mementomori | November 7, 2006Children and teenagers in the US are getting fatter stomachs, putting them at increased risk of developing heart disease and diabetes, say researchers. They found the belly fat of children and teens had increased by more than 65 per cent since the 1990s - directly in line with rising obesity rates.
Thank goodness we don't live in some totalitarian nanny state that commands overweight youngsters to eat less and exercise more, or face being shipped off to the gulags . That would be unfair to the little cupcake-smeared darlings. Here in the U. S. of A. all are free to consume delicious…
mementomori | November 6, 2006 But at my back I always hear
Time's winged chariot hurrying near;
-Andrew Marvell, "To his Coy Mistress"
Exactly seven days ago I walked into Exam Room Number 3 and happened upon a woman in distress. Her symptoms, physical findings and laboratory abnormalities suggested to me that she had advanced stage ovarian cancer, which by the way is highly treatable. The usual sequence of events is to surgically remove as much tumor as possible and then give several cycles of chemotherapy, which frequently produces long term survival.
In this case, though, the patient was about as likely to tra-la-…
mementomori | November 3, 2006Do you get a feeling of relief whenever you see an anti-smoking advertisement directed toward teenagers? If you do you may want to sit down. Now there is a freshly published study out of Australia that concludes the following:
Exposure to tobacco company youth-targeted smoking prevention advertising generally had no beneficial outcomes for youths. Exposure to tobacco company parent-targeted advertising may have harmful effects on youth, especially among youths in grades 10 and 12.
It seems that anti-smoking ads aimed toward parents, such as the "Talk. They'll Listen." campaign only serve…
mementomori | November 2, 2006[This is one of a continuing series...]
While visiting with a patient last week we reached that awkward point in a conversation where both parties have exhausted their supply of neighborly small talk. As I stood up I really couldn't think of any other issues to discuss. The patient's problem, as they say, was obvious - it was the solution that had stymied me. He had been recently diagnosed with cancer and had plenty of troubles related to this. The complications of his malignancy could be relieved. The cancer itself although treatable, was incurable. This fact weighed upon me, producing…
mementomori | October 30, 2006[Editor's note - I hereby declare that I am not responsible for any and all acts that the C. O. may commit tomorrow night. Since he was indeed born on the last day of October he tends to get creepy on All Hallow's Eve. The rest of the year he's just plain weird.]
Before I return to official blogging duties let me entice the gentle reader with one more classic ghost story, written in 1904: "Oh, Whistle, and I'll Come to You, My Lad" by Montague Rhodes James. This tale still gives me the shivers whenever I think of it. For more ghastly suggestions for supernatural thrills go to this…
mementomori | October 29, 2006This may sound silly but I believe you aren't a true fan of Hallowe'en unless you stay up really late, turn out all the nights except one, plop yourself down into an old chair right next to a window - preferably one straining to hold back a wailing wind, and read one of the most famous horror stories of all time.
What is it? Oh, do not ask, dear readers.....it is too frightening to mention by name. Everyone has heard it before, though, and now is the time to shudder over it again.
Just click on this link to read it...and pleasant dreams....heh, heh, heh....
mementomori | October 28, 2006Just in case you were wondering what we were up to last night...
(with apologies to all Tiger fans...even Orac)
mementomori | October 27, 2006...that Afarensis and I happen to reside in the city where little birds will strike holy terror in the minds of lowly tigers on this Friday night.
Ahem...Go Cards!
mementomori | October 26, 2006Once upon a time I was caring for a nice man who was dying in a simply awful way from a cancer that seemed to revel in the act of slowly grinding his body into dust. In order to relieve his suffering the hospital staff gave him narcotics and sedatives intravenously. My job was to make sure that the doses were adequate. I had promised him and his family that we would do everything in our power to keep him free from pain. This is the kind of promise that, like a father walking in at the last minute to his daughter's school play, needs to be kept.
Apparently one of the nurses didn't get the…
mementomori | October 25, 2006The season in which cancer is diagnosed appears to affect survival, as does sunlight exposure to some extent, according to a study published in the October issue of the International Journal of Cancer.
Talk about not having any control over your health - not only do some of us get cancer, but now there is evidence that the season in which we are diagnosed may influence our chance for survival. Not to be frivolous, but is this akin to getting a crappy lower double berth on the Titanic?
Patients who were diagnosed with cancer in summer and autumn had better survival compared to those diagnosed…
mementomori | October 23, 2006[Editor's note: No, you didn't miss the first 23 rules - the narrator is simply tossing them off as they materialize during the course of his normal work day. Speaking of working stiffs, unless he wins the lottery the C.O. will have more examples for you in due time]
In honor of all the doctors around the world who labor with diligence and equanimity to give their patients the best care possible, I would like to share some entries from my little black book stuffed with practical tips for the practicing physician. This is merely an attempt to show readers how clinical decisions are made, or…
mementomori | October 19, 2006Tyger! Tyger! burning bright
In the forests of the night,
What immortal hand or eye
Could frame thy fearful symmetry?
