IM Doc pt 32

 First half of December 2021. IM Doc wasn't active on NC for nearly the first two weeks. When he popped up again, it was in a quote on the main post of the day, 12/11/21. This is also relatively short.

From IM Doc, keep in mind only a small sample…and remember his county has a very high vax rate:

27 [new] COVID cases – on top of the 21 that we had yesterday –

48 total…42 vaccinated – and of those 11 are boostered. 6 unvaccinated….

As far as mildness – 7 of these patients met the criteria for monoclonal antibodies because of the severity of their symptoms….

I am holding my breath about mildness. This will be the third big wave that we have had – OCT of last year – JUN-OCT of this year, and now. All 3 started with these large numbers of younger healthier people often in family clusters, etc. and took weeks to get going and really settle in. The hospitalizations and critical illness lagged behind the initial surge by weeks. This seems to be exactly the same pattern right now. These patients have all been large groups of family clusters. Many have been jetting around the world on holiday. The BIG difference now – many many more vaccinated are getting sick. Again – THIS IS NOT MILD. These people are getting severe flu like illness – just at this point only one has been admitted out of this group – so we are not admitting a lot.

Jason BoxmanDecember 11, 2021 at 11:41 am

The governors of Maine and New York deployed the National Guard in response to dangerously low capacity at statewide medical facilities due to the pandemic.

And because hospitals run to maximize profit don’t like spare capacity?

 

1. GFDecember 11, 2021 at 3:03 pm

   Don’t these National Guard nurses, doctors etc have day jobs as nurses, doctors etc? Are they being pulled from their current medical oriented job when called up? Who takes over their day jobs while they are away?

    
   1. IM DocDecember 11, 2021 at 4:01 pm

      Sssshhh –

      Don’t tell anyone – that is a secret – that no one is supposed to be allowed to ruminate over.

      But in all seriousness – the National Guard in my state has had a presence in the hospitals for a few months now. I am not sure we would be able to survive without them – the depletion of regular employees has become so devastating.

      An actual MD or DO is fairly unusual in their ranks. That is even true of RNs. The few of them that have medical training are basically field medics. That kind of experience is something we can dearly use in the hospitals right now. However, for the most part, the National Guard here are being used for all the other positions – orderlies, front desk people, patient transporters, meal delivery, etc. The ranks of those regular employees in the hospitals have been absolutely torpedoed and these troops have been a welcome relief. However, this is in no way a permanent fix. Most of these Guardsmen have only basic rudimentary medical training. They are very eager to learn and I have been doing all I can to help in that regard. And I am in no way criticizing them. They have saved us and our communities.

      But it is essential for our political leaders to understand – it takes at least 10 years to train an MD. It takes at least 4-6 years to train an RN. Even the more mundane jobs that the CNAs and orderlies and clerks do in the hospital are just simply not intuitively obvious. It takes training and patience to do even the most simple task – for example walking a demented little old lady down the hall.

      You cannot invent these folks out of thin air. When these employees have resigned in the past 6 months or so – literally decades of experience walked out the doors with them. And FIRING them is the absolute peak of imbecility. One of the hospitals I know well fired over 200 people in the past 2 months. I will simply say that the VP of risk management, who I know well, in that organization called me this week and will be submitting their resignation this coming week. They can no longer handle the stress. They are averaging many multiples a week above average of potential lawsuits because the care has gotten so tenuous.

      The thought that you can just stick used car dealers and accountants that are weekend warriors into these roles and have it be “OK” is simply ludicrous.

      I have no idea what is going to be the next phase of the plan once the pandemic is calming down. The hospitals and nursing homes are still going to be cratered.

      This is not just COVID. For decades, it was obvious that there were not near enough doctors and nurses being trained. And to make things worse – there was an extreme imbalance in the specialties chosen by the grads. The economic pressure of medical school has caused most med graduates to gravitate to things like DERM and ORTHO which we do not need and the primary care fields are just withering. Over the past 10-20 years, we have been stealing docs and nurses from other countries to do our primary care. But no one ever thought to ask what would happen if the ready supply of foreign help was no longer available. Now the big push is to have nurse practitioners fill in these roles – but LOL funny is the fact that the NPs are avoiding primary care like the plague as well.

