I find this an interesting subject and one I have pondered over much of my career. As I already mentioned, I can easily see both sides of it Recognizing your position, I want to steel-man the other side, for sake of discussion I will argue that the ideal should be, even in 2026, that *all* cancer patients should be on a clinical trial. And I am solely going to focus on therapeutic intervention here. There are other interventions (like imaging, surveillance etc). But that is not the focus of my point here. For sake of discussion lets put aside greed, corruption, incompetence, poor trial design, as well as practical issues like access. These are of course normal aspects of human behavior and daily life, but for an aspirational goal, we can be idealistic. This is a goal, not a reality. One must recognize that what we consider “successful” treatment in oncology leaves much to be desired. For most “curable” cancers, treatment may require disfiguring surgery, difficult and sometimes lengthy courses of medical therapy (chemo, immune and other) and occasionally radiation, among other things. And what do we get for this? At best, roughly 90-95% cure rates for the most curable cancers. Even stage I lung cancer is sitting at 70-80% cure rates. Cure rates only go down from there for more advanced tumors We do not settle for 95% success in treating pneumonia, appendicitis, or many other diseases. We should not be resting on our laurels in oncology. We pay a high price for at best modest success rates. There is ample room for improvement and we will not see any improvement without clinical trials at every stage of these diseases. There is as much work to be done in improving cure rates, as reducing toxicity. It is a bit unfair to point to “evidence” as to whether or not one should consider a clinical trial. By definition, no data exists. That is the reason for the clinical trial. So how can one say that a “clinical trial” is “better” than standard of care as an aspirational goal, when no data exist? One thing to understand is that for a clinical trial to be approved and ethical, there must be equipoise (ideally determined by an impartial judge). Equipoise is a funny thing. It implies ~equivalence~ that a person should be equally happy to be assigned to ether side of a randomized trial. And yet … in most clinical trials, equipoise is acknowledged with a wink and a nod. No one, from the pharmaceutical company and their scientists, to the clinical investigator, to the patient enrolling in the trial, really thinks there is equipoise. They WANT and HOPE the exciting new drug will work. And yet, the majority of new drugs do not eventually get approved. So how do we square this? To me, equipoise means that statistically the experimental intervention is reasonably likely to be at least equivalent, and toxicity is within an acceptable range. I am glossing over a large amount of uncertainty here, but this uncertainty is the price that must be paid for progress. I justify that by pointing out my original contention, which is that success in oncology is still rather mediocre. So how could participation in a clinical trial be ~better~ for a given patient than simply moving forward with standard of care, when the drug may or may not work, and might add toxicity? To quote Rumsfeld, there are known unknowns and unknown unknowns. Standard of care is not a “known” but a “known unknown” Embarking on standard therapy means accepting a certain statistical chance of success. The individual patient still does not know whether the given treatment will work ~for them~. Only that they will have a 50, or 75 or 95% chance of success. A clinical trial on the other hand introduces a wild card. If you accept that equipoise has been deemed to be present, the person enrolling in a clinical trial has the baseline odds of success *plus* the wild card addition of the experimental drug. Maybe they will get the drug, maybe not. Maybe the new drug will work, maybe it won’t. Maybe it will add toxicity in excess of any benefit. But from the birds eye view, the person embarking on a clinical trial accrues more ~potential~ benefit than the one accepting standard of care. They get the standard odds, plus the wildcard. Even acknowledging that sometimes the experimental drug is a dud, or even net harmful, at large the individual is better off on a clinical trial than not (provided that equipoise has been deemed to be present, by an unbiased third party) because they had the additional *chance* to do better. To now, I have refrained from pointing to a community benefit, because that can be a slippery slope. But that is baked in too. Many patients facing a cancer diagnosis have a genuine desire to help other people in similar circumstance, and a thoughtful patient will realize that the only way we improve care for future cancer patients is for present cancer patients to enroll in clinical trials. As others have noted, generally only about 5% of cancer patients enroll in clinical trials, and if we could double that, or 10X that, we would make much faster progress. Considering that with AI, I anticipate a deluge of potential new drugs to emerge, we are going to have to dramatically ramp up clinical trials to accommodate all these potential new agents So from both an individual, and a community perspective, it is fair to say that enrolling in a clinical trial offers the best care a cancer patient can potentially receive

