Miranda Fielding, MD

When I was young and foolish and just starting out in my career, I found it very hard to take “no” for an answer.  If a patient needed radiation therapy, and he or she didn’t want to have it, I did my very best to talk that patient into it.   I have always been a very persuasive person—if I didn’t get the go ahead on the first formal consultation, there ...

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If you desire healing, let yourself fall ill let yourself fall ill. -Rumi Yesterday I saw a patient—an 80 year old woman with metastatic cancer involving her bones.  She had near complete replacement of her twelfth thoracic vertebra by tumor, and also significant destruction of her fourth and fifth lumbar vertebrae, demonstrated by PET-CT scan and bone scan. She had so much pain in her legs that it was difficult to walk.  In ...

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My husband likes to say, “No good deed goes unpunished.” I don’t always agree, but sometimes you just can’t argue that concept.  One of my favorite patients, a forty nine year old woman who I treated for head and neck cancer a year ago is a good case in point. Head and neck cancer is on the rise, and is linked, like cervical cancer, to infection with human papilloma virus which ...

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The waiting is the hardest part Every day you see one more card You take it on faith, you take it to the heart The waiting is the hardest part. -Tom Petty and the Heartbreakers I’ve never been good at waiting for anything. Instant gratification has been my middle name, and I’ve gotten in lots of trouble because of it. I think that I have improved with age—I am less likely to become apoplectic when ...

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Yesterday I saw a 90-year old woman in consultation.  She presented to the emergency room in September with abdominal pain, and in the process of working her up, a chest x-ray was taken which showed an infiltrate in her lingula, part of the left lower lobe of her lung. As it turned out, there was nothing wrong with her belly, but a follow up CT scan of her chest showed this ...

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It happened again today.  A youngish man, age 59 (youth being relative these days) comes in for a consultation.  His history began eighteen months ago when he started to notice hoarseness.  Thinking he had laryngitis, he saw his primary care doctor.  He was indeed diagnosed with laryngitis despite the fact that he had not been shouting for his grandson at the local soccer playoffs, nor had he had upper respiratory ...

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