December, 2015

In Memorium

By Michael J. Katin, MD

Our practice was preparing projections for 2016 when our attention was called to the November 3 publishing of a book entitled The Death of Cancer, by Dr. Vincent T. DeVita, Jr., and his daughter, Elizabeth DeVita-Raeburn. We immediately checked as to whether it would be possible to get refunds on our registration for the 2016 Multidisciplinary Head and Neck Cancer Symposium in February, and then to see who would be the first of us to get to the personnel office at Walmart before all the good jobs were gone Fortunately, someone actually checked the content of The Death of Cancer and the title, unfortunately, as with certain other books, is not to be taken literally.

We soon learned that, as was the case with Samuel Clemens, reports of The Death of Cancer were greatly exaggerated -- or something like that It would seem definitely premature to use the title The Death of Cancer when in 2015, it is estimated, cancer will have occurred in 1,658,370 Americans and killed 589,430. Is this tempting fate? It is to be recalled that Surgeon General William H. Stewart was reported to have said in the 1960's that "It is time to close the book on infectious diseases, and declare the war against pestilence won." In response to this arrogance, multidrug-resistant bacteria, HIV, and Ebola came into being -- among the great comebacks of all time.

Regardless of our cynicism, it should be recognized that this title was selected by one of the most prominent persons in the entire history of oncology, and if Dr. DeVita is willing to use that title, we should respect that. Since actually reading the book would take time I don't have, I must make assumptions that you might as well accept, at least until the movie version (Vin Diesel as fibrosarcoma? Justin Bieber as seminoma?) comes out.

I would have to presume that Dr. DeVita might have been both envious and resentful that Dr. Siddhartha Mukherjee wrote The Emperor of All Maladies in 2010, which won the Pulitzer Prize for General Non-Fiction and spawned a PBS series by Ken Burns and Barak Goodman. Dr. Mukherjee was born in 1970, just as Dr. DeVita was curing Hodgkin's Disease. Who better than Dr. DeVita to have written The Emperor of Maladies, subtitled A Biography of Cancer? Instead, as Dr. DeVita continued to contribute to the field of oncology and medical science in general, Dr. Mukherjee was writing the book and now is probably better known to the general public than Dr. DeVita.
Years ago, Michael Crichton generated a book named Five Patients, which any of us in residency could have written. All he did was, as a fourth year medical student, elaborate on the history and physical examinations and hospital courses of five patients at Massachusetts General Hospital. Whereas our efforts went into the medical record abyss, Dr. Crichton's went onto the best seller list, and years later he was a multimillionaire entertainment celebrity and we were just working stiffs. Dr. Mukherjee seems headed for the same career trajectory. The DeVita book has now been written and time will eventually tell whether he will catch up with or surpass Dr. Mukherjee, Suzanne Somers, or Neal Barnard.

If we are to assume that Dr. DeVita's premise is that Cancer is on the ropes, it might be well to imagine how an obituary for this disease might appear:

    Cancer, a leading cause of death for the past 200 years was declared to have passed away on Tuesday, November 3, It was 4,500 years old.
    The cause was listed as a combination of continued scientific progress and promulgation of "healthy living tips" from the National Health Information Center and Office of Disease Prevention and Health Promotion of the U.S. Department of Health and Human Services.
    Cancer traveled extensively from its birthplace in Siberia, making its way to the Nile River Valley by 3200 years ago and thence throughout the entire world. Cancer initially was relatively unsuccessful due to competition from plague, malnutrition, and the Inquisition but later came into its own with increasing industrial development. Cancer was at its peak during the latter part of the 20th Century, particularly due to the widespread use of tobacco products. Never the undisputed overall Number One cause of death, cancer was dominant in certain demographic groups and usually was a leading contender in most categories. Cancer's gradual demise came with increasing medical knowledge, control of environmental exposure, avoidance of risk factors, and the efforts of Brian Williams, NBC News. Cancer is survived by its close relatives, fibrous dysplasia, monoclonal gammopathy, and carcinoma in situ.
    Services were held immediately following the announcement. Interment was on the grounds of the National Cancer Institute. Honorary pall bearers were Pestilence, Obesity, HIV, Boko Haram, Chipotle, Texting While Driving, and Climate Change. Mourners included the now-unemployed administrators of the American Society of Clinical Oncology, the American Society of Radiation Oncology, and the American Cancer Society, as well as the CEOs of Roche, Amgen, Novartis, and Celgene. In lieu of flowers, it is requested that high-fat-content confections and smoked meat products be donated to the Harry Chapin Food Bank.

Emanuel Countdown: The Emanuel Countdown will be suspended for several months, to be replaced by a tribute to each of the 23 persons currently seeking the position of President of the United States. The Emanuel Countdown will resume after the nominees of both parties have been selected. The clock, however, will still be running.

Marco Rubio (to the tune of Making Whoopee )
When Donald Trump
Begins to fade
Who will be waiting
To take the stage?
It's not surprising
His star is rising
He's Marco Rubio.

We all recall
His famous speech.
Too bad his drink
Was out of reach.
Now he's hydrating
Before debating
He's Marco Rubio.

Tea party got him started
Now he's with the RNC
Principles are important
But so's flexibility.

He signed up with
The Gang of Eight,
Then changed his mind
A little late.
There's disagreement
About what he meant
He's Marco Rubio.

The more it looks
Like he might win,
The others want
To do him in.
They're wanting answers
'Bout his finances.
He's Marco Rubio.

He loves the Senate
It's plain to see.
He casts a vote
He's out campaigning
That's why he's gaining.
He's Marco Rubio.

Marco's so young and handsome
Charming and smart and kind.
Pollsters should check how can some
Voters make up their minds.

Can he convince
That he can take
Out Hillary?
He's so delectable!
Is he electable?
He's Marco Rubio.