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5/17/2011 Bumps in the RoadThe best laid plans of mice and men often go awry.
-Robert Burns
Her eyes were lowered, and she would not meet my gaze. I was certain I knew why.
I skimmed her chart and reviewed my notes. “How have you been doing since your last clinic visit?” I asked. She finished her cancer treatment about a year ago and was doing fairly well. Her recovery was slow but steady. Her swallowing was gradually improving. Her weight was stable. She reported no new problems at the last few check-up visits. Everything was going fine except for one issue. Even after being treated for cancer, she had never been able to quit smoking.
Last time, she declared she was finally ready to quit. She decided she didn’t want to try any of the medications to help with smoking cessation. She didn’t need the Quit Line phone number (by the way, it is 1-800-QUITNOW). She knew smoking caused her cancer and was bad for her — no need for another lecture. She would just quit. She had a timetable all mapped out and made a solemn promise to quit later that month.
Now, about four months later, she was back for her next visit. I could smell the tobacco smoke on her clothes as I examined her.
“Still smoking?” I asked. “Ready to talk again about quitting?”
I was expecting the usual litany of excuses. Sometimes, people blame their families for leaving cigarettes around the house even when they are trying to quit. Sometimes, they say they were doing just fine until they went out with a friend for a drink or two. Most times, though, they never quite got around to quitting in the first place.
“I’m sorry, Doctor. I really am. I did quit for a few weeks but then started again.”
She paused and then continued.
“Remember the big guy with the Green Bay Packers jacket that always came to my appointments? My husband? Remember him? Well, he dropped dead of a heart attack about a month after I quit smoking. It has been a hard time; real hard. I went out and bought a pack of smokes the day of the funeral. Maybe I will quit again. I don’t know.”
We sat quietly for a while. My prepared speech was on hold. I had assumed she was not meeting my eyes because of her continued smoking. I had been wrong.
We talked about her husband and her family. I reassured her there was no sign of cancer. Encouraging her to quit smoking will have to wait for another day.  Share on FacebookPosted 8:25 AM 5/12/2011 Being "Oprah-ed"
I'm just trying like everybody else. I try to take every conflict, every experience, and learn from it. Life is never dull.
-Oprah Winfrey
She sits in the exam chair with a list of questions, her gray hair falling out from beneath her hat. I remember her from last year. At the time, I had spent time reassuring her that everything was fine and that she was at no risk for oral cavity cancer. "I just feel so much better when I hear you say that!" she tells me again. "You just never know. I’m certain that Michael Douglas never suspected he would get cancer, either!"
 Each May, we host a Head and Neck Cancer Screening event along with dozens of other hospitals and cancer centers around the country. In the early days, our nurse, Kathy, and I would set up our equipment in the corner of the sales floor at the former Small Stones store near the campus. The first year, we screened about 20 people. It was always fun (seeing healthy people always is), but we never identified anyone with cancer. The events are really a moment of community. Mostly, we answered questions about related (and very unrelated) topics.
That is not surprising, actually. Head and neck cancer is rare, with only 40,000 cases per year in the US. In addition, people who attend free public screenings tend to that take pretty good care of themselves and are not in the demographic most at risk for these cancers.
 Interest in our head and neck cancer screening event exploded this year. Michael Douglas, the most famous recent survivor of head and neck cancer was on Oprah two weeks ago and spread the word about the need for people to undergo screening, telling people to go to the website and call for an appointment at their local screening site.
Before the Oprah show, we had about 10 people registered for the event. Within two hours, there were 96. By noon the next day, we had 90 more on the waiting list. We cut off the list after that. It was, as they say, crazy. Our people whose phone numbers were linked to the event can confirm that the potential impact of the media is remarkable. Oprah’s support for this cause has, for the moment, raised awareness all over the country.
 Of the 100 registered, about 75 actually showed up to undergo screening, learn about dental issues, talk with experts about hearing loss, and discover a bit more about head and neck cancer. I do not think we identified any new cancers but more than a few people smiled when they were assured that everything looked fine. And almost everyone told us that it was all because of Oprah. Share on Facebook Posted 8:48 AM
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