Can T-cell engagers create a "tail of the curve" phenomenon in #SCLC#, in a way similar to ICIs? Apparently yes! Long-term Follow-up (22m) of the Dellphi-304 trial as published in @Annals_Oncology and reported in #ESMO2026# by @charlesrudin show 30% pts alive at 2 yrs with tarla compared to 15% with chemo. Sustained disease control for ≥52 weeks was observed in 24.4% versus 4.3%. Confirmatory results of prolonged tarla efficacy, giving hope to our patients @SclcSMASHERS @SCLCYIForum @LungCancerEu @YoungLungCancer @myESMO @IASLC @ASCO

Another midwit take about US/European healthcare comparisons is the snarky observation that US doctors make far more than our international peers. As if this fixing this discrepancy could give the US universal healthcare. Yes, US doctors make about 2x, on average, as doctors in Europe. Also making about double of our European peers: veterinarians, lawyers, pharmacists, software developers, mechanical engineers, and restaurant managers. An In-N-Out manager makes about 4.5x the highest paid fast-food manager in France. In fact, a 2026 study comparing physician incomes in the US, Canada, Netherlands and Sweden found that broader differences in national income distributions statistically explain most of the US physician-income premium. None of us are whining about the pay. We are complaining about a broken system that won't let us care for patients the way we would like. I've repeatedly said I'd take a large pay cut if I could have more autonomy and control over my practice. The US is an extremely wealthy country. People make more money here. That is a good thing.

Ever wonder what cancer care actually costs? Here are my real numbers from 2026 so far. ---- 👉 Insurance: $1,240/mo for me, my wife and kid. No subsidy. ~$15K a year. 👉 Out-of-pocket max: $10,600. Hit it. ---- 👉 Radiation planning: $7,078 billed, $809 insurance, $347 me 👉 CT scan: $6,376 billed, $635 insurance, $0 me 👉 Nerve block (took 5 minutes): $3,430 billed, $1,096 insurance, $0 me 👉 Lorbrena, 1 month (30 pills): $67,292 retail, $19,916 insurance, $0 for me thanks to manufacturer copay assistance I still don't understand. 🚨 Total billed for my care this year: $969,804 🚨 ---- Almost a million dollars. Nobody actually paid that. Nobody can tell you what any of it really costs, including the people sending the bills. In total, I'll end up paying ~$25k for all care in 2026 for myself and my family (almost all of it for me).

