seldom smiles
March 2001

Dead Reckoning

By Michael J. Katin, MD

We have now reached the end of the first full month of the Bush Administration and our new President has already adressed a joint session of Congress and it is disappointing to note that the topic of Radiation Oncology has again been totally ignored in favor of tax cuts, Iraq, and even the Marc Rich pardon. We may finally have to recognize that the vast majority of the world doesn't give a rat's rump about what we do or what we think.

Two of the top stories from this month can help us to focus on the relative insignificance of what we do. First, if we start to get confident that we're actually making a dent in relieving human suffering, keep in mind that 1,100 people were killed in the recent earthquakes in El Salvador. That instantly overwhelms the number of people you have saved with radiation therapy. In fact, it may outnumber the people saved by any university department over the course of several years. And of course over one year there are more earthquakes, floods, volcanic eruptions, and other natural disasters than there are university departments, even counting those that aren't ACR or ACRO accredited.

Second, we are still suffering the aftershocks over the death of Dale Earnhardt, Sr. His accomplishments are too numerous to mention. He finished in the top 10 in Winston Cup points for twenty years. How much do we as oncologists owe to someone who contributed so much to keeping the name of a cigarette in the public consciousness? But the main point of my mentioning his tragic death is that one could be the greatest radiation oncologist in the history of our specialty, producing technical advances, publishing hundreds of papers, and training dozens of practitioners, and possibly, after all this, get an obituary of less than one column in the newspaper. Dale Earnhardt already has entire books about him available at supermarket check-out areas and convenience stores. Should that give us humility, or what?

But just to get a positive result from this tragic event, we should reflect that his death was not unexpected. He made his living driving cars at excessive speed in competitive situations, and was it such a mystery that he should eventually have been impacted by this? And when we get overly sensitive about producing side-effects from our treatment, we need to remember that the purpose of irradiation is to kill cells. Is it a mystery that innocent cells get damaged as well? Of course not. Or are we such proponents of ploidism that we feel that aneuploid cells are not deserving of survival and should be killed by the beam, whereas diploid cells should by divine right be spared of any consequences? No, that just couldn't happen. So Dale Earnhardt was just doing his job as best as he knew and had to obey the laws of physics just like any rookie. And the next time we get criticized for producing mucositis or dermatitis or any other -itis, just think about what Dale Earnhardt told us: "Get the hell out of the race car if you've got feathers on your legs or butt. Put a kerosense rag around your ankles so the ants won't climb up there and eat that candy ass."

I tried to put that on our letterhead but my associates took it off again. I'll try again after I get it translated into Latin.

email: mkatin@radiotherapy.com