It's not good social media practice, in general, and it can seem unbecoming of a physician speaking in a public forum.
But allow me to explain
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I am angry because I took an oath to protect my patients and everyday I see them needlessly endangered.
It has never been hard to keep them healthy (says the doctor who is routinely -- understandably?! -- accused of being a poisoner).
I am angry because I have sat by the bedside of a dying patient who, other than her healthcare workers, would have been alone in the hospital at her last breaths. The separation from her loved ones was, at first, necessary but hopefully temporary, then became permanent & gaping.
Today, during an #ASCO20 clinical science symposium, I'm honored to comment as a patient-physician on the meaning of drug development for rare diseases
Inspired by @DavidFajgenbaum (but not half the man he is) I am going to share my own story
It started with a call from the embassy.
We were moving to the U.S. and needed chest X-rays to exclude TB.
My father's CXR showed no concerning cavitation, but his right hemithorax was mysteriously opacified 👇
Within two weeks of arriving in Texas we had secured a cardiothoracic surgeon and my father then underwent a right pneumonectomy. It was an R2 resection and we were told he would need radiation to "lung cancer" remnant in the mediastinum. XRT was brutal and led to esophagitis.
You can also complete a POLST form (Physician's Orders for Life-Sustaining Treatment). This is not synonymous with an advance directive, and again varies from state to state.
Surely now is the time in America to uncouple employment and healthcare coverage.
In fact, it's long overdue ...
THREAD
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For years now, cancer patients have faced double jeopardy: their malignancies have endangered their ability to carry out their pre-morbid jobs, and when they lose those benefits, their treatments become financially toxic, often to the point of bankruptcy.
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This is seldom a matter of just forsaking luxuries. I have seen patients struggle to pay their electric bill vs. obtain life-preserving medication.
Through twisted logic, they are sick enough to need treatment, but too sick to maintain the jobs that cover that treatment.
3/
Walk with me, won't you, through a thought experiment THREAD
I awake to find a tiger in my house 1/
Perhaps later, at a less alarming moment, I might concern myself with where the tiger came from. But for now I am most preoccupied with the tiger that is -- let's not forget -- NOW IN MY HOUSE.
I would not care if it were, for instance, a Bengali tiger vs. a Siberian tiger. 2/
No, at this time, the Asian provenance of the tiger is not my main issue, which remains its presence IN MY HOUSE.
Oh I have just noticed it is a tigress, about to deliver a litter of baby tigers and multiply my problem several-fold; the more cubs, the worse off I will be! 3/