13 ms·

When A Daughter Dies

324 points by jvilalta 14y ago

noonespecial 14y ago
In the thankfully few times I've had to endure hospitals, I've always been struck by how unbelievable primitive what they're doing actually is. Sure there are some genuine technical miracles (dialasys, pacemakers, etc) but I always get the distinct impression that most of it is window dressing; a kind of theatre to make it seem like they're more in control and much less helpless than they really are.
- justinph 14y ago
  I've come to the same conclusion. "Modern" medicine is just marginal assistance to your body's own healing mechanisms.
  - majorlazer 14y ago
    I sometimes begin to think the same way, and then I remember about these: http://futurity.org/wp-content/uploads/2009/11/oscar-pistorius2.jpg http://futurity.org/wp-content/uploads/2009/11/oscar-pistori... http://static.ddmcdn.com/gif/artificial-heart-abiocor-hand.jpg http://static.ddmcdn.com/gif/artificial-heart-abiocor-hand.j... https://www.23andme.com/ https://www.23andme.com/ http://www.guadalupemed.com/images/xray.jpg http://www.guadalupemed.com/images/xray.jpg http://www.eyeclinicpc.com/lasik/lasik%20steps1.jpg http://www.eyeclinicpc.com/lasik/lasik%20steps1.jpg http://www.piersondental.com/Portals/22078/images/rootcanal%20(1).jpg http://www.piersondental.com/Portals/22078/images/rootcanal%... http://www.bismarckfamilydental.com/dental-implants-bismarck-north-dakota-nd/images/dentalimplants.jpg http://www.bismarckfamilydental.com/dental-implants-bismarck... http://www.nidcd.nih.gov/staticresources/health/images/ear_coch.jpg http://www.nidcd.nih.gov/staticresources/health/images/ear_c... http://emedtravel.files.wordpress.com/2012/04/brain-mri-1.jpg http://emedtravel.files.wordpress.com/2012/04/brain-mri-1.jp... And that's just off the top of my head. I think modern medicine has advanced a lot more than we give it credit for. I know a lot of hackers tend to compare other industries to the tech field, and expect everything to advance at a rate like Moore's law, but that just isn't feasible in most fields.
jeffehobbs 14y ago
Heartbreaking. I hope for a cure for cancer in our lifetimes.
- deleted 14y ago
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- sciurus 14y ago
  There will never be a cure for cancer. There will be cures for cancers.
  - ams6110 14y ago
    I would even say there will never be cures for cancers. There will be treatments.
maskedinvader 14y ago
very touching and heartbreaking read..
dandrews 14y ago
I was struck by the amount of care that was seemingly influenced by fear of litigation. An ambulance driver diverted to a closer e/r despite having a physician onboard. A nurse wouldn't sanction ice chips without the admitting physician's chop. Exhausting and time-consuming tests needlessly repeated. I once asked a veterinarian acquaintance of mine why he hadn't become a physician. "Wouldn't you rather drive something fancier than that pickup truck?" I needled, gesturing out the window at his old F150. "Yeah" he replied, "but those guys spend most of their time doing paperwork. I get to practice medicine."
- hkmurakami 14y ago
  >I once asked a veterinarian acquaintance of mine why he hadn't become a physician. "Wouldn't you rather drive something fancier than that pickup truck?" I needled, gesturing out the window at his old F150. "Yeah" he replied, "but those guys spend most of their time doing paperwork. I get to practice medicine." That is an amazing (albeit gravely unfortunate) quote. I'm going to share it with some friends who are studying to become vets themselves (I hope that's alright with you). Thanks for sharing the anecdote :).
  - brown9-2 14y ago
    Unfortunate how? Based on the choice of car?
    - rrouse 14y ago
      Unfortunate that human doctors have to spend so much time doing paperwork
      - ams6110 14y ago
        Not all do. There are a few who have opted out of the insurance-based system. They run cash practices, and from what I've heard are able to spend more time with patients and charge them less because of the breathtaking amount of overhead they've eliminated.
- 14y ago
jostmey 14y ago
An awesome book titled "The lives of a cell" by "Thomas Lewis" delved into the problems of Medicine (among other things) in the later 70s. He was amazingly prescient about the problems that Medicine faces today. He also offered some wonderful solutions for fixing Medicine.
- aaronharnly 14y ago
  Just to note, I think you mean Lewis Thomas, namesake of Princeton's Lewis Thomas Laboratory.
- ecliptic 14y ago
  "The Lives of a Cell" by Lewis Thomas is a tremendous book, pulling back the curtain on biology. Clear, concise and well written, very similar to Feynman with physics.
enduser 14y ago
I lost my sister to cancer 9 years ago when she was in her early 20s and I was in my teens. Her experience with the medical system was humiliating, futile, and expensive. My parents have never fully recovered emotionally. It has taken me years to integrate the experience, and I still have ghastly memories of the pains she endured recovering from unnecessary surgeries. When I read something like this i feel how much I would like to see a change. It's only partly a techological change--it is also imporant for us as a people to let go when nothing can be done, not to make things worse out of a need to be seen doing something. Unfortunately when a panicked parent is demanding that something be done to save their child, someone will be willing to do something even if the first person knows that nothing can be done. When it is my time to die I intend to fully engage with the experience of dying, and not to numb the experience with knife wounds, drugs, and over-stimulating hospitals. Until then I intend every day to live fully, with great sensitivity, and to remember that each day I live is one my sister did not have. There is no entitlement to health or longevity; some things cannot be predicted nor controlled.
- guylhem 14y ago
  > "it is also imporant for us as a people to let go when nothing can be done, not to make things worse out of a need to be seen doing something" In the case of cancer, universal care unfortunately seems like running in the opposite direction. Sometimes admitting that nothing can be done is the right thing. Look at the case description - I wouldn't be surprised if the total bill was at least between 100k and 200k - for 20 days of useless care which ultimately resulted in the patient death. There are some good economical analysis showing yearly cost that'll make you cry, especially if you consider the alternative uses of that money and how many lives could be saved - say in other countries. With our current technology, universal healthcare for fighting cancer seems like trying to stop a fire with gasoline.
  - niels_olson 14y ago
    > universal healthcare for fighting cancer seems like trying to stop a fire with gasoline Tell that to the unemployed dad whom, twenty minutes ago, I directed to take his son to the ENT. He has had a swollen left tonsil for 5 years (last time he saw his pediatrician). Now he presents with 1 day of left ear pain. There's a mass hanging off his ear drum. Cholesteatoma? Unlikely. Maybe bullous myringitis. But at this point this kid's whole left pharynx is suspect and 5 years of infection starts one thinking about scary things.
akg_67 14y ago
Very sad and heart-breaking. While reading the story, I couldn't stop imagining myself in his daughter's shoes and wondering "what would I do if I was in her place?" Would I struggle and suffer in the hopes of living a few months longer or accept the fate and go in peace sooner. This reminded me of discussion with my wife during will preparation about how long should I be kept alive before plug is pulled.
