“Will I ever get better, Andrew?” my mother asked. She laid in bed, too weak to sit up, unable to eat, her myelofibrosis in the final stages of its relentless course. Her question stunned me – did she not know she was dying? How could she not? Was she in complete denial? Was she simply grasping for a final chance at hope when all seemed hopeless? Reality quickly set in, ...

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"Where did the myth of vampires come from? Like many myths, it is based partly in fact. A blood disorder called porphyria, which has has been with us for millennia, became prevalent among the nobility and royalty of Eastern Europe. A genetic disorder, it becomes more common with inbreeding. Porphyria is a malfunction in the process of hemoglobin production. Hemoglobin is ...

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In early 2001, my sister was tired, paler than usual. We didn’t think much of it. Then, months passed, and crimson pinpoints appeared on her skin. My brother and I took turns grasping her arm and snickering as our handprints would appear as red dots just a few minutes later. Symptoms amassed silently, but on my ninth birthday in May, something big happened. I remember hearing words like “low blood count” spoken ...

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Invisible and unassuming, the radioactive spider slowly descends from the ceiling, and before he knows it, Peter Parker's life has changed forever. With that one bite, he is transformed from a normal man into a reluctant superhero. Only, that infamous spider is COVID-19, and Peter Parker is a health care worker during these troubled times. It may surprise you to know that many of us in health care are uncomfortable being ...

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Like a lot of doctors my age, I was too busy to have checkups, working 60 hours a week plus night and weekend call. But that all changed in 2013 when at age 67, my dentist felt a submental lymph node. A CBC had 35,000 white cells, and I had chronic lymphocytic leukemia. When I told my wife that patients with CLL live a long time and die of something ...

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“You forgot your stethoscope!” The medical student dutifully pointed out as we were on our way to the patient room. “I don’t need it. But let me grab it anyway to pretend. But don’t tell anyone I said that!” I replied.  Her eyes widened with disbelief at the blasphemous statement.

At the turn of the millennium, the world was already going through seismic changes in how it conducts itself ...

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Many people looking in on the world of research have perceptions of brilliant minds at work, rapidly putting forth groundbreaking ideas.  While they’re not entirely wrong, I discovered that this arena of fascinating new discoveries is not always so rapid and not glamorous at all. As a clinical trials research associate, I learned that research is hard. I found that testing and implementing theories and postulations takes time and dedication.  I ...

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Cancer patients have seen the world collapsing before their eyes, and then comes a pandemic. The American Society of Clinical Oncology estimates that this year there will be five thousand new cases of cancer per day in the United States, and COVID-19 adds another layer of worry for people with illnesses such as cancer and ALS. The novel coronavirus will probably be with us for years, having lacerated communities and destroyed ...

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Many years ago, I was given a literary award from the Mary Roberts Rinehart Foundation.  It was for $175 and was an encouragement to finish an American Indian novel I was then writing. "Not enough to quit your job," I remember was a line from the letter I received from the foundation's rep, Barbara. And from thereafter, Barbara and I kept in touch for many years.   Mostly we wrote letters, and ...

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Like other physicians, the past few months have left me with a multitude of feelings; helplessness, fear, anger, and uncertainty among them. As an oncologist, I’ll confess, there’s another emotion I’ve been grappling with…frustration.  As of mid-May, there will be close to 80,000 deaths from COVID-19 in the U.S. During this same time, there have been over 160,000 people who died from cancer. I’m not trying to diminish COVID at all.  COVID ...

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During a recent Zoom call discussing issues of physician wellness, a common theme emerged among some of our pediatric faculty - a form of imposter syndrome.  7 p.m. cheers in New York City ring out for essential workers and medical staff.  Calls, texts, and messages come in from friends and family thanking us for working on the frontlines of the COVID-19 crisis.  Yet those cheers don’t feel like they are ...

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The coronavirus pandemic has incited the necessary fear amongst the public and health care workers. This fear is a positive driver of social distancing and other precautionary measures that assist in protecting health care workers and patients. However, when this fear becomes blinding, patients may be more harmed than they are helped. Last week, I had a patient with a likely stroke refuse to go to the hospital due to ...

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As a health care system, we have united during the COVID-19 public health threat to embrace social distancing and “flatten the curve.”  In order to conserve scarce resources and limit viral transmission, we health care providers have canceled elective surgeries, postponed health screenings, and moved patient encounters to online platforms.  While we are fighting to save critically ill patients affected by the virus inside the hospital, we are attempting to ...

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When physicians present at medical conferences, we usually start with a slide disclosing any potential conflicts of interest to our audience. I probably need to disclose two things here. First, I’m an infuriating and inexhaustible optimist. Second, I’m a cancer doctor but also a recent cancer patient myself, and I understand intimately how it feels when your world unexpectedly spins out of control. With the arrival of COVID-19 on our shores ...

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As I sit here writing this, one of my friends and colleagues is on a ventilator. He’s fighting for his life. He’s a very healthy guy who runs marathons; we even did some race training together a couple of years back. And now, he’s in critical condition and may not survive. He’s one of the numerous physicians and other healthcare workers to be stricken with COVID-19. I do not know ...

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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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