I was on call over a holiday weekend and Friday night at 10 o’clock I was paged by the emergency department about a nosebleed. A man in his 30s had a bloody nose Friday morning and over the course of the day had developed red spots all over his legs. The ED checked his blood and his platelet count was near zero.
Blood looks red because of the oxygen-carrying red blood cells, …
A hematologic emergency in the ER
Sometimes I tell people I’m learning how to treat cancer, and their first question is ‘why haven’t we cured cancer yet?’
We will. It’s coming.
In medicine, we’re much better at treating infections than cancer, but it wasn’t always that way:
The people who will cure cancer are the patients
A few months ago I was paged by a medical student in the emergency room at ten o’clock. I had just changed my clothes, and before my pager went off my attention had been squarely fixed on the newest Jack Reacher novel.
You can usually tell when someone is going to ask you to come into the hospital from home, because there …
Medicine cannot be reduced to just a job. Here’s why.
We’re born into our bodies, and we take that for granted.
Our first job is to take a breath, something we’ll hopefully do many millions of times and never think about. That first breath changes everything: Our blood starts to flow through our heart and lungs in a different way and for the first time we taste a new world.
Before we’re born, all our needs are met via an artery and …
There’s a part of us that’s unafflictable
Last week a patient said to me, “You live your whole life thinking you’re going to have time to enjoy life later on, and then this happens.” Then he started to cry because we had just reviewed his recent CT scans and some of his lab results and he had a new diagnosis of a type and stage of cancer that meant he likely had about eight months to live. …
Missed opportunities give leverage to cancer
There’s no good age to die.
Way too many of the patients I’ve seen over the past two years are harrowingly close to my own age. I think it’s less startling to hear that an older person has cancer than when a young person is diagnosed, but I have yet to identify the age when this transition happens.
Maybe it’s an unspoken understanding that older people die and younger people shouldn’t, but …
Chemotherapy: Giving a man one more day of good life
When you tell people that your dad died of lung cancer, often the the follow up question is, “Did he smoke?”
In my case, the answer is, sort of.
I have fuzzy memories of my dad in our basement, smoking his pipe in his black leather chair and watching the original Doctor Who (I’m still processing the cultural implications of that last detail). Rumor has it he smoked cigars in the ’60s, …
You can never make sense of cancer
A woman in her 70s came into my clinic recently. Her primary doc found a mass so she came to the hospital for a biopsy and passed out on the table so they scanned her head and found a mass there, too. She started radiation and then came to meet me in the outpatient clinic.
She had trouble expressing herself because she’d had a stroke two decades ago, but it didn’t …
During this visit, my job was to watch
Last summer I met with a patient in my clinic who had come to the hospital with leg weakness and his CT scans showed widespread cancer. His type of cancer is rare and treatable with a pill, which he had been taking for about a month. He was tolerating it without too much trouble.
During our first visit, he was insightful but overwhelmed. “I know how sick I am — just …
The cancer journey well-traveled
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