You are on topic about the prequels... but I do not grant them the rank of masterpiece. Why not? Because, in the final analysis, they were written by a retarded boomerlib. And retarded boomerlibs have a perfectly inverted moral compass. Whatever they call good is actually evil. And they will call evil what is actually good. Millenials and GenZ are correct to identify in Anakin Skywalker what the boomers have done to them. But the films were not written to point this out. They were written, instead, as a defense of boomerlib morals and boomerlib theology. Consider the religion of the jedi. It is lifted, chapter and verse, from a bowdlerized versions of eastern religion sold to the flower children of the 60s by Indian grifters. Don't want things, do not work to achieve goals, do not have ambitions, do not desire. Instead, empty yourself, numb your passions, achieve nothing, move in no direction, simply exist where you are, content and at peace even if the world burns around you. Refer to all your responsibilities as "attachments" and seek to shed them. Be attached to nothing. Be an atomized individual with no sense of duty or loyalty. Your moral worth consists not of your deeds, but your inner feelings. This is chaos religion. It is religion for people for people in crapsack societies, where everyone is an 85 IQ retard, and the guy who happens to have a triple digit IQ, the guy who's smart enough to invent a religion, just looks around him and gives up. Fuck it, he says, there's no hope of ever fixing this, I'm just going to stop wanting things and veg out. The sith, by contrast, represent, not any Western religion in particular, but just vaguely Western values in general. Except they represent those values as seen through the eyes of someone who hates them. So, not just work, achieve, ascend, hone yourself, pursue excellence, be passionate about something, and gain power, but also kick some kittens along the way so George Lucas and his fellow retarded boomerlibs can feel good about hating you. See, that's the problem with the whole story. It's a story anti-trope called "debate and switch". A work of fiction sets up a moral dilemma or other painful choice, then finds a way to resolve it without actually addressing the issue it raised. In this case, the Star Wars prequels set up these two opposing philosophies, sith and jedi, but Lucas never actually makes any arguments about why the jedi are right. He just has it pre-inserted into the already-written story that the sith are gonna blow up a planet or two, slaughter some innocent kids, and kick a basket of kittens, therefore bad. And that is the big problem with the prequels. The underlying story, if it were tightened, purged of stupid cameos from characters who aren't supposed to be in it yet, had some plot holes patched, and was written by someone with better dialogue skills and without an inverted moral compass, could have been a good Greek-style tragedy. But the whole point of the story, the whole anvilicious point, inserted repeatedly with all the subtlety of a giraffe in dark glasses trying to get into a polar-bears-only nightclub, is that ANAKIN IS BAD, GUYS, MMKAY? What millenial viewers may not understand, and GenZ viewers certainly won't, is that a lot of the dialogue is actually an extremely hamfisted midwit commentary on the exact political climate of the time.... post 9/11, GWOT, Iraq and Afghanistan, etc. It's all George's stupid boomerlib sentiments that republicans are bad, and muzzie terrorists who blow up our people aren't. So, the movies sucked, and we all thought so at the time. The reason you find them relatable now, and you are right to do so, is that George's moral compass is so perfectly inverted that he accidentally wrote everything his generation was going to do to the young men, without even realizing it was a confession rather than a manifesto. He thought, he still thinks, that everything the Republic was doing was basically fine, with a little unfortunate collateral damage, and everything would have been great if Anakin had just played along. Just as he and his retarded boomerlib compatriots think that you and your entire generation are acceptable collateral damage in the hippie-Buddhist post-ethnic end-of-history world they wanted to build on the ashes of the West. The dead giveaway for this is how he models the sith... there are always two, the master and the apprentice. This models how Western civilization works. Elders train up youths and pass on their knowledge, skill, and power. Teacher to student, father to son. Except Lucas wrote this as the apprentice treacherously killing the master to usurp his place. In the story, it makes no sense. Why would sith Lords train apprentices, if sith history was one constant stream of murder-succession? But outside the story it makes perfect sense. To a healthy father, being succeeded, and then exceeded, by his son is the definition of victory. He is proud of his son, he loves his son, his son is the product not only of his hands and care, but of his very selfhood. Any victory of the child belongs also to the father, and there is no greater joy. But to the retarded boomerlib, such as Lucas, to be succeeded by your son is to be murdered and usurped. Why? Because he cannot stand to take pride in being part of something greater than himself... a lineage, a tribe, a nation, a heritage. He desires to remain forever the main character. It is not insignificant that George Lucas did not leave the Star Wars intellectual property as a legacy for his children to manage and develop, writing their own stories. Instead, he groomed a retarded midwit girlboss for the role, who did not rise even to his modest level of talent. Someone who would never exceed him, would never become more famous and loved for her Star Wars stories than Lucas was for his. And then he sold the whole thing to Disney to cash in. And it should not pass without notice that, while some boomers are out there being parents and grandparents, the majority are liquidating every system of prosperity they ever built or inherited, and spending all the money on an old person's definition of hedonism. Bumper stickers on luxury Airstreams that read "Spending the kids' inheritance". The Star Wars prequels are just the ravings of a delusional anti-civilization nutter who thinks all this is a good thing. So by all means deconstruct the prequels. By all means point out that the jedi are evil, because they are. By all means point out that the sith are good, because if the author wasn't making them kick the dog, they would be. I will cheer for all this. Hell, rewrite it with AI movie tools built for you by GenX techbros, to point out that Anakin and Palpatine are right all along. THAT will be a masterpiece if you do it well enough. But don't try to rehabilitate Lucas. He doesn't deserve it. Peace is a lie. There is only Passion. Through Passion, I gain Strength. Through Strength, I gain Power. Through Power, I gain Victory. Through Victory my chains are Broken. The Force shall free me.

