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When Medical Advice Is Sought From Health Advocates, Not Physicians

It is happening several times a day now. The phone rings. I get stopped at Starbucks, or at the dog park, or at the supermarket. “My friend may have a brain tumor,” “I have been short of breath,” “I am tired all the time.”  Then come the questions: “What do you think I should do? Who should I see?”  I am not a doctor, but people are increasingly looking to me as if I were one. It’s a little daunting.

As you may know, I’ve been producing and/or hosting programs on medical topics for patients since the mid 1980’s. First it was erectile dysfunction, then breast surgery, then multiple sclerosis, cancer, diabetes – you name it, I’ve interviewed someone about it. Town meetings, live audio webcasts, radio shows, and videos. I feel like I’ve gone to med school two or three times. And like a med student I’ve worried common symptoms could mean the worst diagnosis. That headache could be too much coffee OR it could be a brain tumor. Feeling tired could be you are snoring and have sleep apnea OR you have leukemia.

A number of years ago, having just moved from Los Angeles to Seattle, Hollywood called. A friend sold a 5 day a week medical show to MGM and he needed wife/partner Esther and me to be producers. We were the ones who wrote what flashed on the screen when a patient described their symptoms to one of the real docs who were stars of the show “Group One Medical.”  “I have had some blood in my stool, the patient would say. Flash on the screen: could be hemorrhoids. Could be advanced colon cancer.  We walked around the home/office worrying about every ache and pain. I am told that’s just what med students do. The most mundane could be life-threatening. Read more »

*This blog post was originally published at Andrew's Blog*

A Nurse’s Guide To Heart Attacks

How do you know if you’re having a heart attack? Are you thinking about the classic Hollywood example?

Hollywood Loves Drama – Know the Signs of a Heart Attack

The classic example of a Hollywood heart attack is a person clutching their chest, gasping for a breath and falling to the ground.

After all, Hollywood is hot for drama, and when it comes to portraying a person having a heart attack, the exaggerated Hollywood version is far more riveting than a person sitting quietly wondering if their very slight arm discomfort is anything they should be concerned about.

The Hollywood version can be very misleading. Read more »

*This blog post was originally published at Health in 30*

Symptoms Are A Poor Screening Tool For Ovarian Cancer

Thanks to Toni Brayer for pointing out this new study on ovarian cancer symptoms published in the Journal of the National Cancer Institute.

This study confirms previous studies which found that ovarian cancer, long thought to be a silent disease in its early stages, does indeed have symptoms. The problem is that those symptoms – bloating, urinary frequency, pelvic pain, early satiety – are common, non-specific and, according to this new study, 99% of the time not due to an underlying ovarian cancer.

That’s good news, of course, for women with these symptoms. But bad news for those hoping for a means of early detection for ovarian cancer, since early symptom recognition is neither sensitive nor specific enough to be useful as a screening test on a population basis. Read more »

*This blog post was originally published at The Blog that Ate Manhattan*

Why Cancer Is Difficult To Detect


I sat with non-medical friends last night and the discussion turned to “health”, as it often does. One guy related the terrible story of a woman who went to her doctor with a certain pain which turned out to be cancer that had spread and she died within a week. The inevitable question; “How do you detect early cancer, so you can catch it and cure it?”

The answer I gave was less than satisfactory for my friends. In fact, they were a bit incredulous with the answer.

All cancer is genetic, in that it is caused by genes that change. Only a few types are inherited. Most cancers come from random mutations that develop in body cells during one’s lifetime – either as a mistake when cells are going through cell division or in response to injuries from environmental agents such as radiation or chemicals.

Different types of cancer show up differently in the body. We have screening tests for some types of cancer. We can detect early breast cancer with mammography. We detect early colon cancer with colonoscopy and hemocult stool tests. We do screening for cervical cancer with pap smears. Early prostate cancer can be detected with PSA, but it is not very specific. Skin cancers can be found early with visualization and biopsy.

What about brain cancer, testicular cancer, leukemia, sarcoma, lung cancer, ovarian cancer and a number of other less common malignancies? We have no screening tests for these diseases. Perhaps we will discover some gene test or imaging test or breath test in the future, but right now, a person would need to have symptoms that would point to the disease.

This is a scary thought for people…especially those who try to live healthy lives.

It is the randomness of life that has always made us feel vulnerable to things we cannot control.

*This blog post was originally published at EverythingHealth*

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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