Just getting started

My friend Josh recently posted this editorial in the NYT about a woman’s recent cancer diagnosis and her family.  It’s a pretty powerful essay.

She does do a really good job at framing the “cancer experience.” The Just Being of it. I’ve worked with roughly a hundred or so patients on clinical trials and so much of the post diagnosis life becomes that. Even when you hit the five year mark or a complete response on your CTs.  There’s that very “neo buddist” live in the present moment thing that you’ll hear occasionally; I can’t imagine anything more miserable. Maybe it’s not so bad if you don’t have cancer, aren’t constantly thinking of what your family will do when you’re gone.  The blissful absurdity of human experience is ignoring our finite lives and the constant circles we make down the drain of them. The realizing of how much time we actually had and wasted is better left not thought about. Especially at the end.

I can appreciate the author’s catharsis here having seen it so many times.  I understand the importance of it (I even keep a copy of an old patient’s essay she wrote during her dignity therapy because it moved me so).

But I’d tell her we’re far from the end.  We’re just getting started.

Getting up and leaving

It was a gray Saturday morning, my first ever in San Diego, when I laid eyes on the Cancer Center.  Yeah, it was the weekend — but it was the reason I moved west.  It was an idea I had been chasing for almost 3,000 miles.  I needed to know it was real.

July 23rd, 2013

Three years later and this building takes on a whole new meaning for me.  When I look at the copper and glass I see a deepness behind it.  Something I couldn’t possibly respect when I first started, let alone know was there.

I needed to live through it first.  I needed to struggle, professionally and personally, to appreciate the miles later traveled by my shoes in clinic.  I needed to see failure after failure to value any victory, no matter how small.  I needed to hear the stories of those near their life’s end to finally hear my own; to listen to that narrative clear of noise.

I needed to go through all of that with others.  I needed crazy work days laughing with my team inside our cramped office.  Or long hours spent drafting manuscripts with my boss well into twilight.  And most importantly, to be side by side with the clinic staff, who gave me the privilege of helping out as best I could within their world.  Who took me for long walks rounding in the hospital, or down to the microscopes to show me secrets told only by blood slides.

I did not know that I was so empty to be so full1.

And now I’m just another transient shadow that used to walk across the halls, melted away by the following Californian dawn.  Honestly, I always was one.  Just another name written inside friends and colleagues or a string of letters spoken by patient charts and source documents.  I can only hope remembered fondly for the work it represents.

But with that new dawn there’s a new day ahead — for me, too.

(The Original) ET Team, #TheAvengers

I must help my neighbors grow good corn

I pulled this from Drug Monkey, an excellent addiction med research blog:

There was a farmer who grew excellent quality corn. Every year he won the award for the best grown corn. One year a newspaper reporter interviewed him and learned something interesting about how he grew it. The reporter discovered that the farmer shared his seed corn with his neighbors. “How can you afford to share your best seed corn with your neighbors when they are entering corn in competition with yours each year?” the reporter asked.

“Why sir,” said the farmer, “Didn’t you know? The wind picks up pollen from the ripening corn and swirls it from field to field. If my neighbors grow inferior corn, cross-pollination will steadily degrade the quality of my corn. If I am to grow good corn, I must help my neighbors grow good corn.”

A history of irresponsible dreams.

A history of irresponsible dreams. Browsing Quora, I found a really interesting series of responses to a posting discussing a Neil deGrasse Tyson quote (above link takes you to it).  Found some favorite quotes by Feynman and Popper tucked away in a response by contributor Robert Frost…   Take it from Richard Feynman:   “So there came […]

The effects of positive patient testimonials on PTSD treatment choice

I was part of the team that did data collection with the trauma-exposed community sample.   The take home message: navigating to the right options can be overwhelming if you’ve never had treatment for mental illness.  Positive treatment testimonials can help direct treatment naive patients to effective options (like prolonged exposure therapy) that might otherwise be obscured in the deluge of available alternatives (effective and otherwise).  Click the image to go to the full paper.


Despite the existence of effective treatment options for PTSD, these treatments are failing to reach those that stand to benefit from PTSD treatment. Understanding the processes underlying an individual’s treatment seeking behavior holds the potential for reducing treatment-seeking barriers. The current study investigates the effects that positive treatment testimonials have on decisions regarding PTSD treatment. An undergraduate (N = 439) and a trauma-exposed community (N = 203) sample were provided with videotaped treatment rationales for prolonged exposure (PE) and sertraline treatments of PTSD. Half of each sample also viewed testimonials, detailing a fictional patient’s treatment experience. All participants then chose among treatment options and rated the credibility of – and personal reactions toward – those options. Among treatment naïve undergraduates, testimonials increased the proportion choosing PE alone; and among treatment naïve members of the trauma-exposed community sample, testimonials increased the proportion choosing a combined PE plus sertraline treatment. These effects were not observed for those with prior history of either psychotherapeutic or pharmacological treatment. Major barriers exist that prevent individuals with PTSD from seeking treatment. For a critical unreached treatment sample, those who are treatment naïve, positive patient testimonials offer a mechanism in which to make effective treatments more appealing and accessible.