Estelle’s lipstick was apple-red and generous. She did not limit its application to lips, but wore it in the general area of her mouth. Together with pink rouge, color stood out brightly on her pale face. She wore a threadbare…
Estelle’s lipstick was apple-red and generous. She did not limit its application to lips, but wore it in the general area of her mouth. Together with pink rouge, color stood out brightly on her pale face. She wore a threadbare dinner dress, years faded. Estelle had dressed carefully for the visit and I showed respect.
I met Estelle in the winter of her life. 92 years old, she lived by herself …
Throughout my career in oncology, I thought I was communicating difficult concepts to patients and families relatively well. Recently, my wife and I visited our daughter in Salt Lake City over Thanksgiving. Catherine is an extremely accomplished blogger and video…
Throughout my career in oncology, I thought I was communicating difficult concepts to patients and families relatively well. Recently, my wife and I visited our daughter in Salt Lake City over Thanksgiving. Catherine is an extremely accomplished blogger and video broadcaster. So when she commented on my blogs, I paid attention. Her (constructive) criticism was my use of some medical terminology which she didn’t understand. More surprising to me was …
“I’ve been a fighter all my life,” said my new patient, a middle aged man with thinning hair, a worried wife, and a dismal prognosis. He had worked all his life as a plumber with no health insurance. When he…
“I’ve been a fighter all my life,” said my new patient, a middle aged man with thinning hair, a worried wife, and a dismal prognosis. He had worked all his life as a plumber with no health insurance. When he was healthy, it was okay. But now he was sick.
I was meeting him for the first time in the community health center where I work as a family physician, tending …
Cancers of the tongue and throat, all categorized as oropharyngeal cancers, are appearing at an epidemic rate. The old paradigm is that such cancers most often occur in older men who drink and smoke. But this is no longer true.…
Cancers of the tongue and throat, all categorized as oropharyngeal cancers, are appearing at an epidemic rate.
The old paradigm is that such cancers most often occur in older men who drink and smoke. But this is no longer true. Now the most common cause of cancer of the tonsil and tongue is human papillomavirus (HPV). That’s right, the sexually transmitted disease. And it is occurring in ever younger people …
What causes a doctor to commit suicide? A story about a radiation oncologist from Springfield, IL brought this strange case to my attention. Dr. Thomas G. Shanahan committed suicide by cutting his throat in November of 2011. He was respected…
What causes a doctor to commit suicide?
A story about a radiation oncologist from Springfield, IL brought this strange case to my attention. Dr. Thomas G. Shanahan committed suicide by cutting his throat in November of 2011. He was respected in his field, having published many research papers and traveled the world helping to set up brachytherapy clinics in several countries. He also had been an acting alderman in his …
I remember like it was yesterday. My patient was a young blond female with two beautiful Samoan dogs. Her name was Margaret. I was only two years younger than she was. The diagnosis was poor. She was friendly when I…
I remember like it was yesterday. My patient was a young blond female with two beautiful Samoan dogs. Her name was Margaret. I was only two years younger than she was. The diagnosis was poor. She was friendly when I introduced myself. And she proceeded to tell me about her health issues, how she was diagnosed and what treatment she was receiving. Marge as she wanted to be called was …
Political correctness and sensitivity training are interfering with medicine and healthcare. In a recent article published in the journal, Pediatrics, a group of researchers published their findings regarding parental perceptions of the terminology that doctors use to describe childhood obesity…
Political correctness and sensitivity training are interfering with medicine and healthcare. In a recent article published in the journal, Pediatrics, a group of researchers published their findings regarding parental perceptions of the terminology that doctors use to describe childhood obesity (ages 2 to 18). The researchers found that it was undesirable to use the term “fat,” “obese,” or “morbidly obese” because they were stigmatizing, blaming, and the least motivating to …
Some of your relatives have had cancer. And, you’ve heard that people with a family history of the disease may be more likely to get cancer. So, should you consider genetic testing to find out if cancer runs in your…
Some of your relatives have had cancer. And, you’ve heard that people with a family history of the disease may be more likely to get cancer.
So, should you consider genetic testing to find out if cancer runs in your family?
Here’s what you need to know to make a more informed decision.
Most cancer cases aren’t related to family history.
Only about 5 to 10% of cancer cases are due to an …
Cancer is a dreadful disease. Just dreadful. Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just…
Cancer is a dreadful disease. Just dreadful. Make no mistake: I have tremendous respect for the awesome doctors who treat patients afflicted with it day after day. Still, paradoxically, I can’t help but notice that some of them have just as hard a time as do other doctors with caring for patients at the end of their lives. I believe a large part of their difficulty stems from the ridiculously …
Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 42-year-old woman is evaluated for a 3-month history of progressive cervical lymphadenopathy, fatigue, night sweats, bilateral lower-extremity and abdominal wall edema, and a…
A 42-year-old woman is evaluated for a 3-month history of progressive cervical lymphadenopathy, fatigue, night sweats, bilateral lower-extremity and abdominal wall edema, and a 4.5-kg (10.0-lb) weight gain. History is significant for three episodes of weight gain and facial and lower-extremity edema lasting 4 weeks in …
There is a fire burning in America over an issue that at times seems hotter to me than the anger against Wall Street: obesity. Time after time when I talk about taking responsibility for our individual health by eating well,…
There is a fire burning in America over an issue that at times seems hotter to me than the anger against Wall Street: obesity. Time after time when I talk about taking responsibility for our individual health by eating well, maintaining a healthy weight, and exercising more, someone responds in anger.
