Christy Teal talks with colleagues Dr. Anita McSwain and Dr. Joanne Lenert, who together performed her first surgery in January. Photograph by Brandon Bray

Any patient at GW Hospital can pay extra to stay in the large private room on the fifth floor, where Teal stayed, but physicians and their family members get priority when the room isn’t being used. It’s not the hospital’s sole VIP suite—there’s also a room on the cardiology floor, where former Vice President Dick Cheney stayed during his visits. The best thing about VIP rooms, Teal says, is all the windows.

On January 11, six months after seeing her mother’s MRI, Teal was settled into her hospital room, the same one where she’d visited her mom. It had taken three hours for McSwain to remove Teal’s breasts, leaving her nipples intact, and another three for Lenert to insert tissue expanders, which are placed under the muscle and designed to stretch the skin and muscle gradually to make room for the final implants.

That night, Teal was up every hour. Whenever she moved, she felt as if she’d pulled a muscle. It took a while to get the discomfort under control. The drug fentanyl helped, but she was dizzy and wanted the catheter out.

What have I done? she thought.

Still, she felt blessed that she wasn’t there because she had cancer and that she didn’t have to start thinking about radiation or chemotherapy, as some of her patients did. She wondered how they had the strength. The next day, Teal sat in a chair reading work e-mails and called a patient who’d just learned she had metastatic breast cancer.

When she called to talk to her kids, Ashley, the eldest, got on the phone and cried. The girl wasn’t worried that her mom was sick—she just wanted her to come home. McSwain stopped by for a post-op visit to see how Teal was feeling and to check her surgical drains, long tubes inserted into the breast that clear out excess fluid after surgery. Most patients have them for up to two weeks.

“I know how hard this was for you,” Teal said. It was one thing to operate on a colleague, but she and McSwain were friends. “I just want to thank you. I’m convinced you’ve saved my life.”

Teal’s friend Laurie Turney flew in from Colorado after the surgery. Teal had helped Turney recover after her bilateral mastectomies in 2007. She’d had the operation in Washington and spent two weeks at Teal’s house afterward. Teal set up a bedroom for Turney and helped her with her surgical drains. When Turney was craving macaroni and cheese, Teal made it for her. They lay in Teal’s bed reading People magazine.

Turney wanted to be there for Teal the way Teal had been there for her. Turney had leaned on her friend since her first diagnosis in 1997. Her gynecologist was showing her how to do a self-exam when he found a pea-size lump. The diagnosis was infiltrating ductal carcinoma, the most common type of breast cancer, which starts in a milk duct and invades the breast tissue. Her cancer was Stage II because it had spread to one of her lymph nodes. She’d lost her father to breast cancer when she was 22. His doctors were shocked that a 38-year-old man had breast cancer, and within five years the disease had spread to his brain and bones.

I’m going to die, Turney thought when she was alone in bed. I’m going to die like my dad.

She called her best friend.

“I’ll be there soon,” Teal told her. “And you’re not going to die from this.” She got on a plane the next day.

Turney had a lumpectomy followed by chemotherapy and radiation. She didn’t want to see hair on her pillow, so she made an appointment with her hairdresser, brought a bottle of wine and a friend, and had her head shaved. She slept for a few days after every treatment; acupuncture helped ease the nausea.

When Turney finished chemo, doctors put her on tamoxifen for five years. She took a blood test to see if she carried a BRCA mutation, and it came back negative. At that time, there was little discussion about unidentified genetic mutations. Both she and Teal breathed a sigh of relief.

Five years passed, and Turney was cancer-free. One day in 2002, she got a call from an oncologist who’d taken care of her father. The doctor, Charles Vogel, was a pioneer in treating male breast cancers. He’d stayed in touch with her family.

“I want you to consider something,” she remembers him saying. “I’m seeing more and more women come back at six and seven years with a recurrence. Young women. And I don’t want to see you go through this. I know it sounds radical, but I want you to consider bilateral mastectomies and having your ovaries out.”

Turney had just gotten engaged. She felt good. She wanted to have children and be able to nurse them. Now is not the time, she said.

A few years later, she had breast cancer again.

“What did I do wrong? How could this happen?” she asked Teal. The chemo was worse this time: She walked around with a metallic taste in her mouth. Her hands were so sore that it hurt to pick up a napkin.

“You did nothing wrong,” Teal said. “This has nothing to do with you or anything you did or didn’t do. This is a hereditary thing: You have a gene we don’t know about.”