brudgers 14y ago
Stage four cancer? These are things I've learned from almost twenty years as a "hospice spouse." It's probably time to call hospice, not the "We can beat this oncologist." It's probably time to write a living will and a sign the DNR. It's probably time to decide how and where you want to die. It's most assuredly time to decide how you want to live the rest of your life.
- SoftwareMaven 14y ago
  Not always. I know a guy who has been living with stage four colon cancer for four years who, recently, has seen his tumors contracting for the first time ever. So while I agree that you need to identify a point where you say, "Let me die in peace", I don't think that point is always the day you've been told you have stage 4 cancer. I'm not sure that the 20 days reference in the article is really time to come to terms with that.
  - refurb 14y ago
    This is truly the problem with evidence based medicine. You can say how a given treatment will impact a population (i.e. 1 out of 100 patients with stage 4 colon cancer will survive past 6 months) and say it's not worth it, but when you're talking to a single patient, you don't know what the outcome will be. Maybe the treatment will be in vain or maybe he or she will be the one patient that goes into complete remission. What do you do then?
  - gus_massa 14y ago
    It depends on where the tumors are located. For metastasis brain tumors the life expectancy is approximately one year. http://www.nlm.nih.gov/medlineplus/ency/article/000769.htm http://www.nlm.nih.gov/medlineplus/ency/article/000769.htm
VMG 14y ago
Very sad, very scary. What is the cost-benefit ratio for a routine MRI scan every six months?
- niels_olson 14y ago
  Whole-body MRI? Several thousand dollars just for the scan. The radiologist's interpretation typically costs as much. We haven't even begun to talk about resultant interventions. Eat less and exercise more is a lot cheaper and more effective.
  - lostlogin 14y ago
    Where I work, about $700 US. It's not a great test, despite excellent radiologists and brand new equipment as whole body imaging is far lower resolution than localized imaging (its about 1500 pixels by 250 in resolution versus 512x512 when just your knee is done using an educated guess).
- mdonahoe 14y ago
  This. This is the cure for cancer we need: affordable routine scans. Though more scans means more results for doctors to analyze. Hopefully algorithms can make that part cheaper too.
  - tisme 14y ago
    No. Affordable routine scans will result in massive overloading of the health system with unnecessary procedures, and the complications arising from those procedures will kill more people than would have died otherwise from whatever shows up on those scans. There is no such thing as an intervention without risk, and that starts with the risks associated with general anaesthesia. Scanning is one thing, interpreting a scan and deciding when and where to intervene is something that does not scale well at our current level of technology. Basically it needs a human to sit down and spend time analysing the scan to make sure that what is there warrants intervention. So even if the scan costs would drop to 0 you'd still have the component of the interpretation to deal with. The end result of overloading the system like this is that those with symptoms that need care are less likely to receive it or receive it timely, and that those that didn't need the care will suffer from complications. Knowing when to scan and when not to scan is a crucial ingredient in giving good care.
tokenadult 14y ago
Steven D. Levitt's father Michael Levitt http://www.med.umn.edu/gi/faculty/vamc/home.html http://www.med.umn.edu/gi/faculty/vamc/home.html http://www.mayoclinic.org/news2009-rst/5207.html http://www.mayoclinic.org/news2009-rst/5207.html is a medical doctor and academic researcher in medicine at the University of Minnesota. I used to file his grant applications into the office file drawers as a duty of my part-time job while pursuing my undergraduate degree. Michael Levitt is perhaps the world's leading authority on intestinal gas and still has an active research program in diseases of the human bowel. He indeed has seen many patients at a research hospital over the years, the same hospital where my mother worked as a nurse for most of her career. Dr. Levitt writes in the submitted article, "Overnight admission to the hospital is recommended for 'observation' and rest prior to the trip home. Fifty years of experience have taught me that admission to an academic hospital is not restful. I have stopped counting the patients who want to be discharged to get some rest." I have an immediate family member who was given excellent care at the same academic hospital Dr. Levitt knows so well. My relative is in excellent health now decades after that treatment. But indeed, even with best care, the patient experience at a research hospital is not restful, as world experts on the patient's case vie with medical students and a variety of other health science trainees and practitioners to learn from the patient. When a case is puzzling, as was the case of my relative, research-oriented practitioners are curious about how to understand the case, trying to find established, verified practice to help the patient, and otherwise working "empirically" (an ominous word--to me--used by my relative's main doctor to describe a procedure he attempted when he wasn't sure what to do next) to do whatever they can to help. As the father of a daughter, I can hardly imagine a rougher kind of news to hear. Another immediate relative lost a fiancee to cancer years ago, and that relative's memories of that time are full of frustration. The various kinds of cancer are still so varied--as mentioned in the article--that there is essentially NIL prospect of ever having a general treatment that will be an effective first-line treatment for most forms of cancer. Instead, there will continue to be surgical treatment for come cancers, a growing variety of chemotherapies for a variety of cancers, in the best luck genome-matched to vulnerable cancer cell strains, and radiation treatment for other cancers. Ultimately, though, we will all have to learn to die better, http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how-doctors-die/read/nexus/ http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how... because we will all eventually die of something. Meanwhile, if you are a parent, this submission is a reminder to cherish your children while they are here, and if you are a medical researcher, as Michael Levitt is, this is a reminder to continue to strive for better understanding of health and disease, while remembering the patient experience as new tests and treatments are devised.
thrwaway1 14y ago
