Last Sunday my eight-year-old daughter said something really smart. It was bright, funny, even a little political and competitive. My sister, surprised, told her, “You sound just like your Daddy.” We all laughed. It was something my husband would say, we could almost hear him saying it. My daughter answered, “Yeah, my Dad’s a good role model.”
I chimed in on this post-Italian Ice conversation. Our whole family was taking a stroll after dinner and I was a few steps behind them walking with my Dad, her Pop-Pop. “You know, my Dad was a pretty good role model, too.” I explained, as much to her as to myself. I thought how my entire life I have emulated my father. Quiet like him, humble, steady under pressure, a good student, faithful, kind, goofy sense of humor. Even professionally, I became a surgeon, just like him. “Yes,” my daughter answered. “I guess all fathers are good role models.”
I gave her my sad face, like I felt left out from her list of heroes. “No, Mommy, you’re my role model, too,” she explained. “You see, I want to be a doctor, just like you, but I want to talk just like Dad!”
Wednesday, June 21, 2006
Sunday, June 11, 2006
THE DREAM OF A COMMON LANGUAGE
My husband turned to my nine-year-old son at dinner. “This summer,” he proclaimed, “we are going to learn Italian.” Why would he decide to take on such a feat? It couldn’t have been the food. We were sitting at an overpriced strip-mall Italian restaurant, disconcertingly named after the Native American name of our town on Long Island and some neologism combining the word pasta with the word cafeteria.
I doubted that it was the ambiance. There was a strange trompe l’oiel mural covering one wall depicting an open air piazza in Rome or one of the hill towns of Italy. The remainder of the dining room contained fake brick, wood laminates and artificial plants. It was a study in illusion.
I once listened to a patient ramble on in Italian about his latest hospital adventure. I had greeted him with the few phrases of Italian that I knew from our honeymoon in Italy or had learned from the housekeeping staff at the Brooklyn hospital where I used to work. He mistakenly assumed I was fluent in Italian, and began his discourse.
He told me of a recent hospital admission during which he felt he was treated rather gruffly by some of the associates in a large gastroenterology group. First they mistook him for his roommate, then they continued to call him by the wrong first name, then they said they didn’t know why he was bleeding. He felt alienated and dismissed. I shook my head, and let him continue, giving up on my attempts to steer him toward an English version of his story, just enjoying the lilting cadence of his emotional words. Then I answered him, and he smiled, realizing that my answer was in English, but that I had understood everything he had blurted out in his own native tongue. I examined him, reassured him, and he thanked me as he walked out to the receptionist to make a follow-up appointment.
I brought his chart back to my desk and for a moment let myself dream of a common language.
I doubted that it was the ambiance. There was a strange trompe l’oiel mural covering one wall depicting an open air piazza in Rome or one of the hill towns of Italy. The remainder of the dining room contained fake brick, wood laminates and artificial plants. It was a study in illusion.
I once listened to a patient ramble on in Italian about his latest hospital adventure. I had greeted him with the few phrases of Italian that I knew from our honeymoon in Italy or had learned from the housekeeping staff at the Brooklyn hospital where I used to work. He mistakenly assumed I was fluent in Italian, and began his discourse.
He told me of a recent hospital admission during which he felt he was treated rather gruffly by some of the associates in a large gastroenterology group. First they mistook him for his roommate, then they continued to call him by the wrong first name, then they said they didn’t know why he was bleeding. He felt alienated and dismissed. I shook my head, and let him continue, giving up on my attempts to steer him toward an English version of his story, just enjoying the lilting cadence of his emotional words. Then I answered him, and he smiled, realizing that my answer was in English, but that I had understood everything he had blurted out in his own native tongue. I examined him, reassured him, and he thanked me as he walked out to the receptionist to make a follow-up appointment.
I brought his chart back to my desk and for a moment let myself dream of a common language.
Thursday, June 08, 2006
CERVICAL CANCER VACCINE APPROVED
As anticipated on this blog, the FDA has approved the use of Gardasil, the vaccine that protects against human papillomavirus, in 9 to 26 year old girls and women. Strains of this virus are believed to cause 70% of cervical cancers and 90% of genital warts. Click here for today's New York Times article on the subject.
Wednesday, June 07, 2006
HUMP DAY
Nope, can’t have sex yet, just looking for a way to describe my first Wednesday back at work. Raining and gloomy. Traffic snarls. Another fund drive on public radio interrupting my commuting pleasure. A distant colleague, well-known in the hospital where I did a colonoscopy today lost his wife to lung cancer on Saturday. She had worked in his office the past couple of years, since his recent cardiac problems required stents and then bypasses, and a careful eye on his schedule. The endo nurses had gotten to know her as she would walk over to the hospital from his office with cases to book. They say at the wake he looked really crushed. They speculated that he probably thought he would be the first to go. Two adult children at home and a grandchild that they would mind while their children attended college nearby. Now he’s a widower. Sometimes there are just no words.
The office has been busy, but quiet, especially with my compadres out of town at the ASCRS annual meeting. One of my patients got into a rainy day fender-bender when some chuckle-head backed into her car in a parking lot. The weather channel is predicting five more days of rain.
Home now, and Blogger has the hiccups, and is down for maintenance. The Yankees-Red Sox game got rained out. It has not been rescheduled as yet. Guess I’ll catch up on some reading. Safe home everybody. Be careful in the rain.
The office has been busy, but quiet, especially with my compadres out of town at the ASCRS annual meeting. One of my patients got into a rainy day fender-bender when some chuckle-head backed into her car in a parking lot. The weather channel is predicting five more days of rain.
