Losing weight is hard - success might signal that something else is wrong.
As anyone who has been through medical training will tell you, some little scenes just stick with you. I had been seeing a patient in our resident clinic in West Philly for a couple of years. She was in her mid-60s with diabetes and hypertension and a distant smoking history. She was overweight, and had been trying to improve her diet and lose weight since I started seeing her without much luck. One day she came in and was delighted to report she had finally started shedding some pounds - about 15 in the last two months.
I enthusiastically told my preceptor that my careful dietary counseling had finally done the job. She looked through the chart for a moment and said… yeah… is she up to date on her cancer screening? A workup revealed adenocarcinoma of the lung. She did well, actually, but the story… you know… stuck with me.
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