Having spent a long time watching Elon Musk, and having talked with him, I believe I understand what he understood before almost anyone else. And it's something every one of us needs to understand now. Western civilization is not one civilization among many. It is the one that gave the world freedom of thought, modern science and the dignity of the individual. And it is under attack. Not by peoples, but by ideologies that want it dead. If it dies, the world will not become more just. It will become poorer, more brutal and darker. For everyone, including those who hate it. Why? Because civilizations are not interchangeable. We were told that any culture could be blended with any other, like mixing colors, and that the result would always be harmonious. It isn't true. A society where women are equal to men cannot coexist without friction with a worldview in which a woman's testimony is worth half a man's. A society where you can criticize God, change your religion or have none cannot absorb, without fracturing, a worldview in which apostasy is paid for with your life. Every people has its own genius and moves at its own pace. But not all values are equal, and you cannot build a nation on laws that contradict each other. Saying so is not racist. Racism is about blood. I am talking about laws, customs and values. And those values belong to no race: a Japanese, a Senegalese or an Iranian can make them his own, and millions have. That is exactly why they are worth defending. Let's remember where they come from. It all begins in Greece. In Athens, for the first time, men decide that truth does not descend from a throne but is sought through reason, and that a city governs itself through debate. Socrates chooses death rather than give up thinking freely. At Salamis, a handful of free cities stops the greatest empire in the world. Then comes Rome. Rome invents law that binds everyone, the citizen who holds rights, the Republic. And one immense idea: you can become Roman without being born Roman. You become Roman by adopting its laws. Christianity adds the most revolutionary idea in history: every human being, slave and emperor alike, has infinite worth. Then France. The cathedrals, those ships of stone our ancestors built over centuries for descendants they would never see. Descartes, Pascal, Voltaire. The Declaration of the Rights of Man. And Napoleon, who gives France the Civil Code, the lycées, and one simple principle: careers open to talent. Murat, the son of an innkeeper, ends up a Marshal of the Empire and King of Naples. The Civil Code spreads across much of Europe and still shapes the law of dozens of countries today. And this civilization goes on to abolish slavery, which had been practiced on every continent since the dawn of time, to push back the plague, smallpox and the night itself, and to set foot on the Moon. Peoples of the West, be proud of this history. Proud does not mean blind. Every civilization has committed crimes: conquest, slavery, war. Ours is the one that went furthest in examining its own faults, to the point of abolishing what it had once practiced. This capacity to question itself is its greatest strength. And that is exactly the strength now being turned against it. Because for decades, this magnificent system has been getting hacked. Not by an army. By an alliance of two forces that have nothing in common except one enemy: us. The first is communism. It lost the economic war, lost the Cold War, lost history's verdict with its tens of millions of dead. But it never lost the universities. It survived by changing costumes: class struggle became the struggle of the oppressed against their oppressors, and the West was declared guilty of everything. It taught our children to be ashamed of their ancestors, their borders and their culture. It is the root cause, because before you can bring down a civilization, you have to take away its will to defend itself. The second is political Islam. I am not talking about Muslims, many of whom came here precisely to escape this ideology and are its first victims. I am talking about a political project that wants to place religious law above civil law. It has no doubts. It feels no shame. It rushes into the void the first one dug. One disarms. The other advances. And let no one on the left believe they will stay in control. History has already staged this play. In 1978, Michel Foucault was enthusing over the Iranian revolution. Iran's communist party, the Tudeh, backed Khomeini and called on Iranians to vote for his Islamic constitution. By 1983, its leaders had been arrested, the party banned, and its chiefs paraded on television to confess their “crimes.” In 1988, thousands of political prisoners were executed, communist activists among them. The second always ends up devouring the first. Useful idiots are only useful for a while. So here is my call to every Western people. To the French, the Italians, the Poles, the Germans, the Spanish, the Americans, to all of you. We are at a turning point. What we do in the next ten years will decide what our grandchildren are allowed to say, believe, write and love. I am not asking you to die for the West. I am asking you for something harder: to live for it. Learn its history and pass it on. Have children. Speak without fear, even when they call you every name in the book. Vote, get involved, run for office. Build companies, schools, factories, families. Refuse the shame they are trying to inject into you. And stop surrendering anything that makes us who we are: freedom of thought, equality before the law, the dignity of every person. The historian Arnold Toynbee understood it: civilizations are not murdered, they commit suicide. And those who think they can let the West fall without paying the price should remember the Iranian communists. They helped tear down what they despised, and then they were next. The Greeks at Salamis were outnumbered. They won because they knew what they were defending. We are the heirs of Athens, Rome, Notre-Dame and the Civil Code. It is no accident that the rockets that will carry humanity to Mars are being built in a free civilization. It is time to prove ourselves worthy of what we were given. The West is worth defending. And no one will defend it for us.

