"An Atypical Journey" with Author and Breast Cancer Survivor V. Ronnie Laughling

Many thanks to Ronnie Laughlin, breast cancer survivor and author of “An Atypical Journey: Facing Breast Cancer Alone in the Middle East with God and My Tribe.” She also wrote the companion guide, “My Appointment Notebook,” to help people navigate the health care system when challenged with a breast cancer diagnosis. 

During our 30-minute conversation, we discussed how Ronnie handled the diagnosis of breast cancer, which she received while living alone in Saudi Arabia in the midst of the COVID-19 lockdown. She toughed it out during her chemotherapy, employing the determination and resilience that made her a Division 1 basketball player years ago. 

Her competitive nature and resolve were buttressed by strong Catholic Faith. Ronnie believes that her life experiences prior to her breast cancer diagnosis were God’s “perfect preparation” that endowed her with the necessary skills to successfully navigate her illness. 

Ronnie explained that she wrote her books to help other people with breast cancer better understand how it affects their bodies and provide strategies to succeed with treatment. 

Ronnie’s advice to those affected by breast cancer or other life threatening illness? “Keep moving forward and keep a positive attitude.”

You can find Ronnie Laughlin’s books on Amazon. 

For more information, check out her website: ronnielaughlin.com

And social media:

Instagram: @ronnielaughlin

Facebook: V.ronnielaughlin.comauthor

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Transcript

0:08

(Transcribed by TurboScribe.ai. Go Unlimited to remove this message.) Welcome to the Art of Medicine, the program that explores the arts, business, and clinical aspects of the practice of medicine. I'm your host, Dr. Andrew Willner. Today, I'm pleased to welcome Ronnie Laughlin. Ronnie is a breast cancer survivor and author of An Atypical Journey, Facing Breast Cancer Alone in the Middle East with God and My Tribe. She has also written My Appointment Notebook, Your Guide to Helping You Through Your Breast Cancer Journey. Ronnie will tell us more in a minute, but first, a word from our sponsor, locumstory.com. Locumstory.com is a free, unbiased educational resource about locum tenants. It's not an agency. Locumstory answers your questions on their website, podcast, webinars, videos, and they even have a locums 101 crash course. Learn about locums and get insights from real life physicians, PAs, and NPs at locumstory.com. And now to my guest, welcome Ronnie Laughlin. Thank you so much for having me, Dr. Willner. I'm so thrilled to be here. Well, I heard your story and, you know, we, at some point, all of us, either ourselves or somebody we love, ends up with a serious illness. And I think one of our failings, I'll just come out and say it, as a culture is we don't really prepare for that. You know, it's just something that happens and it happens to like everybody you know, and it happened to your parents and it happened to their parents, but nobody ever sits you down when you're 10 years old or 20 years old and says, you know, life is going to get tough at some point. And this is what you're going to be having to deal with. And this is what you should do. I mean, I never got that lecture. And I remember when my father got sick and died, it was like overwhelming. And, you know, I mean, life is hard on a good day and being overwhelmed is kind of a bad thing. And going to the doctor and say, you know, I'm not feeling that great. And then, oh, yeah, look at this. Look at that. Hmm. I don't know. Oh, you have breast cancer. That sort of all of a sudden it's like, wait a minute, let's let's change the channel. I don't want to be in that program. I want to be in a different program. So tell us what happened. Well, I guess I felt the lump probably six, eight, 10 months prior before I even did anything about it. I just kind of put it in the back of my mind. I didn't want to deal with it. And because I have very dense breasts and, you know, when you don't know, but most people know when you have dense breasts that you have a lot of lumps in there and they just kind of go unnoticed and just they're not anything. Every time you have a mammogram, they say they're fine. It's, you know, and so I didn't think anything about it until it began to tether toward my aerial. So my aerial was here and the lump was, well, yeah, my aerial was here and the lump just kind of tethered toward the lump. And I thought, hmm, that's not bad. So I did what any normal person would do. I googled it and it said, that's not normal to see your doctor. And that's what I did. I went to see my OBGYN here in Jeddah, Saudi Arabia. And it's been, it'd been a while since I'd had a doctor's visit like that. So, and I told him, I said, you know, it's been a while since I've had an OBGYN visit. And I'm also concerned about a lump in my breast. He said, well, come on in, you know, cause he was a friend of mine. And so when I went in, he did the gynecological exam and it was fine. And then he did the palpitation of the breast, did the left breast quick, fine, easy, you know, no problem. Right breast, he kept going over the same