With thousands of cancers, thousands of families and thousands of deaths, I came to see deep time. I absorbed the finite nature of existence and gained a long view. Not just yesterday’s tests, today’s battle and tomorrow’s treatment, but the loss to come. I do not know when the reaper will arrive, but understand he will. I mourn each patient before we meet. I have learned not to cry.
Call it …
How this physician learned to cry
One of the questions that I face (and which I am certain many of us do) concerns the use of alternative therapies. Iron chelation therapy, high-dose vitamin C infusions, Chinese herbs — interest in these therapies and others like them are driven by word-of-mouth (“a friend of a friend”), claims on websites and patients curiosity. Cancer is …
Please don’t mix herbal supplements with cancer treatments
Pediatricians face a difficult task determining when to refer a child for a suspected bone marrow failure syndrome. We now realize that only a subset of children with bone marrow failure syndromes present with the findings described in textbooks. These children often appear well and lack classical physical stigmata. By the time they look sick, their marrow’s ability to produce blood cells can be so weakened that it could be …
What pediatricians should know about bone marrow failure syndromes
Dr. Tom Price may become the first medical doctor to lead the U.S. Department of Health and Human Services in 24 years. One might think that having completed medical school and practiced orthopedic surgery before entering politics might give him some extra insight into what works and what doesn’t in medicine. But judging by a letter to then-HHS Secretary Kathleen Sebelius that he signed in 2011 objecting to the …
What Tom Price doesn’t know about prostate cancer screening
Politicians and policymakers are discussing what parts of the Affordable Care Act to change and what to keep. While most of us have little control over those discussions, there is one health care topic that we can control: what we talk about with our doctor.
The Institute of Medicine (IOM) released the landmark publication Crossing the Quality Chasm 15 years ago. The report proposed six aims for …
The most important thing you’re not discussing with your doctor
Danny rarely came to the clinic. He paid a sliding scale fee for the visit but this, in addition to the money he paid for his medicines, was already too much for him to afford. Now, in early November 2013, he had become concerned.
Danny had previously owned a jewelry boutique with his wife, Jacky. She made her own pieces and sold them in the store. Over time, the economy had …
A specter from the implementation and demise of the ACA
I recently reported on Stephanie Waggel, the doctor fired by a prestigious U.S. hospital for getting cancer (story also the Washington Post). In a transcription of her whistleblower video, Stephanie describes how she nearly died due to obstruction of medical care:
It started during my intern year of residency. Which, bizarrely, was the happiest year of my life. And all my friends are …
The doctor fired for having cancer speaks up
I recently consulted a specialist at a major medical center in New York, and a few days later, here came a questionnaire in the mail. “How much time did I spend in the waiting area?” it asked. How long was I kept waiting in the examining room? How close to my appointment time did the doctor see me?
The one thing it didn’t ask was whether I cared.
There’s no mystery about …
Please, doctor, don’t rush on my account
Cancer. The ominous word instantaneously triggers fear and anxiety. According to the American Cancer Society, cancer is the second most common cause of death in the United States, accounting for one in four deaths. Despite the attention cancer has garnered, an inequality exists. Patients without Internet access may not learn about possible therapeutic interventions. As we proceed with the “Moonshot” to better control cancer, we must assure that all patients …
The Cancer Moonshot should not occur on class lines
One of the privileges of medicine is the chance to meet people from every walk of life — many of whom you might never get a chance to know otherwise. Of course, such meetings are never spontaneous. In medicine, we are brought together by illness, and the people coming to see me are seeking advice on treatment for …
Being an oncologist is a privilege, even if it’s sad
In 2000, my husband Brian was diagnosed with Stage III B Hodgkin lymphoma, which has since become a prominent part of our lives. My children and I belong to Gilda’s Club, a cancer support community. And recently, we were asked to help record a promotional video to be featured at a fundraising gala for the local chapter and on the club’s website.
I’m not a “spotlight” kind of girl, and I …
I saw how my family, including me, really felt about my husband’s cancer
In high school and college, I waitressed in a Dunkin’ Donuts shop that sat between Boston Common and the Combat Zone’s porn shops, strip clubs, and bars. The wages paid for school, clothes, rent, and food. At the time, I didn’t realize this job would provide useful skills for my later medical career, an early pre-med training of sorts.
Look the part. I donned the bubblegum pink polyester uniform that clearly identified …
What this physician learned from being a doughnut waitress
I first met her in the urgent care at the cancer center when I was on call one night. She was beautiful: 53 years old, four adult sons, and in incredible pain. She had stage 4 breast cancer, and unbeknownst to her, she had a metastatic lesion in her femoral neck, which she had fractured about four weeks ago. But she’d just had a spine operation for mets in her …
The successes make the challenging cases more bearable
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“Life is just a short walk from the cradle to the grave, and it sure behooves us to be kind to one another along the way.”
– Alice Childress, American playwright, actor, author (1912-1994)
I am awakened in the wee hours by the sound of rain. Ordinarily I would return to bed in hope of stealing more sleep from night, but this particular day I know I have to rise at 4:30 …
A day in the life of a radiologist
This post is based on a “friend of a friend” situation. Important details have been changed to protect anonymity, but not the basic realities I want to discuss.
A 49-year old man was diagnosed with a rare form of lung cancer about a year and a half ago. This sad situation is compounded by the fact that he was in a stable marriage with a wife and two children, ages 10 …
We must tell sad medical stories too
My daughter’s biggest fear before starting kindergarten was would she have enough time to finish her lunch in the time allotted. Luckily, she is not a busy medical oncologist in clinic. A medical clinic is not set up for those who take their time. Modern medicine is predicated that within a fifteen-minute visit, you are expected to see the patient, address their issues, place orders, and come up with a …
Why is my medical oncologist never on time for my appointment?
“So, what’s your story?”
I knew right away what the medical oncologist was really asking. She and I were meeting for the first time while caring for a mutual patient. While getting to know each other, she asked me if I had children; when I answered in the affirmative, she asked me, “So, what’s your story?”
The question meant many things …
Stop being surprised: I’m a physician and a mother
Many of the couples that I see in my practice grow closer after the diagnosis and treatment of cancer. I describe it as being forged by the searing flames of this dreaded disease. First, comes the terror of the diagnosis and the fear of losing one’s love. I see it in the eyes of the women and men as they sit …
Cancer makes couples grow closer or tears them apart
I believe in miracles. That might sound odd coming from an oncologist –especially since our field is driven by the data. Our path forward continues to be built through trials and the collaboration between clinicians and patients, working together to forge a better way to treat cancer. I certainly believe in evidence, but still … I believe in …
An oncologist experiences the joy of being wrong
A Christmas Carol by Charles Dickens is one of the most beloved stories of all time. It is a classic story with a theme that resonates as we end the year and commence a new one. The story revolves around the main character examining his past, present, and future. He realized that key events have shaped his life and turned him into the man he is. Before the story ends, …
Holiday reflections from an oncologist
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