You could say that … but … it’s a process Drawing blood and starting IVs teaches you to gain confidence doing procedures Doing procedures on unwilling and uncooperative patients teaches you psychological tricks Going all over the hospital teaches you who works in the hospital and what they do - they might even get to know you and teach you a few things As I already mentioned. Spending all that time with the patient is the real trick. Seeing the course of the illness first hand over 36 hours … There’s some humility to learn in all that too … 😉 I won’t say it’s all necessary But you also can’t know what is or isn’t necessary And I turned out to be a pretty OK doctor. And as much as I hated it … that’s not what I regret.

My jobs as med student See patient in ER Examine patient. Do rectal exam. Guaiac stool using supplies from pocket. Draw all labs using constant stock of tubes, vacutainers, tourniquets that are always in pockets. Label tubes and hand carry to the lab Replenish pockets from nursing station when needed Transport patient up to room when ready Transport patient to radiology for scans when ready Go to radiology record area. Get film jacket. Bring film jacket to call room Place films on view box Go to medical records. Get last two sets of charts (4-6” thick). Bring to call room Hand write note and place in chart. Use pocket manuals carried at all times to make note sound intelligent If on surgery and lucky, scrub in for urgent surgery Repeat PRN all night long Next day … round, hand write daily surgery progress notes. If on surgery after rounds do all dressing changes and wound changes. During non-call day, especially pre call, read about patient specific issues so you are prepared when attending asks you questions. Do this every 3-4 days for most of 3rd year. If you are at home at any time … you have time to study.

You could say that … but … it’s a process Drawing blood and starting IVs teaches you to gain confidence doing procedures Doing procedures on unwilling and uncooperative patients teaches you psychological tricks Going all over the hospital teaches you who works in the hospital and what they do - they might even get to know you and teach you a few things As I already mentioned. Spending all that time with the patient is the real trick. Seeing the course of the illness first hand over 36 hours … There’s some humility to learn in all that too … 😉 I won’t say it’s all necessary But you also can’t know what is or isn’t necessary And I turned out to be a pretty OK doctor. And as much as I hated it … that’s not what I regret.

My jobs as med student See patient in ER Examine patient. Do rectal exam. Guaiac stool using supplies from pocket. Draw all labs using constant stock of tubes, vacutainers, tourniquets that are always in pockets. Label tubes and hand carry to the lab Replenish pockets from nursing station when needed Transport patient up to room when ready Transport patient to radiology for scans when ready Go to radiology record area. Get film jacket. Bring film jacket to call room Place films on view box Go to medical records. Get last two sets of charts (4-6” thick). Bring to call room Hand write note and place in chart. Use pocket manuals carried at all times to make note sound intelligent If on surgery and lucky, scrub in for urgent surgery Repeat PRN all night long Next day … round, hand write daily surgery progress notes. If on surgery after rounds do all dressing changes and wound changes. During non-call day, especially pre call, read about patient specific issues so you are prepared when attending asks you questions. Do this every 3-4 days for most of 3rd year. If you are at home at any time … you have time to study.

This is still an evolving area so hopefully some of my followers who know more will chime in Scientifically, it is very cool. Tumors, being made of mutated cells, can make unique proteins not present in the healthy cells. Unique proteins offer a suitable target for the immune system to attack. This is the basis for the immune system to kill bacteria and viruses, since they have many unique proteins not present in the human body. Instead of waiting for the body to “figure this out” we can use modern biotech to sequence the genetic code and create an mRNA vaccine that will perfectly match the unique cancer protein and ~hopefully~ trigger a unique immune response to your cancer. But … it is not perfect and not everyone will mount an immune response, and also … we can never be 100% sure there is not some other similar protein elsewhere in the body that might also be a target of the vaccine … from which will come side effects. And the sad truth is, historically, this approach has not been as effective as we would have expected. In the past, cancer vaccines have not always been as cooperative as we would like. Kind of underwhelming actually. So …like every new / experimental medicine … you will have uncertain benefits and uncertain side effects. And the best way to sort all that out would be to run clinical trials … except … how do you run a clinical trial for an “N of 1 vaccine” ?? There are ... challenges. The regulatory machine is grappling with this right now. Because it is simultaneously a bespoke treatment, and an experimental therapy at the same time. For sure, insurance companies are not going to want to pay for what amounts to a fairly expensive treatment with unclear benefit. Worst part is, even if the approach works for one person, you can’t extrapolate that to a different vaccine for a different cancer in a different person. It will always be “N of 1” Meanwhile the cancer community, especially the richer ones among them, are rightfully impatient waiting for the state to sort it out. I completely sympathize with them. “Right to try” and all that. On one front, I am absolutely supportive of patients trying things out with their own money and their own bodies, especially if they have a terminal / incurable disease. And provided there is proper consent. Our people should not have to travel to far abroad to get access to this. But I am not willing to say insurance or medicare should pay for experimental and unproven therapies. To end on a happy note - the recent Moderna study, combining modern immune therapy (pembrolizumab) plus a bespoke melanoma vaccine did have a positive result, which gives hope for the technique. They were able to pull off a clinical trial using bespoke vaccines, setting the model for trials to come. However, melanoma has always been recognized as an immunologically vulnerable cancer, and whether this approach will work broadly across the full range of tumors remains to be seen Put me down as a cautious optimist. Like every new cancer treatment, we will carve off a slice vulnerable to a novel effective therapy, but it will not be a panacea and we will have plenty more work to do when other cancers refuse to cooperate.