area over and over again. And he said, Ronnie, I don't like that. And I said, well, what are we going to do? He said, let's get you an ultrasound first. And then a mammogram. I said, okay. I said, can we do that today? He said, probably not today, but just call and, you know, get it scheduled. So I think I got it like two, three days later, which was really quick, you know, in the Middle East, it was really quick. And I got to the ultrasound girl and she did the left breast really, really fast. No problems. Right breast over, over, over the same area. You know, you're in this position like this and I'm asking, I'm like, what are you looking at? You know? And she said, turn around. She took a deep breath first cause she was very shocked that I asked a question cause they don't do that in this culture. And, and she said, look at this, look at this spot here. And she pointed out a, a circle, not a circle, but like a little disc that was nice, nice edges and everything. And she said, you see this one, this is pretty typical. This is just a benign cyst. She said, but this one, she said, I'm trying to get a good picture so the doctor can take a look at it. Now, I didn't know that at the time that the doctor, that the ultrasound videos were being shot to the doctor's office. She could see it on her computer. So yeah, that's the kind of technology they had. So she was actually viewing it ahead of time. Then she'd come in and look at it again. And she said, I'm trying to get a good picture. So when the doctor comes in, she's going to repeat it, but I want her to get a good idea. And I said, okay. And so doctor comes in and she's very, very great bedside manner, young Saudi doctor. And she comes in, does the left breast fast, right breast, not so fast. And she said, I don't like this one. And I said, what don't you like? She said, I don't like this lump here. She said, I want to do a biopsy. And I said, can you do it today? Can you do it now? She was like, you know, cause as a Westerner, you won't be want things, you know, and they're, they're not like that in this culture. She was shocked. She said, well, she said, if you can get approval, you know, we can do it. And it was close to probably closing time. So I think she stayed a little extra. And so I went out in the hall, got on my app, got the approval, came back in the room. She anesthetized me and took the sample. And Dr. Willner, I don't know what possessed me to ask, but as the sample was in the specimen jar, I said, can I have a picture of that? And she said, it's your body. Yeah. And so I took a picture of it and it looked like a hydra. I'm sure you, I don't, you're in neurology. I'm not sure where you've seen cancer cells. So, so it looked like a hydra. It was a piece of tissue that had all these little tentacles coming from it or whatever. And I just took the picture. Didn't think anything about it. And so I asked another question. I said, doctor, have you ever seen it look like cancer and it not be? And she was stunned. She was stunned. She said, no. And I left the hospital knowing 99.9% of the time I was probably had breast cancer. So I, I got in my car, didn't cry. Didn't, didn't do a pity party, anything like that. I just asked God, I said, please allow me to walk in and out of this hospital on my own for all my treatments. Cause it was at the height of COVID, you know, we were on very different restrictions than you guys were. We had, um, an app that we had to have on our phone that we had to show whenever we went any place. And, um, we were on curfew and lockdowns and certain hours you could go out and that sort of thing. So I kind of knew ahead of time, my friends wouldn't be able to drive me to my treatments and everything. I'd probably have to drive myself. So I just asked God to give me that strength and he did, you know, so that's how it all got started. And, you know, like, I guess a few days later, I met the breast surgeon and talked with her and then the oncologist and then the breast, uh, the breast counselor, they have a counselor that you talk with. And then I went to the, um, the doctor who put the port in and, um, got it all started and then started my chemo. Let me just stop you there for a second. First, uh, re remind us where this all happened. This happened in Jeddah, Saudi Arabia. This is, that's where I'm living and working now. I've been here for about 13 years, 14 years now. And this happened in, in 2020, uh, we went on lockdown, I think in March and I was diagnosed August 23rd. And what do you do over there? I'm a speech language pathologist. I work with children and adults with communication disorders. And, uh, should I ask what are you doing there? Why Jeddah and not New York City or, you know, yeah, it's okay. You can ask. Um, so the first time I came was in the late nineties and it was to train a cohort of about 20 or 25 Middle Eastern students for speech pathology because they didn't have that profession here. And so, um, they wanted to start to grow their own and they teamed with San Jose State. Um, I think it was San Jose State University and they would send professors and instructors over every semester to train and teach the students. And one of my colleagues asked