What to do about a Curved Spine? On Data, ‘BodyCast’ and New Directions

The NIH provides some information on scoliosis …Life is curved, usually, and maybe it’s better that way. Perhaps that was the Bocanegra’s point,

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Should People With Health Problems Talk About their Conditions?

Do you need to explain to the person on the checkout line or, say, a mother organizing a bake sale, why your back hurts? Or why you need a seat on the bus?

Posted in Communication, Essential Lessons, from the author, journalism, Life, Life as a Patient, PrivacyTagged , , , , , , , , 8 Comments on Should People With Health Problems Talk About their Conditions?

Illness is Not Discrete. On Feeling Sick, and Not Knowing What’s Next

A broken arm, a low-stage breast cancer that’s treated and done with, a bout of pneumonia – these are things that a career can afford, an editor can handle, friends can be supportive. But when you have one thing, and then another, and then another, it gets scary, it weighs you down.

Posted in Essential Lessons, Life, Life as a Patient, Life as a writer, Patient AutonomyTagged , , , , 2 Comments on Illness is Not Discrete. On Feeling Sick, and Not Knowing What’s Next

Counterfeit Drugs, A New Concern for Patients

Counterfeit vials were sold and distributed to more than a dozen offices and medical treatment facilities in the U.S. This event, which seems to have affected a small number of patients and practices, should sound a big alarm.

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A Good Personal Health Record is Hard to Find

Over the weekend I developed another bout of diverticulitis. Did the usual: fluids, antibiotics, rest, avoided going to the ER, cancelled travel plans. One of my doctors asked a very simple question: is this happening more frequently? The answer, we both knew, was yes. But I don’t have a Personal Health Record (PHR) that in […]

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Confusing Reports On Coffee and Cancer, and What To Do About Breakfast

When I was a medical resident in the late 1980s, we treated some patients with pancreatic cancer on a regimen nick-named the coffee protocol because it included infusions of intravenous caffeine. How absurd, we thought back then, because years earlier caffeine had been linked to pancreatic cancer as a possible cause. Now, two new studies […]

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Another Take On An Ordinary Day

…Live Each Day Like There’s a Lot of Them Left….What she articulated is the idea that maybe the best thing to do after cancer is to live, essentially, as you would do otherwise, except with a bit of added balance:

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The “Survivor” Term After Breast Cancer: Is There a Better Expression?

The question is, what’s the right, PC and emotionally-sound, sensitive but not sappy term to describe the situation of a person who’s living after breast cancer?

Some might say, who cares if you’ve had it?

Posted in Breast Cancer, cancer awareness, cancer survival, Essential Lessons, language, Oncology (cancer), Psychiatry, Women's HealthTagged , , , , , , 35 Comments on The “Survivor” Term After Breast Cancer: Is There a Better Expression?

A Routine Visit

Yesterday I visited my internist. I had no particular complaint. My back hurt no more than usual. The numbness in my left foot was neither better nor worse than it was last month. I wasn’t suffering from vertigo or abdominal pain. I went because I had an appointment to see her, nothing more.

Until just a few years ago, I rarely

Posted in cancer survival, health care delivery, Life as a Patient, Patient-Doctor Relationship, Primary Care, Women's HealthTagged , , , , 1 Comment on A Routine Visit

An Ordinary Day

If there’s one obvious thing I didn’t learn until I was well into my forties it’s this:

Don’t let a day go by without doing something you feel good about.

This message is not unusual, cryptic or even interesting. It’s simple, really so trite you could find it in most any “how having cancer changed my life” book available in bookstores and on-line.

Why say it again? Everyone knows we should relax and enjoy sunny weekend days like this.

Because it’s a reminder to myself, as much as for some readers and maybe a few fledgling doctors out there. One of my…

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Health Care Costs, Communication and Informed Choices

For those of you who’ve been asleep for the past year: the health care costs conundrum remains unsolved. Our annual medical bills run in the neighborhood of $2.4 trillion and that number’s heading up. Reform, even in its watered-down, reddened form, has stalled.

Despite so much unending review of medical expenses – attributed variously to an unfit, aging population, expensive new cancer drugs, innovative procedures, insurance companies and big Pharma – there’s been surprisingly little consideration for patients’ preferences. What’s missing is a solid discussion of the type and extent of treatments people would want if they were sufficiently informed of their medical options and circumstances.

