma breast cancer. A mother of two small children, the daughter of immigrants from India, she draws on the strength of those who support her to navigate treatment and her relationship with her body. We work through understanding that our mind and our bodies are fighting the same war to heal ourselves. After the credits, stay on for a few more moments to listen to Dr. Jackson and I discuss cancer swag, the concept of corporate pinkwashing and negotiating potential silver linings if we can call them that, to our respective cancer journeys. Just a heads up. This conversation was recorded before the death of Dr. Susan Moore, the physician who before she succumbed to COVID-19 posted videos online about the racism she experienced by the hospital team where she was being treated. I say this because we touch on a few topics in this conversation that we would have likely brought this up. But we're not not talking about it this season. Keep in mind when the conversations are recorded and when they're posted. It may be achronological with current events. Okay, so here's my conversation with Dr. Jackson.

[Theme Music Fades Out]

I also want to let people know that I respect your position and the work that you do. And so even though you did give me permission to call you Kavita, I will call you Dr. Jackson, if you're nasty. *laughs* Do you do that Ms. Jackson?

*Both laugh*

Dr. Kavita Jackson: Oh my gosh!

Jodi-Ann Burey: So I'm really pumped that you're here. I'm really excited to chat with you. I think this is actually the first time that I saw someone on social media and I'm like, I want to talk to this person. And so thank you so much for being here.

Dr. Kavita Jackson: Thank you so much for having me Jodi-Ann. I guess I can call you Ms. Burey? 

Jodi-Ann Burey: No that’s okay. [Dr. Kavita Jackson: laughs] I'm so desperate to get rid of my last name. And so if there's anyone out there who wants to marry me, hit me up. [Dr. Kavita Jackson: Oh my gosh.] Yes. Okay. So I always get excited to talk to other immigrants or one and a half generation. I'm always drawn to learning more about your origin story. So I actually want to start there [Dr. Kavita Jackson: Sure.] setting up some context about who you are, and who you come from.

Dr. Kavita Jackson: So I was born and raised in the suburbs of Michigan. And as you mentioned, I'm a first-generation, I am Indian American, my parents came from India. My dad had come a few years before I was born. And my mom came over, you know, 35 plus weeks pregnant when she wasn't supposed to be flying, actually, just so I could be born in our country. She's a doctor. And she is the only female in her family. She's got three older brothers. So she's the youngest and the only female. And for her to be in medicine is actually quite unheard of in how she got there, which I thought was very interesting. She went to junior high and they had a line for the - you had to pick between arts and science - and the science line was shorter, and she just didn't have that much patience. So she got in the shorter line. And that's how she became a doctor.

Jodi-Ann Burey: I love this. I love this so much.

Dr. Kavita Jackson: I love it so much, because my experience was entirely different - not to say that she didn't have to deal with a lot of rigor, and it still took a lot of determination and hard work and studying. And a lot of home management because she actually had my brother and I while she was training. But, this-her decision point of how she got into it sounds way simpler than all the thought that I had to go through and all the things I had to go through to get to medical school in the United States. So she did all of that, did her training came to the US. Had my brother and I had to repeat some of her training as an immigrant, and has been practicing geriatrics for the last, you know, 20 - Well, how old am I? Yeah, so 30 plus years. And my dad is an engineer, he worked for Ford, you could say, a very typical Indian family [Jodi-Ann: Mhmm.] one engineer and one doctor. And as you know, I'm a physician as well, I'm in emergency medicine, and my brother happens to be an engineer.

Jodi-Ann Burey: I love that, that is like that's a very Indian narrative, if I can say, but also, a lot of people from the Caribbean, a lot of people from different countries in Africa, it's like, you're going to be a doctor, a lawyer, an engineer. [Dr. Kavita Jackson: Yeah.] Like, those are your options. 

Dr. Kavita Jackson: Those are your options. *both laugh* And I think my parents are so lucky that without pushing us into where we are, that they've gotten, what many Indian parents want is an engineer and a doctor. And actually, you know, two kids that have followed in their footsteps and on top of that, so I think they're very lucky. *laughs*

Jodi-Ann Burey: Yes, and you're lucky as well. So you don't have to feel their wrath for the rest of your life.

Dr. Kavita Jackson: Yeah. *laughs* They get-they can't give me crap about anything, because I've done all the things and met all the expectations. But no, really, I am pretty lucky. They never pushed when it was inappropriate. And I've been thinking I-you know, this is totally not where our conversation was going. But I've been thinking about now that I have my own two kids, what it is that they did, how they raised my brother and I so that we could be successful and happy and to where we are right now. We're both very accomplished, we've been very fortunate with our upbringing and our education, and having the ability to explore lots of different interests. And I feel like they've done it, my parents did this all without demanding anything of us without saying, you have to be a doctor, engineer or lawyer. Without threatening us with anything, never really pushing us here we-I like to think very naturally found ourselves into the positions that we're in. And it's almost more satisfying that way, then, you know, I'm here because my parents said I have to be here, and how can I instill that in my kids? So I'm still figuring that out. But I think one thing I realized is that they did push us to try new things and to, you know, study harder, but they never criticized if something didn't go right, right? If we, if we didn't do as well on a test or we, you know, I was in marching band, I played oboe, if something didn't go so great there, they were always there to catch us when we fell, always to support, always to uplift so that we could keep moving forward. And I think that was very helpful to have that mindset and support from my parents, which I've always had. And I still have. So I think that's important. 

Jodi-Ann Burey: Yeah, I think what's also interesting about being first-generation too, is to not just understand your origin stories, but to kind of look back on your life and realize that you were actually witnessing your parents doing some of the hardest things, right? Coming to this country, maybe not having as big of a network as they had where they were from, trying to figure things out and raising small children. And when I turned 34, I realized that I was the same age as my mom, when she came to this country with an infant, [Dr. Kavita Jackson: Mhmm.] I was like, eight months or something. And, you know, three other kids. And then my sister was born three years later, and I'm like, could I have done what my mom did? And there's part of me that's like, Oh hell no, right? I don't have kids. Like, I don't know if I would do that. And then there's part of me that's like, Yes, because there is something about bearing witness to that, that at least gives me gives me the confidence that I can approach hard things and get to the other side of it, which is something that helped carry me through my own cancer journey. I'm curious what your thoughts are on that. 

Dr. Kavita Jackson: Yeah, I absolutely agree. Especially reflecting back on the things that they've done. So I'll tell you at the age of 16, No. I was trying to move as far away from my parents as I could. I was trying to go to college in California, all this kind of stuff. Like we didn't have a great relationship. I had no idea what they'd endured and what they did actually, for my brother and I to have a good life, right? We were the focus of their whole lives and everything they did was for the betterment of us. And now as a parent as reflecting back on that, I'm just like, oh my goodness, right. Like I've handled all these, you know, I've moved across state lines for training, I have young kids, you know, a demanding job. It's a lot to juggle, but I am in the same country that I was born in, I'm familiar with the culture, I speak the language, I was educated here, I have all of these things that assist my fitting into this country. I can't imagine juggling that, you know, being away from your whole network of family, just in this brand new country, right? The promised land. Getting the *chuckles* getting the American Dream [Jodi-Ann: Yup.] that everybody comes here to get. And as you know, in the 80s, things were not as friendly as they're becoming now to first-generations and to immigrants, we still have a lot of work to go. But I just can't imagine, you know how they did all of that. And then mad respect, because they did it for me. They didn't even do it for themselves. It was for me and my brother.

Jodi-Ann Burey: Ugh! Hats off to all the immigrant parents out there. Really annoying, sometimes being bicultural *laughs* trying to navigate who you are culturally there and the roots that you come from, and then being American. And what that is, you know, after this, I feel like, I have to call my mom like, “Mom, you know, thank you so much.”

*Both laugh*

Dr. Kavita Jackson: She'd be like, what's wrong?

Jodi-Ann Burey: I know, she's like, she'll actually be like, oh, Jo is calling me, that never happens. I'm not the best child, but I'm working on it. Watching your mom do all of this and become, like, pursue her medical career... You had a very grueling last decade and a half, navigating your own family life and your career. Can you just share a little bit about what that was like for you?

Dr. Kavita Jackson: Yeah, and I will say with having the immigrant parents - the not realizing all that, you know, their endurance and strength that we were bearing witness to, but it does raise the bar and what's normal for me, what's attainable for me as a woman and in this country. That gave me an example and something that I really appreciate. You know, when I hear from other women, or especially young women, like, “Oh, women don't do that,” or “How can a woman do this, this and that.” But for me, it's normal. Like, my mom did that. I know, it can be done. I've seen it done. Therefore, I know I can do it. And I know you can do it. I know anybody can do it. I'm grateful for that message. It has been very difficult *laughs* for the last 14 years. So I graduated high school. Yeah, about 16 years ago, and it took me 14 years from then to become an emergency medicine physician. During that time, I also got married, and I had two kids during emergency medicine residency. Which just know it is possible, it is not easy. Lots of people will tell you no and will not recommend it. And I say choose what's best for you. And however you need to make things work to reach the goals that are important to you. It is possible, anything is possible, if it's what you want to do. 

My number one supports have been my husband and my mom. Actually, she's been alongside me the whole time. I moved from Michigan to Philadelphia for medical school and to do a post-doc. And when I started to do my residency there and wanted to have kids, she moved across all those states to come live about a mile away from me in a city that she didn't care about, *laughs* in this apartment building that she hated, all to be near me. So I could have kids, and to help me raise the kids and help with that balance, so I could do all the things that I do at work and with my training. And then when I moved to DC, she upped from Philadelphia, and she moved to DC as well.

