Two hours after my post last week, the former President was shot. Diligent awareness and surveillance should have avoided this. It is shocking that even with “protection” though inadequate, this could occur, especially in a sleepy rural town, just 45 minutes from my previous practices. I ache for those families impacted, the terrible loss of a father and the town in shock.

My lesson today is about awareness, protection and action for ourselves. Since the human process last week failed, let’s look to nature to provide. This morning as I walked our sweet cavachon near the pond. The mother duck’s neck stretched high up. Her wings opened and she was almost on tippy duck feet to herd her flock of 8 ducklings into the water….she assumed rightly that the little doggie isn’t a swimmer. Her charges nibbled at the grass and were oblivious to any threat from our presence. Her hyper- surveillance and protection is critical to their well being. She will undoubtedly remain on high alert from the gator and large turtles nearby.

This brave mother duck offers a chance today to remind us of basic instinct. The phrase, “If you see something, say something” needs to be heeded, not ignored, even in healthcare. I frequently see patients who were “lost to followup” or actually just left the oncology system because they were “cured” or controlled. That is ok as long as you become your own observer, or have someone on the family or even a visiting nurse help. We do not need to become hypochondriacs, but some signs and symptoms are obvious and actually require your attention for best outcomes. Surveillance of your own health and body is necessary to live your best life, even with cancer. Don’t assume a doctor is going to find something on a routine yearly physical or blood work. If you have had cancer, even years ago, any growth, pain, numbness, significant lack of appetite, neurological change that does not resolve or keeps growing is cancer until proven otherwise.

Brenda had breast cancer 11 years ago. She undergoes mammograms but post radiation, they are not as helpful. She was told by primary care it was radiation change. By this time her oncologists have discharged her. When she arrived, I was suspicious and the breast MRI confirmed a new cancer. Paul had lung surgery very successfully 15 years ago for a small tumor. With increase cough, a chest xray was normal but hiding behind the heart, lymph nodes were found on a chest ct! Meg is young and also had lung cancer 4 years ago. She is very strong, runs and works out regularly. A mid back pain that didn’t resolve with a chiropractor, had her undergo an MRI and now has biopsy- proven bone mets to spine and ribs. Betsy has fantastic pet scans following treatment for stage 4 breast cancer, but increased confusion and weakness led to a brain MRI and a finding of leptomeningeal disease (covering the brain… a sanctuary sight that chemo doesn’t reach).

Today’s message is not to alarm but empower. As often as I have these findings, I also see patients with concerns whose work up and biopsies are negative. There are fantastic advances in cancer treatment today, but the sooner we attack, the better the outcome. Stay sharp, safe and be in charge of your own surveillance. In all of nature, there is nothing as fascinating, complete or even resilient as the human body. We need to take care of it and follow the example of protective mother duckies.