Old Puzzles, Busy Guys and New Science

Elaine Waples

I am a two year cancer survivor, in remission, feeling good, and focusing on a quality of life that I perhaps took all too much for granted in the past. But like all cancer survivors, I worry about what may be happening inside my body where mutant cells and dormant micro-tumors might be taking up their opportunistic work again. I try not to dwell on it, but there is the ever-present question about what to do if there is a recurrence.

My husband and I have learned that cancers – even cancers with the same name – behave differently before and after treatment. While our doctors help us through the storms of illness, it is unreasonable to expect them to constantly research all possibilities in a world of head-spinning new science.

Cancer Survivor on N-of-One’s Direct-to-Patient Ombudsman Model

Kevin Davies

Posted 5/31/12 on Bio-IT World

The long-term success of N-of-One, a Waltham Mass.-based company offering personalized cancer information, will undoubtedly be shaped by the vision of its newly appointed CEO, Christine Cournoyer, and strategic partnerships with companies like Foundation Medicine, announced this week.

But ultimately it comes down to whether the company’s original direct-to-patient strategy works for cancer patients like Elaine Waples.

Four Perfect Questions

Elaine Waples

Posted 4/07/12 on Care & Cost

In the fall of 2010, Atul Gawande, surgeon at Brigham and Women’s Hospital in Boston and an associate professor at Harvard Medical School, delivered a touching speech at the October New Yorker Festival.  My husband attended with a friend and, because he said it so profoundly impacted the audience, I watched it myself on video the next day. It was indeed amazing. Dr. Gawande, author and national health care presence, spoke unabashedly about his lack of skill in conducting end-of-life conversations with his patients.

Marcus Welby, House and the Wizard of Oz

Elaine Waples

Posted 3/20/12 on Care & Cost

At a recent dinner party my husband and I joined two other couples in a lively discussion on the frustrations of American health care. We rounded up the usual suspects – cost, quality, access, politics, and broken systems. At some point the conversation took a subtle turn and we began to talk about the doctor-patient relationship.

Before long, I offered a comment that I probably wouldn’t have made before my last two years of serious doctor-going. I said that some patients want their doctors to be a combination of Marcus Welby, House and the Wizard of Oz.  They want a great bedside manner, a brilliant diagnosis, and a miraculous solution. And I suspect that doctors want their patients to be compliant, accept a possible imperfect outcome, and have enough insurance to cover it all.

Is My Cancer in the Wrong Body Part?

Elaine Waples

Recently, our city hosted the fifth annual national marathon to fight breast cancer.  This is not part of the Komen “race for the cure” but rather a grassroots effort that mushroomed from its inception five years ago into the impressive event it is today. Thousands of people participate as runners,  volunteers, and cheerleaders clad in the signature color.  I must admit, seeing some grown men run twenty six miles wearing pink tu-tus is both awe inspiring and a testament to dedication over self-image.

It’s supporters include corporate sponsors, vendors, and exhibitors, and (no surprise) pharmaceutical companies. Its originators are a local TV celebrity breast cancer survivor and a cancer physician at Mayo clinic. It promises to donate 100% of the money to breast cancer research or care. To date, the event has raised millions of dollars and has met its contribution promise. It’s all very worthy, noble and heartwarming.

Hello? It's Your Body Talking!

Elaine Waples

Posted 2/16/12 on Care & Cost

Our bodies are pretty savvy in sending us messages about taking care of ourselves.  Most of the time the messages are simple and informative.  Like when we’re tired, we get a signal that tells us to go to sleep.  Occasionally they are a slap on the head because we’ve done something stupid.  These come in the form of things like muscle strains, hangovers, or sunburns.  Then there are the warnings that alert us to things that just aren’t right.  They make up the lists of maladies we commonly refer to as symptoms. The real question is how much attention we pay to them and what we do about them.

My epiphany happened after my body had been delivering a cautionary message for over a year.  I was having some very annoying digestive problems following months of chemotherapy.  To put it politely, food was traveling through my system like an express train.   Since chemo is the granddaddy of side effects, I just assumed my system had been compromised and there wasn’t much to be done.  Nevertheless, every meal had me worried that I would spend some unpleasant time in the bathroom.  I didn’t want to eat out because almost all restaurant food caused misery.

Secret Shoppers: Needing A Weatherman To Know Which Way The Wind's Blowing

Brian Klepper

June 28, 2011

Every now and then, a well-intentioned administration does something relatively harmless but so hare-brained and openly foolish that it takes our breath away. The Obama Administration’s primary care “secret shopper” plan fit this bill, and has already been shelved due to the withering criticism. My inbox a couple days ago was filled with rants by physicians of all political persuasions marveling at the lameness of the idea.

Here’s a short description from Robert Pear’s article in Sunday’s New York Times.

The administration says the survey will address a “critical public policy problem”: the increasing shortage of primary care doctors, including specialists in internal medicine and family practice. It will also try to discover whether doctors are accepting patients with private insurance while turning away those in government health programs that pay lower reimbursement rates.