Jodi-Ann Burey: Go ‘head mom.

Dr. Kavita Jackson: And that was right about the time I was diagnosed with breast cancer, and just like always she has been there the whole time right next to me, by my side, assisting in so many different ways. And I do talk to her about once a day, on average. So we are very close and much closer than we were when I was growing up.

Jodi-Ann Burey: Do you feel like your relationship with her changed with your diagnosis or the kids or kind of what was that shift do you think?

Dr. Kavita Jackson: Yeah, so I think the major shift was kids, for sure. Like just being a parent, it's like you -- I just can't even describe it. No one could describe it to me. But when you have your child like there's all of these emotions and attachments, and just different feelings and thoughts that you have that you've never had before, like now you're responsible for a life and you created it and it's powerful, it's scary. It's exciting. It's so many different things and to be able to relate to somebody about that is nice. Especially with her being an immigrant and growing up in this country. My children are interracial. They are Black, and they're Indian. So that is something that we're very cognizant about, of how we're raising them, the environment we're raising them in, certain values that we discuss and interactions with the world. There are certain things to think about and to be mindful of. So there's no book - I don’t know, I'm sure there's books on this *laughs* - but formally speaking, there is no book that's gonna teach you all of this. So we do have some interesting discussions, and I like to know how she navigated different situations or new situations. I think that's what it is - new and different and how to approach them. 

Jodi-Ann Burey: Yeah, and at this time in your life with, you know, you have young kids, you're transitioning, and then this tumor pops up. So can you take me there? Like, how did you find your tumor?

Dr. Kavita Jackson: Yeah, as you were saying, it was a lot of change in my life. I’d just graduated residency and I was a brand new attending. And that was very stressful. We had just moved, we had very minimal support, having moved here in December of 2019. It was just about a year ago, around the holiday times, I just had a pain. I just felt this sharp pain in my right breast and grabbed it with my right hand. And that's how I felt the tumor or mass. You know, I just touched and I was like, Oh, well, that's weird. How long has that been there? I should probably get this checked out.

Jodi-Ann Burey:  And then what was the path there? You feel this mass, you feel this pain? Then what?

Dr. Kavita Jackson: Yeah, so, well the first thing was, I needed a primary care doctor, which I didn't have one because when we moved here, my kids got their, you know, their pediatrician, they got an allergist, they had a dermatologist for their eczema and stuff like that. My husband got an allergist, and everybody was set up, and I was the last person, because that's what moms do. And so, but this pushed me into, okay, hey, now's the time, I should get this checked out, it's going to be a cyst, it's going to be a fibroadenoma. But you know, just get it done sooner than later. Because I have a long to-do list, you know, just get things done as I can. 

And it takes time to get in with a doctor. So it took me about a month to get in. And I just found my doctor off ZocDoc, and she took my insurance and she was the soonest one I could see, you know, considering all the holidays. So I went in to see her and she was very astute, very on top of it, a young woman of color like myself, so I feel like we connected very well and I trusted everything that she said. And I just needed an ultrasound, honestly, but she wanted a mammogram and an ultrasound. And you know, I was like, okay, Doctor, you know, like I'm the patient and I'm not gonna, I'm going to try not to doctor myself. And if that's your recommendation, absolutely, I'm going to do it. And then we scheduled a mammogram, I got it done, the ultrasound done. And that same day, the radiologist had come in and was reviewing the results with me and recommended an immediate biopsy that they wanted to do that day in an hour. And I thought this is ridiculous. You know, like, let me see the ultrasound images. I ultrasound at work all the time - granted, not on the breast and not looking for tumors, so I'm not actually trained to understand this particular ultrasound - but you know, me, from what I thought I understood, I think this is not anything concerning. You know, this is just all overkill. But once again, if that's the recommendation, they think this is right, you know, I'm not going to disagree, I'm going to do what's recommended. 

And I said, “Well, I have to leave though because I have to pick up my kids, they have to do dinner, I work tonight, I have to get in a nap before I go to work overnight,” and stuff like that. “But I promise I'll be back next week.” I came in the next week I got the biopsy done. Then about a week later, I got the results. And it was a phone call I had received while I was at work, and I knew it was the pathology results from my biopsy. But I was working and I was just trying to stay focused on my patients. And even though I knew it was just a benign cyst, like you know, just focus on my patients and not get distracted by this. 

I’ll look at it when I get home. My preference was to look at my pathology report myself and my own pride, with my own privacy. And I opened it up when I got home and it said invasive ductal carcinoma, Nottingham grade three. And I thought, well, that's cancer, like, I know that that is cancer. And clearly, this got mixed up with somebody else, because I don't have cancer. But you know, there's no way this is my results. Simple misunderstanding. I will call them back tomorrow. And I did and they confirmed the results over the phone. “I am so sorry, Dr. Jackson, that you need to meet with oncology, you need to meet with breast surgery, you need to get an MRI, we need to have a port.” I was just like what. Yeah, I didn't hear anything after that. And that's how it all started.

Jodi-Ann Burey: *Deep sigh* I think it's interesting, like navigating stuff like this when you actually have some type of medical literacy - but you're an actual doctor, right? *laughs* Like you have the terminology, you did the trainings that a lot of these folks that are, you know, managing your care have done. 

And so what was that process, knowing the steps that you were in, being able to speak to these doctors in doctor language *laughs* [Dr. Kavita Jackson: Mhmm.] and then still having this denial of, like, it’s just a cyst Oh, you know, they mixed up the labs. That's a bit of a disassociation.

Dr. Kavita Jackson: Yeah, so I think I was pretty hypercritical in the beginning of my care because, like you said, I understood what was going on. Now, once it - you know, I'm an emergency medicine physician, I'm not a breast physician or surgeon or do anything directly with breast cancer. So I'm not an expert in that regard. But I am familiar, like you said, with treatments and things to expect. 

So I was just reviewing everything down to the tee. All of it was so new, these aren't doctors that I had known for years. I went from getting a brand new primary care doctor to now having a team of like, three to seven different doctors, all brand new, all women, which probably helped immensely, that was huge for me. They're all young women, so people I connected with instantly as a woman in medicine. 

But I was pretty critical. I think until some point I, you know, I had enough trust in them and it was too overwhelming to try to manage myself, when I didn't need to, when I had all the doctors doing that, reviewing everything with a critical eye. They're incredibly intelligent, I understood their recommendations, I agreed with them. And so I had trust. And at some point, I had to release and let them take over, let them do their jobs. You can't be the patient and the doctor at the same time. Right, like you can advocate for yourself - and that's something I think, a skill I had from being in medicine, because I advocate for patients all the time. That's part of my job. In the emergency department, I'm often calling consultants or other specialists to get something for my patient. And I do it because it's for the sake of the patient, and it's what's right for the patient. And I will push and push and push until I get done or get for them a service or whatever it is that I think is right for them. And so I knew how to advocate and I think that's something that helped me immensely. I could stand up for what my thoughts were possibly because I'm a physician and or because my care team was awesome. I always felt heard. And that's an advantage that I had that they were, not just listening, but you know, making certain changes or explaining things to me when I didn't understand things or if I felt confused, or if I may not have, you know, understood why or what was being done. But in the beginning, when I first met my oncologist, I completely just broke down and started crying because she had mentioned chemotherapy. And she said, you know, an awesome doctor sitting face to face grabbed my hands, “Dr.,” - you know, but right before COVID was really taking off. It was okay to hold hands at that point. *laughs*

Jodi-Ann Burey: But back in the day when we could touch people. *laughs*

Dr. Kavita Jackson: Yeah! Now we do like these air hugs. And [Jodi-Ann: Yeah.] I know - side note, but after remission, I saw my doctors and I wanted to just grab them and I couldn't we just from across the - you know, room have to do these air hugs, which was not satisfying. 

But, so she said, “Dr. Jackson, what are you so worried about? What is worrying you? What are you scared about? What are you thinking?” and I said, you know, “breast cancer, chemotherapy, it reminds me of all of the patients that I've seen with this in the emergency department. If someone has cancer, or is on chemotherapy, and they're coming to see me in the ER, they're not doing very well.

I've actively seen people pass away in front of me, or had just really bad health problems or health conditions, because of cancer and chemotherapy. And now that's going to be me.” You know, like, it's like my mind just went to the worst of the worst. *starts getting choked up* And I was really scared and I didn't want to be that person. But my oncologist was awesome and reminded me that that is the lens through which I am seeing all of this. But that the majority of women and people with breast cancer or chemotherapy are treated as outpatients. The majority of people do very well, and I don't see them, because they're doing so well with their treatment and progressing with their cancer. So I truly am seeing the worst of the worst. And that that's not everybody. And that's not necessarily going to be me. 

So. Whew. *laughs and sniffles*

Jodi-Ann Burey: No, I listen. I think a lot of people are afraid of cancer, because to them cancer equals death in kind of a discourse way, right? Like how we just generally talk about it. 

[Dr. Kavita Jackson: Mhmm.] But your experience is very unique because you have seen people that ... it's tough to then try to put yourself on the other side of something. 

I remember when my doctors were telling me about the risk of paralysis from the neck down, just out of commission. And I remember as a personal trainer, helping people, right, with all their physical disabilities, and helping people advance in their physical abilities to run marathons and do this, and I just felt like, Wait, what? Am I the one who's going to be on this other side of needing so much physical care and needing someone to help me? And I've had relationships with clients for years as a trainer, and then to see myself - I've had relationships with my physical therapist and my occupational therapist for years. [Dr. Kavita Jackson: Mhmm.] And so it's hard to, I think, imagine yourself on the reverse of that dynamic, when it's you.

