"It's strange how the worst day of your life often starts just like any other." - Joanna Cannon I prepare for each clinic by reviewing the tests and scans of the patients who will be seen that day. Today, I am dismayed as I read a report for a longstanding patient. The news is not good; his scan shows that his cancer has returned. Twenty years ago on a day like today, I ...

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We are in the middle of an all-day ENT screening clinic at Moi Teaching and Referral Hospital in Kenya. The local ENT physicians have scheduled about 100 patients to return to see our American team to be evaluated for surgery during our visit. We have already seen several people with baseball-sized tumors in their parotids, thyroids, or necks. The surgical schedule for the next few days is getting full. A thirteen-year-old ...

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“We do not remember days, we remember moments.” - Cesare Pavese “A plane! A plane just crashed into the World Trade Center.” The surgical case was moving along steadily. Another surgeon had removed a skin lesion from the patient’s neck, and the pathologist had not been certain if it was a cancer. I had recommended removing the scar and several of the nearby lymph nodes. The surgery had just started and was going ...

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"Knowledge is power. Information is power. The secreting or hoarding of knowledge or information may be an act of tyranny camouflaged as humility." - Robin Morgan Fifteen years into the future, in 2030, a patient returns home after a stay in the hospital. He powers up his mobile device and finds a file that was created during his surgery. “Let’s see,” he says. “I think I’ll turn off the ‘commentary’ for now. Maybe ...

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"To be trusted is a greater compliment than to be loved." - George MacDonald As we adjust her position on the surgical table, I spot some short, vertical scars on the front of her neck. The parallel slashes sit directly over her enlarged thyroid -- a goiter -- and appear to have been deliberately placed. There are two sets of scratches, one set on either side of the neck, nearly identical in length and evenly ...

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Old age is no place for sissies. -Bette Davis “I want the surgery today!” She started to cry. “I’m ninety-four years old. I’ll accept any risk. Just take this thing out!” She looked back and forth between the anesthesiologist and me. Her golf-ball sized tongue cancer had been growing over the past six months. It wasn’t changing from day-to-day, but it had increased over the course of the three weeks since we had ...

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Students undergo a conversion in the third year of medical school: not “pre-clinical” to “clinical,” but “pre-cynical” to “cynical.” — Abraham Verghese, MD The scalpel hovered over the swollen, red and inflamed mass peeking through the opening in the sterile drapes. The patient lay on her side facing away from us, clutching the stiff emergency room pillow against her face and moaning as she rocked back-and-forth. Whenever the surgeon manipulated the mass, ...

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The present time has one advantage over every other - it is our own. - Charles Caleb Colton The cherubic young man smiles from the black-and-white class photo. His open, relaxed appearance captures my attention. He sits on a wooden bench at the far right end of the front row, his sharp white shirt and patterned tie cinched tightly beneath his three-piece wool suit with the stylishly wide lapels. He looks directly at the camera ...

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She was nearing the end of a long and interesting life. Her birth was announced on the party line in her rural community’s first telephone system. Her death, which would come soon, would be shared on Facebook and via cell phone. She had graduated with a degree in home economics from the University of Minnesota in 1938 and had worked for a meat packing company during and after World War ...

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Whatever we learn to do, we learn by actually doing it; men come to be builders, for instance, by building, and harp players by playing the harp. -Aristotle I groaned. "Don't make me operate with him again! I assisted him in surgery just last week!" I was low man on the totem pole and there was no point arguing. All of the residents and fellows kept track of the rotation and I knew ...

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