As you said, Theresa, much to digest in your most recent posting. The point about having humility is well taken, as even in this age of evidence-based practice, much of what we offer (with some exception) comes from consensus. And as you point out, that can change over time. The other benefit of humility is it keeps us grounded with patients, especially when we are having difficult treatment conversations; we can be open as to what we do and don't know about what therapies are available.
As to vaccines, I am a fan as well; I struggled when I was practicing to make sure that my patients obtained what they needed, even if that meant having challenging conversations with resistant individuals. Flu vaccine for smokers was the worst, to the point where one patient challenged me to guarantee that he'd have no side effects. I told him that I couldn't do that, as all treatments have a certain amount of risk, but that I would call him at his house this evening to make sure he was OK. He accepted this, took the shot, and later that evening, I called him at home. When he gruffly answered the phone asking who was calling, I replied that it was his doctor, checking to see if he was dead. We both had a laugh over that, and the next time he needed the vaccine, I do recall it was an easier process. One caution: I had to learn how to use humor carefully with patients, remembering that you needed to know your audience, never be condescending or smug, and always operate with gentle kindness.
Wonderful column, Theresa! (And fantastic photo of you at the end!) It is so important to remain humble and willing to admit we’re wrong in all areas of life, but of course in medicine human lives are at stake. My brother narrowly missed having his tonsils removed when doctors discovered he had a mild clotting issue, which changed the risk-benefit calculation. But pretty much every relative in my parents’ generation had theirs out. Crazy!
Thank you, Theresa for your interesting newsletter and for sharing your experience with tamoxifen. I had a similar experience after my bone marrow transplant for AML leukemia. Several months after transplant, my doctor started me on gilteritnib for maintenance. It was a horrible drug causing elevated liver enzymes and severe muscle pains. I could not tolerate it so had to discontinue it. I just saw my doctor for a six-month check-up. He is wonderful. To his credit, he shared with me that recent studies indicated that this drug did not lead to a decrease in relapse. I am glad he shared this new information with me.
❤️🙏
As you said, Theresa, much to digest in your most recent posting. The point about having humility is well taken, as even in this age of evidence-based practice, much of what we offer (with some exception) comes from consensus. And as you point out, that can change over time. The other benefit of humility is it keeps us grounded with patients, especially when we are having difficult treatment conversations; we can be open as to what we do and don't know about what therapies are available.
As to vaccines, I am a fan as well; I struggled when I was practicing to make sure that my patients obtained what they needed, even if that meant having challenging conversations with resistant individuals. Flu vaccine for smokers was the worst, to the point where one patient challenged me to guarantee that he'd have no side effects. I told him that I couldn't do that, as all treatments have a certain amount of risk, but that I would call him at his house this evening to make sure he was OK. He accepted this, took the shot, and later that evening, I called him at home. When he gruffly answered the phone asking who was calling, I replied that it was his doctor, checking to see if he was dead. We both had a laugh over that, and the next time he needed the vaccine, I do recall it was an easier process. One caution: I had to learn how to use humor carefully with patients, remembering that you needed to know your audience, never be condescending or smug, and always operate with gentle kindness.
Wonderful column, Theresa! (And fantastic photo of you at the end!) It is so important to remain humble and willing to admit we’re wrong in all areas of life, but of course in medicine human lives are at stake. My brother narrowly missed having his tonsils removed when doctors discovered he had a mild clotting issue, which changed the risk-benefit calculation. But pretty much every relative in my parents’ generation had theirs out. Crazy!
Thank you, Theresa for your interesting newsletter and for sharing your experience with tamoxifen. I had a similar experience after my bone marrow transplant for AML leukemia. Several months after transplant, my doctor started me on gilteritnib for maintenance. It was a horrible drug causing elevated liver enzymes and severe muscle pains. I could not tolerate it so had to discontinue it. I just saw my doctor for a six-month check-up. He is wonderful. To his credit, he shared with me that recent studies indicated that this drug did not lead to a decrease in relapse. I am glad he shared this new information with me.
Thoughtful, heartfelt, and beneficial! Keep up the great work, Theresa.