if I would come over and help do the clinical training. And I went for one year and it's supposed to be for two years, but I went for one and came back and took my job back at USF, University of South Florida. And then, um, a university opened up that had a speech pathology program. And the same colleague called and asked if I would come over and set up the clinic. And so I came back in 2010 and worked at a university from 2010 to 2014. And then I went to Riyadh, which is in the, I want to, I want to say, I forget the province. I don't know if it's the East or West, but anyway, outside of Jeddah and, uh, worked at a hospital for three years. And then I came back to work at the university and now I'm just doing private practice. I'm a going back to the beginning, you found this lump and I think you did what, what almost everybody would do is like, well, this is probably nothing. And the best possible thing for me to do is ignore it and it'll just go away. And I won't have to deal with it. And that's like a perfectly natural response. Although we, at this point, we should probably emphasize to anyone listening that if you do find a lump that waiting is not necessarily the best approach. Uh, right. I mean, you can wait, wait a week or two, but not, not six or nine months. Right. Don't wait that long. And then, uh, then you went and you said like, well, I want this now. And I think, I think it's very hard when you go for a test and then you have to wait. It's like, um, I had a lump under my neck and I w and the whole thing drew out for a month, this doctor, and then that doctor, and then getting the scan and then getting the official read of the scan. And it's, it's a really long story. Bottom line, I was fine. It was nothing. And, uh, but that, that waiting is very, very, how did you cope with the waiting? It wasn't a long wait period. You know, once I got the biopsy, uh, I think the biopsy took three days and my doctor called and told me, you know, what it was stage two introductal carcinoma or the early stage, which was good. That was a positive thing. And then it was probably like maybe three or four days after that, that I met my oncologist, my breast, yeah, the, the breast surgeon. And then another two days after that, I met the oncologist and then met the counselor. It just, it just kind of rolled very fast. And I think I had my surgery when my first round of chemo was in August, September, October, I think my first round of chemo was in. So it was a really quick turnaround, unlike the U S you know, where you have a long time to wait. And one of my friends, who's a YouTuber, Angela Michelle, she said, she's, well, I was doing an interview with her last summer. And she said, she said, Ronnie, you know, if you were in the States, you wouldn't have gotten that ultrasound and biopsy the same day. Right. And I was like, Oh yeah, that's right. It probably would probably would have been two, three months, you know, just waiting to get in. So I was very blessed and having good medical care over here. So, well, not to diminish it in any way, but this is a pretty common story. Right. And why a book? What prompted you to write a book about it? You know, I've always wanted to write a book way back in the back of my mind. I'm a journaler. I've been journaling for many, many years, and I even journal throughout my cancer journey. So when I got the diagnosis and pulling together all the information and doing the research and finding out, you know, about my, you know, my mortality rate, a lot of people don't want to know, but I wanted to know, you know, and finding out what kind of cancer and, and, you know, what caused the cancer. And with my familial history of my mother and my aunt passing away from breast cancer, or my aunt was more lung cancer, I think, but my mom was breast cancer. So I wanted to know more about it. And I just kept finding out so much information about breast cancer that just wasn't out there. And I wanted to write a book to let people know that, you know, this is, this is how it can be, this is how it can go. And this is how you can get through it. So my hope, my sole purpose was to just help people have a, like a safety net that they could go to, to find information. And so that wouldn't be such a daunting experience. Right. So the first part of your title of your book is Middle East. We've talked about that. God and my tribe. So why don't we talk about that, how that helped? So I'm a Catholic, I'm a cradle Catholic. And I have a lot of faith, you know, I still do my, my magnificat every morning and every night. So I do my prayers, but I also have just a strong faith that I had a strong faith and I have a strong faith that, you know, God was going to get me through this. And one of the chapters in my book, it's, it's called The Rehearsal. And when I was sat down thinking about my book, I sat down and I was just thinking that, you know, everything in my life and every experience and every person that's been in my life has been the perfect preparation for this journey. So, you know, I had been preparing for unbeknownst to myself that I would need all this, you know, this perseverance, this resilience, this organization, this emotional