A doc’s light goes out, another’s shines

Preventive Medicine Column The mission of every Preventive Medicine specialist is to do all we can to help the healthy stay entirely well; to help those with risk factors control them and avoid disease; to help those with disease avoid progression, disability, and death.

There is almost always something left to prevent.

There is, as well, a careerlong lesson in humility. For in the end, every time, prevention fails; the ineluctable force of our mortality prevails. We all die. What happens when we die? I don’t mean what happens to us, personally. I defer that to your beliefs, and the debates of theologians. I mean what happens down here, in the void of our absence.

We have all heard that we are dust, and unto dust return. But let us allow at a minimum that there are many grades of dust. There is cosmic dust. There is stardust. And as we are the stuff of stars, perhaps at least that, too, is the nature of the dust we leave behind. But there is more to stars than dust; there is also fire.

On the Thursday before Thanksgiving, I received the devastating news that a friend and colleague, Dr. Nancy Cappello, had died. Nancy’s extraordinary story was well told in her obituary in The New York Times. Many years ago, she was diagnosed with an advanced breast cancer missed by mammography due to dense breast tissue. Nancy endured the hardships of treatment, and became a crusader for breast cancer screening tailored to the needs of women with dense breast tissue, some 40 percent of the population. Only after effecting legislation in 36 states, and raising awareness around the world, did Nancy succumb to the long-delayed complications of her disease