How do you respond when patients with a good prognosis want to delay chemotherapy to try an anticancer diet for a few months or visit an unregulated clinic for unproven therapies? I’m asking because of an alarming finding of ASCO’s 2018 National Cancer Opinion Survey: “Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies ...” Clearly, we have a problem in today’s discussion about cancer treatments. ...

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After finishing the pitch for my book at a recent Harvard Writers’ Conference in Boston, I felt relieved and encouraged by the judges’ comments. As I waited for my turn at the podium, I glanced above my notes over the faces of 300 of my fellow attendees who had accomplished so much in their respective fields of medicine, nursing, and counseling. The pitches made by these would-be authors revealed an amazing ...

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I am a mid-40s female rheumatologist. Fortunately, I consider myself to be fairly healthy; my diet and weight are OK, I run 30 to 35 miles per week, and my only medication is a low-estrogen oral contraceptive that I have been self-prescribing for years. Work and life are busy, and my health maintenance could be better. I have been getting regular mammograms since age 40 (some self-prescribed), maybe I see ...

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I recently graduated from residency and fellowship. The last week in-house was a second adolescence. My moods have been up and down. I’d giddily return a parking pass, then surrender IT access in tears. No one could feel this — my — moment as deeply, specifically, or correctly as I could. What word is there for that? There’s song. Influenced by the new film Yesterday, I melodramatically equated my break-up with ...

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To fill an assignment in an undergraduate medical sociology class, my friend and I made an appointment with the assistant administrator in a local hospital. After the interview, we proceeded towards the exit by cutting through the obstetrical wards. We passed an exhausted young doctor with a stethoscope draped over his neck and hunched over a stack of charts. He glanced up as we passed, and we introduced ourselves as ...

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A lot has been written about board recertification requirements. Physicians have grumbled and moaned for years. The objections have caused changes. Some specialty boards have abandoned the tests. And yet — for most specialties, we still find ourselves turning over our credit card numbers, blocking off a day of our incredibly busy lives and heading for a professional testing center. On the surface, the process is absurd. Oh, I get that we ...

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I am one of those lucky souls who actually likes their job. Since I completed my pediatrics residency two years ago, I have been working in urgent care settings. What’s not to like? I get to see a wide variety of patients, I’m always learning something new, and I get to finish my encounters with a high-five from an overeager toddler. If you’re a general pediatrician like me, that’s the ...

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Every morning, after rounding on Mr. Gregory, I felt like an imposter. As I reported on the worsening crackles in his lungs, his decreasing urine output, the mottling of his hands, we continued to simply give him Dilaudid for pain and continued to ensure that he was “comfortable.” In this case, I was at a loss for what this “comfort” meant. Mr. Gregory was the first hospice patient I had. And ...

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I am a small-town family physician, and I am blessed enough to be living my dream. You see, I have always wanted to be a doctor. I cannot think of one other occupation choice that has ever entered my brain. I have wanted this since I was four-years-old, and I can remember in vivid detail telling the world this was what I was destined to be. So what happens when your dream ...

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After years of being busy taking care of critically ill and recovering neonates in the neonatal ICU, then coming home to take care of my children, I’m making new decisions. One of them is to learn how to relax and be still. It’s a new experience for me. It’s taken years and many shifts to get to this place. And it’s becoming a self-care practice that I really enjoy. For the ...

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