The patient was well over 6 feet tall and looked like he had recently lost weight. When he took off his winter coat and hung it over the back of the chair, I could see his scapulae like wings under his sweater. He folded himself into the chair and carefully crossed his legs. He sighed softly as he arranged his ...

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As a doctor, there is an experience that all can relate to. It concerns that particular patient who comes in with not just one concern, but a litany of them. They require more than the prescribed 15 minutes of visit time, and we sit and listen, try our best to console and guide. Yet, for some patients, it never seems ...

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A recent study published in Science, one of the world’s leading academic journals, found that a predictive health care algorithm discriminated against black patients. The tool, created by Optum, was designed to identify high-risk patients with untreated chronic diseases, thereby helping administrators re-distribute medical resources to those who’d benefit the most. But there was a glitch in the algorithm, according to researchers. Rather than ranking the needs ...

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What seems like a tidal wave of pages washes over you. Drowning in a torrential sea of order clarification, bowel regimens, and vital sign deviations — you struggle to stay afloat. Medical school did not prepare you for this. Patients and nurses are calling you, “doctor,” you wish to return to that minimal responsibility role as a medical student. Welcome to your first on-call weekend. These first few days, weeks, and months ...

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asco-logo Mr. G* was diagnosed with advanced prostate cancer two years ago and has been on a succession of medications to control a progressive cancer. His PSA never nadired after surgery, and adjuvant radiation only increased his urinary problems. Androgen deprivation therapy added to his symptoms, and he is now considering taking a second-generation androgen-receptor antagonist. Fortunately, his cancer has not ...

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I'd known Ellis for years — he once hired me for a social work job. Yet when I think of Ellis Ledger, I remember him best the night I encountered him outside of his apartment building. I was out late walking my dog. Ellis stopped to talk. He clearly was drunk, not falling-down-drunk (he never was), but feeling no pain, as they say, and he was upset about something important ...

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At kitchen tables everywhere, ordinary Americans have been grappling with the arcane language of deductibles and co-pays as they’ve struggled to select a health insurance plan during open enrollment season.

Unfortunately, critical information that could literally spell the difference between life and death is conspicuously absent from the glossy brochures and eye-catching websites. Which plan will arrange a consultation with top-tier oncologists if I’m diagnosed with a ...

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Our organization, like most health care providers, is working hard to improve the care we provide to our patients, while also striving to improve the lives of our physicians. All too often, a narrow view of the former can create conflict with the latter. For example, a reductionist view of clinical quality, which equates good care with performance on a small number of “objective” measures like mammography rates and hemoglobin ...

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Take 100 patients who are candidates for colorectal screening. We know that a group of them will try to avoid the procedure or postpone it for as long as possible. Evidence of this, for example, would be rescheduling appointments multiple times to later dates. We also know that among this 100 is another group of people who need a colonoscopy more than others. A family history of cancerous polyps is a ...

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I first became John Dolan’s social worker following his colon surgery, surgery for removal of a very large cancerous tumor, the largest the experienced surgeon said he had ever seen.  John was told he had about three months to live. So much for predictions!  He lived another 16 months. To the chagrin of his very large Catholic family, he was one of thirteen children; he was all the time rejecting their ...

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I heard about you a few times before I ever met you in person. It was my first day on the palliative care service — a week that felt like a relaxing break from the sixteen-hour days I was used to on surgery. Many people don't know what palliative care is. But I suspect these days if you are still living that you know it well. I first heard of you ...

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Most new cancer treatments haven’t been proven to help patients live longer or feel better. Instead, they delay the growth of tumors — which may be faster to measure but doesn’t necessarily indicate a tangible benefit for patients. But you wouldn’t grasp that sobering fact from some recent news coverage:

  • A headline in the UK’s Telegraph about the drug olaparib (Lynparza) read: “Revolution’ in prostate cancer care as off-label ...

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"Words Kill" is a brilliant song about the perils of texting and driving. Spread the message. Courtesy of The Fever Breakers, a band made up of hospital employees. Their socially conscious songs are crafted in the basement of the hospital using a piano used for cancer patient music therapy and subsequently recorded in a studio.

An excerpt from With Mirth and Laughter: Finding Joy in Medicine After Cancer. I am sitting in the waiting area for the one year follow up appointment with my oncologist, Dr. Anne Blaes. Using the handy phone app, “How Long Ago,” I see it’s been eleven months, nine days, five ...

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Who remembers Jack Kevorkian, Doctor Death? He was found guilty in 1998 of second-degree murder. Still, it was because of his advocacy that the terminally ill patient's right to die by physician-assisted suicide was propelled into the public arena. And who can forget Brittany Maynard? It was her advocacy for physician-assisted suicide that reignited the debate on its legality in 2014 — ...

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At first, I thought the light was reflecting off the mirror. But no. There It was - my first gray hair. I did not expect to live to see the day. I was ecstatic! At six months old, I was diagnosed with a severe illness called thalassemia major and was incorrectly expecting to have passed by now. (Google told me so!) Yet, this year, I complete ten years beyond my ...

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As people, we often have multiple stories to tell, from different perspectives. Multiple stories and perspectives can be wed or braided together around the same themes. Here we braid together two separate perspectives of a patient author and a physician author, respectively. From both perspectives, this is a story about the power of care, cancer, and quality of life. Following my cancer diagnosis of nodal marginal zone lymphoma, I struggled with my ...

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I was a brand-new intern in the intensive care unit, and Cassandra was the very first patient I saw there. A petite, slender woman, she was rolled in on a stretcher, accompanied by her tall, athletic husband, Jack. Cassandra was in her 20s, like me — but mortally ill. That grabbed my attention from the start. But the biggest lesson she taught me came about because we got her prognosis all ...

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asco-logo I am a firm believer that medicine is best practiced as a team, with the one undergoing treatment at the center participating fully. It’s a belief embedded in the multidisciplinary care model. I have been fortunate to have been exposed to multidisciplinary clinics in my fellowship at Memorial Sloan Kettering Cancer Center and have worked ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 28-year-old woman undergoes follow-up consultation regarding a pre-employment physical examination. She reports feeling well, with no recent illness. Medical history is notable for gastroesophageal reflux disease. Her only medication is omeprazole. She is black. On physical examination, vital signs and other examination findings are normal. A peripheral blood smear shows ...

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