Maybe, if doctors would ask their adult patients how much care they really want, the price of health care would go down. That’s because many patients would choose less, at least in the way of technology, than their doctors prescribe. And more care.

What I’m talking about is the opposite of rationing. It’s about choosing.

Posted in cancer treatment, Communication, Empowered Patient, health care costs, Informed Consent, Medical Ethics, Patient AutonomyTagged , , , , , , , , 1 Comment on Health Care Costs, Communication and Informed Choices

On Precious

This is my first film review, if it is that.

I was tempted to write about Ethan Hawke, hematologist among vampires in Daybreakers, but gore’s not my favorite genre. A mainstream choice would have been Harrison Ford solving the enzyme deficiency of Pompe disease in Extraordinary Measures, but I didn’t get sucked in.

I chose Precious, instead. This luminous movie relates to the practice of medicine everyday, big-time.

Posted in Communication, Essential Lessons, Life, Life as a Patient, Life in NYC, Medical Education, Medical Ethics, Movies, Patient Autonomy, Reviews, Women's HealthTagged , , , , , , , , , , 1 Comment on On Precious

Henrietta’s Cells Speak

“One of the ways that I gained the trust of the family is that I gave them information.” (R. Skloot, a journalist, speaking about her interactions with Henrietta Lacks’ family, Columbia University, 2/2/10)

Posted in Books, Communication, Essential Lessons, Ideas, Informed Consent, Life as a Patient, Medical Education, Medical Ethics, Oncology (cancer), Patient Autonomy, Patient-Doctor Relationship, Privacy, Reviews, Science, Women's HealthTagged , , , , , , , , , , , , 1 Comment on Henrietta’s Cells Speak

A Visit With My Oncologist

After a while my oncologist stepped out into the waiting area and guided me to the hall by her office. “The cells are low,” she said. “We’ll have to wait another week, that’s all.”

I knew she was right. But a week seemed like a lifetime to me then….

Posted in Breast Cancer, cancer survival, cancer treatment, Life as a Patient, Women's HealthTagged , , , , , , , , 2 Comments on A Visit With My Oncologist

How to Avoid Death in the ICU

It was sometime in April, 1988. I was putting a line in an old man with end-stage kidney disease, cancer (maybe), heart failure, bacteria in his blood and no consciousness. Prince was on the radio, loud, by his bedside. If you could call it that – the uncomfortable, curtained compartment didn’t seem like a good place for resting.

Posted in cancer treatment, Communication, Empowered Patient, Essential Lessons, health care costs, Life as a Doctor, Medical Ethics, Palliative Care, Patient Autonomy, Patient-Doctor RelationshipTagged , , , , , , , , , , , , , , , 4 Comments on How to Avoid Death in the ICU

Why Medical Lessons?

One of the things I liked best about practicing medicine is that I was constantly learning.

Making rounds at seven in the morning on an oncology floor would be a chore if you didn’t get to examine and think and figure out what’s happening to a man with leukemia whose platelets are dangerously low, or whose lymphoma is responding to treatment but can’t take anymore medicine because of an intense, burn-like rash. You’d have to look stuff up, sort among clues

Posted in Communication, from the author, Ideas, Life, Life as a Doctor, Life as a Patient, Medical Education, Medical Ethics, Patient-Doctor RelationshipTagged , , , , , , , , 1 Comment on Why Medical Lessons?

How Well Do You Really Want to Know the “Red Devil?”

I know what it’s like to get the “red devil” in the veins.

You can learn about Adriamycin, a name brand chemotherapy, on WebMD. Or, if you prefer, you can check on doxorubicin, the generic term, using MedlinePlus, a comprehensive and relatively reliable public venture put forth by the National Library of Medicine and National Institutes of Health. If you’re into organic chemistry, you might want to review the structure of 14-hydroxydaunomycin, an antibiotic and cancer therapy first described 40 years ago…

Posted in Breast Cancer, cancer treatment, Essential Lessons, Life as a Doctor, Life as a Patient, Medical Education, Oncology (cancer), Women's HealthTagged , , , , , , , , , 2 Comments on How Well Do You Really Want to Know the “Red Devil?”

Hello Readers!

Well, I went ahead and started this blog without a proper introduction. Why was I in such a hurry?

Because I think the media’s getting – and giving – the wrong message on breast cancer screening. When it comes to long, boring medical publications like those published this week in the Annals of Internal Medicine, perhaps it’s not the devil that’s in the details so much as are the facts.

More on that tomorrow –

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