Those three little words

I still remember the first time I said those three little words. Growing up in a loving Welsh family, I’d heard them said many times. But the first time they roll off your tongue will always be different. You try to choose your moment, but sometimes the words take you, and the listener, by surprise. If “I love you” are the three most important words in life, then “I don’t know” are the three most important in medicine. They’re also the most underused. Their power comes from admitting that doctors don’t, and can’t, know everything.


Some people should stop being screened for cancer. Convincing them isn’t always easy

The catch-cancer-early-save-a-life trope is a bit misleading: the benefit of some tests is smaller than I had initially thought. Say 1,000 women have biennial mammograms between the ages of 50 and 74. Those 12,000 mammograms would prevent seven deaths from breast cancer. Yearly PSA testing among 1,000 men between the ages of 55 and 69 would lead to one to two fewer deaths from prostate cancer. Yet many of these patients are wary when I broach the idea of stopping screening. More