"Hey, you're a med student. Right?" "Yes, I am. Do you need me to scrub in?" "That would be wonderful, yes! Everyone is either out on vacation or is sick. It's just me and the resident." "OK, I'll be back in a few minutes." I was on my OB/GYN rotation, and once a week I follow one of the surgeons. It was 7:20 a.m., and a patient was coming in for an unplanned, stat ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 79-year-old man is evaluated for a 2-month history of progressively worsening headaches, nausea, visual disturbance, and difficulty speaking. He also has hypertension and gastroesophageal reflux disease. Medications are lisinopril and omeprazole. On physical examination, vital signs are normal. Right oculomotor nerve (cranial nerve III) and bilateral abducens nerve (cranial ...

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Most patients have an idea of how surgery and chemotherapy work.  It’s not difficult to picture a surgeon cutting out a cancer or a medical oncologist prescribing chemotherapy.  But how does radiation therapy work?  For the vast majority of patients, and a good number of physicians, radiation therapy is a completely foreign concept. In my practice, I find that a good portion of every new patient consultation is spent explaining what ...

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I see several patients daily with cancer. Some days can be tough, but nothing compares to what they are going through. I know that. The physical anguish and toll that chemotherapy, radiation, and surgery can take on the body. The burden that the disease can take on the mind and the soul. It’s devastating and almost always life-changing. What makes things harder though is when a patient did not go ...

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First, the cancer diagnosis. Then, the barrage of trite encouragements: You can beat this! Don’t give up. Keep fighting! It’s not only friends and family members who utter these clichés — usually at a loss of what else to say. Health care providers also attempt to bolster patients’ morale with well-intentioned but well-worn phrases too. Unfortunately, these sentiments frequently fail to have the intended effect. Instead of conveying comfort and ...

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“We pass through the present with our eyes blindfolded … Only later when the cloth is untied can we glance at the past and find out what we have experienced and what meaning it has.” – Milan Kundera Two days ago, during a clinical skills session on lymph node examination, my classmates insisted that I get what appeared to be an enlarged lymph node in my neck checked by the physician ...

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The news that beloved game show host Alex Trebek has advanced stage pancreatic cancer hit his millions of fans hard this week. His illness has elicited heartbreak and support. As a clinician who treats pancreatic cancer, I anticipated the reaction that would follow next. Fear. While it is a rare form of cancer, pancreatic cancer is possibly the most lethal. Survival rates are slim – fewer than 10 percent with advanced disease ...

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Her name was Callie (identifying information changed). She was four years old. She loved glitter and princesses and anything sparkly. She was affectionate and silly, and I fell hard for her. She was a patient, my patient, on the pediatric oncology unit during my very first ward rotation intern year. On my first day, I was as scared as any person can be, palms sweating, heart pounding, faced with these tiny, ...

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The news that Alex Trebek has advanced stage IV pancreatic cancer has been met with an outpouring of support and good wishes, as would be expected for someone who has been a part of our lives for so many years. The fact is, pancreatic cancer is a difficult disease to treat effectively. That is due in no small part to the fact that -- as the case with ...

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"Please help me. I was brushing my teeth this morning and started bleeding a ton from my mouth." Joe (identifying information changed) pointed to a bucket next to his bed. I was horrified to see close to two pints of blood in it. With gloves on, I pulled out my penlight and a new tongue depressor. "Open your mouth wide for me Joe. I need to see where you are bleeding from." I clicked ...

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