Home now, and Blogger has the hiccups, and is down for maintenance. The Yankees-Red Sox game got rained out. It has not been rescheduled as yet. Guess I’ll catch up on some reading. Safe home everybody. Be careful in the rain.
Friday, June 02, 2006
THE MOST IMPORTANT SOMEONE
The large pharmaceutical company Merck, perhaps still reeling from the troublesome recall of their immensely popular anti-inflammatory, Vioxx, has launched a public awareness campaign for cervical cancer. It’s called “tell someone,” and is penetrating the print and television media with splashy ads, including tear out colorful postcards in Spanish and English and 60+ second television commercials outlining the importance of screening examinations (Pap smears) that can detect cervical cancer at very early, and precancerous stages.
Cervical cancer is the third leading cause of cancer-related mortality in women worldwide. This year an estimated 10,370 women will be diagnosed with cervical cancer in the United States and approximately 3,710 women will die from this disease. Ninety-nine percent of cervical cancers are caused by a virus called the human papillomavirus (HPV). This virus is sexually transmitted and rampant. It is suspected that more than 80% of sexually active adults are infected with or carriers of this virus. Recently published studies demonstrate the effectiveness of an HPV vaccine which Merck will introduce to the market amidst this public service media blitz. Speaking of media, in the time since I was diagnosed, I have seen TV news coverage, news magazine coverage, and even blogs about cervical cancer and HPV, and the controversy surrounding the new vaccine. Glaxo-Smith-Kline, another pharmaceutical giant is working on a vaccine of their own.
In the 15 years since I have graduated from medical school, there have been few medical developments of such magnitude. In surgery, the pendulum has swung from radical mastectomy past lumpectomy and axillary dissection to lumpectomy with sentinel lymph node excision in the treatment of breast cancer. The introduction of laparoscopic surgery continues to influence surgical practice, with more and more minimally invasive procedures developed and perfected each day. But a vaccine to prevent cancer? That is big. Really big.
But while I'm "telling someone," who is the most important "someone" to tell? Obviously too late for me, and for anyone like me, already diagnosed, in fact already treated for cervical cancer. Who will a vaccine that can decrease the risk of this cancer help the most? Editors of The Lancet medical journal wrote a piece this past January exploring this question. The studies on the drug included young women in their teens and twenties. The studies have shown maximal effectiveness in the young women who were not sexually active and who tested negative for HPV. Effectiveness has not yet been proven in men nor in children, although studies are ongoing.
It has been more than 30 years since the model of a cancer causing virus was first proposed. It has taken that long for a vaccine to fight that virus to be developed, and may take a few more years to understand the epidemiology behind eradicating it or at least protecting people from its worst consequences. In the meanwhile, my philosophy will be "Tell Everyone," and the most important "someone" that I need to tell is outside swimming in our pool. She's only eight, and just got home from school, so I have some time to let the FDA and the political pundits work on some of the controversies. It won't be long, though. Indeed, she has already been subject to more than her share of "serious conversations" in the past few weeks. That's how I know that my daughter (and I) will be able to handle this one, too.
Cervical cancer is the third leading cause of cancer-related mortality in women worldwide. This year an estimated 10,370 women will be diagnosed with cervical cancer in the United States and approximately 3,710 women will die from this disease. Ninety-nine percent of cervical cancers are caused by a virus called the human papillomavirus (HPV). This virus is sexually transmitted and rampant. It is suspected that more than 80% of sexually active adults are infected with or carriers of this virus. Recently published studies demonstrate the effectiveness of an HPV vaccine which Merck will introduce to the market amidst this public service media blitz. Speaking of media, in the time since I was diagnosed, I have seen TV news coverage, news magazine coverage, and even blogs about cervical cancer and HPV, and the controversy surrounding the new vaccine. Glaxo-Smith-Kline, another pharmaceutical giant is working on a vaccine of their own.
In the 15 years since I have graduated from medical school, there have been few medical developments of such magnitude. In surgery, the pendulum has swung from radical mastectomy past lumpectomy and axillary dissection to lumpectomy with sentinel lymph node excision in the treatment of breast cancer. The introduction of laparoscopic surgery continues to influence surgical practice, with more and more minimally invasive procedures developed and perfected each day. But a vaccine to prevent cancer? That is big. Really big.
But while I'm "telling someone," who is the most important "someone" to tell? Obviously too late for me, and for anyone like me, already diagnosed, in fact already treated for cervical cancer. Who will a vaccine that can decrease the risk of this cancer help the most? Editors of The Lancet medical journal wrote a piece this past January exploring this question. The studies on the drug included young women in their teens and twenties. The studies have shown maximal effectiveness in the young women who were not sexually active and who tested negative for HPV. Effectiveness has not yet been proven in men nor in children, although studies are ongoing.
It has been more than 30 years since the model of a cancer causing virus was first proposed. It has taken that long for a vaccine to fight that virus to be developed, and may take a few more years to understand the epidemiology behind eradicating it or at least protecting people from its worst consequences. In the meanwhile, my philosophy will be "Tell Everyone," and the most important "someone" that I need to tell is outside swimming in our pool. She's only eight, and just got home from school, so I have some time to let the FDA and the political pundits work on some of the controversies. It won't be long, though. Indeed, she has already been subject to more than her share of "serious conversations" in the past few weeks. That's how I know that my daughter (and I) will be able to handle this one, too.
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