Part 3: Doctors say Bishop Wolf's surgery went 'just perfect';
July 4, 1996
Episcopal Bishop Geralyn Wolf's breast cancer surgery "went just perfect" and presented "no surprises," her doctors said yesterday.
In two procedures spanning nearly seven hours at Women & Infants Hospital, her right breast was removed, then replaced by muscle and fat from her back.
"I feel so sustained by the people here in Rhode Island," a friend of Wolf's, the Rev. Jo-Ann Drake, quoted her as saying at 8:30 p.m., not even four hours after the surgery ended. "I just love them so much. I am so fortunate to be here. I am so fortunate to be here."
Drake said the bishop, who was heavily sedated for the operations and had been expected to remain so into the night, was wide awake, and, even lying on her bandaged back, reported feeling "quite comfortable." She was in good spirits, said Drake, and expressed gratitude for her doctors' skill and caring.
The prognosis for the 49-year-old bishop is "extremely good," Dr. Helena Chang, the surgical oncologist who performed the modified radical mastectomy, said earlier in the afternoon.
As part of the operation, Chang also removed several of Wolf's lymph nodes; tests showing whether they are malignant, along with a pathology report on the removed breast, will help determine her course of treatment, including whether chemotherapy is needed.
Dr. Richard J. Zienowicz, the plastic surgeon who performed the four-hour breast reconstruction, which required 200 stitches, said the operation "was as nice as it could've been for her. Everything looks very, very good."
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Wolf discovered the lump in her breast during a routine self-examination.
Then Chang's persistent testing revealed the cancer: When a mammogram showed nothing, and a sonogram provided only vague information, Chang drew fluid from the lump with a syringe. Dissatisfied when even those results came back negative, she performed the biopsy, which removed all doubt.
Wolf chose to have both cancer operations done at once - the mastectomy and the reconstruction - as do many women who are in good-enough shape to endure it, said Chang. In Wolf's case, she wanted to get her medical ordeal behind her and on with her life.
It's partly for that reason, too, said Zienowicz, that Wolf chose to have tissue removed from her back, instead of from her abdomen, which is the more common location. Wolf, who swims to keep in shape, not only has very little flesh on her midsection to spare, but with back surgery, Zienowicz said, the recovery time is shorter, and "she felt a responsibility to her parishioners."
"That's Gerry," said the Rev. Drake, 47, rector of the Church of the Redeemer in Providence, one of four chaplains assisting the bishop.
She and Vicki Ellis, 44, a friend of Wolf's from Philadelphia, were with the bishop early in the morning. They ushered her into surgery shortly after 10, then waited in the lobby all day and into the evening for word of her condition.
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Words jumped out
Interviewed at 6 a.m., before her pre-operative routine began, Wolf said, "I feel I know exactly what's happening."
She was dressed more casually than usual in khaki slacks, a blue camp shirt, and running shoes, and, aside from a moment's agitation over having gone to the wrong building, she seemed cheerful.
She'd had a normal night's sleep, she said, and woke as usual around 4:15 - "when the birds start." She spent a little time in reflection; the words which jumped out at her from one scripture passage, she said, were "God's loving kindness."
Not surprisingly, though, she also suffered some anxiety - "a little minor traffic jam in my stomach" - knowing that, "by tonight, I will be partly immobile, then it will be that sort of long road back to recovery, till I feel as good as I feel now.
"The cancer," she mused, "is so secret. It's hidden. It's not that I'm sitting here aware that something is growing in my body. I would never know it. . . . if it wasn't on some screen someplace, some form."
The size of the lump will not be known, said Chang, until the removed breast is mapped out by pathologists.
In performing the operation, Chang worked closely with Zienowicz in planning how much tissue would be removed and replaced.
Then it was Zienowicz's job to transfer tissue from her back - specifically, from the Latissimus dorsi muscle - to the new space in her breast by "tunnelling" it around under the skin. For this, the anesthesized bishop had to be shifted twice - first onto her side, and then onto her back again.
The broad, thin Latissimus dorsi muscle is "expendable and will not be missed," said Zienowicz, adding that this same operation has been done with good results for 30 years. It will leave only a slight scar on her back, he said, which likely will be covered by her bra.
"It's a wonderful operation," he said. "Every patient I've ever done this to has been so happy, especially because they're up and around so quickly." He expects Wolf will be discharged on Saturday morning.
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Many cards and letters
Health issues aside, both of Wolf's doctors praised her generous spirit.
"I think she's a real special lady," said Zienowicz. "We teach about the fear that society has, in some respects, about talking about body parts. That is something that's kept the problem in the closet for so long."
Zienowicz, a professor at Brown Medical School, lamented that many of his medical students are not as conscientious about their health as Wolf has been.
"My own wife is a physician," he said, "and doesn't routinely do a breast exam." But because of the bishop's example, he said, she and other women may adopt "a lifelong habit that can be lifesaving."
Chang, for her part, cited Wolf's lack of ego.
"When people are big shots, they act like big shots. Arrogant and so forth," said Chang. "She is not. She is just a lovely, lovely lady.
Since announcing her condition two weeks ago, Wolf has received about 20 0cards and letters from people saying their thoughts are with her. Some asked to know exactly what time the surgery would be, so they could pray for her during those hours.
Among the local clergy who wrote were Bishop Louis B. Gelineau of the Roman Catholic Diocese of Providence; Rabbi Leslie Gutterman of Providence's Temple Beth El; and the Rev. James C. Miller, executive minister of the R.I. State Council of Churches.
Wolf purposely left some letters unopened, intending to read them during her recovery.
"They do bring me a lot of happiness," she said.