I still remember being taken aback by how young she was. “She” was Mary — a 28-year-old woman who had completed chemotherapy for stage II breast cancer. She was treated elsewhere and had moved cities when her husband got a promotion.
“I’m still getting used to this area, but I am happy my hair came back before we had to move. I …
When patients ignore the evidence: Try to understand their values
I gave a talk recently to a group of my peers about addressing the needs of patients after a diagnosis of cancer, emphasizing points where transitions occur — from treatment, to end of therapy, surveillance, recurrence, and extending all the way up to the end of life — and how important it is to consider the entire journey of a person …
Are physicians ready for the e-patient movement?
On one afternoon last week, I sat at my desk working on a paper when my iPhone buzzed, telling me I had a new message. This message, forwarded from my Twitter account, alerted me to an editorial published in the Guardian (which has since been removed because it was “inconsistent with the Guardian editorial code).
Entitled, “Forget funeral selfies. What are the ethics of tweeting …
Twitter and cancer patients: What to make of the outrage?
She came to see me, alongside her husband. She was 26-years-old, diagnosed with metastatic myeloma involving her bones, which had presented when she fractured her hip while jogging. Her disease had progressed on treatment and she was to start a clinical trial. Despite being pale, she looked well. I imagined she often heard, “Wow — you look too good to have …
The desire to have a baby in the face of metastatic cancer
Every once in a while, something unexpected occurs that shakes me to my core — where I question the point of life, ask why we even bother; when in the end, it all just ends.
This time, it happened on a Sunday morning. I woke up in a good enough mood — the sun was shining through my windows, and my cat, …
Valuable lessons I have learned as an oncologist come from patients
I remember when Susan*, a close friend of mine with breast cancer (who had been living with metastatic disease for about a year before), was told she was terminal. Beyond the shock and fear, Susan felt grief and anguish that her life would end so much sooner than she (or any of us) had expected. Suddenly, Susan had so many big …
There can be hope at the end of life
Joan was 42, married, but appeared to be younger than that. Her husband was with her when we first met, as was her beautiful two-year-old son. “We couldn’t get a baby sitter, if you can believe that!” she said.
Sarah was 38 and was also married. She and I were closer to the same age, which was not lost on either of …
People who participate in clinical trials are trailblazers
I was lying in bed, watching something with my son when a chat message popped up on screen. It was my dear friend, Narin, whom I haven’t seen in years but remain in contact with (thanks to the wonders of social media).
“Did you hear that Dave died?” she had written. “I just read it in our college alumni magazine. I am so …
I am no more immortal than my own patients
Maybe I should’ve noticed how she looked. “She” was a new patient, Louise*, and she had been diagnosed with stage IV cervical cancer. Only in her 40s, the diagnosis had hit her extremely hard. At her first meeting, she wanted the “truth,” and I had told her what I felt to be most relevant — that her cancer had spread, that …
The complicated existential dilemma of living with cancer
One of the things I enjoy as an academic oncologist is the opportunity to teach. I like having students, residents, and fellows in my clinic and the opportunity for them to see what oncology is and what we do; how we “marry” the art and science of medicine in our routine care of patients with cancer.
For several years, I’ve co-directed an …
Inspiring a new generation of oncologists
Recently, my family experienced the loss of someone very dear- Uncle Peter. Peter was an ex-Marine, father of three men, and patriarch of my spouse’s family; not to mention, husband to my wonderful and artistic Aunt Helene. He had been admitted to an outside hospital with leg ischemia and was transferred to a tertiary facility. Unfortunately, things did not turn out …
Lessons learned from a family meeting
“What do you think?” my nurse, Laura, had asked as we discussed her call from Ms. Lyons (name changed to protect privacy.)
Ms. Lyons, an ovarian cancer survivor whom I have known for years, had called Laura after she had developed a discoloration on her abdominal wall and vague abdominal pain. She thought it might have something to do with her anticoagulation …
When it comes to cancer, laughter and humor can humanize
I still recall my first rotation as an inpatient attending at Memorial Sloan-Kettering Cancer Center (MSKCC). Perhaps it was the anxiety that I remembered most; that I was “in charge” of a service. Fortunately, having done fellowship at MSKCC, the system was not a foreign one, and I knew exactly where to go to get oriented—I went to Jane and Dorothy, …
Why I rely on non-physician providers
On April 15, 2013, my kids and I were in Stamford, CT, visiting with my sister, Precy, and her family. I had been reading when an email came up, stating a bomb had gone off at the Boston Marathon. I immediately turned to Twitter where #BostonMarathon had already started trending.
There before me, gruesome details emerged, coupled with …
After the Boston Marathon, a reflection on New York
“Great,” I thought, as I stood at my desk, looking at my patient list early in the morning. She was coming in today. “She” was a patient of mine in her forties, with newly diagnosed triple-negative breast cancer, without nodal involvement. Our first meeting had been several months ago, and it had not been a good one.
I had asked about her …
Medicine does not compel us to like everyone we treat
As an oncologist who also runs a sexual health clinic for women treated (or under treatment), I am discovering that my perspective on both issues of cancer treatment (and survival) and life after cancer (and quality of life) is somewhat unique. I am conscious of how difficult it is to bring up cancer therapy and survivorship (let alone sexual health) within …
Sexual health in women treated for cancer
An email was waiting for me one morning from my wonderful nurse, Laura. “Very sad day,” it said in the subject line. I opened the email quickly upon receiving it and read that one of my patients had died. This age-old dilemma again made me wonder what I should do: Should I call the family? Send an email or a card …
The importance of saying goodbye at the end of life
One of the toughest situations in oncology is the discussion about next steps, particularly when it comes to treatment of recurrent or metastatic disease. I believe very much that it is realistic to offer a patient the hope of cancer as a “chronic disease,” that treatment can result in disease stability, even though I cannot predict how chronic “chronic” is.
I was …
Physicians: Improve the experience of communication
I only met her once; she was young—in her mid-thirties—and she had been diagnosed with ovarian cancer during her pregnancy. Following chemotherapy and the delivery of a healthy baby, she underwent a hysterectomy and staging. She was ultimately diagnosed with a rare ovarian cancer: small cell carcinoma. She underwent postoperative chemotherapy and had gone into remission.
Unfortunately, it was short lived, …
A plea to oncologists to confront the treatment of rare diseases
On Friday morning I was seeing a patient, chatting about the holidays. She had given me a gingerbread house making kit for my kids — which she had done annually since I had become her doctor.
“You are doing so well,” I declared, “Have a very Merry Christmas!”
“You too!” she said as we hugged and she left the examination room.
At 12pm …
As an oncologist, I thought I had the words to console the survivors
Get free updates delivered free to your inbox.
