On Being a DoctorAugust 20, 2013Black and WhiteDaniel E. Epner, MDDaniel E. Epner, MDFrom MD Anderson Cancer Center, Houston, Texas.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-159-4-201308200-00015 Audio Reading - “Black and White” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Black and White," by D.E. Epner. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Mrs. Connor was a 51-year-old woman with stage IV colon cancer who was referred to our clinical trials unit after receiving extensive salvage chemotherapy. She was hospitalized for hyperbilirubinemia and possible biliary decompression in preparation for trial enrollment. Within seconds of meeting her, I knew that she would not be a candidate for experimental therapy.She was severely cachectic and debilitated, barely able to sit up in bed. Her belly was tensely swollen. An abdominal CT scan revealed extensive ascites and hepatic metastases nearly replacing the liver. I knew that I was about to embark on the heart-wrenching task of ... Author, Article, and Disclosure InformationAffiliations: From MD Anderson Cancer Center, Houston, Texas.Corresponding Author: Daniel E. Epner, MD, Department of Palliative Care and Rehabilitation Medicine, Unit 1414, MD Anderson Cancer Center, 1400 Pressler Street, Houston, TX 77030; e-mail, [email protected]. PreviousarticleNextarticle Advertisement Audio Reading - “Black and White” Audio. Michael A. LaCombe, MD, Annals Associate Editor, reads "Black and White," by D.E. Epner. Your browser does not support the audio element. Audio player progress bar Step backward in current audio track Play current audio trackPause current audio track Step forward in current audio track Mute current audio trackUnmute current audio track 00:00/ FiguresReferencesRelatedDetails Metrics August 20, 2013Volume 159, Issue 4Page: 304-305KeywordsAscitesBreathingChemotherapyClinical trialsColorectal cancerComputed axial tomographyEnd of life careInflammationLiverMultiple sclerosisQuality of lifeStent implantation ePublished: 20 August 2013 Issue Published: August 20, 2013 Copyright & PermissionsCopyright © 2013 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...