If someone had told me even ten years ago that I would retire young and become an itinerant radiation oncologist, I would have thought he had lost his mind.  As the career medical director of community-based cancer centers, I was used to running the show.  And as the saying goes, I ran a “tight ship.”  Consultations were performed and documented in a timely fashion, day of the request if the ...

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My husband, Mark, called me at my practice. “I’ve been working on something; I need you to come home now.” He spoke definitively, urgently. “Is it the kids?” I was instinctively anxious. “No, not the kids, just come home now.” 6 p.m., a cool evening, an ordinary day. The life before the fact. And then life afterward, irrevocably and catastrophically changed. A tense ride home, then the revelation. “I've been having difficulty ...

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Props to Elana Miller at Zen Psychiatry.  Truly inspiring.

In his last state of the union address, President Obama reinvigorated the nation’s interest in a long-sidelined disease/s: cancer. A call for a moonshot was announced, and the president in his address said, “I’m putting Joe in charge of mission control.” The last time such a national commitment towards this illness was announced was by the efforts of a cancer advocate, Mary Lasker. She advocated fiercely, and the National Cancer Act ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 68-year-old woman undergoes upper endoscopy for evaluation of dyspepsia. She has a history of pernicious anemia. She has no other medical problems and her only medication is oral vitamin B12. On physical examination, vital signs are normal, as is the remainder of the physical examination. Upper endoscopy discloses a 6-mm polyp in the ...

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One weekend about nine-and-a-half years ago, I flew from Minneapolis, where I live, to Atlanta for a publishing conference. A colleague and I were to make a presentation to the vice-president of one of our major customers. For a couple of weeks, I'd been plagued by a sore throat, but I'd written it off as allergies or a virus. When I tried to begin the presentation, though, all that came out ...

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Start with one excellent childhood experience -- a loved one who is cured. Add a generous helping of baseline optimism, a cup at least.  More is better. Mix in well a half cup of ability to suspend disbelief.  And then, maybe a pinch more. Add a teaspoon or two or even three of denial.  Pollyanna had it right. Remember to include an ounce of prevention -- Worth a pound of cure, so they say.  Suspend ...

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asco-logo As an oncologist who also specializes in sexual health, I have realized just how essential it can be. I have seen many grapple with the consequences of cancer and its treatment on their own sexual view of themselves (their sexual self-schema) and how it can impact the relationship between partners. For some, the experience draws them closer; for ...

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Doctors have several bad habits. They order piles of tests just to get a vague, unfocused view of a patient’s health. They order expensive and invasive tests to rule out the unlikely or extraordinarily rare. The worst “bad test habit” is when doctors order a test, which, no matter what the result, will not change what they are planning to do. Why do doctors over order? These same people thought a ...

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"Do you need help getting undressed?" Jon asks from the doorway of our bedroom, one hand holding his BlackBerry, the other tucked into the front pocket of his baggy jeans. His head is slightly tilted, his eyebrows arched, highlighting his forehead wrinkles. His phone vibrates, drawing his eyes from me to the incoming message. I wait. Jon reads, ponders and then looks up, half-absorbed in what he's just read, and registers that ...

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