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 …
Hope is essential in every field of medicine
“Hey, you’re a med student. Right?”
“Yes, I am. Do you need me to scrub in?”
“That would be wonderful, yes! Everyone is either out on vacation or is sick. It’s just me and the resident.”
“OK, I’ll be back in a few minutes.”
I was on my OB/GYN rotation, and once a week I follow one of the surgeons. It was 7:20 a.m., and a patient was coming in for an unplanned, stat …
The story of an attending’s empathy
Her name was Callie (identifying information changed). She was four years old. She loved glitter and princesses and anything sparkly. She was affectionate and silly, and I fell hard for her. She was a patient, my patient, on the pediatric oncology unit during my very first ward rotation intern year.
On my first day, I was as scared as any person can be, palms sweating, heart pounding, faced with these tiny, …
To parents who have lost children: We never forget your children
When I first turned to writing, I had no knowledge of the field of narrative medicine.
It took four years of medical school, three years of residency, three years of subspecialty fellowship and over a decade in practice before I learned of it. (That’s more than 20 years, for those counting.)
Throughout, I’ve struggled to hold fast to my core belief that the key to patient care is to allow the telling …
6 resources on the power of narrative medicine
“We have a consult for radiation oncology regarding a 60-year-old gentleman with a history of lung cancer and is currently admitted. His oncologist is Dr. Heme Onc.”
As a new radiation oncology resident, I was surprised to hear the consulting physician refer to the patient’s medical oncologist as “his oncologist.” What about the patient’s radiation oncologist? Indeed, I remembered the patient well: he was diagnosed with Stage IIIB non-small cell lung …
Radiation oncologists aren’t just strangers in the basement
The woman waiting to see me looked every inch a lawyer or accountant in her black pencil skirt, pink shirt, and a Chanel-style houndstooth jacket. Her ankle boots were reminiscent of those worn by women in Victorian times with a row of small buttons up the side. She had a scarf loosely knotted around her shoulders, and her hair was …
What clothing choice says about a patient
I want to share how the era of immunotherapy, specifically immune-checkpoint-inhibitors, has changed the landscape of community oncology practice in metastatic non-small-cell lung cancer, for oncologists and, more importantly, patients.
I want to tell you the story of Joe. A stage IV lung cancer survivor story. (Name and details changed to protect anonymity.)
In 2015, Joe was diagnosed with stage IV non-small-cell lung cancer (NSCLC), adenocarcinoma. He had multiple metastases to other organs. …
A stage IV lung cancer survivor story
Part 3 of a series.
Patients with advanced cancer are particularly vulnerable to infection due to a compromised immune system. Moreover, the typical symptoms of serious infection, such as fever and chills, may be absent in cancer patients. If not identified and treated early, infection can lead to sepsis, a life-threatening reaction of the immune system that causes organ failure, shock, and death, as …
Why did it take over a week for doctors to initiate treatment?
Over 80,000 new cases of bladder cancer are diagnosed every year. Of the new cases, over 62,000 are men, and over 18,000 are women. Whites have higher incidence rates than blacks, although black patients have higher mortality rates, particularly black women. The majority of cases are found with painless gross hematuria (although most patients with gross painless hematuria don’t have bladder cancer). Nearly 80 percent of patients diagnosed with bladder …
10 essential questions to ask when diagnosed with bladder cancer
Late one evening, I received a text from my oldest daughter.
“What in medicine, that we do now, will we think is barbaric in 50 years?”
Wow. They play more provocative bar games now than they played when I was in my 20s.
I promptly texted back my knee-jerk response: “chemotherapy.” As we are on the brink of precision medicine, what will the next generation think of our “slash, burn and poison” paradigm …
Prostate cancer often presents unique challenges to patients and physicians alike. It can be indolent and non-aggressive — or life-threatening and everything in between. Unlike most cancers that have a dedicated roadmap for treatment for prostate cancer revolves around opinions and biases.
To help patients navigate the landmine of prostate cancer, I’ve compiled a list of 10 basic questions to ask when diagnosed with prostate cancer. Here they are:
1. “What is …
Diagnosed with prostate cancer? You must ask these 10 questions.
“Where there is no struggle, there is no compassion.”
-Frederick Douglass
Growing up with sickle cell anemia exposed me to the field of medicine. As I go through the pain and complications, it humbles me to the point that motivates me to work harder to be the doctor I want for myself. I want to be a physician-scientist that conducts clinical research targeted toward patients like me. I believe that as a …
How sickle cell anemia influences a medical school journey
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 79-year-old man is evaluated for pain in the buttocks region. He was diagnosed with non-Hodgkin large B-cell lymphoma 6 months ago. Although his lymphoma has responded well to therapy and he is without evidence of active disease, he required hospitalization three times for chemotherapy-associated complications during his treatment course. He has been …
MKSAP: 79-year-old man with a sacral ulcer
On my first day of medical school, my father, a dentist, told me he’d just been diagnosed with stage four pancreatic cancer. Cancer had crept back into my life — except this time not into my body.
At age 12, I was diagnosed with brain cancer. After an aggressive surgery, I was tumor-free for 10 years. Then, at 23, I received the news of an inoperable recurrence.
While going through radiation and …
There’s no textbook for when your father is dying
I sat in seat 23F next to the window, took out my leftover dinner from my backpack, and furiously started eating. A few minutes later, a man wearing an Astros baseball cap sat next to me with a puzzled look.
“You sure look hungry.”
“I am, can’t beat fried noodles with chicken. My name’s T.J. Pleasure to meet you.”
“My name’s Mike, Mike Jordan.”
“Are you related to the Michael Jordan?”
“Ha ha! I sure …
Dealing with prejudice as a cancer patient
I’m a pathologist and the main way I communicate to the outside world — to your doctor and ultimately to you, the patient is via the pathology report. But the short missives I send from behind the microscope lack any excitement and can fall short of full communication.
Here’s the usual story:
Skin left scapula, biopsy
Nodular basal cell carcinoma
Negative for perineural invasion
Margin status: Positive
Doesn’t sound real interesting, does it?
How about a more …
A breakdown of your pathology report
The surgical team filed out of the patient’s room. I looked over my shoulder to see a shaken daughter holding the wrinkled hand of her quiet, elderly mother who lay in the bed. I shuddered as I thought of the surgery her body would endure the next day. I knew I needed to return to her room later in the day to find out more about her history. After rounds …
Quality over quantity in life and care
1. Cancer is not rare. Technically, childhood cancer is rare compared to adult cancer, but it’s not as rare as you think. Outside of my work, I can think of 3 people who I know personally that had a childhood cancer. A teammate on my high school basketball team, my sister-in-law, and a high school debate teammate. My guess is that you also know someone from church, a coworker’s …
10 things a pediatric oncologist wants you to know
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians.
A 77-year-old woman is evaluated for frequently fluctuating INRs (<1.8 to >3.5) while taking warfarin therapy. She has undergone INR testing every 1 to 2 weeks and frequent warfarin dose adjustments. She reports a consistent dietary intake. Medical history is notable only for recurrent deep venous thrombosis. She takes no other medications.
On physical …
MKSAP: 77-year-old woman with frequently fluctuating INRs
I am a medical oncologist specializing in breast cancer. I often try to conceal what I do for a living when I meet people for the first time as it always leads down a particular road. “Is that so depressing? I don’t know how to deal with that all day, every day.” But in truth, it …
The most valuable lessons in life can be learned in oncology
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