The United States of America is addicted to narcotics.  I do not mean the millions of individuals who are hooked.  I mean the whole nation is jonesing for the stuff.  I also do not mean the junk that slips into our nation in coffee cans or across midnight borders.  I mean the billions of pills pouring off assembly lines.  I could blame pharma or the FDA, but the truth is ...

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Three months ago, Anne finished chemotherapy.  She is tired, overweight, anxious and her feet burn.  Anne sleeps poorly, cannot concentrate at work and her relationship with her husband is distant, let alone intimate.  In my office for a “survivor’s” visit, Anne asked the glaring question. “Will I recover?  Will I ever be the same?”  After a moment of thought I answer, “I hope not.” Okay, I was not really that cold.  ...

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His wife thinks he looks like Tom Cruise.  There is a resemblance, I can see him riding a motorcycle off the side of a burning building, jaw fixed, eyes on fire, ready to save the damsel ... only he is not so short.  Funny, brilliant and genuine, we have known each other for exactly two decades, sharing the growth of our families, the anxieties of middle age, and the vicissitudes ...

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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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