      Just to understand the scope of the problem – our hospital has had 11 positions advertised in the local paper for the past 3 months. They had ONE application for ONE position this past week.

      We have a big problem. We will see what happens.
      
       

Here's a whole relevant NC post

Omicron Cases Serious in Denmark and Overall Morbidity Picture Not Pretty Either

Posted on December 14, 2021 by Yves Smith

The US press and some wannabe pundits are keeping up the happy talk on Omicron as more and more contradictory evidence is coming in on case severity. Remember as we stressed the baselines are questionable since outside the UK’s REACT surveys, no one has a very good handle on the total level of Covid cases, since asymptomatic cases are seldom caught. And it’s not as if asymptomatic cases are harmless. One large-scale study, through February 2021, estimated that 20% of asymptomatic Covid cases result in long Covid. And that’s pre the more aggressively-replicating Delta became dominant.

There was reason to regard the cheery take that Omicron cases weren’t showing up as severe as premature. Let’s start with how long the lag between disease appearance and first deaths was at the get go:

 

And for the subsequent waves, we’ve seen other patterns that lead to underestimation of severity. First, that’s the story at the start of every big Covid wave. Young people, who have more robust immune systems, get most of the early cases because they are generally much more social as well as often less rigorous about self-protection. Second, hospitalizations and deaths trail infections. Third, for South Africa in particular, its population is young (average age 27 versus 37 in the US and over 40 in the UK), which will somewhat blunt worst outcomes.

As we know, Omicron is mighty contagious, so even less severe cases with many more infection can well yield hospital system collapse, but the claim that Omicron ain’t all that bad is not proven in RSA:

 

And we have disconcerting data from Denmark, which does a good job of reporting:

 

 

77% of Denmark’s population is fully vaccinated and 22% boosted.

With the rise of Omicron, we have also seen something of a revival of the meme that Covid is no worse than the flu in our comments section. I suspect that’s being touted around the Web as part of an informal campaign to preserve holiday spending festivities. So we again need to remind readers that the downside of Covid doesn’t come only from dying or being hospitalized. Unlike the flu, it can and often does wreck all sorts of havoc on a disconcertingly wide range of functions.

At least long Covid is getting more attention, but like chronic fatigue syndrome and advanced Lyme disease, those who don’t have it likely find it hard to relate to how debilitating it is. Due to the very wide range of symptoms, it’s proven difficult to nail down. And a second issue that affects Covid research generally is the time needed to organize and execute a study, vet the data, write a paper and have it accepted for publication. It’s easily a year lag, which means that the vetted studies are nearly all pre-Delta, for instance.

Nevertheless, a study from February 2020 to February 2021 estimated that 20% of asymptomatic cases resulted in long Covid. A metastudy by the Pennsylvania College of Medicine concluded that half of those who contracted Covid had gotten long Covid. From their writeup:

More than half of the 236 million people who have been diagnosed with COVID-19 worldwide since December 2019 will experience post-COVID symptoms — more commonly known as “long COVID” — up to six months after recovering….

….survivors experienced an array of residual health issues associated with COVID-19. Generally, these complications affected a patient’s general well-being, their mobility or organ systems. Overall, one in two survivors experienced long-term COVID manifestations. The rates remained largely constant from one month through six or more months after their initial illness.

The investigators noted several trends among survivors, such as:

• General well-being: More than half of all patients reported weight loss, fatigue, fever or pain.

• Mobility: Roughly one in five survivors experienced a decrease in mobility.

• Neurologic concerns:Nearly one in four survivors experienced difficulty concentrating.

• Mental health disorders:Nearly one in three patients were diagnosed with generalized anxiety disorders.

• Lung abnormalities:Six in ten survivors had chest imaging abnormality and more than a quarter of patients had difficulty breathing.

• Cardiovascular issues:Chest pain and palpitations were among the commonly reported conditions.

• Skin conditions: Nearly one in five patients experienced hair loss or rashes.

• Digestive issues:Stomach pain, lack of appetite, diarrhea and vomiting were among the commonly reported conditions.