and intellectual thinking. So I've been preparing for it all along. And I, and I had all the skills I just needed to kind of hone them in and that book hones it in for me. And I, and I wanted to share that with others. Well, you're a pretty focused, focused person. I was reading in your bio, you're a division one basketball player. Former. We have to put former in there because Ronnie can't do that anymore, but yes. Yeah. Well, I don't know how many years they let you stay in division one, but, but it's a, it's at a pretty high level, right? It is at a high level. Yeah. And I played for coach K. Yao, who was the Olympic coach. I forget what year she was Olympic coach, but played for her and she, she died of breast cancer back in 2009. So, you know, with her being my coach and a mentor and a dear friend and watching her with the battle, again, a preparation, I saw how she handled it. You know, she set up a K. Yao cancer fund prior to her death, you know? So I had a lot of good mentors. My other mentor who passed away with a series of cancers was Amelia Hudson, one of my professors at LSU that I had for my master's program. So, you know, I had a lot of people in my mom and dad and my family members. So all of those people, including God, you know, helped me get through it. My tribe here in Jeddah, my close friends, you know, they were always willing to help me, even though we couldn't see each other, you know, they'd always call and say, do you need something? Or can I drop something by, you know, we were still in the washing groceries stage, you know, early on, you know, and stuff. So they were all, it was all very important and very helpful. And the book talks about the importance of having good support, because that's so important in your rehabilitation that you, you know, you advocate for yourself and that you have good support. I worked at the hospital through COVID. And I remember one of the sort of awkward and painful and frustrating things is when we had patients who were sick, then they couldn't have visitors. Yeah. And so they were alone and sometimes to the point of dying alone, because that was just, you know, the way, the way it was, it all kind of evolved over those few years, but it was pretty messy and painful for a lot of people. And, and some people, in fact, could not even get the care that they needed. I think you were lucky that at least they were able to provide the care for you under during, you know, the lockdown that, you know, that the surgeon was willing to show up and do what he needed to do. And everybody did that. Were there any, must've been some pretty bad days. Why don't we talk about those? The bad days that I tell you, I wouldn't wish the feelings that I had and, and the experiences that I had with the chemo on my worst enemy. It was one of the hardest things I think I've ever done in my life. The, when you have chemo, you have your, your chemo done. Like I had mine done on Thursdays because that would give me, our work week here is Sunday through Thursday, because it's a Muslim country. So Friday's their day of worship. So I had my chemos on Thursday mornings and I could still do my few clients in the afternoon because I was feeling okay. And then Friday and Saturday would give me time to kind of recoup to get ready for Sunday. But that seventh and eighth and ninth day after the chemo, it, it's, it's just, it's, it's called cancer related fatigue. And it's something that is just worse than just being tired. It's a, I woke up the first, after my first round of chemo and I couldn't move. I felt like one of those big concrete things that they have on the highway was laying on top of me and I couldn't move. And I had, and I had an eight o'clock session. I got up like 530. I had an eight o'clock session that I needed to be up and out and to go to at that time, because I was still doing one child face to face, just, you know, one kid. And it was horrible, horrible, horrible, horrible. And I, you know, it has a cumulative effect. So after every round, it gets worse and worse and worse. And after my second round, I told my oncologist, I said, I, I'm still working. I said, I'm unlike the Saudi women who have a nanny or who have help and that sort of thing. I said, it's just me. I've got to work. And I said, I need to find a solution. He said, well, no, you can, you know, try vitamin B6, B12. And I did all that. Nothing was helping. And it was, uh, the only thing that helped was a drug that was a derivative or used in one of the ADHD, ADHD meds. And I got that. And that was the, the helping thing that, that got me through round three and round four, because I don't know if I would have made it. I probably would have made it, but it would have been really hard. It was just hard. And, um, that and the constipation and just the, the fatigue is just, I still suffer a little bit from the fatigue to this day. I'm not, I'm not back to where I was before, but I'm also a lot older. So I can't, I can't determine if it's just aging or if it's, if it's a combination of the cancer and chemo and aging too, I think it's probably a combination of them. Right. Well, it depends where you set the bar. You know, my, my 95 year old mother complains