MeadKingofRuddyHall1

Hello Dr. Montori. I am a medical student interested in pursuing personalized medicine. What do you think about personalized medicines potential in the patient revolution?

Hello Mr. Stone. My friend's younger brother dated your daughter. One time we had to pick him up from your house and he came sprinting out the door. He had heard you were coming. He was very scared of you. What did you think of him? His last name was a medieval soldier who wore armor.

Im not sure, but I assume he saw Natural Born Killers.

I definitely see how personalized medicine can lead to disparities in care. For example advanced personalized medicine care in oncology can take place more easily in big academic hospitals then in rural health care settings or clinics in low income areas. But i also think it can lead to higher patient involvement because the team based medicine approach requires more informed consent . But perhaps it can also lead to further doctor disempowerment as you mentioned. Where cancer was previously the domain of the oncologist or the surgeon, the team based medicine approach now involves bioethicists (which is good for the patient), pathologists, and others on the tumor board.

Sorry for this long winded statement/question, I am just very interested in personalized medicine and believe it's a paradigm that can completely revolutionize medicine and wanted your thoughts on this.

Also my dad trained at the Mayo Clinic and I find your guys biorepository fascinating. Is it true that you have tumor samples from the 1800s?

Thanks for your time.

One thing I was very taken by in undergrad was Sherwin Nulands how we die where he talks about "The Riddle"

In it Dr. Nuland says that physicians have the tendency to dehumanize patients and view their disease as simply a Riddle to solve. Rather than focusing on patient needs, the doctor becomes obsessed with solving the riddle/ curing their disease because the inability to do so reflects poorly on the doctor. In their effort to do this, they lose sight of what is best for the patient by subjecting them to treatments that may not be in their best interest in order to solve this Riddle.

Do you see this in practice today still? The book was written in the 80s and I would like to think the medical practice has evolved past this mentality.