The research on whether vaccines prevent long Covid is mixed. From a late November article in Nature:

Vaccines reduce the risk of long COVID by lowering the chances of contracting COVID-19 in the first place. But for those who do experience a breakthrough infection, studies suggest that vaccination might only halve the risk of long COVID — or have no effect on it at all…

At present, public-health officials are flying blind when it comes to long COVID and vaccination. Although vaccines greatly reduce the rates of serious illness and death caused by COVID-19, they are not as effective at completely preventing the disease, and long COVID can arise even after a mild or asymptomatic coronavirus infection. Countries with high infection rates could still end up with many cases of long COVID, even if nations have high rates of vaccination.

IM Doc is reporting even more collateral damage. From a recent e-mail:

Other than the immediate post-SARS issues related to the lungs – which if the patient survives seems to be improving in most people, the vascular issues (MIs, DVTs, PEs, CVAs many weeks and months later) and the brain issues are by far and away the most important. Brain fog, depression, memory loss are the most common with brain function. I am now also seeing highly advanced intellectual people being forced to quit their jobs. They no longer have the attention span nor the ability to do their work. In the past month, a nuclear physicist and a climatologist, both in their late 50s, have both told me they can no longer evaluate datasets and do calculations correctly, and will be retiring in the near future.

Another concerning thing I am beginning to hear from my oncology friends is the absolute explosion of soft tissue cancers that are happening. This is especially true of malignant melanoma and renal cell carcinoma. One of my oncology colleagues noted to me the other day that he found it very troubling that these two in particular were going parabolic – the two soft tissue cancers whose etiology most have to do with a disordered immune system. Lymph tumors like lymphoma and myeloma are also apparently going off the charts as well.

The media seems to be content informing everyone this is happening because of a delay in diagnosis [due to lockdowns]. I could see validity in that a year ago. Now, that supposition is just sheer lunacy. My own office is crawling with in-person visits. The tele-visits for the most part are over and really only used for acute COVID and lab results and long distance patients.

GM added:

This was predicted already last year when it became clear what the virus does to T cells.

You go through a large T-cell exhaustion and derangement event and then you have fewer of them to monitor your own cells for malignancies. Thus one of the key mechanisms through which the body cleanses itself of tumors is diminished. An aged immune system is not so good with dealing with them, which is one reason (along with the sheer accumulation of mutations over time) why old people get cancer so much more frequently.

Well, the virus directly causes derangement of cellular immunity so logically it should also cause an explosion in cancers. If what your are seeing is confirmed as a trend, and if it’s these two types specifically that are exploding that is quite solid supporting evidence, then that hypothesis will turn out to be have been correct.

So don’t kid yourself. Mask up. Ventilate. Be very discriminating as to who you see over the holidays, and use every excuse to have it be outdoors if the weather is at all accommodating. Better to be a Scrooge this year and have more happy and healthy Christmases down the road.

Hank GeorgeDecember 14, 2021 at 7:08 pm

“Another concerning thing I am beginning to hear from my oncology friends is the absolute explosion of soft tissue cancers that are happening. This is especially true of malignant melanoma and renal cell carcinoma. One of my oncology colleagues noted to me the other day that he found it very troubling that these two in particular were going parabolic – the two soft tissue cancers whose etiology most have to do with a disordered immune system. Lymph tumors like lymphoma and myeloma are also apparently going off the charts as well.”

I am very suspicious of this statement. It strongly suggests it wasn’t written by a physician or for that matter anyone with even a nodding acquaintance with oncology.

Melanoma and kidney cancer are never referred to as “soft tissue cancers.” Neither are lymphomas or multiple myeloma.

Soft tissue malignancies are mainly sarcomas and primary bone/cartilage cancers. They have far lower incidence rates than the cancers mislabeled here as being of “soft tissue” origin

I spent 50 years as one of the country’s leading life insurance medical underwriters and I guarantee you no experienced underwriter with a degree in basket weaving would make such a dopey mistake as mislabeling melanoma, kidney cancer, lymphoma and multiple myeloma as soft-tissue malignancies.

