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What an oncoplastic breast surgeon does in a workday

Welcome to The Work Day, a series that charts a single day in various women’s working lives

(Courtesy of Sasa Espino/Washington Post illustration)
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Welcome to The Work Day, a series that charts a single day in various women’s working lives — from gallery owners to stay-at-home parents to chief executives. In this installment, we hear from Sasa Espino, an oncoplastic breast surgeon who recorded a workday in April.

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Name: Sasa Espino

Age: 40

Location: Richmond and Fredericksburg, Va.

Job title/current role: Oncoplastic breast surgeon

Previous jobs: While studying economics and biology at New York University, I worked as a chemistry laboratory teaching assistant as well as a resident assistant in the dorms. After graduation in 2002, I moved to D.C. to work as a business development consultant for hospitals for five years. There I learned a lot about how the business side of medicine works.

What led me to my current role: As a daughter of traditional Filipino parents, there were high expectations for me to be a physician. My younger self politely rebelled against my elders by entering health-care consulting after college. Exposure to clinical medicine made me long for patient interaction and led me to pursue medical school.

My mother was diagnosed with breast cancer as I started my first year of medical school at Virginia Commonwealth University. Her journey undoubtedly influenced my career goals. Four years of medical school, five years of general surgery residency and a surgical breast fellowship later, I began my practice as an oncoplastic breast surgeon. Ridding the world of breast cancer is my first priority, and making sure women (and men) aren’t reminded of me every time they look in the mirror is a very close second.

How I spend the majority of my workday: My days are spent either seeing patients in the office or in the operating room (OR). On Wednesdays, I get to do both! I see patients in clinic during the morning and scrub into the OR right after.

My workday

Wednesday, April 6, 2022

5:45 a.m.: Alarm goes off. Snooze about five times.

6:13 a.m.: Get dressed, finishing my look by stepping into bright orange high heels. Have my breakfast in the car: coffee, protein shake and two pieces of Dave’s Killer Bread. Wednesdays are super rushed, and I don’t usually find time to sit down to eat my meals.

7:11 a.m.: Head to the hospital for Breast Tumor Board, where breast cancer specialists (surgeons, chemotherapy doctors, radiation doctors, social workers, nurse navigators) get together to discuss treatment plans for our patients. We all need to be on the same page to make sure our patients’ care is seamless.

8 a.m.: I see 10 to 20 patients in the office. It’s a mix of all patient types: women with new breast cancer diagnoses, patients who see me 10 years after their cancer surgeries, women with a new lump or infection, women who have gigantomastia (extremely large breasts) with back and shoulder pain and want a breast reduction.

12:02 p.m.: Grab a protein bar and trail mix and dash down the hospital corridor (still in my heels) and into the surgery area to meet my first surgical patient in the preoperative area. She’s a 36-year-old woman who felt a lump while showering and was proactive in getting a mammogram. I remind her that, although she’s here because she has breast cancer, the coolest thing about today is that she’ll be going home without it. She cracks a nervous smile, hugs her sister and says she’s ready.

12:20 p.m.: In the OR, we perform a timeout, when everyone in the room verifies the patient’s name, date of birth, surgery to be done and the correct side of surgery. I proceed with my operation, remove the cancer and work for a while moving different areas of the breast tissue together to make sure it looks as natural and similar to the other breast as possible.

1:49 p.m.: The patient wakes up from surgery and goes to the recovery room, and I find her sister to update her.

1:59 p.m.: My phone rings and I answer some questions from my powerhouse of an all-female office staff who hold the fort down while I’m not in clinic.

2:05 p.m.: Sneak in some low-carb tortillas and an energy drink before heading off to see my second patient (a young-at-heart 69-year-old). She finished radiation and is ready to get her final breast implants. An exciting day for another cancer patient!

2:15 p.m.: We roll into the OR and the patient asks to listen to Post Malone’s “Circles” as she’s going to sleep. Surgery for this patient begins with removing the previously placed plastic spacer from her right mastectomy site and replacing it with a soft silicone implant. Now her right breast looks young and perky (like her personality!). I turn my attention to her left breast and perform a breast lift to make her symmetrical. I think she’s going to be pleased when she wakes up. Breast cancer seriously sucks, but having the ability to re-create how you look afterward can sometimes make it a less difficult journey.

5:06 p.m.: I find her husband in the waiting room, tell him she’s doing amazingly and that she needs to stay away from wearing a bikini for a month. He laughs with tears of happiness in his eyes. This is totally the best job ever!

5:21 p.m.: All operative reports are done and I head out to my car.

5:58 p.m.: I pull into my garage and find my husband about to take off on a mountain bike ride without me. The audacity! I make him wait a few minutes, chug a protein shake, get changed into biking gear and we head into the James River Park System for our bike date.

8:09 p.m.: I huff and puff my way back into the garage as my heart rate slows down from the maximum of 171 beats per minute during the 15-mile ride. I look over at my husband and he looks as if he hasn’t even broken a sweat. “What’s for dinner?,” we ask each other simultaneously. Tofu scramble and broccoli for me, and a quesadilla and guacamole for him. We plop on the couch and eat dinner while watching the latest episode of “House Hunters.”

10:40 p.m.: Showered and ready for bed. I set my [five] alarms. I have to get up early again tomorrow to lift weights before another day in the OR!

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