Dr. Kavita Jackson: I think you're so correct about this concept of the other side. So as I was blogging, I investigated a little bit about just, like, physicians with any sort of chronic illness and why this is something we have such a difficult time accepting and addressing. Like, if you're a doctor and you get sick, it's like this extra insult for some reason. You know? And it's a very much of like, it's them; the patient gets illness, and that's them. I am the healer. We don't get sick. [Jodi-Ann: Yep.] But that's not true. You know, this identity of you can be a healer, you can be a care provider, you know - not just a doctor - in whatever role that you do it as a family member, or as a physical therapist, or whatever your role is. We all take care of, you know, other people in different ways. So you don't just have to be a doctor. But it's a very much Oh, this is me, I take care of people. So I'm not used to being the patient. Like, it's just not a role I identify with. And something I had read, it was an interview of physicians describing why their chronic illness or whatever their condition was, was so challenging for them. So not only is this, we don't get sick, right, but there's this obligation of like, oh, now these, you know, my colleagues, they probably think I'm weaker. I'm ashamed because I can't do my job. They're gonna see me as less. I'm no longer this intelligent, strong person, and I'm going to be seen as incapacitated. When that may not be true at all, you know, if you have something like hypertension, or high blood pressure - that doesn't really affect your ability to be a doctor. You can still be incredibly successful in providing care to other people. But there's this idea that it's like, we need permission to be sick. We need somebody to say, “Hey, you have cancer, and it's okay.” Or like, you know, “You have high blood pressure. It's okay, that doesn't mean the end of your professional life or your professional abilities, and it doesn't make you any less capable of doing them.”

Jodi-Ann Burey: Yeah, it actually can strengthen your ability to do that. And so after my surgery, I came back to Seattle, and I went to go see my primary care physician. When she walked into the room. She had no hair, no eyebrows, nothing. And I'm like, she's actively going through chemotherapy. And she's coming in here to help me with my own cancer stuff. [Dr. Kavita Jackson: Yeah.] And to just sit there. My doctor is also a woman of color - love her so much. *both laugh* To just sit and talk with her about our experiences. And I know that she knows what she's talking about, because she has also been through that. From the patient perspective, I see her, I almost hold her to a higher regard. She's not less than, she's more than, because she knows the journey. She can relate. But it's interesting if, like, physician to physician, if it's like, “Oh, yeah, you're not as strong because it got you too,” or something.

Dr. Kavita Jackson: Yeah, and it's like, you know, I can't say I ever felt like that about any of my colleagues that I knew were having a chronic condition. So I think we don't actively choose to think that, but there is at least a perception that my colleagues will see me in this way. And this whole idea of us versus them, you know, like doctor versus patient, I think it's just being challenged, you know, at least recently, and even for my own mind. Like, why is there an us and them when we are actually like, we're so entangled together, right? Like, why is there an us and them like, I am the doctor and you're the patient. 

You know? I think this experience for me as a physician, when I go back to practice is actually breaking down a lot of barriers with my patients. And you know, like you mentioned - I feel like your doctor, you know, when you saw her, that was more human and more real to you and more relatable. And you may have trusted her a little bit more, you know, without realizing it, but just having that knowledge of what she's going through, or that physicians do get ill, I think it does break those barriers down. And we’re absolutely in medicine, moving away from the traditional paternalistic approach of like, I'm the doctor, I'm going to tell you to do X, Y, and Z. And you're going to go do it, because that's what I said, right? Like, we're being more involved in our care. We are understanding and taking responsibility of our health a little bit more and learning how to advocate for ourselves. And now there's this idea of shared decision making, which is, you know, certain things - let's say you present with some kind of pain, and there's a couple of different tests you can get. And one is not clearly better than the other, or it is. Instead of just telling you, you're going to get test A, I'm going to say, Hey, here's a couple different tests. I'm going to recommend A because this-and-that, but there's also B and C, and you should know about the pros and cons of them. What are your thoughts? You're going to be much more invested in your health and taking responsibility with that sort of a conversation. So, I think this whole thing just breaks down some barriers, and, you know, hopefully will make me more approachable in my interactions with patients. 

Jodi-Ann Burey: That's my dream for Folks of Color to be able to advocate for themselves, to understand that they have shared decision making ability  [Dr. Kavita Jackson: Yeah.] in conversations with people who are, you know, maybe still of this mindset of I have the white coat, I'm the one who has the MD, I'm going to tell you, X, Y and Z. And at least in my own experience, if I just listened to my doctors, I would be paralyzed right now. It was my own self-advocacy that got me the MRI that found the tumor. [Dr. Kavita Jackson: Yeah.] And so just being able to understand your own - if you're a doctor or not. Doctor, [Dr. Kavita Jackson: Yep.] you know, MPH, whatever, you have a voice. You have an investment in your health and in your life.

Dr. Kavita Jackson: Absolutely. It is your health, it's your body. These are your decisions that you should be involved in making. And I encourage you as a patient, or when you're in the patient's seat to advocate, to ask questions, to make sure you understand. You know, I myself am about to discharge someone from the ER, and I'll just break things down and then you know, be like, Alright, so you go to see your doctor in a couple days. Do you have any questions? And so they'll be like, “I understood none of that!” And I'm like, oh, shoot, okay, I didn't explain something well enough. But I'm so glad you said that because what I said for you to do, the next steps of what I recommended are things you should look out for are actually really important. So let's break it down. Whether that means writing it down, whether that means using some different language, whether that means telling a second family member that they want involved. You know, there's different ways to do that. And what works for one person doesn't work for the next. And I also highly encourage you, this does not sound as simple, but we're not perfect. We all have different personalities as physicians. One doctor may not be the right fit or the best fit for three different patients. So if you're with a doctor, and for whatever reason, you just don't feel like the relationship is jiving, it doesn't mean they're a bad doctor, it does not mean you are a bad or non-compliant patient, it just might mean it's not the best fit. The best of your ability and insurance or non-insurance allowing, it's okay to ask for another doctor or to make an appointment with somebody else. This is somebody you want to trust and have a trusting relationship with. So it's absolutely okay to have a different doctor.

Jodi-Ann Burey: Yes. Or a team of doctors, too. [Dr. Kavita Jackson: Yes.] Like, I have so many doctors. *laughs*

Dr. Kavita Jackson: *laughs* Yeah. 

Jodi-Ann Burey: So it's interesting, when you get your diagnosis, it feels like a very singular experience. It is a personal journey when you're sitting there that this is this thing that is happening to my body. But we're connected to so many people. And what I love about this podcast is also trying to think about the cancer journeys of folks who don't have a diagnosis. And so for you, you know, you have your practice of telling patients tough news. How did you navigate telling your loved ones, your husband, your parents, your kids? Like, how do you share that information with people who love you?

Dr. Kavita Jackson: That is such a good question and I think I did nothing that I ever have recommended to anybody. You know, when you are in those shoes, I guarantee it's just a completely different situation. *laughs* And anytime someone says that to me now I believe them, and I will honor and respect what they're saying because I have no idea. So when it happened, my approach - essentially, I would have told nobody if I didn't have to tell anybody. Then  I would have just kept it all to myself - which I did for a very long time [Jodi-Ann: Yeah.] until I got the diagnosis. And then I was like, Shoot, well, I can't go to chemo without people noticing. [Jodi-Ann: Yeah. *laughs] At home, like my husband and my mom, and my kids - they're gonna notice. I have to tell them. My mom was actually visiting from Philadelphia to look at apartments to move in and what I did: we were just sitting in bed, the kids were asleep, and she was laying down - I just pulled up my phone, and I pulled up the path results. And I just handed it to her. *laughs* I couldn't bear to say much more than that. And as a physician, I knew she'd read it and she’d know exactly what was going on. And her response, you know, was like, “No...” she's like, “Whose results are these? Why are you showing me this?” 

Jodi-Ann Burey: *laughs* Is this a patient? Is this HIPAA compliant?

Dr. Kavita Jackson: Exactly! Right? *laughs* And I was like, “Wait, no, scroll up, look at the name, look at the date of birth.” And that's how that conversation started. And we didn't talk too much about it, because I just couldn't handle - I just could not handle it. I was not saying the word “cancer”. I didn't say that I think until a couple months in, saying the C-word, or that I have the C-word or anything like that. The other people close to me, like my brother and some very close friends - I sent a text message. And the last line of the text message was: Don't call me. I don't want to talk about it. But I just wanted you to know, here's what's going on with me.

Jodi-Ann Burey: I like that, like the boundary setting.

Dr. Kavita Jackson: Yeah, like I said, I wouldn't have told anybody if I didn't have to. At least in the beginning, you know, like I just didn't even know how I felt about it ‘cause I felt 1,000 different things about it - 99% of them negative things, obviously. But yeah, there's a whole, you know, this whole group of support people - these people affected by cancer, right? I didn't hear that until recently, like, someone affected by cancer to me translated to: they've been diagnosed with cancer. [Jodi-Ann: Yeah.] No. There's so many people - even more than the people diagnosed with cancer are people affected by cancer; as a family member, a friend, you know, whoever, your neighbor -you can still be affected by it. And it's really important to give those support people the attention and encouragement and their own support, whether they're, you know, providing physical care, or emotional support, or whatever it is, because they're bearing a lot of this diagnosis, even though it's not in their bodies.

Jodi-Ann Burey: How did you tell your kids or did you tell them? Like, how do you navigate this conversation with very small people?

