There is no completely safe dose or form of alcohol We live in a strange world. What would happen if tomorrow a common sedative was found to cause 21,000 cancer deaths every year? What if it resulted in breast cancer, mouth cancer, hepatoma and esophageal malignancies, and if the average patient lost 19 years of life?  What if the drug also killed by cirrhosis, massive upper GI bleeding, accelerated dementia, and for ...

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Angelina Jolie: Why her story comes at a crucial time for BRCA testing Dear Ms. Jolie, Thank you for your bravery and leadership in the battle against breast cancer.  In a small way, through my patients, I understand the challenge and pain it took not only to undergo prophylactic mastectomies, because you carry the BRCA1 cancer gene, but also to reveal this deeply personal part of your life to the world.   You had no ...

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The unexamined life is not worth living. –Plato There are obstacles to dignity at the end of life.  Disease inflicted pain and debilitation, cost and confusion, poor planning and fear, all aggravated by our societal ignorance regarding dying, result in unneeded suffering and isolation.  In addition, it occurs to me that a hindrance to control and quality is that we are overwhelmed by the pressure of our day-to-day lives.  In other words, ...

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After a terribly painful and debilitating illness, Steve died.  He had been treated for Stage 2 Hodgkin’s Disease with a series of intense therapies including German enzymes, American antineoplastins, Mexican naturopathy and Chinese herbs, complemented by focused meditation, innumerable vitamins, extreme diet modification and acupuncture for severe pain.  He fought the cancer with every ounce of his being, doing everything to survive, except the one thing that had an 85% ...

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At some point, this gets to be ridiculous. Online, I can buy any item from anywhere at any price, pay any bill, watch any movie, listen to any song, order dinner, schedule car repair or read about any subject on Wikipedia.  I can determine the weather in Rio, sport scores of Barcelona, Parisian traffic or by GPS the location of my kids, just down the block. However, I absolutely cannot learn ...

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Yesterday I had office hours: 26 patients at 15-minute intervals, followed by 3 new patients for one-hour visits, interspersed with 4 emergencies and 33 phone calls. An active normal day.  However, the 1:30, 1:45, 2:00 patients all arrived at 2:15 and suddenly I was looking at an afternoon that would run deeply into eve.  I really hate it when patients are late. Now, I have to admit this is a unique ...

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I was watching a macho shoot-em-up movie the other day; the type where everyone shoots everyone and in the final scene, the dirty blood-stained hero rides homeward on a helicopter or maybe a horse, into a red sunrise or sunset.  He stares blankly, focused on nothing, focused on everything, his look reflecting the turmoil of what he has seen, done and lost.  The hero’s grease-smeared face shows the understanding that ...

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The Oxford English Dictionary (OED) identifies the first use of the term “doctour”, as the year 1303 AD, shortened to “doctor” in the 1557 addition of the Geneva Bible.  The OED first defines doctor not as a caregiver or healer, not as a science researcher or expert and not even as one with an advanced educational degree.  The OED, the world’s foremost English language dictionary, defines “doctor,” 700 years ago ...

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I have been married and practicing medicine for 32 years and during that time I have learned lessons that equally apply.  First, listen carefully; both wives and patients need to be heard.  Second, prepare and think before you speak; as the saying goes “put brain in gear before operating mouth.” Finally, perhaps the hardest lesson of all is, when necessary, be 100% inconclusive. Any man or woman, who has been in ...

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Think you know something about oncology?  Ok then, pop quiz: If you are giving chemotherapy to a patient who does not have cancer, how can you tell if it works?  Ridiculous question?  Not at all.  The answer to that question is; “hopefully, we will never know,” and it is at the core of modern cancer care. In the 1960s, breast cancer surgeons had a serious problem.  They were doing large complex ...

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