Are We Measuring Correctly? | Erin Stevens, MD
Metrics are becoming very important in the treatment of cancer. As physicians, we want to know that all patients are being given the correct treatments for their disease. We can measure this by using databases and codes. Nationwide, we use these metrics as a way to tell us how far we have to go get all patients to receive the standard of care. We also have metrics on end of life care and things we should avoid with our cancer patients, including hospital admissions and chemotherapy in the last two weeks of life. But sometimes numbers do not tell the whole story.
Changing Red to Black | B.J. Rimel, MD
Every day after clinic, I sit with my list of patients in front of the computer screen. I type in the login and the password that keeps changing every month. Entering each medical record number, I wait for the electronic medical record to load so I can view the results. In my deepest, most secret place in my heart I say a little prayer for black. Black numbers are good, inside the normal range. Red numbers are the computers way of alerting me that the value I’m expecting is outside of the normal range and something is not as I want it to be.
Making Our Voices be Heard | Dee Sparacio
“Dear Congressman Holt,
I am a constituent and an eight-year ovarian cancer survivor. I respectfully request that you continue your support of ovarian cancer research …”
This is how I began an email I recently sent to my representative in Washington, DC. In the email I asked him to sign the Fitzpatrick-DeLauro Dear Colleague Letter requesting $20 million for the Ovarian Cancer Research Program, one of the Congressionally Directed Medical Research Programs at the Department of Defense. I sent this email using a system on the Ovarian Cancer National Alliance website. In sending it I added my name to the growing list of survivors who are taking an active role in advocating for research and awareness at the national and state levels.
A View from the Trenches | Eijean Wu, MD, MPP
The line starts forming outside the building around 6:00 a.m. When I walk from the parking lot to the cafeteria to get my morning coffee, I see my patients, crowded under the awning, ready for the monthly ritual of coming to a county cancer clinic. Many of them have bags packed with magazines and snacks. Some are holding sleeping grandchildren. I marvel at how they have adapted their lives to a clunky bureaucracy that doesn’t respect their time.
Full Disclosure | B.J. Rimel, MD
As a junior attending, teaching residents in clinic is one of the most frustrating and joyful experiences of my practice. Balancing the desire to educate with the ever present need to keep wait times down in a busy clinic leads me to sometimes cut off the protracted history-taking that residents inevitably perform, but I feel bad about it every time. The residents rotate onto the gynecologic oncology service for a few weeks at a time every year of their training, and with rare exceptions, our service is the only time that they will interact with gynecologic cancer patients during the residency.
A Letter to My Patients: Promises Part 2 | Erin Stevens, MD
This is Part 2 of an excerpt of a speech I gave at the Stony Brook University Hospital’s Gynecologic Oncology Candlelight Ceremony in September 2012.
I promise to remember who my patients are. My patients are women, just like myself. And women spend most of their lives nurturing those around them, putting others first. This makes cancer a very humbling disease. Being diagnosed with cancer means reaching out to others nurturing while you are putting yourself first. It is a time when you must be at least a little selfish, which is extraordinarily difficult for most women.
‘Is my chemotherapy vegan?’ | B.J. Rimel, MD
“Is my chemotherapy vegan?”
Despite my 12 years of post-graduate training, I was completely floored by this question. To be honest, my initial response was not what it could have been.
“I have no earthly idea,” I said, in my best doctor voice. I left the clinic feeling completely incredulous that anyone with a life-threatening cancer would care if their chemo was in any way associated with animal products. As a new attending, I initially felt righteous that I had not given in to a long discussion about non-evidence based treatments, and instead steered our conversation back to symptom management, dosing schedule and a review of the side effects she was likely to experience.
New Year’s Aspirations | Dee Sparacio
On January 1, 2006, when I was in treatment for ovarian cancer, I decided that I wouldn’t make resolutions anymore. Why? Because there were only two things I aspired to do, finish chemo and live! Since then I have made aspirations for each new year. For me setting these goals is my way of looking forward to the year ahead and how to make my life, however long it might be, better.
In the past, I aspired to complete chemotherapy treatments for my recurrence (2009), raise money for ovarian cancer research at my cancer center (2012), write more frequently on my blog (2011) and travel more (every year).
This year, I have a few new aspirations.
Wound Healing | Eijean Wu, MD, MPP
Maria was one of my luckier patients, someone with a solid support system and safe home. She came into the hospital for a relatively small surgery. Her concerned family drilled me with questions.
“How is her wound?”
“It’s looking pink and clean, just like it should.”
“Is abuelita in pain?”
“I think the morphine is helping. Her face is peaceful.”