I was midway through a busy afternoon clinic when my pager erupted—an inpatient consult request. The case sounded messy: Chronic pancreatitis that had suddenly spiraled downward. A fresh, sizable mass sat in the pancreatic head; tumor markers were positive. Two endoscopic biopsies had failed, and surgery felt too risky for this frail patient. Cancer seemed the only plausible answer.

Rheumatology—my service—was called in because her ANA was weakly positive (1:40). In …

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It is early Sunday morning—there’s the rare kind of quiet today that feels borrowed. My daughter is still asleep beside my wife, and the house is hushed in that golden stillness. I find myself flipping through the paper copy of The Rheumatologist’s “Best of 2024” supplement that had arrived earlier in the week—I just wanted a brief escape from medical records (and even more so, from studying).

Half-skimming, half-unwinding, I …

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