This reminds me of the story of Dr. Ben Carson, a famous neurosurgeon who also teaches oncology at John Hopkins. In 2002, he was diagnosed with prostate cancer and successfully underwent traditional treatment. However, Dr. Carson has stated publicly, both at conferences and on radio interviews, that he believes he was largely cured by a controversial holistic treatment called glyconutrients. However, due to legal liabilities on the company's part, they banned all testimonials and would threaten lawsuits to anyone who publicized this information. 20/20 did a story on glyconutrients, disproving them based on glycobiologist Dr. Ronald Schnaar from John Hopkins School of Medicine. Dr. Schnaar said, "All of the sugar building blocks that we need in our body are made from the most common foods we eat." Contrary to this, Dr. Carson says we do not get these simple sugars from our natural diet and said that his family, his employees and everyone he knows uses glyconutrients with great results. He said he considered not having traditional surgery but he didn't want others mistakenly following his path to the detriment of their health. Dr. Carson is not a glycobiologist. However, he is the Director of Pediatric Neurosurgery at John Hopkins and a colleague of Dr. Schanaar. He's been awarded the Presidential Medal of Freedom and had a film made about his life story starring Cuba Gooding Jr. But none of this information about his alternative cancer treatment is widely known. Not one word on his Wikipedia page (http://en.wikipedia.org/wiki/Ben_Carson http://en.wikipedia.org/wiki/Ben_Carson) nor on the page about glyconutrients. It's disappointing there's no unbiased scientific research to explain what is factually true. And it's unbelievable that such a high profile cancer survivor could make these claims with virtually no one knowing. Dr. Carson's speech http://www.youtube.com/watch?v=ROzftYwJihg http://www.youtube.com/watch?v=ROzftYwJihg Dr. Carson's Story in the Dallas Weekly http://glyconutrientsarevital.blogspot.com/2006/08/dr-ben-carson-glyconutrients.html http://glyconutrientsarevital.blogspot.com/2006/08/dr-ben-ca... Related Local News story on Baby Hadley http://www.youtube.com/watch?v=oK3U4mrqslk http://www.youtube.com/watch?v=oK3U4mrqslk
- guard-of-terra 14y ago
  As far as I (IANAD) understand, there is no such thing as an universal cure for cancer. If and when we beat cancer, the solution will not present itself as a magic pill. Therefore for any instance of magic pills (glyconutrients included) we can infer that it won't cure cancer with any reliability. You can have a narrow tool that strikes one kind of cancer and does nothing (or even harms a little) on all others, or we can have something that comforts you a bit but without much statistical outcome. If you have malignant cells dividing inside you, they would not be easily stopped. Trying to self-medicate a random cancer with a random magic pill will likely yield no result at all - or maybe only from Placebo effect. Therefore if you're at earlier stage, your best bet is conventional treatment, and if you're at late stage, it might be better to spend the remaining time wisely.
javajosh 14y ago
>The purpose of this brief chronicle is not to criticize the practice of medicine. Perhaps that wasn't his purpose, but that was the result. And it is a scathing, justified criticism, especially coming from an experienced doctor. My father died of lung cancer, and we went through similar experiences with the health care system. Before claiming that something is not a criticism, we have to ask whether or not we can imagine a better outcome, ask what is getting in the way of that outcome, and then make a change. This could be something small, like moving patients around less, and with less resistance. (The purely informational resistance in medical care is appalling, and this story shows it's real human cost. Electronic patient records is not about assuaging "people who can't be bothered to fill out forms".) Or it could be something huge, like revolutionizing what late-stage cancer patients, and their families, expect, and how they will be treated. If you get late-stage cancer, the health insurance company should hand you $100,000 in cash, a large supply of morphine that can be easily self-administered, and a ticket to Hawaii. Huge bag of weed optional. The message is clear: you're going to die soon, so make your peace with it. Talk to your family. My father fought until he fell unconscious, his personality ravaged by whole-brain radiation and chemo, in complete denial. He never got a change to face his sentence with courage, and he never really talked to me before he died. So yes, the practice of medicine needs to be criticized.
- jaggederest 14y ago
  I also tend to think that the word 'criticism' is linked with a negative aspect that is undeserved. Consider a glowing movie review that is thorough and thoughtful - certainly criticism, but in no way negative.
mcmatterson 14y ago
This hits close to home. I came within a hair's breadth of losing my infant daughter to cancer just over a year ago, and a few things come up in my thoughts: - Not all medical systems are the disaster described here. We elected to move back from the US to our native Canada to undergo treatment, and our experience in ward (pre and post-op as well as on the oncology floor) was a dream (at least given the circumstances). We experienced nothing but exemplary inter-disciplinary cooperation, compassion for the patient (and family) experience, and a professionalism driven by clinical need rather than liti-mitigation. These qualities were exhibited even more strongly during the initial phases of treatment post-discovery, which unfolded along a timeline similar to the one discussed here. - Academic hospitals are exhausting. My spouse ended up being the real hero in this story (she was still breastfeeding at the time, and only one parent was allowed to overnight in the room). My job was to make sure she and our daughter had recovered enough each day to make it through a night of vitals, endless beeping, and the occasional overnight chemo administration (don't even get me started about that). - The need for patients and their families to drive the narrative of their hospital experience and be their own champion is critical. I had worked in healthcare for many years before this nightmare began (my old office was at the hospital across the street from her room) and knew the system very, very well. We divided up responsibilities so 'I looked outward, and [my spouse] looked inward', meaning that I spent my time making sure that the relevant referrals happened, that medications were administered on time and on dose, and so on. My wife looked inwards towards our daughter, making sure she was fed, entertained, and comfortable. This setup worked very well for us, and was a likely contributor to our level of care. - The power of parents to be strong in the face of terrible (often inevitable) odds is truly inspiring. We were lucky enough to know with reasonable certainty fairly early on that we would one day be leaving the hospital and resuming a normal life. Many, many families we met were not so lucky. To see a parent express joy and love in the face of such long and terrible odds is a truly unique experience. I myself am a measurably better parent for having witnessed it.
- aculver 14y ago
  Great thoughts. Very happy for your family that you came through this successfully. Lots to be thankful for there. So, I've seen a couple of your comments on HN in the past, and just wanted to mention it would be helpful if you had some contact information (e.g. Twitter, URL, etc.) in your HN profile so people can follow-up one-on-one when it makes sense to do so. Unless, of course, you're trying to avoid people. :-)
citricsquid 14y ago
He described her as a "previously healthy 50 year-old daughter" and then she went from feeling weird to death in a month? I had no idea cancer could be so aggressive, is it 1 in a million that it can be this aggressive (from showing symptoms to death) or is this something common? This would explain why early diagnosis is so emphasised, I still didn't understand how much it could matter.
- colmvp 14y ago
  It's also possible she experienced minor symptoms earlier but ignored them, associating them with aging or random stuff humans endure.
- jaggederest 14y ago
  Cancer can absolutely be that aggressive, and many of your internal organs don't have the sorts of pain and proprioception sensors we think of from our experience interacting with the world through our skin. It's possible to have twenty small tumors throughout your body, causing no real issue, and then shortly thereafter they continue growing enough to impinge nerves, blood vessels, airways... And you're suddenly diagnosed with stage IV cancer.