This is still an evolving area so hopefully some of my followers who know more will chime in Scientifically, it is very cool. Tumors, being made of mutated cells, can make unique proteins not present in the healthy cells. Unique proteins offer a suitable target for the immune system to attack. This is the basis for the immune system to kill bacteria and viruses, since they have many unique proteins not present in the human body. Instead of waiting for the body to “figure this out” we can use modern biotech to sequence the genetic code and create an mRNA vaccine that will perfectly match the unique cancer protein and ~hopefully~ trigger a unique immune response to your cancer. But … it is not perfect and not everyone will mount an immune response, and also … we can never be 100% sure there is not some other similar protein elsewhere in the body that might also be a target of the vaccine … from which will come side effects. And the sad truth is, historically, this approach has not been as effective as we would have expected. In the past, cancer vaccines have not always been as cooperative as we would like. Kind of underwhelming actually. So …like every new / experimental medicine … you will have uncertain benefits and uncertain side effects. And the best way to sort all that out would be to run clinical trials … except … how do you run a clinical trial for an “N of 1 vaccine” ?? There are ... challenges. The regulatory machine is grappling with this right now. Because it is simultaneously a bespoke treatment, and an experimental therapy at the same time. For sure, insurance companies are not going to want to pay for what amounts to a fairly expensive treatment with unclear benefit. Worst part is, even if the approach works for one person, you can’t extrapolate that to a different vaccine for a different cancer in a different person. It will always be “N of 1” Meanwhile the cancer community, especially the richer ones among them, are rightfully impatient waiting for the state to sort it out. I completely sympathize with them. “Right to try” and all that. On one front, I am absolutely supportive of patients trying things out with their own money and their own bodies, especially if they have a terminal / incurable disease. And provided there is proper consent. Our people should not have to travel to far abroad to get access to this. But I am not willing to say insurance or medicare should pay for experimental and unproven therapies. To end on a happy note - the recent Moderna study, combining modern immune therapy (pembrolizumab) plus a bespoke melanoma vaccine did have a positive result, which gives hope for the technique. They were able to pull off a clinical trial using bespoke vaccines, setting the model for trials to come. However, melanoma has always been recognized as an immunologically vulnerable cancer, and whether this approach will work broadly across the full range of tumors remains to be seen Put me down as a cautious optimist. Like every new cancer treatment, we will carve off a slice vulnerable to a novel effective therapy, but it will not be a panacea and we will have plenty more work to do when other cancers refuse to cooperate.

The giant skeleton fell victim to a storm and had the dreaded C1-C2 fracture First C-spine fusion attempt failed - hoping a combo of wire, duct tape and epoxy will hold for tonight Neurosurgery consult pending - @ElswickClay @DrDiGiorgio

I’ve got a funny bone marrow biopsy story I was doing an inpatient, bedside bone marrow biopsy on a consult patient, not on the oncology floor, working with a nurse that hadn’t done assisted before As I’m proceeding I look across and she said “I’m getting warm” and then slowly passed out As she went down, another person in the room helped her and she quickly came to I said “are you ok” and she said “yeah, i just got warm with the gown etc etc” I stupidly believed her … resumed the procedure (which was already underway) and she passes out. Again. So I stop what I’m doing and we get her in a chair and find another nurse So you just never know …

So thrilled for Ben having a phenomenal response to immune therapy which is one of the miracles of modern cancer therapy May it go on for years ! Loving forward to more new content on @HTTOTW 😊 😊 😊