The Hollywood treatment of oncologistsRecently, I passed my friend and colleague, Dr. Ekaterini Tsiapali, in the stairwell. We rarely get to catch up these days, so it was really quite a nice surprise to see her. "What did you do this weekend?" I asked. "I watched Wit, you know, the movie where Emma Thompson plays Dr. Vivian Bearing, a 50-year-old woman with terminal ovarian cancer? She's such ...

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I walked down the hospital corridor listlessly. My feet dragged as they fought each attempt to lift off the ground. My body was tired and achy. The phone calls the night before had been relentless. Each stolen moment of sleep was interrupted before a deep, restful state was reached. It was Monday morning. I sat at the nursing station flipping through charts. A colleague across the table was staring intently at ...

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Here today, gone tomorrow.  The older I get, the more often I get the call: “This is the ER at Any Hospital, can you hold for Dr. X?”  Dr. X then comes on the line and tells me my patient had a catastrophic event, that the paramedics and ER crew did everything possible but that the patient expired. My patient had no reason to die.  He was relatively young and healthy. ...

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The ambulance crew rolled him into my ER breathless in his pajamas, O2 mask on his face, gasping for air, his short cropped hair a mess, standing straight up. Eugene was what the staff called a "frequent flyer." As the nurse injected some IV Lasix I reviewed his chart to find a classic downward spiral. It was a busy evening. The bays were full of the usual cuts, broken bones and ...

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Medicine improves regularly. Our tests, our surgeries, our medicines are better now than they were 10 years ago. The main driver of this improvement is the scientific method. Using this, the worse is discarded and the better retained. Doctors have to work hard to keep up with the progress. They rely on impartial and accurate information transmitted by articles, reviews, and CME material in order to advise and treat their ...

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I met with a young patient recently, a woman who has been done with chemotherapy for lymphoma for close to a year. She was feeling well, and she had no symptoms of cancer, nothing that made her suspicious of a recurrence. After I examined her and reviewed her most recent CT scan and labs, I agreed. No recurrence. I wrote in my note, “NED,” the acronym for no evidence of ...

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If you Google “skinny definition” what will pop up is the following: Adjective: (of a person or part of their body) Unattractively thin. The word skinny according to Webster’s is defined as the following: 1. resembling skin: membranous 2a. lacking sufficient flesh: very thin: emaciated 2b. lacking usual or desirable bulk, quantity, qualities or significance. So how did our culture take this word and use it to represent a goal, or rather set "skinny" as a ...

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I have participated in two transitions in care with my mother.  The first was when she was released from the hospital after undergoing neurosurgery for a malignant brain tumor.  Immediately after surgery of her brain tumor, she went through two weeks of intensive physical, occupational, and speech therapy.  At the end of this period, the recommendation was clear.  She required around the clock supervision.  The plan was to send her ...

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Another call night in downtown L.A. It had not been a particularly eventful day: the usual offering of people hit by cars, falling off of things, and victims of man-made violence. Some injuries happen as a result of an accident, some as a result of carelessness, and of course many happen because of an intentional act. At about 1am the trauma pager went off; the text announced a "Level 1 ...

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The call came in the middle of a busy office day; the radiologist had found a suspicious area on the mammogram. I had received similar calls many times in my primary care practice. This time was different; the patient was me. My first thought "thank God I’m insured." My second thought was for all those who are not. It was hard enough waiting the week, until further testing could be performed; ...

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