- stcredzero 14y ago
  > He described her as a "previously healthy 50 year-old daughter" and then she went from feeling weird to death in a month? I had no idea cancer could be so aggressive, is it 1 in a million that it can be this aggressive (from showing symptoms to death) or is this something common? Up til just a decade ago, certain kinds of pancreatic cancer could kill you in as little as 2 weeks after diagnosis. I wouldn't be surprised if this was still the case. Also, my understanding is that sudden early death from cancer is fairly rare, but yes, it can happen.
- tisme 14y ago
  I lost a friend (55) to a brain tumour. From initial diagnosis to funeral: 17 days. His last words to me were 'I'm going to fight this thing'. He never stood a chance.
- mturmon 14y ago
VBprogrammer 14y ago
I don't want to de-rail the conversation too much but this line brought home to me one of the most sickening injustices of the civilised world - “When the chemotherapy does not work, you will have to finish the job.” No one should have to plead with their father to end their life early, this should be a choice that anyone can make without fear of consequence to their loved ones. This should be a well established and regulated part of terminal illness.
velar 14y ago
Effective treatment against cancer can be found outside the USA, not inside. Eg: See http://www.lef.org/magazine/mag2012/nov2012_Innovative_Laser_Therapy_01.htm http://www.lef.org/magazine/mag2012/nov2012_Innovative_Laser...
philwelch 14y ago
My father spent much of his last year of life in hospitals. It was a frustrating experience as well. As far as the expenses went, he had Medicare in addition to supplemental insurance as a retired Marine. So he paid nothing out of pocket. I can definitely understand how this would add to the frustration of the experience. A huge problem is that no one is actually in charge of a patient's treatment. The individual doctors were quite good, with maybe one or two exceptions, but there was never enough evidence of actual coordination between them for me to feel very confident. I saw him on a daily basis, but much of my time was spent staying on top of what half a dozen doctors and nurses were doing or planning to do at any given time and keeping everything coordinated. I worry about people who end up in the hospital without anyone else around to watch over them. Hospitalization can be a very frustrating and disorienting experience, especially for older patients. The thing about hospitalization is that it's essentially a form of captivity. You could write a good psychological horror story that took place in a hospital, and it wouldn't be too far from reality.
- Spooky23 14y ago
  I hate to say it, but hospitals need medical project managers. My wife had some minor complications after a C-Section. We must have recited our name, address, insurance provider, drug allergies, first pet's name, etc about 250 times during the 8 day stay. The older nurses rocked. The attending physician was someone we know well and rocked. Everyone else, from resident down to tech were not to be trusted. An incompetent tech burned my wife's arm by putting a blood pressure cuff wet with bleach. A resident waited until I went to grab breakfast to try to pressure her into a procedure that she didn't want.
  - wisty 14y ago
    > I hate to say it, but hospitals need medical project managers. They are called GPs, or internal physicians. Dr Cox (Scrubs) is an example. The new name is Hospitalist, I think (actually, there's a push to have this as a distinct specialty, so experienced non-specialists have a better development path). If you didn't have a doctor competently managing your case, it wasn't because no-one was responsible, but the doctor who should have been managing the case wasn't.
platz 14y ago
I suffered a mini-panic-attack halfway through reading this, and had put my head on the floor until the nausea passed.
fabiandesimone 14y ago
Oh wow, this brought back some painful memories. My mom died of lung cancer 3 years ago (in a third world country) I can't begin to tell you the things my family and me had to put up with.
lostlogin 14y ago
Your point number one occurred in New Zealand too. And the US is pressuring the NZ government to abandon its very successful drug purchasing agency as part of a free trade agreement. Having one agency purchase drugs for 4 million people creates a fair bit of bargaining power, which US companies do not like.
johnx123-up 14y ago
FWIW, my Indian friend says there's a medicine for cancer in South India with Siddha. When I searched http://en.wikipedia.org/wiki/Siddha_medicine http://en.wikipedia.org/wiki/Siddha_medicine some editors seem to have removed references to cancer from the article.
- confluence 14y ago
  Yeah, because it's complete bullshit. Leave your pseudoscience clap trap away from vulnerable people.
  - johnx123-up 14y ago
    I'll be happy to get more details on your reasoning. Do you have any bad experience with it?
    - matthewowen 14y ago
      We know how cancers work to a pretty good level of detail. This means that it can be fairly straightforward to classify many treatments as ineffective. The other point is that cancer research is incredibly well funded by non-partisan, non-commerical organisations (charities like Cancer Research UK don't have an active stake in one approach over another). The notion that these alternative remedies are being wilfully ignored doesn't stand up to any remotely rigorous evaluation.
      - johnx123-up 14y ago
        > We know how cancers work to a pretty good level of detail. IIRC, Steve Jobs was survived with alternative medicine for sometime than surgery. So, I'm more interested to know any research conducted on alternative medicines (to prove that they're wrong and ineffective). As it seems to work for Indians this can better be tried like yoga
        deleted 14y ago
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nnq 14y ago
Not to be insensitive (I've had a few encounters with cancer myself, from both the p.o.v. of a healthcare professional and from that of a relative/friend of a patient), but WHY is this on the front page of HN?! The story is (unfortunately) very typical and repeats time and time again in all parts of the world... but this type of description really brings no new information to "the anti-cancer game"... I know it touches everybody's emotions and stuff, but is this really the place to have these conversations?
newbie12 14y ago
We are all working on the wrong things. How can society not be spending far greater percentages of GDP on health care research? Yet the medical establishment, supported by Congress, operates as a guild that keeps people/innovation out, and the system wastes billions of dollars a year on futile treatments in the last year late in life, instead of finding cures.
sireat 14y ago
Selfish question here: can one actually screen reliably for most cancers from age 40 to say 60 and actually do something about it? That is say, do as complete as possible cancer screening every 3 months? The worst seem to be the ones like pancreatic cancer, you have a very little chance of catching it before it has spread. I just want to see my daughters grow up that is all.
gbeeson 14y ago
Great read and for myself, someone who is not part of the medical community though who is a father of a daughter, I can imagine the professional and personal frustration that must have been felt. Thanks for the write up - could not have been easy (even clinically) to put together.

