There are people who have worked at Northwell Health for just days. There are other employees who started a few weeks ago or even a couple of years back. And then there are professionals who have devoted their lives to this organization, like Elvira Francischelli.
Elvira is a radiologic technologist who has specialized in mammography for 30 years at Long Island Jewish (LIJ) Medical Center in New Hyde Park and Northwell’s Center For Advanced Medicine in Lake Success, NY. She has been a technologist for 39 years and was a student at LIJ in 1975. She is vivacious and has a natural confidence when she speaks about her work. Elvira also understands the delicacy of screening someone for cancer, and the importance of having empathy while doing so.
The mere mention of the word "mammography" can bring on myriad of thoughts and emotions in the mind of any woman (and sometimes man), none of them particularly good. Fear may be the most common.
Elvira is well acquainted with this emotion; she sees it in patients daily. She will hold the hands of patients and family members if they need her – and most importantly, she will listen. And in that moment, her expertise goes beyond technology and crosses into understanding.
Elvira does the majority of her work in an imaging room on the first floor of LIJ. It’s her room and she’s proud of it. Hand- picked prayers, jokes, photos and animal pictures line the walls of the room. It’s decorated for her patients, who see Elvira at their most vulnerable moment. She wants to give them something else to hold onto other than fear.
Many of the mammographies are more than annual screenings. Some women come to Elvira with a diagnosis of cancer already. Or perhaps something has been detected in their breasts.
Her field has experienced many advances in technology over the last 39 years. She was the first mammography technologist to perform stereotactic needle biopsies on the East Coast when LIJ became the first facility to implement the procedure in 1991. She has become friends with many of her patients, and never lost the love for what she does.
When did you know that you had chosen the right profession?
Almost as soon as I started. For me, it was actually fun to put patients in different positions and see these beautiful X-rays. These beautiful photos of the body if you will. And you know what? You're the first one to see everything, even before the doctor. In x-ray you learn a little bit of everything.
How do you keep your patients calm during these procedures?
I always tell my patients: I’m a fantastic hand-holder. And my arms are around them for support and also because they are not allowed to move. But I have a wall full of cheery pictures and poems and prayers and jokes. Patients are laughing their heads off the majority of the time! I say to them, `You know what? Nobody wants a diagnosis. But praise be to God it’s found, because after the surgical procedure it’s in the garbage. Gone. Goodbye, if you will.’ I even say to them sometimes, `You know what? Today is your new birthday.’ And a lot of time they say, `You know what? You’re right.’
Have you ever had a patient who you couldn’t stop thinking about when you got home?
That’s a constant. I’ve become friends with a number of my patients. I’ve met them on the outside after I‘ve performed their procedures. Working here 30 years, they become an extended family. I remember their faces, and when I look at their diagnosis and I see what they’ve been through, I’ve positively cried. I’ve had my heart skip a beat when I see some of these patients. You can’t not be affected by it. You can’t.
Are you ever nervous to get your yearly mammogram, or are you too close to it so it doesn’t affect you?
That’s a great question because I think I speak for all of us in the field. Because we’re in it every day, our fear level in our stomach is way down, because we also see that there is more benign stuff than bad stuff. I can’t lose sleep over it.
What would you say to women who are afraid to schedule a mammography?
It’s what I say to all of my first time patients all the time, `It’s not as horrible as you think. Mammography is fast.’ And I just chatter away with my patients to get their minds off what I’m doing.
How has advancement in technology changed diagnosis?
Mammography is so amazing. Because we see things that are the size of pinpoints. That could be cancer and that can unfortunately kill somebody. Years ago when I first started, we were using regular X-ray equipment with a cone on it and a balloon jammed in the cone, and that’s what we used for compression. And unless the area of interest was the size of a marble or a marshmallow, you couldn’t see squat. Now we have the 3D mammography, also known as Tomosynthesis, and the things that we see are incredible!
Did you ever think you’d work in this job for 30 years?
Yes, absolutely! It’s hard for me to think that retirement is relatively soon in my future. (laughs) Because I’m not a quitter. I’m not somebody who very easily changes things. Especially if we do good work, and here at LIJ we do very good work for our patients. Some of the doctors that I knew from when I was a student in 1975 are still here and that says a lot.
Woman should obtain their first baseline mammogram at the age of 40, according to the American Cancer Society. After that, they should receive yearly mammograms. Women who are at high risk for developing breast cancer may need to obtain mammograms earlier than these recommendations and at more frequent intervals.