In between snippets of conversation exchanged with my husband about how the first day of remote learning went for our 9 year old and whether the latest nanny was likely to quit given health risks associated with working in a two-physician frontline worker household in the context of COVID-19, we also discuss some potentially dangerous scenarios. The discussion is quite mundane, between what we are having for dinner and how ...

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Today, we got called on a patient in the ICU who recently had a new brain mass removed surgically. The specimen came back positive for an aggressive brain tumor known as glioblastoma multiforme. We discussed his diagnosis and prognosis with him at bedside alone, with his wife and daughter on speakerphone given visitor restrictions due to the current coronavirus pandemic.

Unfortunately, this type of situation is rather ...

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In cancer language, it’s not unusual for the medical or scientific meaning of a word to be different from the way the same word is understood in everyday language. Sometimes the difference reflects a focus on populations vs. individuals, and in that case, the context in which the term is used is critical. Media reports often add to the confusion by failing to clarify these differences. Here are five frequently used ...

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Charles looks older than his sixty-one years; he is very thin and quite stooped, and his eyes are what I guess are described as "lazy." One goes one way, and one another. He is badly in need of dental work. He has emphysema, though he continues to smoke heavily. His coloring is not right, and overall, he looks unwell. But for the almost ten years I've known him, he has never ...

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Do you remember when you were a bright-eyed pre-med student, head bowed at the computer, typing your personal statement? Type, type … backspace, backspace … type. You didn’t want to use the phrase “to help people” in your statement as your reason for wanting to be a physician. Maybe you said something like me. I mentioned how there were no doctors in my family, and I wanted to be the ...

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An excerpt from Of Plagues and Vampires: Believable Myths and Unbelievable Facts from Medical Practice. The concept of a vampire predates Bram Stoker's tales of Count Dracula – probably by several centuries. But did vampires ever really exist? In 1819, 80 years before the publication of Dracula, John ...

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Being an oncologist in New York, having recovered from the trauma of flooding from Hurricane Sandy and the aftermath that ensued when hospitals were flooded in 2012, my anxieties are now heightened again over the global threat and uncertainties surrounding the novel coronavirus. Daily emails from administrators at my institution seek to both reassure as well as prepare us on the front line of health care to deal with the specter ...

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About three months ago, something awful happened. The oncology nurse practitioner (NP) whom I trained for the past two years in my subspecialty decided to seek employment elsewhere in order to have a more flexible work schedule. My team and I lamented we had a going-away dinner to say thank you for her work. And for the next three months, I trudged through my days in a busy oncology clinic, seeing ...

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I pushed open the door with a huge smile on my face while my eyes searched the room for the chubby toddler that was my patient. One sweep across the roomful of siblings, and my eyes stopped on the child crinkling the paper on the examination table. I could see the long, smooth scar poking out from beneath the hemline of her skirt. She smiled and waved at me with a skinny, ...

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Test your medicine knowledge with the MKSAP challenge, in partnership with the American College of Physicians. A 52-year-old woman undergoes perioperative evaluation. She has osteoarthritis of the right hip since sustaining injuries in a motor vehicle accident 15 years ago and is scheduled for elective hip arthroplasty in the next few months. Medical history is otherwise notable for type 2 diabetes mellitus. She ...

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asco-logo I first met JB* when the receptionist at the clinic called to tell me that a patient was asking to see me. His name did not ring a bell, and on a quick review of my patient schedule for the week, his name did not appear. I went to the waiting room to see if I at least recognized his ...

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One of the most valuable jobs I held following fellowship was working as a full-time deputy editor at UpToDate. My “territory” was breast, gynecologic, and genitourinary oncology, and I helped launch cancer survivorship and palliative care. I learned to really and critically read the literature, and how I could summarize it quickly so that my ...

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In a shocking development that could transform the medical profession, the International Journal of Health Services published the findings of a study titled, “Primary care, specialty care, and life chances.” Using multiple regression analysis, the researchers concluded that “primary care is by far the most significant variable related to better health status,” correlating with lower mortality, fewer deaths from heart disease and cancer, and a host of other beneficial health outcomes. By contrast, ...

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Prostate cancer is the second most common type of cancer diagnosed in men in the U.S. According to statistics gathered by the American Cancer Society, approximately 191,930 new cases of prostate cancer will be diagnosed in this country in 2020, with one in nine men at risk of being diagnosed with this cancer during his lifetime. While advanced or aggressive disease can lead to death from prostate cancer, most men ...

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My uncle died last year. As physicians, we are all too familiar with death. Even if we are practicing primary care, we are touched by death and the line between life and death. That patient who had what statistically should’ve been acid reflux, but who you found to have stomach cancer. That breastfeeding mom who thought a little lump was a clogged milk duct, when it actually turned out to ...

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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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