324 points by jvilalta 14y ago

In the thankfully few times I've had to endure hospitals, I've always been struck by how unbelievable primitive what they're doing actually is. Sure there are some genuine technical miracles (dialasys, pacemakers, etc) but I always get the distinct impression that most of it is window dressing; a kind of theatre to make it seem like they're more in control and much less helpless than they really are.

justinph 14y ago
I've come to the same conclusion. "Modern" medicine is just marginal assistance to your body's own healing mechanisms.
- majorlazer 14y ago
  I sometimes begin to think the same way, and then I remember about these: http://futurity.org/wp-content/uploads/2009/11/oscar-pistorius2.jpg http://futurity.org/wp-content/uploads/2009/11/oscar-pistori... http://static.ddmcdn.com/gif/artificial-heart-abiocor-hand.jpg http://static.ddmcdn.com/gif/artificial-heart-abiocor-hand.j... https://www.23andme.com/ https://www.23andme.com/ http://www.guadalupemed.com/images/xray.jpg http://www.guadalupemed.com/images/xray.jpg http://www.eyeclinicpc.com/lasik/lasik%20steps1.jpg http://www.eyeclinicpc.com/lasik/lasik%20steps1.jpg http://www.piersondental.com/Portals/22078/images/rootcanal%20(1).jpg http://www.piersondental.com/Portals/22078/images/rootcanal%... http://www.bismarckfamilydental.com/dental-implants-bismarck-north-dakota-nd/images/dentalimplants.jpg http://www.bismarckfamilydental.com/dental-implants-bismarck... http://www.nidcd.nih.gov/staticresources/health/images/ear_coch.jpg http://www.nidcd.nih.gov/staticresources/health/images/ear_c... http://emedtravel.files.wordpress.com/2012/04/brain-mri-1.jpg http://emedtravel.files.wordpress.com/2012/04/brain-mri-1.jp... And that's just off the top of my head. I think modern medicine has advanced a lot more than we give it credit for. I know a lot of hackers tend to compare other industries to the tech field, and expect everything to advance at a rate like Moore's law, but that just isn't feasible in most fields.

jeffehobbs 14y ago

Heartbreaking. I hope for a cure for cancer in our lifetimes.

deleted 14y ago
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- deleted 14y ago
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sciurus 14y ago
There will never be a cure for cancer. There will be cures for cancers.
- ams6110 14y ago
  I would even say there will never be cures for cancers. There will be treatments.

maskedinvader 14y ago

very touching and heartbreaking read..

dandrews 14y ago

I was struck by the amount of care that was seemingly influenced by fear of litigation. An ambulance driver diverted to a closer e/r despite having a physician onboard. A nurse wouldn't sanction ice chips without the admitting physician's chop. Exhausting and time-consuming tests needlessly repeated. I once asked a veterinarian acquaintance of mine why he hadn't become a physician. "Wouldn't you rather drive something fancier than that pickup truck?" I needled, gesturing out the window at his old F150. "Yeah" he replied, "but those guys spend most of their time doing paperwork. I get to practice medicine."

hkmurakami 14y ago
>I once asked a veterinarian acquaintance of mine why he hadn't become a physician. "Wouldn't you rather drive something fancier than that pickup truck?" I needled, gesturing out the window at his old F150. "Yeah" he replied, "but those guys spend most of their time doing paperwork. I get to practice medicine." That is an amazing (albeit gravely unfortunate) quote. I'm going to share it with some friends who are studying to become vets themselves (I hope that's alright with you). Thanks for sharing the anecdote :).
- brown9-2 14y ago
  Unfortunate how? Based on the choice of car?
  - rrouse 14y ago
    Unfortunate that human doctors have to spend so much time doing paperwork
    - ams6110 14y ago
      Not all do. There are a few who have opted out of the insurance-based system. They run cash practices, and from what I've heard are able to spend more time with patients and charge them less because of the breathtaking amount of overhead they've eliminated.
14y ago

jostmey 14y ago

An awesome book titled "The lives of a cell" by "Thomas Lewis" delved into the problems of Medicine (among other things) in the later 70s. He was amazingly prescient about the problems that Medicine faces today. He also offered some wonderful solutions for fixing Medicine.

aaronharnly 14y ago
Just to note, I think you mean Lewis Thomas, namesake of Princeton's Lewis Thomas Laboratory.
ecliptic 14y ago
"The Lives of a Cell" by Lewis Thomas is a tremendous book, pulling back the curtain on biology. Clear, concise and well written, very similar to Feynman with physics.

enduser 14y ago

I lost my sister to cancer 9 years ago when she was in her early 20s and I was in my teens. Her experience with the medical system was humiliating, futile, and expensive. My parents have never fully recovered emotionally. It has taken me years to integrate the experience, and I still have ghastly memories of the pains she endured recovering from unnecessary surgeries. When I read something like this i feel how much I would like to see a change. It's only partly a techological change--it is also imporant for us as a people to let go when nothing can be done, not to make things worse out of a need to be seen doing something. Unfortunately when a panicked parent is demanding that something be done to save their child, someone will be willing to do something even if the first person knows that nothing can be done. When it is my time to die I intend to fully engage with the experience of dying, and not to numb the experience with knife wounds, drugs, and over-stimulating hospitals. Until then I intend every day to live fully, with great sensitivity, and to remember that each day I live is one my sister did not have. There is no entitlement to health or longevity; some things cannot be predicted nor controlled.

guylhem 14y ago
> "it is also imporant for us as a people to let go when nothing can be done, not to make things worse out of a need to be seen doing something" In the case of cancer, universal care unfortunately seems like running in the opposite direction. Sometimes admitting that nothing can be done is the right thing. Look at the case description - I wouldn't be surprised if the total bill was at least between 100k and 200k - for 20 days of useless care which ultimately resulted in the patient death. There are some good economical analysis showing yearly cost that'll make you cry, especially if you consider the alternative uses of that money and how many lives could be saved - say in other countries. With our current technology, universal healthcare for fighting cancer seems like trying to stop a fire with gasoline.
- niels_olson 14y ago
  > universal healthcare for fighting cancer seems like trying to stop a fire with gasoline Tell that to the unemployed dad whom, twenty minutes ago, I directed to take his son to the ENT. He has had a swollen left tonsil for 5 years (last time he saw his pediatrician). Now he presents with 1 day of left ear pain. There's a mass hanging off his ear drum. Cholesteatoma? Unlikely. Maybe bullous myringitis. But at this point this kid's whole left pharynx is suspect and 5 years of infection starts one thinking about scary things.

akg_67 14y ago

Very sad and heart-breaking. While reading the story, I couldn't stop imagining myself in his daughter's shoes and wondering "what would I do if I was in her place?" Would I struggle and suffer in the hopes of living a few months longer or accept the fate and go in peace sooner. This reminded me of discussion with my wife during will preparation about how long should I be kept alive before plug is pulled.

brudgers 14y ago

Stage four cancer? These are things I've learned from almost twenty years as a "hospice spouse." It's probably time to call hospice, not the "We can beat this oncologist." It's probably time to write a living will and a sign the DNR. It's probably time to decide how and where you want to die. It's most assuredly time to decide how you want to live the rest of your life.