*both laugh*

Dr. Kavita Jackson: Right? I thought, you know, I have to tell them. I should. I'm very close with them. Also, we're in COVID pandemic and we’re quarantining together. And you can't really hide, you know, at least the physical signs of cancer, so they're gonna know what's up. I had told them that, “Mommy has a big boo boo on her chest and so she's going to the doctor, she gets medicine.” I involved them, at least my four-year-old, who was very observant - wanted to be involved and had lots of questions. So I showed her, I showed her my band aids. she still to this day, she takes my band aids off. If I go - for whatever reason - she'll get to take the band aids off. I showed her my port, and I let her kind of touch and feel it. After surgery, she thought the JP drains were really cool. So she would just kind of, you know, sterilely and cleanly squish the liquids around. *laughs* And I think people probably think that's so incredibly gross, but this is also a medical household I guess. [Jodi-Ann: Yeah.] I mean, regardless of being a doctor, it has become a full on medical household. So, we are not as grossed out anymore. These things are normal to us. But she liked to stay involved in that way. And my two-year-old kind of gets it - not really. *laughs* She's pretty, just like...blissful in her own understanding of things. But she asks me, now more recently - I think she's caught on - she asked me if my boo boo is all fixed. And she wants to look (I don't have bandages and stuff to show them on my chest anymore) but she likes to - kind of - every now and then look there. 

 So, that's kind of how I did it and I tried to make it fun, you know, with their positive and fun energy … it just contributed so much positivity and light to my experience. Like when I cut my hair, I think was what I anticipated to be the most difficult part of this because of my attachment - not just physically to my hair - but the pride that I took in my hair. [Jodi-Ann: Mmhmm.] I always had very long hair and I style it and take a lot of care with that. So knowing I was going to lose my hair was very anxiety provoking for me. And so we sectioned it off, and my husband buzzed it all off. And my kids were at my parents house at that time, because this was something, you know, we thought we should - it's probably best if we just do the two of us. And I FaceTimed my daughter, and she goes, “Oh, my gosh, you have a haircut, like, Nana, like Daddy-” and all the men in my family. And she just thought it was so cool and she insisted to have her haircut done the same way. And I considered it because there's this thing in Indian culture called a Mundan, where you do cut kids’ hair when they're very young with the idea that hair carries, you know, part of your life in it. And because we believe in karma and reincarnation, the hair you're born with is from your prior lives, and you want to start a fresh life without any of the badness that might be transferring over. So you cut it off. And I ended up not going through with it because I thought, you know, she's four, and *exhales*...I couldn't get myself to do it. But we might maybe next year.

Jodi-Ann Burey: I recently heard about that because Mindy Kaling had another baby [Dr. Kavita Jackson: Mmhm. Yeah.] during quarantine. And no one knew about it. *laguhs*

Dr. Kavita Jackson: I did not know. I'm just finding out and now I have the urge to go look it up. *both laugh* I'll do it after the podcast.

Jodi-Ann Burey: Yeah, but she was talking about how she cut her daughter's hair and that whole process. [Dr. Kavita Jackson: Yeah.] And I just I just loved the way you involved them. And I'm assuming it wasn't something that could feel scary for them, like they knew what was going on...in the way that they can understand it.

Dr. Kavita Jackson: Yeah. So they don't they don't know the word “cancer”, you know? I didn't think that hard about it. I just thought, Let me try to communicate in some way and see where it goes. I didn't really have a formal plan, but I wanted them … I didn't want to hide it from them if I didn’t have to.

Jodi-Ann Burey: Can I ask you a tough question - maybe a tough question? I don't know if it's tough. But we'll see. [Dr. Kavita Jackson: Yep.] So, as you're navigating this with your kids, and talking about boo boos, and all of that -  like, underlying all of that, at any point, did you feel like you were going to die?

Dr. Kavita Jackson: In the beginning. You know, when I got that diagnosis: breast cancer, you know, invasive ductal carcinoma. And then at that point, I knew nothing else, right? So for me, I knew about staging and the next biggest concern was: well, what stage is it? Stage One is very different than Stage Four. And I did not know. I didn't really find out until I was done with chemo and after my first surgery. So I was diagnosed in March, and I found out at the end of July what stage I was. I’m a Stage Two-A - it was all because I had to wait on the lymph node evaluation. But in the beginning, that's kind of instantly where my mind had gone to. It's kind of like, You have this mass and you actually assumed the best - the most common - you assumed what the textbooks would tell you is that: “In a young woman with no risk factors for cancer, that this is probably a fibroadenoma or a cyst.” And it turned out not to be. And I was not going to let myself be fooled again. I went back to my mindset of worst case scenario, which is how I live my life professionally and personally *laughs*. And I was almost ashamed that I let this slip away from me, and almost thought it was something you know, benign. But just all the uncertainty, it crossed my mind, Well, you might die. You might die soon. And are you ready? And for me, it wasn't even mental. My mind went through the checklist of: Is your will set up? Do you have your advanced directive? The girls college funds are set up - are they automated? You know, automated to be funded and things like that. The logistics of “what am I going to do for my family?” - considering I may not be here - I should write some letters to my girls, you know, stuff like that. Just without having known, my mind went straight there and I started to prepare.

Jodi-Ann Burey: So what does it mean to you to be a survivor?

Dr. Kavita Jackson: So I'm pretty new to survivorhood and I am learning about it. I really did think you know, You go into remission and the cancer is gone. No evidence of disease. And that's great, you move on. Never looking back. You know, knowing that there are some things from this experience, things I learned about myself in the world that I will take forward - but I'm like, “Bye cancer, see you never!” *laughs* And it didn't really happen like that. [Jodi-Ann: Deuces.]. Right, right. Yeah, like, “See you never - never going to deal with this.” 

But you know, shortly after I was planning to go back to work and then because of my chemotherapy and recovering immune system in the pandemic, I found out that I'm not actually going back to work and then this thing that I thought was done is actually continuing to affect me and what I'm doing day-to-day still. The effects from surgery, like I have a lot of numbness and some physical restrictions that I'm still working through. So, “survivor”, for me, right now, means that there is no evidence of disease, the cancer itself is not there, and my treatments are done. And I'm done with the surgeries. So that's kind of what it means: treatment in cancer in one way it's done. But I am forever a breast cancer patient or survivor of breast cancer. This is going to be a part of me and I'm going to make it as positive of an experience as I can going forward. And now, I feel an obligation to educate and empower and reach out to anyone in the world who will listen. But, women, Women of Color, Indian women, people across the country, across the world - to talk about self breast exams; about what cancer is; what it's like to have cancer; what it was like as a doctor; what it's like as a mom - sharing just real, raw experiences. I have nothing to be ashamed of from having breast cancer and if it's going to help empower or relate, make one other person be able to relate or feel supported, I am all for it.

Jodi-Ann Burey: Can we talk about the self breast exam? [Dr. Kavita Jackson: Yeah.] When we had talked about this before, you said that in your medical studies, you know, you knew that - like because of what you knew then - you weren't doing self breast exams. And now your experience shifted that. Can you share a little bit about why you  felt that self breast exams weren't the way to go? And now you're like, Check your boobs, like, every day.

Dr. Kavita Jackson: Yeah, absolutely. So in medical school, we learn certain guidelines from different governing bodies. So, for example, the American College of Obstetricians and Gynecologists,- that's ACOG, A-C-O-G - and several other organizations - like the American Cancer Society - they make different recommendations based on a lot of research that has been done. So, self breast exams were not recommended for women to do because the research shows, if you do self breast exams, women tend to find a lot of abnormalities, that leads to a lot of additional invasive testing. So, mammograms and biopsies, and sometimes surgery, which in the end, ended up being unnecessary, ‘cause they did not have cancer. So doing the self breast exam - people were finding a lot of benign lesions, but they got a lot of invasive testing to work it out and it ended up not being cancer. And all that invasive testing has some side effects that go along with it. So, it was not a benign process. 

You know, money is also a concern. The amount of healthcare dollars, which for my personal purposes, is less important in this conversation, but things that people when they make recommendations in our country are thinking about. We as patients are less thinking about that when we want - when we think we need certain tests done. So I didn't do it because of the high false-positive rate. Then when I felt this pain, and you know, I got the mass, I felt the mass, and all that kind of stuff, I was diagnosed with cancer. I was like, hold on a minute. How long has it been there? Would I have found it sooner if I had done the breast exams on myself? They’re so easy to do. It doesn't take formal training. My mass was big enough that if I had just looked at myself, sideways in a mirror, I would have noticed it. I wasn't even looking. You know, you definitely will not find something that you are not looking for, or at least aware to look for. 

So, now I highly encourage, and I have been teaching self breast exams - through social media, to women in India, to physicians in India, people in the US, wherever - to anybody that's interested to learn really about breast health and breast awareness can learn about a self breast exam. Which that sentence didn't totally make sense. But the idea is to have breast awareness. I think the ACOG now mentions encouraging breast awareness, then it's up to a physician and the patient to decide, you know, if you want to do it through an exam, or how you want to do that. Essentially, you want to just know what is normal for you, so you can notice any sort of change. Any change is a red flag. It's alarming. You don't have to remember the list of like, Oh a mass, a rash, nipple discharge... No. If you know what's normal for you, and you look once a month, you feel once a month, you notice something different - that prompts a conversation with your doctor that you have found something

Jodi-Ann Burey: I think it's a sense of having a very intimate relationship with your body? [Dr. Kavita Jackson: Yeah.] Like, not just breast awareness, but your body awareness? [Dr. Kavita Jackson: Yes.] And trusting your body and trusting your assessment of your body, like, Hey, this is different. This is not normal. And I think especially for women of color, I feel like a lot of times we can normalize physically or mentally being in chronic pain. *chuckles* [Dr. Kavita Jackson: Mmhmm.] And like, that's actually not okay. [Dr. Kavita Jackson: Yeah.] So how can you advocate for yourself? But then, on the flip side, when your body - like, you’re here trusting your body [Dr. Kavita Jackson: chuckles] and having this beautiful relationship with your body - and then your body's like, “I'm just gonna grow masses in places.” *chuckles* Right? Like, what? 

