A colleague complained that during a particular type of critical conversation his advice is ignored. Women with breast cancer deciding whether to have mastectomies disregard his guidance and seem to have reached a conclusion before he discusses the issue. Given that this physician has committed his career to the study and treatment of breast cancer, communicates clearly and patiently, projects caring and compassion, I thought that his observation warranted discussion. Some ...

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shutterstock_284306441 How do we measure a doctor? Hospital length of stay? Infection rate? Flu shot compliance? Waiting time? These reality surrogates do not tell us how a patient feels or the quality of life. They are complex to measure, require major data crunching and may not focus on an individual physician. This week, two patients reminded me of a basic screening tool for ...

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There was a doctor. The doctor had an office. In the office, he had a practice. The doctor worked hard, was honest, smart and compassionate. He took care of many patients, everyday, and helped many people. The people paid with cents, checks, and chickens. He was solo, alone, by himself. It was good. There was a hospital, near the doctor. It was an important hospital. It took care of many patients, ...

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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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