Many would consider me to be a wellness evangelist. They would be right. For nearly a decade I was sick …
Well-meaning but clueless person: "Let me know if you need anything." Snarky me: "Really? Thanks! Empty your purse and let's see what you have in there. Wait, is that purse Prada? I need that; I have medical bills to pay…
Well-meaning but clueless person: “Let me know if you need anything.” Snarky me: “Really? Thanks! Empty your purse and let’s see what you have in there. Wait, is that purse Prada? I need that; I have medical bills to pay and want to look good paying them. Oh, that’s a pretty wedding ring, lots of diamonds, can I have that too?”
What you should say is absolutely nothing. This is a time …
It was an invitation that made no sense. I was asked to be a special guest of the South Korean Ministry of Tourism and KMI International, a company that markets medical tourism. Why me, I wondered? As I re-read the…
It was an invitation that made no sense. I was asked to be a special guest of the South Korean Ministry of Tourism and KMI International, a company that markets medical tourism. Why me, I wondered? As I re-read the invitation, I remembered another strange offer I received in the 1970’s during a tense period in Israeli-Arab relations.
“Hello Dr. Goldberg,” an official from the Jordan Ministry of Education had said. …
In this day and age, with excellent rehabilitation care available for nearly every injury or illness—no matter how serious—it’s hard to believe that there are millions of people who leave the acute medical system far worse off than they entered…
In this day and age, with excellent rehabilitation care available for nearly every injury or illness—no matter how serious—it’s hard to believe that there are millions of people who leave the acute medical system far worse off than they entered it, and aren’t routinely offered rehab. I’m talking about cancer survivors– a group of individuals known for their tremendous advocacy abilities. It’s no surprise that these folks are really starting …
November is Pancreas Cancer Awareness Month and with the recent passing of Patrick Swayze and Steve Jobs, now is as good a time as ever to educate ourselves about this deadly disease. Almost 40,000 people per year will die of…
November is Pancreas Cancer Awareness Month and with the recent passing of Patrick Swayze and Steve Jobs, now is as good a time as ever to educate ourselves about this deadly disease. Almost 40,000 people per year will die of this disease in the U.S., making it the 4th most common cancer killer. It is through education and research that we can continue to improve survival and outcome …
Radiation therapy has advanced dramatically in the past few decades and the rate of change is increasing rapidly. Innovations as a result of engineering and computer advances along with conceptual advances are making a dramatic difference. Some of the new…
Radiation therapy has advanced dramatically in the past few decades and the rate of change is increasing rapidly. Innovations as a result of engineering and computer advances along with conceptual advances are making a dramatic difference.
Some of the new technologies include improved computer assisted treatment planning (smarter and faster and has more capability like auto-contouring, smart segmentation and improved algorithms) , continuous imaging guidance (fluoroscopic, stereoscopic, and cone beam CT), …
The American public seems to consider cancer and cardiovascular disease in diametrically opposing ways. Cancer evokes the threat of relentless, painful suffering and whatever medical science can do to delay the judgement day is appreciated. Therapeutic regimens may involve disfiguring…
The American public seems to consider cancer and cardiovascular disease in diametrically opposing ways. Cancer evokes the threat of relentless, painful suffering and whatever medical science can do to delay the judgement day is appreciated. Therapeutic regimens may involve disfiguring operations, prolonged toxic irradiation and chemotherapeutic agents that may be beneficial if they do not kill you first.
Response to treatment of limited incidence and duration are accepted and deemed beneficial. …
Cardiologist Dr. Richard Fogoros has issued this blunt warning to those at risk for developing heart disease: "You need to change your life. If you don’t, you will suffer the consequences – possibly decades earlier than is necessary." In his…
Cardiologist Dr. Richard Fogoros has issued this blunt warning to those at risk for developing heart disease: “You need to change your life. If you don’t, you will suffer the consequences – possibly decades earlier than is necessary.”
In his Heart Health Center column, he observed that most high-risk people end up making only half-hearted efforts to modify their heart attack risk. And he blamed doctors for enabling this lack of …
I see five major themes in cancer care advances: new approaches to screening and diagnosis, better understanding of the role of viruses as causative agents, targeted therapies, new technologies and improved approaches to ensuring better quality of life. Screening for…
I see five major themes in cancer care advances: new approaches to screening and diagnosis, better understanding of the role of viruses as causative agents, targeted therapies, new technologies and improved approaches to ensuring better quality of life.
Screening for the most common major cancers has been straight forward for years – women should get an annual mammogram and Pap smear, men should get a PSA test annually, both should get …
The longer I continue in practice, the more complex it becomes. I thought advances in our understanding of the molecular basis of cancer would clarify decision making; instead answers have led to more questions. In the spirit of the immortal…
The longer I continue in practice, the more complex it becomes. I thought advances in our understanding of the molecular basis of cancer would clarify decision making; instead answers have led to more questions. In the spirit of the immortal Henny Youngman: Take the issue of cancer screening, please.
The story of screening for colorectal cancer (CRC) and prostate cancer has many similarities. The primary screening and diagnostic tool during my …
Test your medicine knowledge with the MKSAP challenge, in partnership with the 