Dr. Kavita Jackson: I had this total mind-body disconnect when I was diagnosed, and probably for the first time in my life, I understood the difference between mind and body and the mind-body connection. It's something I just did not did not understand. Right? Because like, my mind and my body we’re not only physically connected, but we work as one, right? And then so when cancer happened, I had this hate and I felt totally betrayed by my body. Like, how the F did you go and do this to me? Like, this is my body. I didn't give you permission to do that. You have now waged this unwelcome war. You didn't consult me! You didn't give me a heads up! Aren't we? Don't we do this together? [Jodi-Ann: Yeah.] Like you belong to me? What is this shit that you have gone and decided to do? Like, that's totally not cool.

And like you can't - aside from. *chuckles* This isn't even funny. But it's not, you know, the only way to literally separate these two things, is to behead yourself I guess, [Jodi-Ann: Yeah.] which is like super morbid. And I don't know if you want to include that. [Jodi-Ann: *laughs*] But when the chemo started, and you know, I was at war with my body, I was at war with cancer. And then chemotherapy started, and you start to feel those physical side-effects and that illness, you just - your body feels awful, your mind feels awful. 

I kind of realized, like, Hey, we're actually in this together, like, we are fighting the same war, and we are going to be stronger together. You show up for chemo every day. Every day you wake up, you show up for your treatments, you show up for all the visits, you know, my body is there showing up and now it's time for my mind to get on board. I'm going to support you. You supported me in so many ways in the past, you - I'm going to believe you did not choose cancer - cancer chose you, cancer chose us, because we would not have made that decision. So I'm here for you. I'm going to nourish you. I'm going to take care of you however you need because we're doing this together. So we are reconnected now.

Jodi-Ann Burey: *sighs* I struggle with that a lot too. ‘Cause just literally with someone with a spinal cord injury, my mind and my body are disconnected *chuckles* [Dr. Kavita Jackson: Yeah.] in a lot of different ways. And for years, I felt that betrayal, that war. I felt like I was fighting with my body, because my mind was like, Oh, let's go walk upstairs. And my body wasn't doing it. [Dr. Kavita Jackson: Yeah.] Right? And so then as you're trying to heal, as you're trying to get better - you know, how do you have that conversation with your body? And honestly, it's been a couple years for me now and I recently took a yoga class on my little Peloton App - Chelsea Jackson Roberts. Team Chelsea all the way. [Dr. Kavita Jackson: *laughs*] I only do the Black and Brown yoga instructors. [Dr. Kavita Jackson: laughs] I just can't, *both laugh* like, I need - if we're talking about my body, I need you to see me, you know?

So Chelsea said something like, “What does justice look like in your body? What does equity look like in your body? How can you understand what your body needs and give it that?” And it clicked. It - this is a couple months ago - it just clicked. Like, Oh my god. [Dr. Kavita Jackson: Yeah.] How can I be equitable to my body? How can I trust that we're, as you say, we're fighting the same war. So what can we do to give each other what we need to heal? [Dr. Kavita Jackson: Yes.Yes.] 

And it's so interesting, as you say that. You know, I also had this bias to like, Alright, cancer, treatment, I'm good to go. And then the numbness. Listen, numbness is a thing. It sounds so benign. [Dr. Kavita Jackson: Mmhmm.] Like, “Oh, yeah, you know, my hand is numb.” No, like, numbness is a thing. [Dr. Kavita Jackson: Yeah.] Neuropathy is a thing. [Dr. Kavita Jackson: Yeah.] And it's  this lingering sense [Dr. Kavita Jackson: Yeah.] that this thing happened to you. And this relationship with your body is in that conversation and “What does justice look like?” will be forever - to have that connection and that appreciation that your body is trying to get better.

Dr. Kavita Jackson: Yeah, and all of it's a very much a give and take. It's a two way street, like you said, right? Like, our bodies are giving us, you know, doing all the things that they do - giving us all these things, allowing our minds to live physically. What are we doing for our bodies? You know, what are we giving back? Like, how does hate serve us? Right, like hating our bodies? How does that serve us? Punishing our bodies - how does that serve us? It doesn't. 

These are questions I had with myself, you know, throughout the cancer treatment and stuff. Then I start, you know, thinking, How are my actions and thoughts serving me right now? And if they're serving me negatively, or poorly - you know, not just like experiencing a negative emotion, so I can understand it and move forward and move upward - but if this is affecting me negatively, if I want to stay negative, and that's the direction I want to go, stay down that path. And that's okay. I mean, you just have to ask yourself the question, so you know which way you're headed. And if not, if I want to feel good, I want to feel strong, I want to feel positive, there's a separate path for that. And that doesn't mean ignoring your negative emotions and feelings, you should absolutely explore and understand them. Otherwise, I found they kind of build up until they burst out. And that's never pretty, and it does not feel good. Like, respect them for what they are. And then move the direction that you want to move.

Jodi-Ann Burey: That is so powerful. It's so powerful, and it resonates with me, because of where I am in my journey now. I think if you told me that, two or three years ago, I would be like, “Whatever, Kavita.” *both laugh* [Dr. Kavita Jackson: Right?]

Everything that you're saying will make sense, when you're ready to understand it.

Dr. Kavita Jackson: When you are ready. Things that people have told me you know, unrelated to cancer - like advice about going to medical school, advice about being a parent - and you just kind of hear it and you're like, “Yes, I respect your thoughts. And you're, you know, this advice you're giving is great.” But until you experience it, and become ready to understand that message or that advice, it has no bearing on you, it will not influence your actions, and you will just not understand that. So, you know, when it's the time and you are ready, you will understand it.

Jodi-Ann Burey: Yeah. And so I want to ask you a question that you had flipped on me [Dr. Kavita Jackson: *chuckles*] when we talked about this before?

Dr. Kavita Jackson: I know. I don't think I have an answer yet. I tried to think of one. *laughs* I saw that on your list. And I was like, shhh-still trying to figure this out. But yeah, ask away.

Jodi-Ann Burey: Well, alright - let's work through this: so if you bumped into your future self, so Dr. Jackson five years from now, what would she say to you?

Dr. Kavita Jackson: That is such a good question. And I told you, I'm still figuring this out, but I love this question. The opposite of what would I tell myself five years ago, which I thought of that answer right away. My future self would say to me: there are bigger and better things happening for you. Even if that's not clear for you, even if you may not have a clear goal in mind, you are moving forward, you are moving towards happiness, and that's what you will achieve. To embrace some of the uncertainty that you're feeling right now. Because I feel like my life has been for myself, I've created a checklist of things of which just about everything I have achieved, and I was feeling a little bit lost when all of this started. And then I don't have to make a rigid, regimented checklist for the next five years, I'm going to allow myself to kind of go with the flow.

Jodi-Ann Burey: I like that ‘cause as I'm reflecting too, what I hear is, “stop worrying.” *chuckles* [Dr. Kavita Jackson: Yeah! Yeah.] Stop worrying. What I hope for myself and what I hope for you is that you're in a position where you can actually hear that now.

Dr. Kavita Jackson: I think that's like a great summation of what my *laughs* myself is saying to myself five years from now, I might have to steal that, but that summarized, I think, very well, just the sentiment, the message that I'm trying to give myself. Stop worrying, like things are going to be okay, you don't have to control every single detail of your life. ‘Cause by exerting that control, I think we feel power but then when something goes wrong, it wreaks the most havoc. And I think I've had a harder time adjusting when things don't go the way I had foreseen them, ‘cause then it feels like something bad's happening. And that's not necessarily true. Like this whole experience with cancer - cancer is not good, right? That's obvious. Cancer is bad,iIt's awful, it's the worst, I don't wish it upon anybody. But I have grown so much as an individual through this experience, and I have gained so much more than I could have ever realized. And this is-it's turned into an overall - I don't want to say positive experience - an overall growth, I think, from this experience. So yeah, I do like that. I think I'm telling myself not to worry.

Jodi-Ann Burey: For you-for us to be part of a process of elevating and amplifying our stories, it matters a lot. Like, I wish that I could listen to your story when I was going through my thing a couple years ago. And so I just yep, yeah, I hope that this matters. I know that this will matter to somebody, somewhere at some point in their own process.

Dr. Kavita Jackson: And that is my hope with being a part of this podcast, which I am so grateful for, for that exact reason. I like that “amplify and elevate,” because when I was diagnosed with breast cancer, I may naively believe that Indian women do not get breast cancer. Which is so far from the truth. Call me stupid, but I literally had no idea - I had never seen, even throughout all the patients that I've seen with breast cancer, I have not seen a single Indian woman or ever cared for a single Indian woman with breast cancer, and I thought I was an exception. Which I am not. I'm actually a truth, and that's what I want people to know. And it's not to be fearful, it's just to be aware of the truth, to be cognizant of your bodies, to advocate for yourself. Those are all things. There's a whole community of women and people like us, just people affected by cancer - we understand, we're here for you, we will always be here for you. 

Jodi-Ann Burey: It's just like, very easy to talk to you. And I think that could be surprising for people when they talk to like, serious doctors. Like you are not messing around when you're like, I'm going to be a physician. So I think people feel like maybe you're not relatable, or you make this assumption, because you have this position that you're not a person who also navigates this not just through a medical lens, but with your family and-and your life and your parents, like you are a full person.