to me that she can't do all the things that she used to do. And she gets tired during the day. And I said, well, I can appreciate that. And I'm sure that's frustrating. It's like, on the other hand, uh, you're still here. So it's like, where's the bar? It's like, well, I'm not as good as I want to be, but I survived breast cancer or I'm, you know, in this case, 95 years old and still walking and talking. So amazing. You know, it's like, where's, where's the bar? Well, did your faith, was it ever challenged? It's like, Hey, why me? I was, I was good. You know? Yeah. Yeah. Yeah. I never did. Dr. Wilner. I never had a, I never said why me? I never said, you know, woe is me or anything like that. I just shifted right into intellectual mode, emotional mode. Didn't think about it. Didn't even get emotional about it. Never cried. You know, I just wanted to beat this thing and get through it and make sure that, you know, um, I was here for my family and for my friends, you know? So, um, and I learned that from my mentor, you know, she said, Ronnie, there's two ways that you can respond to problems or situations, you know, you can go emotionally and you won't get anything out of it. She said, but you can go intellectually and figure out what you need to do. And that's exactly what I did. I just went down, you know, as a speech language pathologist, you know, you're very regimented in sequences of things, you know, you do this first and that, and this, and I just use those skills and tie them all in. And that's how I approached the whole cancer thing. Sounds like there was some division one, uh, competitive skills in there too. Oh yeah. Okay. It's me versus you. And you know, I'm not giving up. Oh yeah. Oh yeah. Those days of working out and, uh, and I worked out almost every day, even during the chemo, because I knew that I had to drive myself. And if I, if I wasn't mobile and agile, I wouldn't be able to do it. So I worked out, it wasn't anything outrageous, you know, but I still did my stretches. I still did some body weights. I still did a little bit of, you know, weightlifting, that sort of thing, just to keep my body going and to keep moving. And that's what I tell, you know, people in the book is that you, you just can't get sedentary because your body wants you to, but you have to get that mind control and, and, and keep moving. Cause if you stop, everything's going to seize up. And as you know, I was 62 when I had cancer. So, you know, that's, um, that's an age where, you know, you're not young anymore. And if you don't move, you know, you, you, you have a tendency to tighten up, you know? So, um, I just kept moving and moving forward every day. I, I, I walked and I did my weightlifting, I did my stretching, I stretch at night, still do it, still do it. And that was going to be from basketball. I'll put a plug in for a fitness. I think it becomes even more important. You know, I see a lot of patients in their sixties, seventies, eighties, and boy, there's such a huge divergence. I mean, there are 60 year olds that look like they're 40 and there are 60 year olds that look like they're 80. And, uh, at that age, it really starts to matter the fitness. So, you know, when you're 30, you're a little more fit or less fit, you know, nobody really cares, but the fitness comes easy when you're in your thirties and even forties, it comes easy. But, you know, when women hit that menopausal period and, and, you know, you put on a couple of pounds, it's not easy to get them off, you know? So it's, it's, it's interesting. What is the appointment notebook? So the appointment notebook was something that I came up with after the book. And, um, it was, I developed it because I would take a little book with me that had all of my appointment notes in it. You know, I, um, I would take notes as I talk with my doctors and, you know, write down dates and results of tests and that sort of thing. So I could discuss them with them. If I didn't understand some verbiage or language of a test, I'd ask them about it. So I kept this little book and I always ask questions. The night before my, um, follow-up appointments, I always just sat down and just got really quiet and thought, you know, what is it that I need to ask my doctor? And I just write down these questions. So I would take that to each appointment and they, my whole medical staff, they, you know, they came to know that I would have questions, you know? And so, um, I thought it would be a good idea and a good way to keep all of your, all of a cancer patient's information together with, you know, your chemo treatments, your radiation, your surgery, your contact information, um, your test results, all of that. So that's where my appointment notebook came, came in. Well, I'll tell you a little anecdote. Uh, I, I think your, your bio resonated with me because in 1982, I wrote a book called the patient's companion. And, uh, the purpose of that book was it was a book you could take to the hospital with you and it would explain what you're going in for gallbladder surgery or a heart surgery, whatever it was. And it would kind of give you, uh, the, it was never published. I could not find a publisher who would publish that book. It