The stench here is quite disconcerting, doubly so considering the importance of hyping up the latest COVID-19 variant like chicken little running around the barnyard trying to rake in billions more vaccine revenue!

 

1. DwightDecember 14, 2021 at 7:23 pm

   He didn’t describe lymph tumors as soft-tissue malignancies. And what about “subcutaneous metastasis of sarcomatoid renal cell carcinoma”? https://pubmed.ncbi.nlm.nih.gov/28675457/
   I have no expertise, just curious if your accusation is correct.

    
2. Yves SmithDecember 14, 2021 at 8:28 pm

   IM Doc has taught for years at a med school which has top tier national standing in his speciality, internal medicine, and been on an Institutional Review Board for over a decade, including as its chairman, for clinical trials. You are out of line in challenging him and even worse in accusing him of not being a doctor and us of not having vetted him.

   I hoisted his comment from e-mail, which on the one hand he knows is fair game within our Covid Brain Trust unless they’ve asked that it be treated as confidential, but on the other hand he did not write with publication in mind. His response:

   This is a classification scheme that has been ongoing change for years –

   When I was young – these were both referred to as soft tissue cancers – however, now they are referred to as solid tissue cancers.

   THat is my fault – and I should always endeavor to be much more accurate in my writing –

   The fact is that medical people would look at that statement and know exactly what I was talking about.

   Currently – SOFT TISSUE cancers – are muscle, ligaments, bone, and SKIN

   SOLID TISSUE cancers are all the organs – so technically today a RENAL CELL CARCINOMA would be considered a SOLID TISSUE cancer –

   FLUID and LYMPH CANCERS are leukemia’s and lympomas.

   When I was young the SOFT and SOLID were all lumped together in SOFT –

   I am sorry – this person is a severe nit picker. We older physicians make “mistakes” like this all the time – and everyone knows exactly what we mean. Someone who is trying to discredit a statement with an overdone argument has no such grace.

Comments

The governors of Maine and New York deployed the National Guard in response to dangerously low capacity at statewide medical facilities due to the pandemic.

And because hospitals run to maximize profit don’t like spare capacity?

The governors of Maine and New York deployed the National Guard in response to dangerously low capacity at statewide medical facilities due to the pandemic.

And because hospitals run to maximize profit don’t like spare capacity?

Sssshhh –

Don’t tell anyone – that is a secret – that no one is supposed to be allowed to ruminate over.

But in all seriousness – the National Guard in my state has had a presence in the hospitals for a few months now. I am not sure we would be able to survive without them – the depletion of regular employees has become so devastating.

An actual MD or DO is fairly unusual in their ranks. That is even true of RNs. The few of them that have medical training are basically field medics. That kind of experience is something we can dearly use in the hospitals right now. However, for the most part, the National Guard here are being used for all the other positions – orderlies, front desk people, patient transporters, meal delivery, etc. The ranks of those regular employees in the hospitals have been absolutely torpedoed and these troops have been a welcome relief. However, this is in no way a permanent fix. Most of these Guardsmen have only basic rudimentary medical training. They are very eager to learn and I have been doing all I can to help in that regard. And I am in no way criticizing them. They have saved us and our communities.

But it is essential for our political leaders to understand – it takes at least 10 years to train an MD. It takes at least 4-6 years to train an RN. Even the more mundane jobs that the CNAs and orderlies and clerks do in the hospital are just simply not intuitively obvious. It takes training and patience to do even the most simple task – for example walking a demented little old lady down the hall.

You cannot invent these folks out of thin air. When these employees have resigned in the past 6 months or so – literally decades of experience walked out the doors with them. And FIRING them is the absolute peak of imbecility. One of the hospitals I know well fired over 200 people in the past 2 months. I will simply say that the VP of risk management, who I know well, in that organization called me this week and will be submitting their resignation this coming week. They can no longer handle the stress. They are averaging many multiples a week above average of potential lawsuits because the care has gotten so tenuous.

The thought that you can just stick used car dealers and accountants that are weekend warriors into these roles and have it be “OK” is simply ludicrous.

I have no idea what is going to be the next phase of the plan once the pandemic is calming down. The hospitals and nursing homes are still going to be cratered.