SoftwareMaven 14y ago
Not always. I know a guy who has been living with stage four colon cancer for four years who, recently, has seen his tumors contracting for the first time ever. So while I agree that you need to identify a point where you say, "Let me die in peace", I don't think that point is always the day you've been told you have stage 4 cancer. I'm not sure that the 20 days reference in the article is really time to come to terms with that.
- refurb 14y ago
  This is truly the problem with evidence based medicine. You can say how a given treatment will impact a population (i.e. 1 out of 100 patients with stage 4 colon cancer will survive past 6 months) and say it's not worth it, but when you're talking to a single patient, you don't know what the outcome will be. Maybe the treatment will be in vain or maybe he or she will be the one patient that goes into complete remission. What do you do then?
- gus_massa 14y ago
  It depends on where the tumors are located. For metastasis brain tumors the life expectancy is approximately one year. http://www.nlm.nih.gov/medlineplus/ency/article/000769.htm http://www.nlm.nih.gov/medlineplus/ency/article/000769.htm

VMG 14y ago

Very sad, very scary. What is the cost-benefit ratio for a routine MRI scan every six months?

niels_olson 14y ago
Whole-body MRI? Several thousand dollars just for the scan. The radiologist's interpretation typically costs as much. We haven't even begun to talk about resultant interventions. Eat less and exercise more is a lot cheaper and more effective.
- lostlogin 14y ago
  Where I work, about $700 US. It's not a great test, despite excellent radiologists and brand new equipment as whole body imaging is far lower resolution than localized imaging (its about 1500 pixels by 250 in resolution versus 512x512 when just your knee is done using an educated guess).
mdonahoe 14y ago
This. This is the cure for cancer we need: affordable routine scans. Though more scans means more results for doctors to analyze. Hopefully algorithms can make that part cheaper too.
- tisme 14y ago
  No. Affordable routine scans will result in massive overloading of the health system with unnecessary procedures, and the complications arising from those procedures will kill more people than would have died otherwise from whatever shows up on those scans. There is no such thing as an intervention without risk, and that starts with the risks associated with general anaesthesia. Scanning is one thing, interpreting a scan and deciding when and where to intervene is something that does not scale well at our current level of technology. Basically it needs a human to sit down and spend time analysing the scan to make sure that what is there warrants intervention. So even if the scan costs would drop to 0 you'd still have the component of the interpretation to deal with. The end result of overloading the system like this is that those with symptoms that need care are less likely to receive it or receive it timely, and that those that didn't need the care will suffer from complications. Knowing when to scan and when not to scan is a crucial ingredient in giving good care.

tokenadult 14y ago

Steven D. Levitt's father Michael Levitt http://www.med.umn.edu/gi/faculty/vamc/home.html http://www.med.umn.edu/gi/faculty/vamc/home.html http://www.mayoclinic.org/news2009-rst/5207.html http://www.mayoclinic.org/news2009-rst/5207.html is a medical doctor and academic researcher in medicine at the University of Minnesota. I used to file his grant applications into the office file drawers as a duty of my part-time job while pursuing my undergraduate degree. Michael Levitt is perhaps the world's leading authority on intestinal gas and still has an active research program in diseases of the human bowel. He indeed has seen many patients at a research hospital over the years, the same hospital where my mother worked as a nurse for most of her career. Dr. Levitt writes in the submitted article, "Overnight admission to the hospital is recommended for 'observation' and rest prior to the trip home. Fifty years of experience have taught me that admission to an academic hospital is not restful. I have stopped counting the patients who want to be discharged to get some rest." I have an immediate family member who was given excellent care at the same academic hospital Dr. Levitt knows so well. My relative is in excellent health now decades after that treatment. But indeed, even with best care, the patient experience at a research hospital is not restful, as world experts on the patient's case vie with medical students and a variety of other health science trainees and practitioners to learn from the patient. When a case is puzzling, as was the case of my relative, research-oriented practitioners are curious about how to understand the case, trying to find established, verified practice to help the patient, and otherwise working "empirically" (an ominous word--to me--used by my relative's main doctor to describe a procedure he attempted when he wasn't sure what to do next) to do whatever they can to help. As the father of a daughter, I can hardly imagine a rougher kind of news to hear. Another immediate relative lost a fiancee to cancer years ago, and that relative's memories of that time are full of frustration. The various kinds of cancer are still so varied--as mentioned in the article--that there is essentially NIL prospect of ever having a general treatment that will be an effective first-line treatment for most forms of cancer. Instead, there will continue to be surgical treatment for come cancers, a growing variety of chemotherapies for a variety of cancers, in the best luck genome-matched to vulnerable cancer cell strains, and radiation treatment for other cancers. Ultimately, though, we will all have to learn to die better, http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how-doctors-die/read/nexus/ http://zocalopublicsquare.org/thepublicsquare/2011/11/30/how... because we will all eventually die of something. Meanwhile, if you are a parent, this submission is a reminder to cherish your children while they are here, and if you are a medical researcher, as Michael Levitt is, this is a reminder to continue to strive for better understanding of health and disease, while remembering the patient experience as new tests and treatments are devised.

