In his soulful book, How We Die: Reflections on Life's Final Chapter, the late surgeon and author Sherwin Nuland describes one of his patient encounters as a medical student. The patient, a 50-year-old man, presented to the hospital after a heart attack. A few hours later, the patient suddenly collapsed pulseless and unconscious. Training in an era when there was no defibrillator or CPR, the author notes:

For reasons I cannot explain to ...

Read more...

The modern news cycle’s obsession with all things Trump has moved light years beyond dispiriting with cacophonous reams of vitriol shoveled endlessly back and forth. One could opt out, I suppose, and simply take an elongated holiday from all things media-related. But like moths drawn to a flame, we can’t seem to help ourselves, and your humble scribe is no exception. And so, I took note last week of Andrew Coyne’s ruminations ...

Read more...

Bill is a 58-year-old male with a history of head and neck cancer as well as chronic low back pain who presents to his new primary care doctor for a routine checkup and visit for a medication refill. He works in construction and has been on chronic opioid therapy after his cancer — with a stable dose of 15 mg of oxycodone for over five years. At his new primary care ...

Read more...

“So, will this mammogram save my life?” she asked. I thought for a few seconds … "I have no idea.” “What?” she sounded perplexed. “Well, if you have a cancer that’s aggressive enough to kill you before everything else, but not aggressive enough to have already had cells metastasize, and not so aggressive that it responds appropriately to chemo but it still needs to be rapidly dividing enough to respond to chemo, and we ...

Read more...

Technological advancement often outpaces society’s ability to understand how to use new advances. Direct-to-consumer genetic testing (DTC-GT) is one such technology whose true power far exceeds our collective mental bandwidth to comprehend. Home testing kits have come into mainstream culture over a short period of time. In 2010, the direct to consumer testing market was valued at $15 million. It grew almost nine times to $130 million in just five years ...

Read more...

asco-logo I have been fortunate enough to find a home in academic medicine. Most of that time I’ve spent in oncology -- working with residents, fellows, and colleagues on projects, whether they be chart-based or prospectively designed trials. I’ve lectured a ton, and written even more. Yet, my experience in academia has also allowed me to ...

Read more...

Six weeks ago, I was diagnosed with invasive breast cancer. As a breast cancer and breast plastic surgeon, I see women all the time who are in the exact same place I’ve been since receiving the phone call from the pathologist.  Shocked and terrified by the news, overwhelmed by what this is going to mean for their life in both the short- and the long-term, waiting for results from what seems like ...

Read more...

It was a long December. A few years ago, my husband of 37 years got his death sentence: recurrence of liver cancer with mets to his lungs and lymph nodes. He had a “Whipple” — a surgical procedure for pancreatic cancer — on Dec 24, 2015, and the surgeon discovered liver cancer too. So it was a 16-hour surgery. We were told he might die on the table. His eyes haunted me as ...

Read more...

asco-logo Isn’t getting cancer bad enough? That’s the frustrated thought that goes through my mind when I see patients with cancer suffering -- not from their cancer, but from the failure of the health care system. Take Nancy,* a 60-year-old woman with hormone-positive breast cancer. When she came to the emergency room with a fungating breast mass, we knew immediately ...

Read more...

"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 ...

Read more...

Most Popular

Join 137,000+ subscribers

Get the best of KevinMD in your inbox

Sign me up! It's free. 
close-link
✓ Join 137,000+ subscribers 
✓ Get KevinMD's 5 most popular stories
Subscribe. It's free.
close-image