-William Blake (1757-1827), The Tyger
Assonance: identity or similarity in sound between internal vowels in neighboring words.Alliteration: repetition of initial consonant sound.
Blake's famous poem is an excellent example of the power of alliteration and assonance to jolt the reader awake, if not draw attention to the underlying meaning of the words on the page. These classical devices are a writer's best friend. By linking words together the writer lights an emotional…
mementomori | October 18, 2006O for a beaker full of the warm South,
Full of the true, the blushful Hippocrene,
With beaded bubbles winking at the brim,
And purple-stained mouth;
John Keats, "Ode to a Nightingale"
"Grape seeds may help attack colon tumors"
A new study shows that feeding colorectal cancer-stricken mice with grape seed extract (that's right - grape seeds, not a bottle of the good stuff from the back of the wine cellar, so don't get any ideas) shrank their tumors by an average of 44%. This will undoubtedly lead to banner headlines in the murine press, but can these results be…
mementomori | October 16, 2006Inquiring minds want to know! Well, at least this inquiring mind wanted to find out just how much of a capitalist he really is, so I took this quickie test. I was surprised at the results, but in reality I shouldn't be. I suspect most doctors who love their work are not 100% capitalists. How can physicians dedicate their career to helping the needy and simultaneously renounce this doctrine? The only example I know is a creation of fiction - Dr. Hendricks, a character in Ayn Rand's epic novel Atlas Shrugged. When under fire from proponents of socialized medicine and reaching the point…
mementomori | October 15, 2006To jaw-jaw is always better than to war-war.
Sir Winston Churchill, 1954
No one can read the writings or speeches of Churchill and not admire his mastery of classic rhetorical terms. Churchill, who was trained in rhetoric in school, used such memorable figures throughout his adult life. For example, his use of oxymoron during a speech he gave in Fulton, Missouri on March 5, 1946 has become legendary:
."From Stettin in the Baltic to Trieste in the Adriatic an iron curtain has descended across the Continent."
It is certainly easier to learn and use rhetorical terms in one's writing than in…
mementomori | October 11, 2006I've said it before and I'll say it again - in fact I just said it to a patient of mine who came in for his ten-year checkup after battling one of the nastier cancers coiled in the soft, verdant field we call "life." (He's cured now, thank God.) He expressed dire unhappiness with his weight, so I said it to him:
"Exercise Beneficial In Breast Cancer Radiation Therapy."
Hmm...this may be a tad inaccurate. I think what I was trying to say was that exercise is beneficial for cancer survivors. Unfortunately my words of wisdom seemed to have the same effect on this patient as the advice I gave…
mementomori | October 9, 2006Yet knowing how way leads on to way,
I doubted if I should ever come back.
Robert Frost, The Road Not Taken, 1915
Last week I had the unpleasant task of informing a patient that his chemotherapy was no longer working. It was obvious that numerous new nodules had appeared on a follow-up CT scan; this matched the rise in his serum tumor marker. True, he had enjoyed an amazing year-and-a-half of essentially no symptoms from his cancer and no toxicity from his chemotherapy. Part of this was due to good luck, I thought, and part of it due to the fact that his tumor shrank tremendously on…
mementomori | October 6, 2006My, but the folks who think up names for pharmaceuticals have been busy lately! Here is just one example of a new compound from the promising world of translational research and now approved for usage. Just please don't ask me to pronounce it - I said it fast three times last night and conjured up the ghost of Tatanka Iyotanka.
"FDA Approves Vectibix (panitumumab) for Advanced Colorectal Cancer"
Those of us who follow the latest developments in colon cancer research (and don't you dare call us a bunch of nerds) are thrilled with the approval of panitumumab. Is it possible to translate this…
mementomori | October 4, 2006As a medical oncologist I'm not particularly a fan of cigarette smoking. In fact I have been known to try to coerce people to cease and desist from the smelly habit. Because of the siren song of nicotine and its addictive properties, however, I realize that many smokers are both mentally and physically unable to simply walk away from a luscious pack of cigarettes. Perhaps they lie awake in bed at night, frustrated with their addiction and vowing to throw away the coffin nails for good cometh the dawn. Perhaps they invest in stop-smoking classes, nictotine-replacement products, pills or…
mementomori | October 1, 2006[Editor's Note: In honor of the first day of October (and by request) here is a brief essay first posted the C.O. in 2004. In honor of the practice of improving one's prose, I've asked him to re-write the thing, to which he has grudgingly agreed to.]
Last weekend I got off the couch and took a long walk through the crisp forests of Missouri, a journey long overdue. As I tramped along, the bronze and yellow-gold giants of autumn towered over me, lightly swaying in the October breeze. Fall is a poignant time for many people, representing turning points that are deeply embedded in the psyche…