was way before it's time. There was no internet, there were no FAQs. Um, it was, you know, not, it was just, gee, what's this? Who would write a book like this? And of course now there are hundreds of books like that is this is back in 1982. So we're talking 45, more than 45, uh, years ago. So I am, I'm very, uh, uh, sympathetic with that concept that it's important. Also, uh, if you ha the, the other part of that book was you need an advocate and, uh, I, I've long felt that you should be assigned somebody when you get into the hospital, it's like, okay, George is going to be at your side through your hospital stay and explain what's going on because there is no George. You're just kind of on your own and you get what you can from this nurse and that nurse and who's ever wheeling you down the hall. Uh, and if you're lucky, you have friends or family who are kind of supervising. And I've played that role a couple times, but it's very, uh, very, very difficult to actually, I mean, it's a, for most people, this is a foreign environment. You don't know the language, right? The vocabulary. Right. And also kind of where do I fit in this picture? You know, am I just going down the drain or is everything going to be rosy? You don't really, you know, you don't, you don't know what you want to know. Right. Right. But, and that's where the appointment notebook came in because I, I, you know, have it sectioned out into the different, um, sections with, you know, as you go through the whole process, you know, what to ask the OBGYN, what to ask the oncologist, the breast surgeon, the, the, uh, the cancer counselor, the, the getting a port, you know, all that kind of information. So it's just, it just takes you through the whole sequence. And it's just a nice way to have everything in one place. I'm, I'm sort of kind of organized and I like to have things in one compact place. And that's just one-stop shopping that I think is real, real helpful. And, you know, you don't have to run around thinking of where's my, you know, what did I forget? Did I forget to ask? Oh, I meant to ask him this, or I meant to ask him that. You can write it down and have all that information. Now, you mentioned that one of your mentors, uh, did die of, uh, breast cancer. You know, you came out on the, on the, on the upside of all this, but you know, some people, when they're diagnosed, it's already, uh, you know, everywhere it's metastasized and their prognosis is poor and they're still going to do everything they can, but it looks kind of bleak. Um, well, what advice would you have for them? You know, I, I think that you just try and keep a positive attitude and get, get your number one, get your affairs in order so that, you know, your family's not left scrambling and get your affairs in order and just continue to have a positive attitude and live out those remaining days as happily and as easily as you can and as comfortably as you can. Um, I, I can't even begin to imagine if it had, if it had been late stage cancer, what I would have done. I'm sure I would have figured it out, but it's not something you can sit here and like pontificate about, you know, you can't really just sit and think, well, this is what I would do if I was, you don't know. Cause I, I, you know, you just don't know. So, um, I do know that keeping a positive attitude goes a long way when you're diagnosed with any kind of, um, disease or disorder or anything because it's all about your mind, you know, it's mind over matter. Now, in your particular case, are you free and clear or. I am, I am. I'm free and clear and I'm on, um, my kind of cancer was estrogen driven. So I'm on an estrogen suppress. I'm going to be on that for about five years. I'm probably coming up to the end of that. And also I have to take a calcium supplements and then, um, omega three. And, um, but other than that, a little bit of hypertension, just, I came with that already, but, um, so other than that, everything's good. Little, little ache and pain here, but it doesn't, it doesn't slow my golf game down. Now, if people want to contact you or find your book, where should they go? They can go to Amazon and find it and just look up atypical journey or the, my appointment notebook. And you can also find it on my website at Ronnie Laughlin.com. Um, I'm on Instagram, Ronnie Laughlin, and also Facebook. I think it's V Ronnie Laughlin.com, uh, dot com author. So those are the places. Well, Ronnie, I think this has been very interesting and helpful discussion. Is there anything you'd like to add before we wrap up? I want to just say, thanks so much for having the opportunity. I, um, I want people to go out and buy the book and, and let me know what they think about it and try the appointment notebook and let me know, give me some feedback on, you know, does it work? Does it not work? Do I need to tweak it? You know, what would you do differently or, and that sort of thing, but, um, just keep moving forward. If you have a diagnosis of any kind of cancer or anything, that's a setback, just keep moving forward and keep a positive attitude. Great advice, Ronnie Laughlin. Thanks for joining me on the art of medicine. Thank you for having me, Dr. Wilner.