Dr. Kavita Jackson: Yeah, it's really-it's interesting because I feel like I, as you said that I was just thinking, I-I think I'm learning that myself this year honestly, right? Like my identity up until now has been ER doctor, like mom. And I love those identities. But just like cancer, cancer does not define us, it is a part of who I am. And I'm learning now I have the time, I have the circumstance to like learn about myself. Like really like stupid stuff, like what do you like? Or what do you not like, or just - I've never had the time, or I've never given it the priority or attention that I'm giving it now. And this has all allowed me to do that. And I did-I told my husband before I started all this social media stuff, like it's not for the followers, it's not for any of this. Actually the goal, aside from educating and empowering and connecting with other people, like this has to benefit me in some way. Like, I-I have to get something out of this. And as long as I continue to get something out of this, like it doesn't feel like work or a chore. As long as I continue to get something out of it, and I feel it's positive, it's worth it. 

And I do-I hope I break some of those barriers down because doctors can be really intimidating. [Jodi-Ann: Yeah.]  And I'm sure I have done that to many people because it was all just kind of - you work to get here, and I am in this position, and it's part of your role. But I think medicine as a culture hopefully is shifting a little. Me as an individual, I've shifted a lot and I'm one of the more liberal, more open people in my field as a younger person, and a woman, and of color and all that kind of stuff, but I as well have room to grow. [Jodi-Ann: Yeah.] I want people to trust us. That's a really big thing [Jodi-Ann: Yeah.] especially in People of Color. I mean, there's - I'm sure you're aware- there's a long standing history. [Jodi-Ann: Oh, yeah.]  of why. And it's not going to happen overnight, but I at least just want to be like there's people like me, I don't-I don't see patients outside the ER, but like, there's a lot of people like me, like we're here. And that's why I say, like I say that piece about like find a doctor that works for you. Because we're here, you can have good care!

Jodi-Ann Burey: You can have that, and you deserve it. [Dr. Kavita Jackson: You des-absolutely.] Yeah. And I think people find that difficult to own. [Dr. Kavita Jackson: Yeah.] Like, shop around! [Dr. Kavita Jackson: It's okay.] It’s okay! And then also balance and like, if you can. [Dr. Kavita Jackson: Yeah.] So what I always tell people is, listen, I don't know your financial situation, I know that the health care system in this country is trash, within whatever you can do, [Dr. Kavita Jackson: Right.] advocate for yourself and try to find the right space. [Dr. Kavita Jackson: Yeah.] Like, try to find the right person.

Dr. Kavita Jackson: Yeah, I-I, that's super important: within your circumstances. And I as well, when I kind of say that, like shop around, I say considering your situation - I'm not assuming everybody can just afford to go to five different doctors and pick the best, right? [Jodi-Ann: Yeah.] Like, it-it's not that simple, but know that you can, and that it's okay to do so. Like I think-I also didn't really think about it, like, oh no, you get a doctor, and that's your doctor, like that's the one you get, they're covered by your insurance. Like you can be with somebody for 20 years and go pick somebody else. It's what you want, right? [Jodi-Ann: Yeah.] Like you're a consumer of healthcare, you actually have a lot of rights. It's your body, it's your health, like all of that stuff, the-the power is actually in the patient. [Jodi-Ann: Yeah.] And I see that from the physician perspective as well, like there's cases where I'll be like, Oh, I wish X, Y and Z had happened. But this person made these decisions, but that is their life, right? Like I am not here to control anybody. My job is to make recommendations based off my expertise. And it's the patient's responsibility and power to accept, modify, do whatever they want to do with that info-whatever they choose to, or not to do, with that information. And I also have to accept that myself, so I think coming to grips with that is a little challenging *laughs*, but-but that's their right.

Jodi-Ann Burey: Yeah, that's why medical literacy is so important to be able to not only navigate conversations with doctors, but to be in that like co-decision making process. [Dr. Kavita Jackson: Yes!] Like the first surgeon that I had a consult with, I asked like when-when do I actually need to be in surgery? Right? Because I could-if I didn't find this out yesterday, I would have-I would have still went snowboarding today, [Dr. Kavita Jackson: Yeah.] like I would have been living my life, like when do I actually need to be in surgery? And he's like, you need to be in surgery like within a week. And I'm like, how about a month? Like can I actually-is there time for me to shop around? Like I need to-I don't know anything about the composition of a spinal cord, [Dr. Kavita Jackson: Yeah.] like I don't even know enough to be in these conversations, like [Dr. Kavita Jackson: Yeah.] can I have some time here? And we've had that conversation. He's just like, “Yes, the reason why you need to need surgery sooner is that we cannot make you better than you are. So like the more time passes, if something happens to your spine or whatever, we can't reverse that.” And so I'm like, okay, cool - I'm just gonna live my life for a little bit *laughs* [Dr. Kavita Jackson: Mm-hmm] go to-go to my snowboarding trip in Europe, and try to see if I can make the best decisions, and in that time, like I found the right surgeon to do my surgery. Like that first surgeon I talked to, his approach was okay, but it wasn't the right approach for what I actually needed. And he had only done, I think, four of that type of surgery within that year, and the surgeon that I ended up going to does like over 100 of them, like he is the guy.

Dr. Kavita Jackson: Which is so important. [Jodi-Ann: Yeah.] And that's like, people put out lists of things to ask your surgeon or things to ask your doctor like, it's-it-it may feel uncomfortable to ask some of those questions *laughs*- I even have anxiety like asking a surgeon like wait, how many of these procedures have you done? [Jodi-Ann: Yes! *laughs*] But that's an extremely valid, relevant question that if you are considering it, you absolutely deserve the answer to that question. If it's going to help you with your decision making, like you ask away. I tell patients that all the time, like time allowing, ask away. Like if you have those questions and I can provide an answer, that's what I'm here for. I don't have to like the questions, that's irrelevant. [Jodi-Ann: Yeah.] But I am that source of knowledge. Ask me the questions.

Jodi-Ann Burey: Mmhmm. And in different steps in your process to like when I was talking to Erika for Season 1 of the podcast, she, you know, spoke briefly about, like shopping around to find the right person to do her reconstruction. [Dr. Kavita Jackson: Yeah.] and like trying to figure out what was important to her around like, you know, saving the nipple and “this and that” [Dr. Kavita Jackson: Yeah.] And like what type of mastectomy experience did she want to have and taking some ownership in your decision making on that.

Dr. Kavita Jackson: Yeah. Know it's well within your right [Jodi-Ann: Yeah.] to do these things, and you should. And if you don't want to, that's fine. There were certain aspects of my care, I know, where I was just like, completely released control. Well, you know, as you're getting the anesthesia shot. *Both laughing* Right, right. Kavita, you just gotta let this go. 

Like, I remember the night before my surgery, [Jodi-Ann: Uh huh.] my mastectomy, I was like, super anxious. And you know, understandably, I was like, you know, you're nervous. You've never had surgery. And so that's normal. It's a big surgery, whatever. But then I kind of did this like, like a little thought work of like, just get inside. Like, what is the reason behind this? Right? It actually wasn't even the anxiety of the surgery. It's like, I felt this pressure as if I was operating on myself. And thinking like, You have to rest up for, you know, this grueling seven hour procedure, you're going to be scrubbed in. And I was like, picturing, like, the incisions and the suturing and the removal, you know? And then I was like, Wait, you're not doing that. That's the surgeon’s job. Right. All you have to do [Jodi-Ann: chuckles] is lay on the table and stay alive, right? Like, obviously. So why am I stressing out about the technicalities of like, you know, it just once I got down to that, I was like, Alright, so let that go. Now that I know what that's about, like my job here is actually very easy. Their job is hard. They're trained, she's excellent. You trust her. Let her do that. Don't worry about all that stuff. *both laugh*

Jodi-Ann Burey: So like, I think there was -- there for me, like the night before, there was that moment of release where, like, I actually don't have to do anything tomorrow. [Dr. Kavita Jackson: Yes!]  I just need to show up with a clean body [Dr. Kavita Jackson: Yes.] put that solution on my skin like they told me to. And I'm just - they’re doing everything. [Dr. Kavita Jackson: Yes.] And there is this moment of peace, where I was just imagining, like, going under and just not waking up. [Dr. Kavita Jackson: Yeah.] What if I just never woke up? And, just being okay with that. I just, I just reached this point where it's like, I can't do anything. I just, I can't do anything. So, it is what it is. [Dr. Kavita Jackson: Mmhmm.]  I would like to wake up. *chuckles* [Dr. Kavita Jackson: Yeah.] I would like to be able to move my body and feel my body. And we'll just see what happens on the other side.

Dr. Kavita Jackson: Yeah, I think, I think that's, it's - what you said was, like, really important. The, like, “I can't do anything else.” Or, you know, like, “I can't do anything in this moment to change what's happening.”  Like, it is what it is. [Jodi-Ann: Yeah.] And like, on the surface, it sounds so disempowering, but it's actually like such a relief of like, [Jodi-Ann: Yasss.] it actually ends up being empowering of like, I have done all the things I can control. And now I have to just relieve that, like, relieve this stress that I'm putting on myself as something that I no longer have control over. It's just like, you know, this burden on your shoulders until you realize like, wait, it's gonna go how it goes, like, yeah, like you're, you know, like, I'm okay with that. I've done all the things I can do. Whatever's coming, I can handle it. It's just such a relief. And I agree, I walked in, like, you know, my job's the easy job. I'm just gonna lay on the table. Why am I stressing? I'm not the med student that has to put in my foley. Like, I used to be that med student putting in all the foley catheters in the OR. I don't even have to do that. I feel sorry for that med student.

