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 conti…
Category: Oncology/Hematology
My colleagues are nervous. My patients are crying. And yet, we are here.
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 w…
The medical basis of vampires
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…
Practicing oncology during COVID-19
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 surroun…
Should nurse practitioners complete medical residencies?
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 …
The financial hole for patients begins on the first day of diagnosis
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 c…
MKSAP: 52-year-old woman with osteoarthritis of the right hip
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 …
The sexual side effects after prostate cancer treatment
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 s…
Why physicians should acknowledge the validity of second opinions
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 t…
The primary care solution is obvious, but don’t expect policymakers to jump on board
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 rese…