This is not just COVID. For decades, it was obvious that there were not near enough doctors and nurses being trained. And to make things worse – there was an extreme imbalance in the specialties chosen by the grads. The economic pressure of medical school has caused most med graduates to gravitate to things like DERM and ORTHO which we do not need and the primary care fields are just withering. Over the past 10-20 years, we have been stealing docs and nurses from other countries to do our primary care. But no one ever thought to ask what would happen if the ready supply of foreign help was no longer available. Now the big push is to have nurse practitioners fill in these roles – but LOL funny is the fact that the NPs are avoiding primary care like the plague as well.

Just to understand the scope of the problem – our hospital has had 11 positions advertised in the local paper for the past 3 months. They had ONE application for ONE position this past week.

We have a big problem. We will see what happens.

 

Don’t these National Guard nurses, doctors etc have day jobs as nurses, doctors etc? Are they being pulled from their current medical oriented job when called up? Who takes over their day jobs while they are away?

Don’t these National Guard nurses, doctors etc have day jobs as nurses, doctors etc? Are they being pulled from their current medical oriented job when called up? Who takes over their day jobs while they are away?

Sssshhh –

Don’t tell anyone – that is a secret – that no one is supposed to be allowed to ruminate over.

But in all seriousness – the National Guard in my state has had a presence in the hospitals for a few months now. I am not sure we would be able to survive without them – the depletion of regular employees has become so devastating.

An actual MD or DO is fairly unusual in their ranks. That is even true of RNs. The few of them that have medical training are basically field medics. That kind of experience is something we can dearly use in the hospitals right now. However, for the most part, the National Guard here are being used for all the other positions – orderlies, front desk people, patient transporters, meal delivery, etc. The ranks of those regular employees in the hospitals have been absolutely torpedoed and these troops have been a welcome relief. However, this is in no way a permanent fix. Most of these Guardsmen have only basic rudimentary medical training. They are very eager to learn and I have been doing all I can to help in that regard. And I am in no way criticizing them. They have saved us and our communities.

But it is essential for our political leaders to understand – it takes at least 10 years to train an MD. It takes at least 4-6 years to train an RN. Even the more mundane jobs that the CNAs and orderlies and clerks do in the hospital are just simply not intuitively obvious. It takes training and patience to do even the most simple task – for example walking a demented little old lady down the hall.

You cannot invent these folks out of thin air. When these employees have resigned in the past 6 months or so – literally decades of experience walked out the doors with them. And FIRING them is the absolute peak of imbecility. One of the hospitals I know well fired over 200 people in the past 2 months. I will simply say that the VP of risk management, who I know well, in that organization called me this week and will be submitting their resignation this coming week. They can no longer handle the stress. They are averaging many multiples a week above average of potential lawsuits because the care has gotten so tenuous.

The thought that you can just stick used car dealers and accountants that are weekend warriors into these roles and have it be “OK” is simply ludicrous.

I have no idea what is going to be the next phase of the plan once the pandemic is calming down. The hospitals and nursing homes are still going to be cratered.

This is not just COVID. For decades, it was obvious that there were not near enough doctors and nurses being trained. And to make things worse – there was an extreme imbalance in the specialties chosen by the grads. The economic pressure of medical school has caused most med graduates to gravitate to things like DERM and ORTHO which we do not need and the primary care fields are just withering. Over the past 10-20 years, we have been stealing docs and nurses from other countries to do our primary care. But no one ever thought to ask what would happen if the ready supply of foreign help was no longer available. Now the big push is to have nurse practitioners fill in these roles – but LOL funny is the fact that the NPs are avoiding primary care like the plague as well.

Just to understand the scope of the problem – our hospital has had 11 positions advertised in the local paper for the past 3 months. They had ONE application for ONE position this past week.

We have a big problem. We will see what happens.

 

Sssshhh –

Don’t tell anyone – that is a secret – that no one is supposed to be allowed to ruminate over.

But in all seriousness – the National Guard in my state has had a presence in the hospitals for a few months now. I am not sure we would be able to survive without them – the depletion of regular employees has become so devastating.

