My new patient was having trouble breathing and had lost his ability to swallow; despite this, he had been too proud to call either friends or family for help. He had lost thirty pounds and his clothes hung loosely. His belt was far too long. The day I met him, I thought, “This man could walk through a harp.” People had tried. Over the previous months, his worried family members had ...

Read more...

"We are what we repeatedly do. Excellence, then, is not an act but a habit." - Will Durrant, historian For better or worse, all of my high school English teachers were memorable. Each held a precise but non-overlapping image of the perfectly crafted essay; therefore, every September I found myself adopting a brand new writing style. A paper that would have garnered an “A” at the end of one school year routinely received ...

Read more...

Cancer treatment delays are sometimes inevitable. Here is a story, though, that haunts me. Years ago, long before the Affordable Care Act, I was asked to evaluate a very pleasant man with hoarseness in a local free clinic. He struggled to make himself heard. "Things have been getting worse and worse," he said. "When did you start losing your voice?" I asked. "About six weeks ago," he responded. "When it started getting more ...

Read more...

"Medicine is a science of uncertainty and an art of probability." - Sir William Osler Two people presented to my clinic on the same day with classic symptoms of head and neck cancer. Each reported several weeks of unilateral throat discomfort, ear pain, and a neck mass. Each was having some trouble swallowing and had changed his diet to accommodate the soreness. When they opened their mouths, each had a mass with a ...

Read more...

"I like good strong words that mean something." - Louisa May Alcott My resident and I are removing a large, recurrent cancer from the neck. Dense scar tissue is everywhere from prior surgery and radiation therapy. The going is slow. Each move is arduous, and bleeding obscures the view of the anatomy. “Watch out,” I tell her. “The jugular vein is nearby, probably buried in that scar.” “Yeah,” she responds. “Look at this nerve! ...

Read more...

“An expert is a person who has made all the mistakes that can be made in a very narrow field.” - Niels Bohr Five experienced, well-published, and widely respected head and neck cancer surgeons are sharing the dais at the national medical meeting to explore the topic “Can We Be Better?” The panel represents a spectrum of experts from around North America, and they have served as program leaders, department chairs, and ...

Read more...

"It's strange how the worst day of your life often starts just like any other." - Joanna Cannon I prepare for each clinic by reviewing the tests and scans of the patients who will be seen that day. Today, I am dismayed as I read a report for a longstanding patient. The news is not good; his scan shows that his cancer has returned. Twenty years ago on a day like today, I ...

Read more...

We are in the middle of an all-day ENT screening clinic at Moi Teaching and Referral Hospital in Kenya. The local ENT physicians have scheduled about 100 patients to return to see our American team to be evaluated for surgery during our visit. We have already seen several people with baseball-sized tumors in their parotids, thyroids, or necks. The surgical schedule for the next few days is getting full. A thirteen-year-old ...

Read more...

“We do not remember days, we remember moments.” - Cesare Pavese “A plane! A plane just crashed into the World Trade Center.” The surgical case was moving along steadily. Another surgeon had removed a skin lesion from the patient’s neck, and the pathologist had not been certain if it was a cancer. I had recommended removing the scar and several of the nearby lymph nodes. The surgery had just started and was going ...

Read more...

"Knowledge is power. Information is power. The secreting or hoarding of knowledge or information may be an act of tyranny camouflaged as humility." - Robin Morgan Fifteen years into the future, in 2030, a patient returns home after a stay in the hospital. He powers up his mobile device and finds a file that was created during his surgery. “Let’s see,” he says. “I think I’ll turn off the ‘commentary’ for now. Maybe ...

Read more...

5 Pages

Most Popular

Get KevinMD's 5 most popular stories.