Jodi-Ann Burey: It’s so - I, you know what’s so funny? I was so anxious about the catheter. [Dr. Kavita Jackson: Yeah.] I was like, Oh my god, I would have a catheter? Like, it just was so gross to me, because I've seen people with catheters and I'm like, Ew. That's like, connected to you. [Dr. Kavita Jackson: Yeah.] But they're like, “Oh, we do all of that when you're sleeping.” I’m like, “Okay, great.” *laughs*

Dr. Kavita Jackson: Which is awesome. Which is so great. I know they gave me a heads up because I wasn't expecting the catheter. [Jodi-Ann: Yeah.] I’m glad they gave me a heads up. And yeah, prefaced by you know, “We'll do it once you're asleep.” And I was like, “thank you.” I do really appreciate that. Like, even though the like, the even the little happy juice cocktail, they gave me a little verse that had fentanyl as I was rolling back, I was like, you know, I really appreciate that. Like, who's - you know, I don't want to be like, feel like also when you're a doctor, and you're like, Oh, I'm anxious, I need some meds like that. I just feel like I would be judged or people would just think it's suspicious. And so it was really nice. They said, “We give it to everybody.” So I was like, okay, that's really helpful. Anybody rolling into the OR is going to have a little, you know, like, your heart rate goes up a little bit. *chuckles*

Jodi-Ann Burey: You know what was comforting for me? I don't know if this happened at your surgery, but they had this little old lady, bless her heart, was like the hospital chaplain. And like, when they bring the chaplain in before you go under, I'm like, Oh, this is serious. *chuckles* [Dr. Kavita Jackson: Yeah.] So like, we had a whole thing. But, what really put me at ease... 1) I had six, seven family members there, everybody was wearing the tumor swag. I felt so supported. And one of the nurses, OR nurses came in, and it was a Black woman, and she had like a Kente head wrap thing. [Dr. Kavita Jackson: Mmhmm.]  And I was like you. [Dr. Kavita Jackson: Yeah.] You. I want you. I'm talking to you individually, to make sure that they don't leave cotton swabs in my spine *chuckles* She was like, “That is my job. Don’t worry, I got you.”  [Dr. Kavita Jackson: Yeah.] 

So to see a Black woman with like, this Kente thing, I felt so affirmed. [Dr. Kavita Jackson: Mmhmm.] And then the woman who rolled me into the OR was this Latinx woman, and I like - that meant a lot to me, too. [Dr. Kavita Jackson: Yeah.] And that's why I'm, like, so glad that I did my surgery in New York versus Seattle, because I was just surrounded by so many Women of Color.

Dr. Kavita Jackson: Yeah. And it makes a difference.

Jodi-Ann Burey: That, yeah. Ugh. That makes a difference, yeah. 

Dr. Kavita Jackson: Yeah. It's like something about like, you know, you don't want to judge people on appearances or something, you know? Like, that isn't - it's not the same. It's just - but seeing somebody that you can recognize or that you reckon with that looks like - like literally just looks like you there's just a different level of understanding of like, they're gonna have my back. You know, hopefully, not that someone would do anything malicious. But like, we just look out for each other a little bit more. Or just in a - in a way that, I don't want to say non-colored, but *laughs* 

Jodi-Ann Burey: These white people out here. *laughs* Yes, it’s okay, they’re white people. 

Dr. Kavita Jackson: They’re white people. Trying to be PC and I'm making up like some, like, not nice things. [Jodi-Ann: No.] 

Jodi-Ann Burey: You know what’s so funny? That like, they’ll say, white people and non-white people, just like - But we don't say, “non-man” to describe women. [Dr. Kavita Jackson: That’s true, that’s true.] And so, like not describing people by what they're not... [Dr. Kavita Jackson: That's true.] If I can say Black people, Latinx folks, Indian folks, etc., we should also be able to say white people. [Dr. Kavita Jackson: Yeah.] I think it's hard because anytime we think about white folks as a collective, like when you just see like white people organizing together, you're just like, so am I gonna die today, like what's happening? *chuckles* [Dr. Kavita Jackson: Right? Seriously.] Oh, it’s just like, is this a white supremacists group? Like, what’s going on. [Dr. Kavita Jackson: Yeah.] *chuckles* Ah! 

Anyway, I think it just matters so much to just know other women of color, who are navigating this. And I think a lot of times people think that if you come from a sense of like, economic privilege, or academic privilege, or medical literacy privilege, that things are easier for you. [Dr. Kavita Jackson: Mmhmm.] And that is, in some cases, true - in a lot of cases, not true. Because you're still a person trying to navigate some of the hardest moments of your life.

Dr. Kavita Jackson: Yeah, and it is. Cancer does not discriminate, like socioeconomic, economic status, color, age, gender, your personal professional identity. 

Jodi-Ann Burey: It’s coming for you. No. *both laugh*

[Theme Music Begins]

Jodi-Ann Burey, as host: Black Cancer is created, edited and produced by me, Jodi-Ann.Thank you so much, Dr. Jackson, for sharing your story. To make sure that other Black Cancer stories become center to how we talk about cancer: rate, subscribe, you know to do. Check us out online at blackcancer.co and on Instagram, @_black_ cancer. You can find Dr. Jackson there too, at @drkavitajackson. Trauma comes with endless wisdom for ourselves and those around us. Tell someone you know about Black Cancer.

[Theme Music Fades Out]

Jodi-Ann Burey: What do you think about, like, cancer swag?

Dr. Kavita Jackson: It's... *chuckles* a lot of a - Well, so, when October started, and I had just gone into remission and it was like pink overload, I felt this obligation, like my first experience, right? Ever. I've never thought about it. Like this obligation of like, I gotta buy everything that's pink, and everything that's supporting breast cancer, like now that's me, so I have to buy it all and support people. And honestly, the pink is not my favorite. Like, the pink as a color itself. There's no disrespect to the ribbon. It’s just the pink is not my favorite. So I'm like, okay, I'm buying all this stuff that I don't actually really … want. *laughs* You know? And then I learned about pinkwashing actually from somebody on Instagram and I was just like, I had no idea. Like, I never thought about these things.

Jodi-Ann Burey: To me - talk to me about pinkwashing.

Dr. Kavita Jackson: So pinkwashing: the concept of companies or brands use the pink, pink breast cancer ribbon or breast cancer awareness, the name of that, and saying that they're supporting things is part of their marketing strategy. And possibly not actually supporting any sort of organization or nonprofit or research. And so, you know, you buy your product thinking or kind of assuming that a portion is being shared with a research organization or something, and it's not. Or they give like a fraction, you know, a percentage that it's like negligible, and you do better just donating yourself. So just to be mindful of what I was buying, what people said the money was going towards, and you know, just digging on what I support.

Jodi-Ann Burey: Yeah, it's so funny, I boycott kind of those types of things. You remember those yogurt lid things? [Dr. Kavita Jackson: Mmhmm.] Where people were - So this was when I was an undergrad, and I had this thing, I was a Resident Assistant. [Dr. Kavita Jackson: Mmhmm.] So I was like, asking all my residents to, you know, take these lids, and I'll collect them, and I'll send them in. And then as I kept looking at these lids all the time, it says like in the fine print that for every lid, they'll donate, I don't know, a couple cents, but up to, let's say, $100,000 or a million dollars, whatever it is. And I'm like, whoa, whoa, whoa, wait. If y'all have the capacity to donate a million dollars, donate the million dollars. [Dr. Kavita Jackson: Yeah.]  Why am I sending you aluminum foil? Right? *laughs* [Dr. Kavita Jackson: Yeah.] Or make it limitless. If people are just, like, buying this stuff, then that should increase your capacity to donate.

Dr. Kavita Jackson: Yeah, like, I don't understand why, you know, if more people buy it, then you have more proceeds of which a portion? Yeah, like, why is there a limit?

Jodi-Ann Burey:  Yeah. So anytime I see that stuff, where it's like,”We'll donate up to $10 million” And I’m like, no. Limitless, or to limit it to $10 million. But yeah, pinkwashing is interesting. I remember when I was - this is like my first trip unsupervised by medical professional when I was at Sloan Kettering - and my family was with me, and I had a walker. And so I was walking into the gift shop, which I was like, You don't think broken people come to this gift shop? This is not accessible, like these aisles are too small for my walker. *laughs* [Dr. Kavita Jackson: They're always so crowded.] Yes! So this is me with my walker and try… *chuckles* trying to walk through the gift shop. And they had all these like, colored ribbons for different types of cancer. And I was like, Oh, okay, what's my color? And I just like, I want blue, which, [Dr. Kavita Jackson: mhm.] that’s not  how that's like, you know *laughs* [Dr. Kavita Jackson: *laughs* Yeah, you don’t get to pick!] it works. So then I saw one, I think blue is like for cervical cancer. And I was like, Yes! Because my tumor was at my cervical spine. And I'm like, Oh, that's not what they mean. [Dr. Kavita Jackson: *laughs* different!] to say cervical cancer to like, wait, I don't get a ribbon? *laughs*

Dr. Kavita Jackson: Yeah. Wait, so you don't have a ribbon?

Jodi-Ann Burey: I don't think there's…  I don't think I have a ribbon. But it's funny to be both critical of the ribbon. Like, [Dr. Kavita Jackson: Yeah.] fuck these ribbons. And then also like, I don't have a ribbon. *laughs*

Dr. Kavita Jackson: Yeah, no, I totally agree. And like, at first, I was like, I felt really guilty about how I felt like, Oh, no, you should be unanimously supporting this pink ribbon. But what if you don't like the pink ribbon? And I don't mean disrespect to the pink and all that, you know, and like people say, like, pink sister and like, stuff like that. And I don't want to be like, Rawr, like, I don't like pink! You know, it's, that's like, not even the point. You know, it's we relate, and we're having a relationship and conversation and that's fine. It has nothing to do with pink if we don't want it to. [Jodi-Ann: Yeah.]