An actual MD or DO is fairly unusual in their ranks. That is even true of RNs. The few of them that have medical training are basically field medics. That kind of experience is something we can dearly use in the hospitals right now. However, for the most part, the National Guard here are being used for all the other positions – orderlies, front desk people, patient transporters, meal delivery, etc. The ranks of those regular employees in the hospitals have been absolutely torpedoed and these troops have been a welcome relief. However, this is in no way a permanent fix. Most of these Guardsmen have only basic rudimentary medical training. They are very eager to learn and I have been doing all I can to help in that regard. And I am in no way criticizing them. They have saved us and our communities.

But it is essential for our political leaders to understand – it takes at least 10 years to train an MD. It takes at least 4-6 years to train an RN. Even the more mundane jobs that the CNAs and orderlies and clerks do in the hospital are just simply not intuitively obvious. It takes training and patience to do even the most simple task – for example walking a demented little old lady down the hall.

You cannot invent these folks out of thin air. When these employees have resigned in the past 6 months or so – literally decades of experience walked out the doors with them. And FIRING them is the absolute peak of imbecility. One of the hospitals I know well fired over 200 people in the past 2 months. I will simply say that the VP of risk management, who I know well, in that organization called me this week and will be submitting their resignation this coming week. They can no longer handle the stress. They are averaging many multiples a week above average of potential lawsuits because the care has gotten so tenuous.

The thought that you can just stick used car dealers and accountants that are weekend warriors into these roles and have it be “OK” is simply ludicrous.

I have no idea what is going to be the next phase of the plan once the pandemic is calming down. The hospitals and nursing homes are still going to be cratered.

This is not just COVID. For decades, it was obvious that there were not near enough doctors and nurses being trained. And to make things worse – there was an extreme imbalance in the specialties chosen by the grads. The economic pressure of medical school has caused most med graduates to gravitate to things like DERM and ORTHO which we do not need and the primary care fields are just withering. Over the past 10-20 years, we have been stealing docs and nurses from other countries to do our primary care. But no one ever thought to ask what would happen if the ready supply of foreign help was no longer available. Now the big push is to have nurse practitioners fill in these roles – but LOL funny is the fact that the NPs are avoiding primary care like the plague as well.

Just to understand the scope of the problem – our hospital has had 11 positions advertised in the local paper for the past 3 months. They had ONE application for ONE position this past week.

We have a big problem. We will see what happens.

 

Sssshhh –

Don’t tell anyone – that is a secret – that no one is supposed to be allowed to ruminate over.

But in all seriousness – the National Guard in my state has had a presence in the hospitals for a few months now. I am not sure we would be able to survive without them – the depletion of regular employees has become so devastating.

An actual MD or DO is fairly unusual in their ranks. That is even true of RNs. The few of them that have medical training are basically field medics. That kind of experience is something we can dearly use in the hospitals right now. However, for the most part, the National Guard here are being used for all the other positions – orderlies, front desk people, patient transporters, meal delivery, etc. The ranks of those regular employees in the hospitals have been absolutely torpedoed and these troops have been a welcome relief. However, this is in no way a permanent fix. Most of these Guardsmen have only basic rudimentary medical training. They are very eager to learn and I have been doing all I can to help in that regard. And I am in no way criticizing them. They have saved us and our communities.

But it is essential for our political leaders to understand – it takes at least 10 years to train an MD. It takes at least 4-6 years to train an RN. Even the more mundane jobs that the CNAs and orderlies and clerks do in the hospital are just simply not intuitively obvious. It takes training and patience to do even the most simple task – for example walking a demented little old lady down the hall.

You cannot invent these folks out of thin air. When these employees have resigned in the past 6 months or so – literally decades of experience walked out the doors with them. And FIRING them is the absolute peak of imbecility. One of the hospitals I know well fired over 200 people in the past 2 months. I will simply say that the VP of risk management, who I know well, in that organization called me this week and will be submitting their resignation this coming week. They can no longer handle the stress. They are averaging many multiples a week above average of potential lawsuits because the care has gotten so tenuous.

The thought that you can just stick used car dealers and accountants that are weekend warriors into these roles and have it be “OK” is simply ludicrous.

