Laughing Through Tears
If you’re in Debra Faulk’s presence for more than five minutes and haven’t laughed out loud, you might want to get checked out.
The 54-year-old comedienne and performer feels deeply and intently, and she channels her feelings on stage. Especially pain.
“People don’t realize that’s all comedy is, is a bunch of pain,” Debra said. “We try to figure out, ‘How can I make this horrible sickness of a disease into something that’s funny?’ How can I get people to understand that it was my positivity – and my wonderful personality – that got me through this?”
Debra is a breast cancer survivor whose treatment was paused when a drug used to treat her cancer negatively impacted her heart. Familiarity with breast cancer — her sister died from it at 33 — and 16 years of experience as a caregiver for her late father, who had dementia, prepared Debra for the unexpected challenges in her own cancer battle. She anticipated the worst outcome, but wasn’t going to accept it without a fight — or a laugh.
“The thing that kept me going was the fact that I do have a sense of humor,” Debra said. “So even when I wanted to cry, I laughed until I was able to gain an understanding. That’s what I did. I cried and laughed the whole way through.”
‘I started planning my funeral’
In January 2021, Debra went in for her annual mammogram. The year before, she was asked to undergo further ultrasound testing because of a 5-millimeter mass in her right breast. That same ask was made following her 2021 mammogram: the growth had increased to 7 millimeters, prompting the need for a biopsy a month later at the UK Markey Cancer Center. It was determined Debra had Stage 1 breast cancer that was triple-positive, meaning her tumors had estrogen receptors, progesterone receptors and a larger than normal number of HER2 receptors. The HER2 protein promotes the growth of cancer cells.
“When I was told that I had cancer, all I heard was ‘death,’ ” Debra said. “And immediately, I started planning my funeral, because I know a lot of people that didn’t make it.”
Preparing for the worst was something Debra had power over, affording her some stress relief. A self-described “control freak,” she wanted the same ownership of her care. She never stopped asking questions, and when the answers came, she doubled down and asked more. Cancer was a stand-up routine with a bad punchline, and Debra was intent on perfecting it.
She was memorable among the hundreds of patients that Dr. Emily Marcinkowski has treated over the years. A surgical oncologist, Dr. Marcinkowski says many patients are — understandably — stoic or scared when she first meets them. Whatever anxieties Debra had were well-concealed by her readiness for the challenge ahead.
“She wasn’t somebody who waffled back and forth. Here we are, I’m telling a healthy woman that she has breast cancer, and she was just ready to get after it and move on with her life,” said Dr. Marcinkowski. “She was very focused, accepting and determined to move on. She truly had all of the power in her. With breast cancer, there’s this total-loss-of-control element, so whenever a patient can get some of that power back, it’s such a wonderful thing.”
The mass in Debra’s breast was small enough that she could choose between a mastectomy – the removal of the entire breast – or a lumpectomy to remove just the cancer.
“I thought immediately, ‘Just take out what you need! Don’t take all my goods,’” Debra said with a laugh.
Chemotherapy treatment paused
Chemotherapy was physically and mentally exhausting for Debra, but her attitude — and her audiences — eased her journey, even when one of her cancer treatments proved problematic.
Herceptin, a cancer therapy drug that targets the aggressive HER2 protein, is among the cancer treatments that can produce side-effects on patients’ hearts. It did so in Debra, forcing her therapies to be paused until a protective measure could be determined and her heart function improved.
The relationship between the UK Markey Cancer Center and UK Gill Heart & Vascular Institute led to establishment of the UK HealthCare cardio-oncology program, which was recently named a Gold Class Center of Excellence by the International Cardio-Oncology Society. It is one of just 27 hospitals in the U.S. with that distinction, and the only one in Kentucky.
If she had to be among the 10 percent of cancer patients who suffer heart damage that can arise from cancer treatment, Debra was in the best place she could be.
Dr. Amit Arbune, UK HealthCare’s director of cardio-oncology, began seeing Debra after a post-chemotherapy echocardiogram revealed a reduction in the “ejection fraction,” or squeezing capacity, in her heart.
There was a time not so long ago when, if adverse effects developed during cancer treatments, doctors had to discontinue that specific therapy and, as a result, reduce a patient’s chances of remission. Cardiologists like Dr. Arbune, who are specialists in treating heart issues in cancer patients, have been game-changers.
“In the past, if patients developed chest pain or coronary spasms related to their chemotherapy, the treatment would be written off,” Dr. Arbune said. “I’ve had a patient who was sent to hospice at a different hospital because she developed cardiovascular side-effects, and she came to Markey for a second opinion. When she was referred to me, we were able to start her on medicine to protect her heart, get her back on chemotherapy, and give her several more years of life.”
That’s what Dr. Arbune was able to do for Debra as well. She resumed her treatments and continued her “normal” life as best she could. Normal, for Debra, means educating others and making them laugh across a variety of stages. Her treatments coincided with a residency as a civic artist for CivicLex and her ongoing role as Nancy Green — the Kentucky woman whose likeness inspired “Aunt Jemima” — for the Kentucky Humanities’ Chautauqua program.
Continuing to do what she loved was never a question for Debra. That made a difference in her recovery.
“The most important thing to Debra was getting to those plays,” Dr. Marcinkowski said. “I have to tell most patients, ‘Cancer doesn’t get to stop you from living.’ That was unique with Debra; I didn’t have to convince her. She was more convincing me. When I was telling her that, she was like, ‘Oh, no doubt. I already knew that. We’re gonna be fine and keep moving.’”
‘Baby, I’m just getting started’
Her typical audiences range from schoolchildren to rowdy adults, so Debra’s fellow patients undergoing chemotherapy were quite unique.
As she started to lose her hair, she made the most of it and donned extravagant hats to entertain others as much as herself. She started using Facebook Live to stream her chemotherapy appointments, giving people a window into a process often discussed but rarely seen by those who don’t have to experience it. Like she does through her work, Debra made it her mission to educate – and entertain – those outside and within the room. Her personality wouldn’t allow otherwise.
“There are a lot of different people that come through that waiting room,” Debra said. “And for me to see people sitting there and not conversing, not talking to each other? You can’t act like you don’t see me and we’re both sitting here wrapped up with this tiny little robe on. C’mon, talk to me!
“I think I was able to help some women loosen up and widen their mind to some possibilities. Yeah, we’re sick, but we’re not dead.”
Debra was a vocal advocate for herself during treatment and continues to be one for people going through similar experiences. Because of concerns about scarring, Debra was adamant about not using a PICC line or port. Her treatments were administered through veins in her hand and – at her request – by providers with a long history of using needles.
“Every week, my greatest fear was being stuck with this needle,” Debra said. “But all I kept thinking was, ‘I won’t have any scars.’ You got to find the ‘something’ that gets you through.”
Debra is in remission, and genetic testing determined that her breast cancer was not hereditary, easing another one of her fears
When she was told she had cancer, all Debra heard was ‘death.’ Now all she hears is laughter.
“Baby, I’m just getting started,” Debra said. “Let your light shine. Do things that matter. Chemo helped me love better and harder. I forgive people — I ain’t forgot nothing — but I forgive. And with that same heart that we were able to save at Gill, I can still love and laugh and live.
“That’s what cancer did for me.”