"Being from a small town in Florida, I assumed that Atlanta had everything," said McCain, a patient educator and counselor in the School of Medicine's Department of Plastic and Reconstructive Surgery who works with breast cancer patients. "So I told them, `Sure, I'll get you the names of the groups and get you in touch with them.' What I found out was that there was no such group."
McCain was amazed that in a city with dozens of support groups for women undergoing the trauma of breast cancer treatment, there was no group for women who had already been through that process and were dealing with breast reconstruction surgery.
"Breast reconstruction is different from breast cancer," said McCain, a Duke-educated nurse. "Most of the women undergoing breast reconstruction have already dealt with the issues of death and dying, and now have an aesthetic concern that has to do with body image and self image. Getting a breast back after cancer surgery ties into femininity, feelings of sexuality and feeling whole. The breast cancer groups weren't addressing any of those issues. So I just thought we really needed to have a group that gives these women the information they need on breast reconstruction, but also a group that would alleviate their fears and educate them on reconstruction and what their options are."
"In forming the group, I thought about what had been some of the best, most effective support groups in the country," she recalled. "Of course AA (Alcoholics Anonymous) came to mind. So I called and found out what chapter was closest to me. Then I went undercover, since I'm not an alcoholic, and just sat in on their meetings each week."
From that undercover work, McCain formulated the kind of group she believed would be most beneficial to women undergoing breast reconstruction, which takes about a year for most patients. This included keeping the group size small and having the members sit in a circle to encourage eye contact. "I wanted there to be collaboration," McCain said. "I didn't want to be standing in front of them as a speaker. I wanted to be a group leader to help facilitate conversation. I wanted to provide an arena for them to ventilate their feelings."
After months of planning and research, McCain held the first meeting of the support group in January 1988. Four people showed up. "I went home in tears," she said. "I thought there must not be a need for the group if only four out of 200 people invited showed up." But McCain did not give up on the group. As the first few months went by, she realized the group meetings needed to be more structured and address specific topics each month. To date, more than 100 women have participated in the group. Topics that have been addressed recently include hormone replacement therapy after breast cancer surgery and cancer recurrence.
In 1989, the members decided to give their group a name: Image Reborn. "They wanted that name because they said being in the group was like the rebirth of a new self image for them," McCain said.
John Bostwick III, a professor in the medical school and chief of plastic surgery at The Emory Clinic, has seen many of his patients experience a rebirth in the support group. "I can see lower levels of anxiety in patients who have been to Lynne's group," Bostwick said. "She is really enhancing the quality of life for these women." Bostwick said he is especially pleased that McCain has helped form other Image Reborn chapters not only in the United States, but also in other countries.
"I don't take life for granted anymore," McCain said. "I think the overriding theme with cancer is that, suddenly, they look at things that used to be important, and their priorities change. Without having had cancer myself, I have had my priorities changed by them. The things that you think you just have to get done, the laundry every Sunday or the grocery shopping every Saturday, all of a sudden, those things just don't matter. It's more important that, if you've always wanted to go to Europe, then go now. Don't put things off. The group has taught me that life is precious. You let go of some of the rigidity you tend to put into your life."
As a "recovering" Type A person, McCain also appreciates the group's healthy use of humor and their ability to help her relax a little.
"I feel kind of guilty when people talk about my having the idea for the group," she said. "I didn't have the idea; other women did. But it's a great group. It's my love."