I have no idea what is going to be the next phase of the plan once the pandemic is calming down. The hospitals and nursing homes are still going to be cratered.

This is not just COVID. For decades, it was obvious that there were not near enough doctors and nurses being trained. And to make things worse – there was an extreme imbalance in the specialties chosen by the grads. The economic pressure of medical school has caused most med graduates to gravitate to things like DERM and ORTHO which we do not need and the primary care fields are just withering. Over the past 10-20 years, we have been stealing docs and nurses from other countries to do our primary care. But no one ever thought to ask what would happen if the ready supply of foreign help was no longer available. Now the big push is to have nurse practitioners fill in these roles – but LOL funny is the fact that the NPs are avoiding primary care like the plague as well.

Just to understand the scope of the problem – our hospital has had 11 positions advertised in the local paper for the past 3 months. They had ONE application for ONE position this past week.

We have a big problem. We will see what happens.

 

“Another concerning thing I am beginning to hear from my oncology friends is the absolute explosion of soft tissue cancers that are happening. This is especially true of malignant melanoma and renal cell carcinoma. One of my oncology colleagues noted to me the other day that he found it very troubling that these two in particular were going parabolic – the two soft tissue cancers whose etiology most have to do with a disordered immune system. Lymph tumors like lymphoma and myeloma are also apparently going off the charts as well.”

I am very suspicious of this statement. It strongly suggests it wasn’t written by a physician or for that matter anyone with even a nodding acquaintance with oncology.

Melanoma and kidney cancer are never referred to as “soft tissue cancers.” Neither are lymphomas or multiple myeloma.

Soft tissue malignancies are mainly sarcomas and primary bone/cartilage cancers. They have far lower incidence rates than the cancers mislabeled here as being of “soft tissue” origin

I spent 50 years as one of the country’s leading life insurance medical underwriters and I guarantee you no experienced underwriter with a degree in basket weaving would make such a dopey mistake as mislabeling melanoma, kidney cancer, lymphoma and multiple myeloma as soft-tissue malignancies.

The stench here is quite disconcerting, doubly so considering the importance of hyping up the latest COVID-19 variant like chicken little running around the barnyard trying to rake in billions more vaccine revenue!

“Another concerning thing I am beginning to hear from my oncology friends is the absolute explosion of soft tissue cancers that are happening. This is especially true of malignant melanoma and renal cell carcinoma. One of my oncology colleagues noted to me the other day that he found it very troubling that these two in particular were going parabolic – the two soft tissue cancers whose etiology most have to do with a disordered immune system. Lymph tumors like lymphoma and myeloma are also apparently going off the charts as well.”

I am very suspicious of this statement. It strongly suggests it wasn’t written by a physician or for that matter anyone with even a nodding acquaintance with oncology.

Melanoma and kidney cancer are never referred to as “soft tissue cancers.” Neither are lymphomas or multiple myeloma.

Soft tissue malignancies are mainly sarcomas and primary bone/cartilage cancers. They have far lower incidence rates than the cancers mislabeled here as being of “soft tissue” origin

I spent 50 years as one of the country’s leading life insurance medical underwriters and I guarantee you no experienced underwriter with a degree in basket weaving would make such a dopey mistake as mislabeling melanoma, kidney cancer, lymphoma and multiple myeloma as soft-tissue malignancies.

The stench here is quite disconcerting, doubly so considering the importance of hyping up the latest COVID-19 variant like chicken little running around the barnyard trying to rake in billions more vaccine revenue!

He didn’t describe lymph tumors as soft-tissue malignancies. And what about “subcutaneous metastasis of sarcomatoid renal cell carcinoma”? https://pubmed.ncbi.nlm.nih.gov/28675457/
I have no expertise, just curious if your accusation is correct.

He didn’t describe lymph tumors as soft-tissue malignancies. And what about “subcutaneous metastasis of sarcomatoid renal cell carcinoma”? https://pubmed.ncbi.nlm.nih.gov/28675457/
I have no expertise, just curious if your accusation is correct.

