Oncology/Hematology

Should nurse practitioners complete medical residencies?

Anonymous

Physician

March 1, 2020

About three months ago, something awful happened. The oncology nurse practitioner (NP) whom I trained for the past two years in my subspecialty decided to seek employment elsewhere in order to have a more flexible work schedule.

My team and I lamented we had a going-away dinner to say thank you for her work. And for the next three months, I trudged through my days in a busy oncology clinic, seeing …

The intern who knows everything

Jason Lizalek, MD

Conditions

January 3, 2020

What seems like a tidal wave of pages washes over you. Drowning in a torrential sea of order clarification, bowel regimens, and vital sign deviations — you struggle to stay afloat. Medical school did not prepare you for this. Patients and nurses are calling you, “doctor,” you wish to return to that minimal responsibility role as a medical student.

Welcome to your first on-call weekend.

These first few days, weeks, and months …

Read more…

The intern who knows everything

The hidden benefits of your health insurance plan can save your life

Michael L. Millenson

Policy

January 1, 2020

At kitchen tables everywhere, ordinary Americans have been grappling with the arcane language of deductibles and co-pays as they’ve struggled to select a health insurance plan during open enrollment season.

Unfortunately, critical information that could literally spell the difference between life and death is conspicuously absent from the glossy brochures and eye-catching websites.

Which plan will arrange a consultation with top-tier oncologists if I’m diagnosed with a complex …

A letter to a cancer patient in palliative care

Alison Vasa

Education

December 10, 2019

I heard about you a few times before I ever met you in person. It was my first day on the palliative care service — a week that felt like a relaxing break from the sixteen-hour days I was used to on surgery. Many people don’t know what palliative care is. But I suspect these days if you are still living that you know it well.

I first heard of you …

A brilliant song about the perils of texting and driving

Admin

Video

November 25, 2019

“Words Kill” is a brilliant song about the perils of texting and driving. Spread the message.

Courtesy of The Fever Breakers, a band made up of hospital employees. Their socially conscious songs are crafted in the basement of the hospital using a piano used for cancer patient music therapy and subsequently recorded in a studio.

A brilliant song about the perils of texting and driving

MKSAP: 28-year-old woman follows-up after a pre-employment physical examination

mksap

Conditions

November 2, 2019

Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.

A 28-year-old woman undergoes follow-up consultation regarding a pre-employment physical examination. She reports feeling well, with no recent illness. Medical history is notable for gastroesophageal reflux disease. Her only medication is omeprazole. She is black.

On physical examination, vital signs and other examination findings are normal.

A peripheral blood smear shows …

An expensive treatment may be a victim of its own widening use

Julie Appleby

Meds

October 1, 2019

Medical treatment has knocked down tumors in 6-year-old Easton Daniels’ brain, but the drug used also wiped out his immune system.

To bolster his immune function and help keep him healthy, he has visited a hospital for intravenous infusions of immune globulin about every month for the past year and a half.

But in early July, his family was stunned by a letter from Cincinnati Children’s Hospital: “All of Easton’s appointments canceled …

Explaining Peter Fonda’s lung cancer

Michele R. Berman, MD and Mark S. Boguski, MD, PhD

Conditions

September 3, 2019

Actor Peter Fonda, son of Henry Fonda and younger brother of Jane Fonda, passed away August 16 at his Los Angeles home. Fonda, who was 79, is probably best known for his role as Wyatt in Easy Rider, a movie he co-wrote, produced, and starred in. Fonda was nominated for the Academy Award for Best Original Screenplay for that film as …

Read more…

Explaining Peter Fonda’s lung cancer

To first-generation college pre-medical students: Your future patients need you

Jenny Ruiz, MD

Physician

July 22, 2019

Being a first-generation college student is hard. Being a first-generation college student and being pre-med is even harder. And since education and income are closely linked in the U.S., it’s no surprise that many first-generation college students also come from a low-income background.

I fell into this category.

My parents did not finish high school, and money was always tight. I had never heard of pre-med until I got to college. I …

The line between family member and personal doctor

Brian Vukelic, MD

Physician

July 12, 2019

I, like many physicians, am the only doctor in my extended family. To say that they are proud is probably an understatement. I’ve been a practicing physician for seven years now and yet my grandmother each time I see her greets me with, “There’s my doctor grandson.” I have worked quite hard to get to where I am, and I enjoy what I do. I, too, am proud to be the …

After cancer treatment: It’s time to reconsider the ringing of the bell

Anne Katz, RN, PhD

Conditions

July 8, 2019

It’s become a common practice in oncology institutions across North America: A patient completes their prescribed course of treatment and they ring a bell. Usually, it’s a large bell, like one that used to be rung in schools signaling the end of recess. Or it’s a ship’s bell, attached to a wall outside the radiation department or the chemotherapy unit. …

What should a cure for cancer look like?

