When first introduced four decades ago, breast cancer screening with mammography was widely regarded as an important tool in the fight against this terrible disease.  It seemed obvious that the earlier it could be diagnosed the more lives could be saved. Aggressive treatment, it was thought, would prevent the cancer from spreading through the body.  A huge amount of research evidence since then has slowly and painfully led to a ...

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When it comes to surgery for cancer, having a “positive margin” is a bad thing.  It means that when the surgeon said he “got it all,” even though he meant it with all of his heart, likely he didn’t.  For a woman undergoing a lumpectomy for breast cancer, that positive margin means a re-excision of the lumpectomy site or alternatively, a mastectomy.  For a woman who has just had a ...

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Over the course of medical school, you are expected to get comfortable with a whole host of expensive-sounding equipment (see: popsicle stick becomes tongue depressor). You sling a stethoscope around your neck, maybe tuck a reflex hammer in your white coat pocket, and begin that privileged journey of looking for things that don't sound or sit quite right. You learn rather quickly that it won't be you on stage, and somehow, you landed ...

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In this post, I will do my best to try and address what is commonly said by doctors, dentists and lactation consultants who don't understand the correlation between tongue-tie and lip-tie and poor breastfeeding. I think that we must first disprove what they think they know. I think these myths are born out of a complete lack of education, and with time, hopefully we won't hear them as frequently. I've compiled a list ...

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It should be easy, right? I mean, I am a professional with what feels like eons of training. So how can an oncologist with years of experience fail at perhaps the most important question a patient can ask, ”How long do I have, Doc?” It’s not that I want to avoid the question. Well, okay, sometimes I do. It’s not the most pleasant of conversations to have. But really, I don’t ...

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March is colorectal cancer (CRC) awareness month, so it’s an appropriate time to reflect on how to increase the number of people who get screened for this cancer that’s largely preventable through screening. Between 2005 and 2012, Kaiser Permanente, Northern California, doubled the percentage of our eligible patients who were screened for CRC. So how did we do it? We employ a combined screening model with fecal immunochemical test (FIT) outreach and ...

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CNN recently released a report on picky eaters. This short piece featured the family of a picky pre-schooler, Harper O’Bamsawin. The brave O’Bamsawin family opened their house to the world, seeking solutions to improve their dinner table experience. The result, however, was an expose of common problems left unsolved. As the camera revealed a typical meal in Harper’s home, it quickly became clear that Harper’s parents have fallen into ...

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I was up helping my son for the majority of the night. He’s got a stomach bug (which he got from his brother) therefore I was up dealing with the enormous mess that comes with vomiting in the middle of the night. I know you know my woe. This is the second round of this bug at our house so I was clearly exhausted when 6am rolled around. First thing I ...

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Hot oil splatters as thick fatty fish slips into the smoking pan, next to boiling rice and simmering garlic greens.  Quickly golden, she flips the fillet and turns down the heat.  Small feet pound down the stairs, drawn by the crackling aroma, but it’s a mother’s trap; she motions the child to set the table. One by one, the family gathers, as plates and utensils clatter onto the wood and ...

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When someone asks me what a developmental pediatrician does, I tell him or her that I treat children who have a variety of developmental problems, such as attention deficit hyperactivity disorder (ADHD). Without fail, that disclosure elicits some sort of an emotional reaction. Many people have strong opinions about whether the disorder really exists. Parents are still being told, by family and so-called friends, that it’s “their fault,” and that all ...

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