"Those who suffer illness learn by hearing themselves tell their stories, absorbing others’ reactions, and experiencing their stories being shared." - Arthur Frank We stand together at the clinic room door, preparing to enter. “Tongue cancer. This is a 78-year-old man with an oral cavity mass and some memory loss. He had an ulcer on the side of his tongue for a few weeks which was biopsied by an outside doctor. No imaging ...

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"A teacher affects eternity; he can never tell where his influence stops." - Henry Adams Mrs. Jones (identifying information changed) is a vibrant woman in her eighties who has been admitted to the hospital with swallowing problems and a fever. The CT scans show some swelling next to one of the major blood vessels and our team has been asked to see her and decide if she would benefit from surgery. She ...

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"They may forget what you said, but they will never forget how you made them feel." - Carl W. Buechner I draw back the curtain and look within. My patient, Mr. Buchanan, is on the cart. His daughter, Jessica, whom I met during his office visit, sits in a chair with her preschool-aged daughter. He wears a hospital-issue gown and has an IV taped in place. The little girl looks intently at ...

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"You've got to jump off cliffs all the time and build your wings on the way down." - Annie Dillard Months ago, when my patient and his wife were in my office for the very first time, I could already tell that he would resist any display of sympathy from her and she would clearly be uncomfortable with ever being a caregiver for him. There was tension in the room. He “had not ...

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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 ...

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"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 ...

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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 ...

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"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 ...

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"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! ...

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“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 ...

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