thrwaway1 14y ago

This reminds me of the story of Dr. Ben Carson, a famous neurosurgeon who also teaches oncology at John Hopkins. In 2002, he was diagnosed with prostate cancer and successfully underwent traditional treatment. However, Dr. Carson has stated publicly, both at conferences and on radio interviews, that he believes he was largely cured by a controversial holistic treatment called glyconutrients. However, due to legal liabilities on the company's part, they banned all testimonials and would threaten lawsuits to anyone who publicized this information. 20/20 did a story on glyconutrients, disproving them based on glycobiologist Dr. Ronald Schnaar from John Hopkins School of Medicine. Dr. Schnaar said, "All of the sugar building blocks that we need in our body are made from the most common foods we eat." Contrary to this, Dr. Carson says we do not get these simple sugars from our natural diet and said that his family, his employees and everyone he knows uses glyconutrients with great results. He said he considered not having traditional surgery but he didn't want others mistakenly following his path to the detriment of their health. Dr. Carson is not a glycobiologist. However, he is the Director of Pediatric Neurosurgery at John Hopkins and a colleague of Dr. Schanaar. He's been awarded the Presidential Medal of Freedom and had a film made about his life story starring Cuba Gooding Jr. But none of this information about his alternative cancer treatment is widely known. Not one word on his Wikipedia page (http://en.wikipedia.org/wiki/Ben_Carson http://en.wikipedia.org/wiki/Ben_Carson) nor on the page about glyconutrients. It's disappointing there's no unbiased scientific research to explain what is factually true. And it's unbelievable that such a high profile cancer survivor could make these claims with virtually no one knowing. Dr. Carson's speech http://www.youtube.com/watch?v=ROzftYwJihg http://www.youtube.com/watch?v=ROzftYwJihg Dr. Carson's Story in the Dallas Weekly http://glyconutrientsarevital.blogspot.com/2006/08/dr-ben-carson-glyconutrients.html http://glyconutrientsarevital.blogspot.com/2006/08/dr-ben-ca... Related Local News story on Baby Hadley http://www.youtube.com/watch?v=oK3U4mrqslk http://www.youtube.com/watch?v=oK3U4mrqslk

guard-of-terra 14y ago
As far as I (IANAD) understand, there is no such thing as an universal cure for cancer. If and when we beat cancer, the solution will not present itself as a magic pill. Therefore for any instance of magic pills (glyconutrients included) we can infer that it won't cure cancer with any reliability. You can have a narrow tool that strikes one kind of cancer and does nothing (or even harms a little) on all others, or we can have something that comforts you a bit but without much statistical outcome. If you have malignant cells dividing inside you, they would not be easily stopped. Trying to self-medicate a random cancer with a random magic pill will likely yield no result at all - or maybe only from Placebo effect. Therefore if you're at earlier stage, your best bet is conventional treatment, and if you're at late stage, it might be better to spend the remaining time wisely.

javajosh 14y ago

>The purpose of this brief chronicle is not to criticize the practice of medicine. Perhaps that wasn't his purpose, but that was the result. And it is a scathing, justified criticism, especially coming from an experienced doctor. My father died of lung cancer, and we went through similar experiences with the health care system. Before claiming that something is not a criticism, we have to ask whether or not we can imagine a better outcome, ask what is getting in the way of that outcome, and then make a change. This could be something small, like moving patients around less, and with less resistance. (The purely informational resistance in medical care is appalling, and this story shows it's real human cost. Electronic patient records is not about assuaging "people who can't be bothered to fill out forms".) Or it could be something huge, like revolutionizing what late-stage cancer patients, and their families, expect, and how they will be treated. If you get late-stage cancer, the health insurance company should hand you $100,000 in cash, a large supply of morphine that can be easily self-administered, and a ticket to Hawaii. Huge bag of weed optional. The message is clear: you're going to die soon, so make your peace with it. Talk to your family. My father fought until he fell unconscious, his personality ravaged by whole-brain radiation and chemo, in complete denial. He never got a change to face his sentence with courage, and he never really talked to me before he died. So yes, the practice of medicine needs to be criticized.

jaggederest 14y ago
I also tend to think that the word 'criticism' is linked with a negative aspect that is undeserved. Consider a glowing movie review that is thorough and thoughtful - certainly criticism, but in no way negative.

mcmatterson 14y ago

This hits close to home. I came within a hair's breadth of losing my infant daughter to cancer just over a year ago, and a few things come up in my thoughts: - Not all medical systems are the disaster described here. We elected to move back from the US to our native Canada to undergo treatment, and our experience in ward (pre and post-op as well as on the oncology floor) was a dream (at least given the circumstances). We experienced nothing but exemplary inter-disciplinary cooperation, compassion for the patient (and family) experience, and a professionalism driven by clinical need rather than liti-mitigation. These qualities were exhibited even more strongly during the initial phases of treatment post-discovery, which unfolded along a timeline similar to the one discussed here. - Academic hospitals are exhausting. My spouse ended up being the real hero in this story (she was still breastfeeding at the time, and only one parent was allowed to overnight in the room). My job was to make sure she and our daughter had recovered enough each day to make it through a night of vitals, endless beeping, and the occasional overnight chemo administration (don't even get me started about that). - The need for patients and their families to drive the narrative of their hospital experience and be their own champion is critical. I had worked in healthcare for many years before this nightmare began (my old office was at the hospital across the street from her room) and knew the system very, very well. We divided up responsibilities so 'I looked outward, and [my spouse] looked inward', meaning that I spent my time making sure that the relevant referrals happened, that medications were administered on time and on dose, and so on. My wife looked inwards towards our daughter, making sure she was fed, entertained, and comfortable. This setup worked very well for us, and was a likely contributor to our level of care. - The power of parents to be strong in the face of terrible (often inevitable) odds is truly inspiring. We were lucky enough to know with reasonable certainty fairly early on that we would one day be leaving the hospital and resuming a normal life. Many, many families we met were not so lucky. To see a parent express joy and love in the face of such long and terrible odds is a truly unique experience. I myself am a measurably better parent for having witnessed it.

aculver 14y ago
Great thoughts. Very happy for your family that you came through this successfully. Lots to be thankful for there. So, I've seen a couple of your comments on HN in the past, and just wanted to mention it would be helpful if you had some contact information (e.g. Twitter, URL, etc.) in your HN profile so people can follow-up one-on-one when it makes sense to do so. Unless, of course, you're trying to avoid people. :-)

citricsquid 14y ago

He described her as a "previously healthy 50 year-old daughter" and then she went from feeling weird to death in a month? I had no idea cancer could be so aggressive, is it 1 in a million that it can be this aggressive (from showing symptoms to death) or is this something common? This would explain why early diagnosis is so emphasised, I still didn't understand how much it could matter.

