If someone had told me even ten years ago that I would retire young and become an itinerant radiation oncologist, I would have thought he had lost his mind. As the career medical director of community-based cancer centers, I was used to running the show. And as the saying goes, I ran a “tight ship.” Consultations were performed and documented in a timely fashion, day of the request if the …
I began to love medicine again
Start with one excellent childhood experience — a loved one who is cured.
Add a generous helping of baseline optimism, a cup at least. More is better.
Mix in well a half cup of ability to suspend disbelief. And then, maybe a pinch more.
Add a teaspoon or two or even three of denial. Pollyanna had it right.
Remember to include an ounce of prevention —
Worth a pound of cure, so they say. Suspend …
What is the recipe for a great cancer doctor?
My friend Dawn and I recently attended an evening meeting of the Houston Society of Plastic Surgeons. Since we were invited guests, and not plastic surgeons, we didn’t stop on the way into the lovely formal dining room to pick up our name badges because the organizers had not made them for us. On the way out, however, we both noticed clear plastic perfectly formed oval objects sitting on the …
Plastic surgery is more than Botox. Hopefully doctors can remember that.
I have always been one of Angelina Jolie’s biggest fans. The Academy of Motion Picture Arts and Sciences saw fit to reward her 1999 performance in Girl Interrupted with an Oscar, but I wasn’t well and truly smitten until the second Lara Croft Tomb Raider movie was released in 2003. In that film, Jolie, who performs her own stunts, is seen …
Angelina Jolie’s story is one of true courage and grit
Recently a friend of my husband’s in San Diego had a mammogram that showed some suspicious microcalcifications in her right breast. She underwent a stereotactic biopsy which revealed ductal carcinoma in situ, the earliest form of breast cancer also known as stage 0 breast cancer. This type of cancer is non-invasive and does not metastasize, however, if untreated it can progress or recur as a more serious type of breast …
Stop with the curbside consultations. They don’t help anyone.
In 1994, I was working at my first radiation oncology job in San Diego at Grossmont Hospital when I came into work to hear disturbing news. One of my colleagues in medical oncology, a compassionate man known for his gentle nature, had stayed late at the cancer center the evening before to finish up paperwork. With his back to his ever …
The legacy of Dr. Michael Davidson
A patient story tonight, from Jackie:
It was one of those days. I had been to the gynecologist the week prior because I somehow knew the sporadic bleeding, which I had experienced, was not a simple urinary tract infection for which I had been treated three times. My doctor did the scrapings and biopsies and had me run down the hall for an ultrasound. I’d had lots of ultrasounds during my pregnancies — …
When cancer comes to call you, rise up and fight the good fight
I have a new favorite doctor show, “The Knick” on Cinemax, airing on Friday nights. The show stars Clive Owen as the charismatic cocaine-addicted chief of surgery Dr. John Thackery at a fictitious New York City hospital called The Kickerbocker at a time when surgery was one foot out of the barbershop. The tagline is as they say, priceless: “Modern medicine had to start somewhere.”
On the third episode, last Friday …
A bystander to the evolution of plastic surgery
I’ve always been good at pattern recognition and my visual-spatial orientation is excellent. Photography is my hobby, so it was only natural that as a medical student and internal medicine resident, I loved my dermatology electives. Each day yielded up a new parade of interesting skin lesions and rashes, and by the end of my rotations I was confident in my diagnoses and recommendations. Contact dermatitis? Steroids! Eczema? Steroids! Psoriasis? …
After retirement, a visit to a dermatology office
to live in this world
you must be able
to do three things
to love what is mortal;
to hold it
against your bones knowing
your own life depends on it;
and, when the time comes to let it go,
to let it go
-Mary Oliver, New and Selected Poems, Vol. 1
As a parent, you are not supposed to have a favorite child, and since some of us physicians feel a strange but kindred protectiveness for our patients, likewise we …
My favorite patient died last night
A few days ago I decided that since I have been officially retired for two months, it was time to change my profile on the LinkedIn social network. After all, the purpose of that network is to link business and professional people to potential opportunities and ideas. I needed to let contacts know that I am no longer with the university where I practiced for the last seven years, while …
Keys to creating a community cancer center
Heisenberg uncertainty principle: A principle in quantum mechanics holding that increasing the accuracy of measurement of one observable quantity increases the uncertainty with which another conjugate quantity may be known.
Perhaps it is because I just got back from Albuquerque, a city which has become like a second home to me, that I have Heisenberg on my mind. For the one or two of you out there who are not Breaking …
The uncertainty of monitoring prostate cancer post-prostatectomy
When it comes to surgery for cancer, having a “positive margin” is a bad thing. It means that when the surgeon said he “got it all,” even though he meant it with all of his heart, likely he didn’t. For a woman undergoing a lumpectomy for breast cancer, that positive margin means a re-excision of the lumpectomy site or alternatively, a mastectomy. For a woman who has just had a …
Get rid of the cancer first before considering breast reconstruction
A couple of weeks ago my nurse came to me with a request for a consultation. Since our schedule has been packed full lately, she’s been asking me where I can squeeze patients in.
She said, “I’m not sure about this one — he says you treated him twenty years ago and he wants to see you. But there is no new pathology so I don’t know how urgent it is.”
I …
A cancer patient return visit after 20 years
Where I come from, when most people refer to the Good Book, they are referring to the Bible. This is not true for my father, because to him, the Good Books are something else entirely.
He describes a scene early in his career as a plastic surgeon, when he had taken his doting mother to see his new office. Coincidentally, a lovely thank you note had just arrived from one of …
When patients write to doctors, and what it means
I don’t have much in the way of eyebrows. They were victims of too much plucking back in the 1960’s and when you do that, sometimes they don’t grow back. There’s a very nice woman in Solana Beach who shapes and darkens what I have left, infrequently, when I bother to think about it which isn’t very often.
I was in there about a year ago when she told me, “I …
The cost of peace of mind: A case of unneeded bilateral mastectomy
Ex-marines are some of the toughest patients I ever see, when it comes to dealing with pain from cancer. And career ex-Marines have the market cornered on toughness.
Take for example, an elderly friend in Kansas who woke up one morning with severe upper back pain, feeling faint, and decided as was his Marine Corps habit that a cold shower would be “just the thing.” The cold shower likely saved his …
The best gift of all: When the sickest patients feel better
The institution that employs me is very bullish on customer satisfaction. Having come from a fourteen year stint in private practice before I came back into the university fold six years ago, the little things that make a practice run smoothly come naturally to me.
Patients are typically seen within a week of the consultation request — same day if they are in an emergency situation. My front office staff actually …
Eagerly awaiting the results of a patient satisfaction survey
I was saddened earlier this week to read, first on Facebook as posted by his son Daniel, that Michael Palmer had passed away after suffering a heart attack and then a stroke, while going through customs in New York on the way back from a trip to Africa. Many of you know Dr. Palmer as the bestselling author who wrote medical mystery thrillers like “The Sisterhood” in 1982, …
Michael Palmer: A doctor first, in the truest sense of the word
Thirty three years ago my husband and I went to Jamaica for a belated honeymoon. We got married on the last weekend of my internship year, and immediately flew back to Boston for me to start my second year of internal medicine training. Seven months later in the dead of winter, we flew to Jamaica to a lux resort in Ocho Rios where I spent a blissful week drinking sweet …
For the most desperate, it’s about faith, love, and human kindness
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