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

Looking Ahead on Breast Cancer Screening

The risks and costs of breast cancer screening are exaggerated and misrepresented in the recent news…. My conclusion is that rather than ditching a life-saving procedure that’s imperfect, we should make sure that all doctors and radiology facilities are up to snuff.

We need to distinguish between errors in the measurement (cancer or not) and errors in decisions that we – patients and doctors – make after upon detecting a premalignant or early-stage malignancy in a woman’s breast.

A Bit More on False Positives, Dec 2009, Part 1

Why bother, you might ask – wouldn’t it be easier to drop the subject?

“Make it go away,” sang Sheryl Crow on her radiation sessions.

I’ll answer as might a physician and board-certified oncologist who happens to be a BC survivor in her 40s: we need establish how often false positives lead, in current practice, to additional procedures and inappropriate treatment…These numbers matter. They’re essential to the claim that the risks of breast cancer screening outweigh the benefits.

Information Overload

Last week I received an email from a former patient. He has hemochromatosis, an inherited disposition to iron overload. His body is programmed to take in excessive amounts of iron, which then might deposit in the liver, glands, heart and skin. He mentioned “some amazing videos on hematology and hemochromatosis and genetics” he’d discovered on YouTube.

This is the future of medicine, I realized. … Whether physicians want their patients to search the Internet for medical advice is beside the point. We’re there already, whether or not it’s good for us and whether what we find there is true.

Legitimate Concerns and Unfortunate Timing on Radiation from C.T. Scanning

The risks of radiation from CT scanning will almost certainly add to the current confusion and concerns about the risks of breast cancer screening.

Mammography differs from CT scanning in several important ways:

1. Mammograms involve much less radiation exposure than CT scans.
2. Mammography is well-regulated by the Food and Drug Administration (FDA) and other agencies. The Mammography Quality Standards Act (MQSA) requires…
3. Women who undergo screening mammograms can control when and where they get this procedure. Screening mammograms are elective by nature..

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…

Doctors Don’t Tweet

I didn’t know much about social media until the summer of 2008. Then, I entered Columbia University’s Graduate School of Journalism as a new student and attended an optional lunch-time session on Facebook, Gmail and Twitter.

My kids used Facebook, so I knew about that. Still, I hesitated…

On Juno and Screening Test Stats

“Well, well” says the convenience store clerk. “Back for another test?”

“I think the first one was defective. The plus sign looks more like a division symbol, so I remain unconvinced,” states Juno the pregnant teenager.

“Third test today, mama-bear,” notes the clerk.

…”There it is. The little pink plus sign is so unholy,” Juno responds.

She’s pregnant, clearly, and she knows she is.

(see clip from Juno the movie*)

Think of how a statistician might consider Juno’s predicament…

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