On Being a Doctor6 March 2012Death PanelsMark Vierra, MDMark Vierra, MDFrom Monterey County Surgical Associates, Monterey, CA 93940.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-5-201203060-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail “He is 69 years old, on an experimental treatment for metastatic colon cancer, and he has free air,” explained the emergency department physician. It was a Sunday afternoon, and I was the surgeon on call.The CT scan had been done without intravenous contrast, and the cava was flat, from which I inferred that his renal function was poor. He had liver metastases, but there was still plenty of normal liver, and the metastases alone would not explain this much ascites. There was scattered free air, but too much ascites to be from an acute perforation, and the pleural effusions ... Author, Article, and Disclosure InformationAffiliations: From Monterey County Surgical Associates, Monterey, CA 93940.Corresponding Author: Mark Vierra, MD, Monterey County Surgical Associates, 2 Upper Ragsdale, Suite 230, Building B, Monterey, CA 93940; e-mail, [email protected]com. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByNonbeneficial CareImplementation of a Pilot Accountable Care Organization Payment Model and the Use of Discretionary and Nondiscretionary Cardiovascular Care 6 March 2012Volume 156, Issue 5Page: 394-395KeywordsCancer treatmentColorectal cancerComputed axial tomographyHealth careIntensive care unitsLegislationLiverMedicareMusclesVentilators ePublished: 6 March 2012 Issue Published: 6 March 2012 CopyrightCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...