As I look back, I remember teachers.  One taught to be compulsive and complete.  Another, calm and humor in the face of chaos.  Another believed in me and thereby taught me to believe in myself.  One made me write and rewrite.  Above all, there was a mentor who opened my heart and eyes to the need for compassion.  That special teacher was Dr. Black. Tuesday afternoon, 8:30am, July 12, 1966:  Dr. ...

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America is one of the sickest places on earth.  We have the best diabetic care, but the most diabetes.  First-rate cardiac care, but we are obese, hypertensive, inactive, and have high rates of heart disease.  We are the world’s standard for cancer technology, innovation and access, but we have high cancer rates even while we waste most of the money from cigarette taxes on road repairs.  At every socioeconomic level, ...

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Hegira: To take flight to escape.  To travel from a place of danger to a place of safety. “You have cancer.” You hear the words.  Your mind does not understand. “You have cancer.” Shock.  Distance.  Isolation.  Someone else.  A mistake.  A lie.  Bizarre, strange, you float above the room.  Everyone speaks; nothing is said. “You have cancer.” A fog-like curse, a venomous reality, a phantom idea.  A cold ghost foreign to the soul.  I must run. ...

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Sometimes it seems that life is unfair and the odds are stacked incredibly against us.  More than 1 in 3 persons will get cancer.  The chance of survival if you get lung, pancreatic or brain tumors is pathetically small.  The most common cancer in 20 to 30-year-olds is the deadly beast melanoma. We have no easy or effective early detection for most cancers. However, there are remarkable stories of hope.  Here ...

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Allow me to describe a recent case and ask your opinion.  Today, you are the intake nurse at hospice and you are asked to evaluate Stan.  This gentleman has incurable cancer, but treatment would probably prolong his survival.   However, Stan has refused that treatment and been referred to you.  It is your job to decide if he is “hospice appropriate.” Why has Stan refused therapy?  It is not that he denies ...

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Have you ever had a conversation that rattles around in your head for days? Maybe, it changed what you thought you knew about the world.  Perhaps the ideas or comments did not make any sense.  I had a discussion last week and it seemed that logic stood on its head.  The means was defined by the end, with no connection to the beginning, or more exactly, the tail wagged the ...

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It happens, now and then; not as often as one would wish, but occasionally.   In other professions, a perfect day is when you make that super sale, finish a protracted project, win an important race or craft a special, remarkable piece of art.  An oncology perfect day can be without bells, whistles, pats on the back, nor cash register’s whirr.  Some of the best days lack pizzazz, vibrant emotion or ...

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Hot oil splatters as thick fatty fish slips into the smoking pan, next to boiling rice and simmering garlic greens.  Quickly golden, she flips the fillet and turns down the heat.  Small feet pound down the stairs, drawn by the crackling aroma, but it’s a mother’s trap; she motions the child to set the table. One by one, the family gathers, as plates and utensils clatter onto the wood and ...

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On December 23, 1971, President Richard M. Nixon signed the National Cancer Act of 1971, and declared the "war on cancer."  The allusion to combat appealed to the soul of the American people not long after their success in World War II and the humiliation of Vietnam; they intuitively understood the sacrifice, teamwork and massive effort, which is implied in the concept of War and they were ready for another victory.  Committing dollars, ...

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Today, I hesitated to refer a patient to hospice. The patient is perfect for that model of care.  She has strong family and friend supports, multiple opportunities to maintain quality, independence and dignity, and while she has a disease we cannot fix, she will do very well with personal palliation. Nonetheless, I almost did not recommend hospice, because I realize that hospice is going to completely fail to take care of a ...

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