And you know, with all this merch stuff, I got really excited, actually, around October. I was like, I'm gonna start designing a bunch of merch, like cancer merch, right? [Jodi Ann: Yes!] Like, I just got really excited to do it. I did all these designs about like, METAvivor Thriver. And try to empower… And I'm glad I never actually, I didn't go all the way through, you know, because I was like, You know, think about it, and what is your plan here? And then I kind of felt a little differently about it, like once we got through October or you know, Breast Cancer Awareness month, and I just started to think, a little critically, like, What are my motivations behind that? Like, What am I...? I don't know, I kind of just let that go.

Jodi-Ann Burey: Yeah, I actually, I designed my tumor swag. [Dr. Kavita Jackson: Mhmm.] I had this motto that kind of helped me through my process and I think it became something that people could rally around. And as I was designing it, I was like, I want to make something that is definitely about my cancer situation but also just a cool workout shirt. *chuckles* [Dr. Kavita Jackson: Yeah, yeah!] And so, I made all these, these designs that said ‘Strong In, Stronger Out’, like hoodies, [Dr: Kavita Jackson: I like that.] and t-shirts, and like everyone who was, I call my ‘tumor troop’. And so my whole tumor troop like people were posting photos of it and all that stuff. [Dr. Kavita Jackson: Yeah.]  That was really cool. And then I had an MRI scan of my brain, cause once you have a tumor anywhere in your spinal cord, they have to check the whole thing. [Dr. Kavita Jackson: Yeah.] So I had these brain scans. And I was like, What? Like, it was just a really interesting design. [Dr. Kavita Jackson: Yeah.] And so I've put it on... [Dr. Kavita Jackson: They’re beautiful!] Right? Right? I’ve put it on a tote bag.

Dr. Kavita Jackson: Oh, that’s awesome. But that's so cool. You know, like, very unique, it's very personal actually. Like, but most people looking at it, you know, are not gonna understand the whole thing, I mean, they're gonna be like, Oh, that looks so cool. It’s actually is like a conversation starter.

Jodi-Ann Burey: Yeah, it's like, that's… my brain.

Dr. Kavita Jackson: So did you do it? Did you print those?

Jodi-Ann Burey: I did, I print those. I sold a bunch of them. It's weird, because like, I see them in the world sometimes when I like, meet up with friends and stuff. And they're like, Yeah, I just actually really liked this bag, or like, This is one of my favorite workout shirts, or whatever. I knew, I think it's like, you know, as we talk about how people support us, finding ways that feel accessible for people who might find it difficult to navigate these types of issues. And so maybe they can't, or don't feel comfortable, like asking you about your cancer story. But y'all could talk about tumor swag, you know?

Dr. Kavita Jackson: Yeah, yeah. That's what I mean. It's like a conversation starter, yeah. And then you have people that have like, the ribbons, like tattooed on themselves. And I feel like [Jodi-Ann: Yeah.] that's like an opening. Like, you're welcoming a conversation. I think, for me, it's like, Okay, let's talk about it. *chuckles* You know?

Jodi-Ann Burey: Yeah. I find it hard if someone like, had a visible tattoo, and you ask them about it, and they got annoyed... It's like, [Dr. Kavita Jackson: Yes! I agree.] You could have put that somewhere else. [Dr. Kavita Jackson: Yeah.]

Dr. Kavita Jackson: Yeah, I agree. But the swag stuff is interesting. I had people like, send me some swag. And, you know, it's like, I guess it just depends on my mood, it's still a little up and down sometimes, like, you know? Like, I don't want I don't want to wear this out. Like, I like, it's like you're wearing a label, you know, like, [Jodi-Ann: Yeah] like, I have this. I actually love it. I think I can't remember now it says it sounds like Wife, Mom, Fighter… something like that. And I was like, Oh, that's cool, like I am those things. [Jodi-Ann: Yeah.] But some days, I'm just like, I don't...I don't feel like giving that label out. You know, like, [Jodi-Ann: Yeah.] everything about me on the shirt that I'm wearing. Cause it's more than that.

Jodi-Ann Burey: Yeah. Or, you know, we should make swag with all the things that we don't want people to say to us, [Dr. Kavita Jackson: Ohhh... ] like, you know, we just posted something on @_black_cancer, we’re posting something on Instagram saying that “My mastectomy is not a boob job.”

Dr. Kavita Jackson: It's so funny, because [Jodi-Ann: chuckles] I don't remember if we talked about this last time, but I'm working on, for my social media, just like a quick, you know, there’s a lot of these but my version of like, you know, “Five Things Not to Say [Jodi-Ann: Yes.] to Someone Who has Cancer” or some and you know, boob job is one of them where it's like one of those, like, it's so obvious, I think you know you should know better, but I'm going to say it here. And then I want to give alternatives of like, you know, Try this instead. 

But I got the boob job one. And it's funny, because I honestly myself, like, believed that for quite a while. You know, it's like, Oh, you're right, like, I am kind of getting a boob job. And especially because I was put, I always had really large, a very large chest since like, age 12, since I - you know, started my periods. And so that that's interesting from, you know, just as a woman and as a young girl, and as you, you know, whatever, interactions with society. 

So my plan was when I was done having kids as I was going to have a reduction, like, that was my long term plan. And I kind of had that opportunity, you know, with a mastectomy, to size down and all that kind of stuff. And so I did for a while, you know, it's kind of like two birds or I am getting kind of a free boob job in a sense, like, Hey, you're getting something you wanted and there's just like that give and take of like, but I wouldn't have chosen to do it this way, if I had a say. [Jodi-Ann: Yeah] And and anybody that says free, I really challenge them, like, define free, right? It's not just about money, like, consider the things that we have given up, and in various types of surgery, right? Like, it's just, it's not free. It's not that simple.

Jodi-Ann Burey: It's not that simple. And I think it's really nuanced, and there are opportunities in some of our worst traumas for, you know, to try to get some of the things that we want. Like this is not similar at all, but I'm going to start talking about it anyway *chuckles* [Dr. Kavita Jackson: Sure] 

But, so I have a handicap pass for my car. [Dr. Kavita Jackson: Mhm.] ‘Cause part of my surgery paralyzed me and I didn't know what my situation would be around driving or, you know, I can drive places but then walking can be difficult in certain situations. And so I was like, I'm gonna get a handicap pass, like I have a disability. Here's my opportunity to not have to pay for public parking for five years. *laughs* [Dr. Jackson: Yeah.]

Dr. Kavita Jackson: Yeah, yeah!

Jodi-Ann Burey: *laughing* And so I'm hanging out with my friend. And I was like, Oh yeah, let's go downtown. So we wanted to go to some event and they were like, “I don't want to pay to park.” And I'm like, “Oh, I don't pay to park.” and then my friend’s like, “Man, maybe that was kind of worth it.” And I'm like, “No, bro…” *laughs*

Dr. Kavita Jackson: No, no, no, no... Okay. You didn't have to take it there. And, you know, I'm sure that they didn’t like think all the way. Like, I feel like the words left their mouth. And I hope they thought twice about that…  *both laugh* No, not worth it.

Jodi-Ann Burey: Like, he was like “Oh that’s great.” Like, I don't think I would want to be paralyzed and like, be suffering physically, just so I don't have to pay for parking.

Dr. Kavita Jackson: For this perk, right?

Jodi-Ann Burey: Yeah. But also, I do enjoy it!

Dr. Kavita Jackson: Yeah. I feel like you're trying to see the positive of the situation, right? And I think that's what I was, as well, like, Hey, at least you're getting this thing that you wanted, in a slightly different way. So that was one of my silver linings. Now, I remember, we were talking about this last time! And I was like, I had all these silver linings of which I could only think of one, which was time with my kids. But, you know, I got something I wanted that I didn't see myself getting towards, you know, within the next year, or anything. So how do you be happy about that? [Jodi-Ann: Yeah.] But I, you know, but it's not worth it to have gone… Maybe it is worth it to have gone through? I don't know. 

Jodi-Ann Burey: It's like, it's like, it is what it is. This is how it happened. You know? And I think your case is really interesting, cause I think when people think about boob jobs, they think about augmentation. [Dr. Kavita Jackson: Yes.] And like, Ooh, yes, you can have these like, you know, perky new girls sitting on your chest. And you're like, No, I've had that since I was 12. So trying to go down. *chuckles*

Dr. Kavita Jackson: Yeah, trying to go down, like the opposite. No one has ever understood that. Of trying to go down. You're right, because the majority of people are trying to go up.

Jodi-Ann Burey: Yeah, like, well, my back hurts.

Dr. Kavita Jackson: Yeah. My back hurts. My neck hurts. My shoulder hurts. My clothes don't fit. I've already, I've like stocked up on some really nice bras afterwards, like bras that I've never ever been able to wear because, yeah, right? [Jodi-Ann: Oh yes!] Like new tops and stuff. I'm like, Okay, this is finally like semi-flattering or like, I can wear something like this now.

Jodi-Ann Burey: Yeah, that happened to me when I was marathon running for a bit. And I went from a D to a C. [Dr. Kavita Jackson: Mmhmm.] And people are like, Oh, you know, people want D cups or whatever. And I'm like, Oh, do you know that I could fit my bathing suit tops now? *both laugh* Right now I'm not like diving into a pool without falling out of my chest like that’s great.

[End of podcast]