The morning before she moved to Georgia, Nikki Sroka, MD performed three mastectomies. Leaving her fellowship at Memorial Sloan Kettering Cancer Center in New York City turned out to be more difficult than anticipated—her colleagues couldn’t get enough of her surgical skill.
An hour and a half before her flight, she turned to her team in the operating room.
“I’m going to miss my plane,” she says. “I love you. I’m leaving.”
Nikki had chosen to move south for a position at Piedmont Fayette Hospital for two reasons: her fiancée’s parents lived in the area, and she had visited—and loved—the hospital during her residency at Atlanta Medical Center.
This created a problem during her interview at Piedmont Fayette. While taking her around, the former president and CEO of the hospital, Darrell Cutts, found that old friends constantly stopped them to say hello.
“You know, I have to say, Nikki, this is the only time I’ve had to schedule hug time into the interview,” Nikki recalls him saying.
When they heard Nikki was interviewing for a job, everyone from technicians to janitors, nurses, and staff in the intensive care unit told Cutts, “I can’t wait! Bring her by!”
Nine years later, Nikki still schedules hug time into her appointments.
As a surgeon, Nikki sees from 15-20 patients per day and performs on average six surgeries a week. That adds up to somewhere near 3,000 surgeries since becoming Piedmont Fayette’s first breast surgeon to join the hospital staff. SShe also holds the distinction of being the first surgeon to be Fellowship trained in breast surgery; many breast surgeries in the metro Atlanta area are performed by general surgeons.
In surgery, Nikki cuts with precision, minimizing scarring and soothing over the memory of pain. Catherine Hoffman, manager of oncology operations, says Nikki works with such accuracy that it’s difficult to tell where the knife has been.
“We actually had to start using a marker so that we could figure out where her surgery happened. She makes our job hard in radiation oncology,” she says. “But in a good way, you know.”
The aesthetic element of cancer recovery, an important part of the healing process, reintroduces normalcy into the patient’s life. Nikki’s patients and coworkers will say that’s her goal.
“We take normal, we crumple it up and throw it in the garbage and we hand you a reality that you never asked for, you don’t want, and you can’t give back. So how do we get that new reality to be as close to normal as possible? Be invisible while we’re there. So we’ve developed techniques that no one else is using around the country to try and get those,” she says.
Despite her surgical talent, Nikki pursues one cure missing from an operating room: not mere recovery, but full healing.
Sometimes removing the cancer is not all it takes.
Elaine Harbin, who has worked with Nikki as a cancer navigator for seven years, says Nikki constantly dismantles outside barriers to the care she provides in the hospital.
“She tries to take care of the whole patient, so she’s calling me if there’s an issue with anything from social issues to financial issues to medical issues, insurance issues, things like that,” she says. “By the time she gets finished with her consultation, she has a picture kind of the whole patient and all the dynamics.”
Harbin helps all of Nikki’s newly diagnosed breast cancer patients from diagnosis through treatment. Nikki was happy she was chosen for the job, Harbin says, because she was a cancer survivor herself. Because of her experience, Harbin understands the importance of carefully explaining the process to the patient each step of the way.
Once, a patient came into Nikki’s office with a severe barrier to treatment: she couldn’t hear. The woman had spilled water on her hearing aid, and because she was on a fixed income, she couldn’t afford a new one. Nikki recalls hoping no privacy rules were being violated as she hollered at the woman in her office. She resorted to writing notes.
The next time the woman came in for treatment, she still hadn’t replaced her hearing aid. Her dog and only companion had gotten sick, leaving her no extra money. So, after passing the woman notes again, Nikki found resources to pay for the hearing aids.
This is what Nikki calls “the art of medicine,” the dying practice of paying attention to all of a patient’s needs, not just the ones that come up in the test results.
So when it comes to diagnosing a patient, she doesn’t just look at a screen. She listens to the patient, to her concerns, to her warning signs.
One patient had a normal ultrasound, MRI, and PET/CT scan, but Nikki discovered that she had stage 3 breast cancer after performing a physical examination. When all the results pointed toward health, she could tell something was off by doing what physicians are meant to do: examining the patient.
More than eight years later, the patient is still cancer-free thanks to the intuition of Dr. Sroka.
So much of what Nikki does stretches beyond knife-in-the-operating-room precision. And sometimes, she has to be even more than a doctor.
Patients have come into her office and left with a referral for other types of care, like carpal tunnel surgery.
