When Pat Schmoke awoke after breast cancer surgery, one of the first voices she heard was that of a TV reporter broadcasting her condition on the local evening news. Although she was still groggy from the sedative, one thing was clear: Maintaining her privacy was not going to be easy.
Now 15 months later -- after a modified radical mastectomy, chemotherapy and reconstructive surgery -- Mayor Kurt Schmoke's wife has decided to speak out about the illness that threatened, and forever changed, her life. Yesterday, in her first in-depth interview since being diagnosed in July 1990, she talked about coping with breast cancer.
"The thing that was the scariest to me was: If I had this thing and it was terminal, I wouldn't see my kids grow up. Once you start thinking like that, it can get to you," says Dr. Patricia Schmoke, mother of 20-year-old Gregory and 11-year-old Katherine.
Sitting in her Liberty Medical Center office, Dr. Schmoke, an ophthalmologist, appeared upbeat and candid, laughingly recounting her own war stories, including how she used a shoulder pad as a prosthesis when leaving Sinai hospital after surgery. Her speech halted only once: the first time she mentioned the word cancer.
It was concern for others facing a similar ordeal that prompted her to come forward. "The fact that this is breast cancer awareness month made it an opportune time," she says.
In her more public role, Dr. Schmoke recently has taped a TV public service announcement for the American Cancer Society encouraging women to take advantage of a new Maryland law requiring most insurance companies to pay for a screening mammogram.
She has a good reason to believe in them: One helped save her life.
At age 36, Dr. Schmoke had her first mammogram. She knew she was in a higher-risk category, since an aunt had died from the disease. Although the first test proved inconclusive, a second showed a lump in her breast; the biopsy came back malignant.
"It was odd because I was emotionally prepared for this. As a matter of fact, I had talked to my husband and a couple of my close friends . . . and said, 'I just know this is cancer.' It was almost like I was resigned to the fact. All my life I've had this premonition about something terrible happening to me when I was 37," says Dr. Schmoke, now 38.
While telling her children was difficult, it was not as painful as breaking the news to her own parents, Joseph and Cleo Locks. After several failed attempts, she had her husband tell them. Although her reaction still baffles her, she believes she was trying, in part, to protect them.
"I think I would have more of a problem dealing with a life-threatening illness in my child than in myself," she says. "Maybe that was my rationale."
While she and her husband always have been close, her illness has made them even closer.
"Even before I told him, I knew what to expect. That was one of the things that kept me going early on: This guy is not going to be a jerk," she says with a laugh.
What also kept her going was her positive outlook, says her physician, Dr. Miles G. Harrison Jr. "She was scrutinized more than your average patient, but . . . Pat has the personality that lends itself to honest sharing of a problem like this. She handled it very gracefully," he says.
Although some breast cancer patients today choose a lumpectomy, surgery in which only the lump and a small amount of tissue are removed, Dr. Schmoke opted to have a modified radical mastectomy, in which the breast tissue and lymph node are removed. She endured four months of chemotherapy, during which she went completely bald, and then reconstructive surgery, in which tissue from another part of her body was used to form another breast. (She declines to say which breast was affected.) The cancer was localized, which gives her a 5-year survival rate of 90 percent.
For her daughter Katherine though, the most frightening part was watching her mother lose her hair. Due to the kind of chemotherapy administered, Dr. Schmoke lost all of it within days of beginning treatment. "Cancer is sort of abstract," she says of her daughter's reaction. "Hair loss made it very real."
While some breast cancer patients question their femininity and sexual desirability after surgery, Dr. Schmoke says she did not experience those feelings. "I felt very lucky. . . . [Some women say], 'I'd rather die than lose my breast.'. . . I think women now see themselves as whole people, rather than a collection of anatomical parts. The idea of being less of a woman never entered my mind. If I was a lot younger or single, maybe I would have been more self-conscious."
Since the surgery, she's been surprised at the number of friends, patients and colleagues who have shared their own stories of breast cancer. "It's kind of a secret sorority," she says. "So many people you see are functioning normally and doing great, and they've had the surgery."