The Mullin Sisters

Adam L. Johnson, MD

African American women not only have the highest mortality rate of any ethnic group in the United States, but also the lowest cause-specific 5-year survival from breast cancer. I am acutely aware of this fact because breast cancer has directly affected multiple women in my family. Though I could write a book about each woman in my family, I hope to provide a brief snapshot of the most impactful memories that inspired my career in breast surgical oncology.

Marilyn Mullin Johnson

On December 28, 1988, my mom received a diagnosis of stage IV breast cancer 3 months after my maternal grandmother, Mary Emma Mullin, died from the disease. The following day my dad wrote a letter to my mom stating that God told him they would have a son named Adam.

After 2 rounds of chemotherapy, a mastectomy, radiation therapy, and cessation of her menstrual cycle, in addition to advanced maternal age, she discovered she was pregnant. During the pregnancy, one of her physicians suggested an abortion, due to the increased chance of the cancer recurring. My mom chose to continue with the pregnancy, and I was born on June 28, 1991, coincidentally under the astrological sign Cancer.

Her cancer recurred in 2001 and due to complications from chemotherapy, her kidneys failed in 2002. Subsequently, she was placed on disability. I remember her being sad that she could no longer teach, as my mom was a passionate educator. She homeschooled me in eighth grade, and in tenth grade, she coordinated a shadowing experience for me with a urologist in Warner Robins, Georgia.

One day I came home from shadowing Melvin Fussell, MD, and met my mom in the kitchen; she would often try to teach me how to cook and I would decline. I looked at her and said, “When I grow up, I want to be a surgeon.” My mom, who had experienced myriad health issues, smiled, looked at me, and said, “When you become a surgeon, you can operate on me.” I optimistically and naively responded, “By the time I become a surgeon you won’t even need surgery.” In a way, we were both correct.

I was 20 years old when my mom died on September 9, 2011, secondary to sepsis from a dialysis line infection. She was 56 years old.

Barbara “Ann” Mullin

I remember the holiday gatherings at my Aunt Ann’s house in Albany, Georgia. She had a beautiful home with a large backyard that my cousins and I would play in. A favorite treat that would be waiting for us were soft caramels she kept inside a bowl.

The last distinct memory I have of her is her bald head, as she was lying in the hospital bed and mustering up the strength to whisper a “Hey, baby.” My mom told me that one of her last memories of her sister was Ann saying, “Mal, I wanted to have children.”

I was 5 years old when my Aunt Ann died on March 11, 1996, from metastatic breast cancer. She was 43 years old.

Carolyn Mullin Darensburg

It was always a joy when my Aunt Carolyn would come visit. My mom always seemed to have more energy when she was around. Aunt Carolyn learned she had a BRCA1 mutation while I was in medical school. She was preparing to have a double prophylactic mastectomy in 2020; however, the COVID-19 pandemic halted this process.

When I was in my chief year of my general surgery residency, Aunt Carolyn informed me that she felt a swollen lymph node in her left armpit. She was hopeful that it was secondary to having recent vaccines injected in her left arm, especially as a bilateral breast MRI earlier that year had not demonstrated any concerning findings.

I went to visit her during the holiday season of 2022, and she invited me to come with her for her biopsy. I was back in Kansas when my Aunt Carolyn called, as a nurse navigator shared the results. It was cancer. My aunt cried for less than a minute. Though I was not in the room with my mother when she received her diagnosis twice, what a full circle moment and honor it was that my aunt would call me to support her at that time.

From that day on, my aunt has demonstrated the power of most cancer survivors. She is determined to not let this defeat her. She continued to train and graduate from a yoga instructor class while she completed neoadjuvant chemotherapy. She underwent surgery in July 2023 and completed adjuvant radiation therapy in September. She is a coauthor of a survivorship book entitled Empowered Volume 2 and continues to encourage women fighting breast cancer through yoga and volunteering in 3 different cancer foundations. She is 62 years old.

Below are 10 lessons I learned from watching these beautiful women and their battle with breast cancer:

1. Never let a beautiful, sunny day go by without appreciating it.

2. Laughter is like medicine.

3. Life is short. Live it to the fullest. Be your truest, most authentic self—unless you’re a jerk. In that case, please choose to be someone else.

4. Journal. Mind your business. Change yourself. Change the world.

5. Find joy in seeing other people win.

6. It is only considered a failure once you give up, otherwise it is a lesson. Life is about progression, not perfection.

7. Look for the best in people, but after a while, give yourself permission to stop looking.

8. The bigger the risk, the bigger the reward, and sometimes the outcomes can be miraculous.

9. Not everything deserves a response. Conserve and protect your energy for things and for people that matter.

10. Be courageous. Be strong. Be a queen. Be unapologetically great. Be fierce. Live free. Be a warrior and fight like a girl!

It is an honor to serve as a breast surgical oncologist, and I look forward to providing all my patients with the same care I have devoted to my family members.