He didn’t describe lymph tumors as soft-tissue malignancies. And what about “subcutaneous metastasis of sarcomatoid renal cell carcinoma”? https://pubmed.ncbi.nlm.nih.gov/28675457/
I have no expertise, just curious if your accusation is correct.

IM Doc has taught for years at a med school which has top tier national standing in his speciality, internal medicine, and been on an Institutional Review Board for over a decade, including as its chairman, for clinical trials. You are out of line in challenging him and even worse in accusing him of not being a doctor and us of not having vetted him.

I hoisted his comment from e-mail, which on the one hand he knows is fair game within our Covid Brain Trust unless they’ve asked that it be treated as confidential, but on the other hand he did not write with publication in mind. His response:

This is a classification scheme that has been ongoing change for years –

When I was young – these were both referred to as soft tissue cancers – however, now they are referred to as solid tissue cancers.

THat is my fault – and I should always endeavor to be much more accurate in my writing –

The fact is that medical people would look at that statement and know exactly what I was talking about.

Currently – SOFT TISSUE cancers – are muscle, ligaments, bone, and SKIN

SOLID TISSUE cancers are all the organs – so technically today a RENAL CELL CARCINOMA would be considered a SOLID TISSUE cancer –

FLUID and LYMPH CANCERS are leukemia’s and lympomas.

When I was young the SOFT and SOLID were all lumped together in SOFT –

I am sorry – this person is a severe nit picker. We older physicians make “mistakes” like this all the time – and everyone knows exactly what we mean. Someone who is trying to discredit a statement with an overdone argument has no such grace.

IM Doc has taught for years at a med school which has top tier national standing in his speciality, internal medicine, and been on an Institutional Review Board for over a decade, including as its chairman, for clinical trials. You are out of line in challenging him and even worse in accusing him of not being a doctor and us of not having vetted him.

I hoisted his comment from e-mail, which on the one hand he knows is fair game within our Covid Brain Trust unless they’ve asked that it be treated as confidential, but on the other hand he did not write with publication in mind. His response:

This is a classification scheme that has been ongoing change for years –

When I was young – these were both referred to as soft tissue cancers – however, now they are referred to as solid tissue cancers.

THat is my fault – and I should always endeavor to be much more accurate in my writing –

The fact is that medical people would look at that statement and know exactly what I was talking about.

Currently – SOFT TISSUE cancers – are muscle, ligaments, bone, and SKIN

SOLID TISSUE cancers are all the organs – so technically today a RENAL CELL CARCINOMA would be considered a SOLID TISSUE cancer –

FLUID and LYMPH CANCERS are leukemia’s and lympomas.

When I was young the SOFT and SOLID were all lumped together in SOFT –

I am sorry – this person is a severe nit picker. We older physicians make “mistakes” like this all the time – and everyone knows exactly what we mean. Someone who is trying to discredit a statement with an overdone argument has no such grace.

IM Doc has taught for years at a med school which has top tier national standing in his speciality, internal medicine, and been on an Institutional Review Board for over a decade, including as its chairman, for clinical trials. You are out of line in challenging him and even worse in accusing him of not being a doctor and us of not having vetted him.

I hoisted his comment from e-mail, which on the one hand he knows is fair game within our Covid Brain Trust unless they’ve asked that it be treated as confidential, but on the other hand he did not write with publication in mind. His response:

This is a classification scheme that has been ongoing change for years –

When I was young – these were both referred to as soft tissue cancers – however, now they are referred to as solid tissue cancers.

THat is my fault – and I should always endeavor to be much more accurate in my writing –

The fact is that medical people would look at that statement and know exactly what I was talking about.

Currently – SOFT TISSUE cancers – are muscle, ligaments, bone, and SKIN

SOLID TISSUE cancers are all the organs – so technically today a RENAL CELL CARCINOMA would be considered a SOLID TISSUE cancer –

FLUID and LYMPH CANCERS are leukemia’s and lympomas.

When I was young the SOFT and SOLID were all lumped together in SOFT –

I am sorry – this person is a severe nit picker. We older physicians make “mistakes” like this all the time – and everyone knows exactly what we mean. Someone who is trying to discredit a statement with an overdone argument has no such grace.