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A Piece of My Mind
April 16, 2019

Casting

Author Affiliations
  • 1Department of Otolaryngology, Massachusetts Eye and Ear, Boston
JAMA. 2019;321(15):1455-1456. doi:10.1001/jama.2019.3954

It’s 3 am and I’ve just put my feet up in the on-call room when my beeper chirps. “Miss Nancy is worried about her tongue,” reads the message. “She thinks it is more swollen.”

I have cared for Nancy for months, through several small procedures to remove cancers from her mouth. When the cancer recurred, she underwent a much larger surgery—a so-called big whack—and one that I worried about, given her age. But she breezed through the recovery and went home without a tracheotomy, eating a normal diet within a week. In the world of head and neck cancer this was a huge victory. But the victory was to be short-lived: soon her disease multiplied with newfound virulence, eating away at her tongue, threatening to erode through the skin on her neck, as if galvanized by our efforts.

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