J. Leonard Lichtenfeld, MD

Conditions

June 23, 2019

Words have meaning. And when it comes to cancer, especially advanced cancer, there aren’t many words that have more meaning than the word “cure.” It is that very word and concept that is top of mind for some of us these days.

We clinicians are guilty as charged when it comes to reluctance declaring those who have had a remarkable response to treatments for advanced cancer “cured.” Experience has taught us …

How is Alex Trebek doing with his pancreatic cancer treatment?

Michele R. Berman, MD and Mark S. Boguski, MD, PhD

Conditions

June 20, 2019

In a recent People article, Jeopardy! host Alex Trebek shared some good news. Diagnosed with stage 4 pancreatic cancer in March, Trebek said he was told that he has been responding very well to his chemotherapy regimen, and that he’s in “near remission.”

He went on to say, “It’s kind of mind-boggling. … The doctors said they hadn’t seen this kind of positive …

Celebrities are bringing a myriad of health conditions into the public consciousness

Joshua Mansour, MD

Physician

May 21, 2019

It seems now as if every day and every month is associated with a “national day” or an “awareness month.” Some such as “national taco day” may be less important than others, well depending on one’s priorities. Although many illnesses now also have a dedicated day or month, many of these diseases will go unnoticed. They will rarely be discussed — that is until a celebrity or someone in the …

The simplest and most important question to ask in the exam room

Michael L. Millenson

Conditions

May 16, 2019

It was the first time the young woman had come to the health center in a suburb just north of Chicago. When the 26 year old walked into the exam room back in 2008. There was no paper chart or electronic health record (EHR) accompanying her, no background information — nothing to indicate anything but a routine annual gynecological exam.

She and her husband were about to try to have their …

Why would adult children disapprove of their parent’s happiness?

Anne Katz, RN, PhD

Physician

May 13, 2019

Going through the process of diagnosis, treatment decision making, and often lengthy treatment without a partner can be challenging. While children, friends, and other family members are supportive, for the single individual, there is no one to talk to in the middle of the night when fear and doubt often surface. I often counsel people who have finished treatment for their …

Death through the eyes of a medical student

Taliya Lantsman

Education

May 6, 2019

Growing up, I was discouraged from becoming a doctor; I was too emotional. My mother, a geriatrician, worried about my attachment to patients and the volatility of inpatient medicine. To some degree, I understood her concerns; I’m tearful during goodbyes and inconsolable at funerals. Yet my interest in medicine persisted, and I began medical school. In my third-year, I experienced the innumerable emotions associated with witnessing patients’ deaths. I was …

Why didn’t your doctors tell you the truth?

Charlotte Grinberg, MD

Conditions

April 24, 2019

Here’s what they should have told you: “We found cancer in your lymph nodes, your liver, your lungs, and your brain. It explains your weight loss, your difficulty breathing and your loss of appetite. This wasn’t just your depression like you thought. It started in your lungs, and now it’s everywhere. This cancer has been growing for quite some time. You cannot, even with the strongest medications and the longest …

Screening elderly men for prostate cancer: More harm than good?

Peter Ubel, MD

Conditions

April 10, 2019

Most men diagnosed with prostate cancer don’t die of the disease. Between 2011 and 2015, 112.6 per 100,000 men per year were diagnosed with prostate cancer in the U.S., but only 19.5 per 100,000 men per year died of the disease over that same period of time. That is still far too many deaths. But the huge disparity between deaths and diagnoses arises in large part from overdiagnosis of prostate …

Hope is essential in every field of medicine

Shannon Casey, PA-C

Conditions

March 22, 2019

A man in his fifties is wheeled into the emergency department on a gurney hoping he’ll still be around to cheer from the sidelines at his daughter’s next soccer game. A little girl on the pediatric floor upstairs simply hopes her tummy stops hurting. A woman in the clinic explains her puzzling symptoms and hopes that this is the specialist who will finally be able to ascertain why she hasn’t …

Oncology/Hematology

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