‘Less is more’ for Santa Rosa breast cancer surgeon
Elizabeth ‘Lisa’ Tito, a college athlete with ambitions of treating bones, joints, tendons and muscles as an orthopedic surgeon, had expected to start medical school after graduating in 1987 with a biology degree from Bates College in Lewiston, Maine.
But after turning in her medical school application too late to receive an acceptance, she said she instead found herself working as a volunteer at a hospital in Winterton, South Africa, a rural area where families lived in huts without running water.
There, Tito worked with a translator to treat young patients suffering from diarrhea due to a lack of access to sterilized water.
During mobile clinics, Tito said, she weighed growing babies on scales that had been set up under trees, while at a nearby community center, mothers were taught how to grow food and treat dehydrated children.
She said she also obtained experience in the hospital’s operating room, where primary care doctors — not trained as surgeons — did “the best they could” to treat their patients.
Her job was to hold the medical textbook and turn the page so the operating doctor knew what to do next.
“That’s when I realized I didn’t want to be an orthopedic surgeon, I wanted to do all of it,” Tito said. “What I saw in our operating room in Africa … we were saving lives.”
‘Empower them with knowledge’
Nearly 35 years after her six-month stay at the South African hospital -- which ended with her admittance to Dartmouth College’s Geisel School of Medicine, where she trained as a general surgeon -- Tito believes she has found her calling.
Working with breast cancer patients, she oversees Providence Medical Group’s Breast Center at Santa Rosa Memorial Hospital as its medical director and surgeon.
Driving Tito’s work: A fierce commitment to individualized, patient-centered medical care, along with her relentless pursuit of the latest breast cancer data -- the latter of which has led to less intrusive treatments and more post-breast surgery patients recovering in the comfort of their own homes, rather than a hospital bed.
The majority of Tito’s patients are breast cancer patients. In her first visit with them, she said, she operates in “quarterback” mode, developing a treatment plan and sending orders to the medical oncologists, radiologists, medical assistants and other staff who need to be involved.
Her top priority is to prepare her patients for the journey ahead, Tito said.
“My first job, my goal, is to empower them with knowledge to understand what’s going on and make them feel calm,” she said. “They walk in stressed, and they walk out like, ‘We can do this.’”
‘Thoughtful and yet tough’
Harmony Susalla, a 52-year-old Gualala resident, said Tito’s ability to explain in simple terms what was happening to her body, and the best options for care, was especially important to her as she underwent treatment for breast cancer in 2017.
Susalla said she was raised in a Christian Science household, which meant she and her family relied on prayer rather than medical treatment. She said was raised with a limited knowledge of the human body and medicine, as well as a belief that talking about an illness made it more real.
When Susalla met with Tito soon after she was diagnosed with breast cancer in August 2017, she said she explained her religion and its impact on her upbringing.
What followed was a monthlong process of preparing for surgery as Tito worked through Susalla’s questions and concerns. Though Tito had determined that Susalla needed only one breast removed, Susalla wanted a double mastectomy.
Susalla ultimately stuck with her decision to have both breasts removed, Tito said, but only after Tito had fully informed her of all her options.
As part of the process, Tito said she read a book on Christian Science to better understand Susalla’s background.
“She never made me feel stupid or like an alien,” Susalla said of Tito. “She was very kind, very considerate, very thoughtful and yet tough.”
The journey to Sonoma County
After graduating from medical school in 1992 and working as a general surgeon in Cooperstown, New York, Tito quickly realized she wanted to specialize in breast cancer surgery. She enjoyed working with women with breast cancer and was intrigued by the challenging and evolving nature of breast cancer research, she said.
The shift led her to a job at the Women & Infants Hospital in Rhode Island in 2001, where she taught training doctors about breast cancer surgery. Tito was then tapped to develop a breast cancer program in Taunton, Massachusetts, a leadership role that gave her the opportunity to assemble her own team, as well as work with the community to shape and raise money for the program, she said.