“She’ll hear things that maybe another physician doesn’t know, and she’s the breast surgeon but somehow they’ll tell her,” Harbin says. “So they feel very comfortable with her.”
With each new case, Nikki is more than a surgeon in the operating room or a physician in her office. So when the next patient walks in the door, she has to figure out what her role is and who she’s dealing with.
“I think the toughest part about this is figuring out what type of person I have in front of me because I’ve got to do it…” she snaps her fingers to indicate urgency.
If Nikki stopped at “How are you?” she’d never learn what was bothering the patient because sometimes the patient herself doesn’t know. Nikki looks for the invisible battles, patients struggling through the fallout of a cancer diagnosis with depression or insomnia. But they rarely share what’s going on at first. They need to be comforted, prodded, and questioned by a kind and knowledgeable source.
“That’s why I’m here, that’s why you’re here,” Nikki says, as if speaking to a patient. “That’s why I bring you…” here she draws out the vowel for emphasis, “baaaack.”
For better or worse, when a new patient shows up in Nikki’s office, she’s stuck with her. Instead of having her patients meet with assistants, Nikki prefers to see her patients for follow-up appointments herself. Some months into recovery she’ll start meeting with patients every other visit, but they always know that she’s right down the hall if they need her.
Determining a patient’s needs is the first step. Filling them requires more than good questions and careful observation. Sometimes, it means shedding a few tears.
When she talks about sending patients to chemotherapy, Nikki pauses, sighing. Her amber eyes fill up. How do you tell them what they need to go through?
“You pray,” she says, “you cry with them, you hold their hand. You say, ‘It sucks. It’s not fair.’ What are we going to do? Let’s make a plan, okay?”
Norma Jacobson, who has been a patient, says Nikki sat with her knee-to-knee, writing notes upside down so she could read them.
“She takes a person with high anxiety, such as myself, through a two-hour, step-by-step process, explaining that patient’s particular cancer and giving hope,” Jacobson said. “I’m not alone in my experience with Dr. Sroka. I’ve talked to other friends who’ve related similar stories.”
Patient reviews on the hospital website describe Nikki as “thorough” and “attentive.” One patient wrote, “She saved my life not only physically but emotionally, as well.”
Another said, “Love the way Dr. Sroka makes your visit very personal…from her hugs to her own personal stories…really puts me at ease and makes me feel like she really understands me.”
One of her stories involves a two-year-old Jaxon (he’s now seven) singing and dancing to “Don’t Stop Believing” at a wedding till the guests began chanting his name. Nikki belly laughs while telling it but insists he didn’t get his over-the-top personality from her.
What he did certainly pick up from his mom is the family motto, “Go big or go home.”
Every fourth weekend, Nikki’s husband, Jason Maveragames, gets off from work at Homeland Security, and the family goes camping. They have a camper and new boat, and Nikki says she has names for them already picked out.
“Why don’t we just use our motto?” she says jokingly. “The boat could be ‘Go big,’ and the camper would be ‘Go home.’”
This all-in philosophy doesn’t just apply to her patients, her family, and her outdoors equipment. Nikki was also a concert pianist in college, and she always choose to learn the hardest music. At 19, she practiced four to six hours daily on the piano.
She was drawn to the technical pieces, like Chopin’s “Fantaisie Impromptu” and Beethoven’s “Tempest,” where her fingers flew across the keys. She still plays the piano on occasion, but she lets someone else teach the skill to Jaxon.
He wouldn’t listen to her if she tried, she says, so she when she found out a former patient taught piano, she also found a teacher.
Despite her talent, Nikki gave up dreams of pursuing a career in music because medicine had always been her calling. Growing up in Catholic school, however, gave her a second idea.
“When I was six,” Nikki says, “I wanted to be one of two things: a doctor or a nun.”
She lost interest in the second option when she realized she’d have to give up boys. But what attracted her to the idea in the first place, the ability to help people, has never left.
Dr. Geetha Rao, a radiation oncologist at Piedmont Fayette, sees Nikki’s patients to recommend whether they need radiation treatment. Whenever they arrive, she says they are consistently well-informed and “glowing” over the treatment they’ve received.
“I have referred my own best friend to her,” Rao said. “Because I trust her and I trust that she’s going to do the right thing for the patient.”
With her laser-like focus, both in surgery and in speech, Nikki manages to serve as the tool that cuts and the hand that heals.
But her eye isn’t on the operating table. Her focus is, always, on the next person who walks in the door.