Abstract

I grew up hearing stories about my grandmother, a missionary and an American-trained surgeon, who brought her doctoring skills to Korea at the turn of the twentieth century. She spent her first few months there learning the language and customs of this ancient kingdom where she’d spend the rest of her life. Working in a preantibiotic era, supportive care was an important part of her practice. Keeping her patients comfortable was sometimes the best she could offer (see Fig. 1). The personal side of medicine, often known as high touch, was as important as her surgical technique. Thus began my appreciation of the interplay between high tech and high touch. Not surprisingly, as an undergraduate I majored in anthropology and East Asian studies. When later accepted to medical school, I saw myself as a family practitioner. A chance conversation with a radiation oncologist on a shared car ride and a subsequent elective in the field changed my career course. Radiation oncology seemed the perfect way to merge some of my major life influences. I would be able to enlist my math and physics skills, courtesy of my math teacher father, into the service of hands-on doctoring like my grandmother, or so I thought. Radiation oncology has long been on the leading edge of technological advances in treatment planning and delivery systems. During my residency, computerized tomography (CT) imaging became more readily available. Today, CT-based volumetric planning with the fusion of magnetic resonance imaging(MRI)andpositron-emitting tomography(PET)scans, automated beam-shaping devices, and daily field imaging are common in practice. In plain language, with their current tools, radiation oncologists can customize treatment to accurately target the tumor and better spare surrounding normal tissue. During my residency, rigorous attention was given to mastery of the technical aspects of radiation oncology, but supportive care, though deemed important, was never given the same intense focus. You learned how to address treatmentrelated side effects on a case-by-case basis. Instruction and feedback on communication skills were not formalized and rarely mentioned, except when a major faux pas occurred

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