colmvp 14y ago
It's also possible she experienced minor symptoms earlier but ignored them, associating them with aging or random stuff humans endure.
jaggederest 14y ago
Cancer can absolutely be that aggressive, and many of your internal organs don't have the sorts of pain and proprioception sensors we think of from our experience interacting with the world through our skin. It's possible to have twenty small tumors throughout your body, causing no real issue, and then shortly thereafter they continue growing enough to impinge nerves, blood vessels, airways... And you're suddenly diagnosed with stage IV cancer.
stcredzero 14y ago
> He described her as a "previously healthy 50 year-old daughter" and then she went from feeling weird to death in a month? I had no idea cancer could be so aggressive, is it 1 in a million that it can be this aggressive (from showing symptoms to death) or is this something common? Up til just a decade ago, certain kinds of pancreatic cancer could kill you in as little as 2 weeks after diagnosis. I wouldn't be surprised if this was still the case. Also, my understanding is that sudden early death from cancer is fairly rare, but yes, it can happen.
tisme 14y ago
I lost a friend (55) to a brain tumour. From initial diagnosis to funeral: 17 days. His last words to me were 'I'm going to fight this thing'. He never stood a chance.
mturmon 14y ago

VBprogrammer 14y ago

I don't want to de-rail the conversation too much but this line brought home to me one of the most sickening injustices of the civilised world - “When the chemotherapy does not work, you will have to finish the job.” No one should have to plead with their father to end their life early, this should be a choice that anyone can make without fear of consequence to their loved ones. This should be a well established and regulated part of terminal illness.

velar 14y ago

Effective treatment against cancer can be found outside the USA, not inside. Eg: See http://www.lef.org/magazine/mag2012/nov2012_Innovative_Laser_Therapy_01.htm http://www.lef.org/magazine/mag2012/nov2012_Innovative_Laser...

philwelch 14y ago

My father spent much of his last year of life in hospitals. It was a frustrating experience as well. As far as the expenses went, he had Medicare in addition to supplemental insurance as a retired Marine. So he paid nothing out of pocket. I can definitely understand how this would add to the frustration of the experience. A huge problem is that no one is actually in charge of a patient's treatment. The individual doctors were quite good, with maybe one or two exceptions, but there was never enough evidence of actual coordination between them for me to feel very confident. I saw him on a daily basis, but much of my time was spent staying on top of what half a dozen doctors and nurses were doing or planning to do at any given time and keeping everything coordinated. I worry about people who end up in the hospital without anyone else around to watch over them. Hospitalization can be a very frustrating and disorienting experience, especially for older patients. The thing about hospitalization is that it's essentially a form of captivity. You could write a good psychological horror story that took place in a hospital, and it wouldn't be too far from reality.

Spooky23 14y ago
I hate to say it, but hospitals need medical project managers. My wife had some minor complications after a C-Section. We must have recited our name, address, insurance provider, drug allergies, first pet's name, etc about 250 times during the 8 day stay. The older nurses rocked. The attending physician was someone we know well and rocked. Everyone else, from resident down to tech were not to be trusted. An incompetent tech burned my wife's arm by putting a blood pressure cuff wet with bleach. A resident waited until I went to grab breakfast to try to pressure her into a procedure that she didn't want.
- wisty 14y ago
  > I hate to say it, but hospitals need medical project managers. They are called GPs, or internal physicians. Dr Cox (Scrubs) is an example. The new name is Hospitalist, I think (actually, there's a push to have this as a distinct specialty, so experienced non-specialists have a better development path). If you didn't have a doctor competently managing your case, it wasn't because no-one was responsible, but the doctor who should have been managing the case wasn't.

platz 14y ago

I suffered a mini-panic-attack halfway through reading this, and had put my head on the floor until the nausea passed.

fabiandesimone 14y ago

Oh wow, this brought back some painful memories. My mom died of lung cancer 3 years ago (in a third world country) I can't begin to tell you the things my family and me had to put up with.

lostlogin 14y ago

Your point number one occurred in New Zealand too. And the US is pressuring the NZ government to abandon its very successful drug purchasing agency as part of a free trade agreement. Having one agency purchase drugs for 4 million people creates a fair bit of bargaining power, which US companies do not like.

johnx123-up 14y ago

FWIW, my Indian friend says there's a medicine for cancer in South India with Siddha. When I searched http://en.wikipedia.org/wiki/Siddha_medicine http://en.wikipedia.org/wiki/Siddha_medicine some editors seem to have removed references to cancer from the article.

confluence 14y ago
Yeah, because it's complete bullshit. Leave your pseudoscience clap trap away from vulnerable people.
- johnx123-up 14y ago
  I'll be happy to get more details on your reasoning. Do you have any bad experience with it?
  - matthewowen 14y ago
    We know how cancers work to a pretty good level of detail. This means that it can be fairly straightforward to classify many treatments as ineffective. The other point is that cancer research is incredibly well funded by non-partisan, non-commerical organisations (charities like Cancer Research UK don't have an active stake in one approach over another). The notion that these alternative remedies are being wilfully ignored doesn't stand up to any remotely rigorous evaluation.
    - johnx123-up 14y ago
      > We know how cancers work to a pretty good level of detail. IIRC, Steve Jobs was survived with alternative medicine for sometime than surgery. So, I'm more interested to know any research conducted on alternative medicines (to prove that they're wrong and ineffective). As it seems to work for Indians this can better be tried like yoga
      - deleted 14y ago
        [deleted]

nnq 14y ago

Not to be insensitive (I've had a few encounters with cancer myself, from both the p.o.v. of a healthcare professional and from that of a relative/friend of a patient), but WHY is this on the front page of HN?! The story is (unfortunately) very typical and repeats time and time again in all parts of the world... but this type of description really brings no new information to "the anti-cancer game"... I know it touches everybody's emotions and stuff, but is this really the place to have these conversations?

newbie12 14y ago

We are all working on the wrong things. How can society not be spending far greater percentages of GDP on health care research? Yet the medical establishment, supported by Congress, operates as a guild that keeps people/innovation out, and the system wastes billions of dollars a year on futile treatments in the last year late in life, instead of finding cures.

sireat 14y ago

Selfish question here: can one actually screen reliably for most cancers from age 40 to say 60 and actually do something about it? That is say, do as complete as possible cancer screening every 3 months? The worst seem to be the ones like pancreatic cancer, you have a very little chance of catching it before it has spread. I just want to see my daughters grow up that is all.

gbeeson 14y ago

Great read and for myself, someone who is not part of the medical community though who is a father of a daughter, I can imagine the professional and personal frustration that must have been felt. Thanks for the write up - could not have been easy (even clinically) to put together.