“He had an intuitive gift as a physician in diagnosing and managing breast cancer. His expertise helped countless patients, and he was deeply appreciated by those he cared for. He felt an enormous sense of gratitude to be able to help his patients and be an integral part of their care.”

I didn’t want to have cancer again, and who would? It was December 29, 2021, just over a year since my last surgery. I was at yet another medical appointment for a magnetic clip (mag seed) insertion to prepare for surgery the following morning. I wished to be at home celebrating the holidays with my family.

The radiologist I was going to meet that day may have been thinking the same thing. The radiology technician told me, “This should be quick. We’ll have you out of here soon.” She took several mammogram images, exited to confer with the radiologist, returned, took several more, and then several more.

It was not quick.

I leaned in to the right, to the left, and intentionally forward toward the machine on command. She looked at me and smiled, “Trust me; you’re in great hands with this radiologist!”

All I wanted was to go home. I was not thinking about the Herculean task he faced. The 9mm tumor had only been visualized on MRI, and 7mm had already been removed during the biopsy. Unfortunately, the metal clip inserted that day to mark the tumor site was significantly displaced. We did not have an MRI machine on that dark, late winter afternoon.

“We’re going across the hall; he wants to see if he can visualize it by ultrasound.”

That’s when I met my irreplaceable radiologist.

He introduced himself, prepped the area, and moved the transducer around, and around, and around. This way and that. Over, and over, and over again. Finally–“I think I found it!” The radiology tech wheeled in the sterile supplies; he inserted the mag seed and checked placement by mammogram.

We got to talking and discovered we had worked at the same hospital during the same time period over 30 years ago! I was a physical therapist, while he was a radiology resident. He retrieved his business card and offered it to me, commenting that this was the most challenging mag seed placement he had ever performed during his 30 years as a breast radiologist. I thanked him for everything and went home.

A week later, my surgeon entered the exam room with a simultaneous expression of joy and relief, having just received the pathology report. “We got clear margins; it was like looking for a needle in a haystack!”

Only 2mm of residual cancer was present in the pathology specimen. My surgeon shared that the radiologist could never have visualized it; he must have seen the shadow where the tissue was disturbed during the original biopsy several weeks earlier. The surgical success was a credit to my radiologist’s high level of experience, skill, and intuition in getting the mag seed exactly where it needed to be, and a credit to my highly skilled surgeon in sensing just how much tissue he needed to extract. I knew how incredibly fortunate I was to have them both on my team, and I made sure to let them know.

Five months later, like some miserable version of “Groundhog Day,” we met again, my radiologist being tasked with inserting another mag seed in preparation for cancer surgery on the other side. He stood in the doorway, offered an empathetic look, and said my name. “I just don’t want to do all of this again already,” I quietly quivered, with glassy eyes, dreading the radiation to come as much as, or more than the surgery. “You need a hug!” said my irreplaceable radiologist. We shared a warm embrace as the radiology technician looked on with a compassionate smile.

He completed the procedure, then called me over, “You have to see this. This never happens!” After checking a few different angles to be sure, he realized he had gotten the tiny magnetic clip to actually pierce the equally small metal clip. Amazing!

As I prepared to leave the radiology room that day, my radiologist offered, “You need another hug!”

That was the last time I ever saw my irreplaceable radiologist.

After the surgery, my surgeon shared that he was quite impressed with our radiologist, likening the intertwining of the clips to threading a needle when you can’t even see the needle! I sent my surgeon and radiologist a second round of thank you notes, with much gratitude for yet another successful surgery and clear margins. Shortly after that, I was sitting on the beach when my phone rang. My radiologist had just read my card and was calling to thank me. He echoed back a line where I thanked him for continuing to practice, adding that I appreciated him and understood that “the excessive demands placed on physicians these days have become an immense burden,” to which he whispered, “That’s exactly what it feels like!”

“Patients like you are the reason I continue to do this.” “I’m sorry you’re going through all this, but I’m looking forward to seeing you again.” He knew I needed to return for another mammogram and ultrasound in the fall. I told him I was looking forward to seeing him again too.

That was the last time I ever spoke with my irreplaceable radiologist.

I arrived at the imaging facility on the scheduled morning in early October, expecting a routine appointment and a welcomed opportunity to visit my wonderful radiologist. He was not in his reading room when I passed by. I asked the front desk where he was and received a response I never expected.

“He died a month ago.”

I actually asked if she was joking.

“No.”

I could not comprehend it.

I could not stop crying.

They discovered another mass that day, requiring another biopsy. This time it was not cancer.

As a health care professional and three-time cancer survivor, I have experienced firsthand the challenges facing clinicians. I remain devastated by the death of my radiologist. I had already begun to look for ways to promote physician well-being within my local health care system. Now, it has become my life’s purpose.

This is my heartfelt tribute to Dr. Steven Sferlazza, my irreplaceable radiologist. It opens with an excerpt from his beautifully written obituary. It ends with a passage from the back of his funeral card, overlaying an exquisite photograph he had taken of the sun setting over a lake. Photography was just one of his many talents.

“Memory. A nostalgia. The pain of absence. But it isn’t absence that causes sorrow. It is affection and love. Without affection, without love, such absences would cause us no pain. For this reason, even the pain caused by absence is in the end something good and even beautiful. Because it feeds on that which gives meaning to life.”
– Carlo Rovelli, L’ordine del tempo

Kim Downey is a physical therapist.