Norman cried the night his daughter was born. For hours and hours. Each time he looked at her perfect head, touched the few strands of blond hair, held her in his arms, soft, smooth skin, soapy smell, pale blue eyes, tears poured down his cheeks. He felt alive. He felt alone. They named her Matilda, after his father. It was the right thing to do, because his father, Matthew, had ...

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Let me be clear. I have spent a career, my adult life, 80 hours a week, 131,000 hours, fighting the dread disease: every method, every drug, every machine, every medical technique, every sinew of my being, to control or cure malignancy. A synopsis of my existence will say, “fought cancer.” Nonetheless, let us take a step back, if just for a moment, and reflect on the idea of saying, “no.” In ...

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shutterstock_133750277 In the movies, pain is glorious. The runner pushing to the edge. The magic of childbirth. The soldier battles impossible odds to conquer. Pain? “Suck, it up, maggot, pain is nature’s way of telling you that you’re alive.” But, to the cancer patient, in the real world? Pain is nature’s way of saying “you may soon be dead.” For a patient suffering ...

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shutterstock_169002578 Much of medicine is no harder than Mom, a Band-Aid and a scrapped knee. Flu shots save lives, give flu shots. Bleeding causes anemia, give iron or, if severe, blood. There is a fracture, fix it. A boil hurts, lance it.  This is not rocket science. Perhaps medicine is so simple that it can be automated. Instead of a doctor at all, ...

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That first time there was a moist sweet smell, the hiss of oxygen and pictures of grandchildren on the wall. Unopened juice containers, papers, a Kindle, the phone and some plastic table wear, crowded the bedside stand. Jack was thin, tired, and the tightness of his eyes spoke of uncontrolled pain. “Oh, I know you. You took care of my wife’s friend. You’re the cancer doc.’ “Yes, that’s me, nice to meet ...

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At the wake, when the kids kept running around, disturbing the disturbed, their mother, or maybe their aunt, or maybe their neighbor, shooed them to the basement. Adult quiet and proper mourning returned. However, I noticed that Mary, eight years old, or so, stayed upstairs. For a while, I watched her, carrying food, clearing plates, even answering the front door. A petite, hard working, hostess. I wondered why. “Mary,” I said, ...

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The theater darkens; children stop laughing, adults sit forward in their chairs. Framed by a single light in the center of the stage, he stands; tuxedo, white shirt, black tie. He stares into the silent crowd, slowly turning his head, lips touched with the slightest, smallest, cruelest of smiles. His gaze fixes upon you; he is just feet away. His hand rises to the brim of his tall hat and ...

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The nightmare sickens me. A small child trusts a man to protect her, take care of her, and shield her from harm. The man, for incomprehensible and useless reasons, neglects her unto death. For me, when I think of Germanwings flight 9525, I am haunted by the photo of a single tiny girl, taken in the last days of life; the obliteration of that perfect life’s potential. Waste, tragedy, evil. In the ...

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shutterstock_233430226 Where does doctor stop and computer begin? Who is in charge? Do we care? Are these silly, academic questions from some sci-fi future or is it an onrushing tomorrow? Consider:

  • Ten years ago, the EMR recorded the date you or your nurse gave Sam his flu shot.
  • Today, the EMR reminds you it is time to have your nurse give Sam his flu shot.
  • Soon, the EMR will order the flu ...

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For 25 years, I have taught medical students how to give bad news.  Step one: Be prepared.  Step two: Find a safe, personal, quiet environment.  Step three, and this is most important: Before you speak, ask.  What do the patient and family understand? Fail to follow this vital rule and reap the whirlwind.   So, therefore, you might ask, if I have such wisdom and experience in this critical area ...

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