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Imagine knowing you have pancreatic cancer and your doctor is unwilling to tell you how bad it is because they’re uncomfortable.That’s the situation Dr. Ron Naito, a now-retired physician, found himself in this past August.“It’s never an easy task to tell someone they have a terminal illness. How can it be?” Naito says, sitting on a couch in his home in Portland, Oregon. “I mean it brings your own mortality into the picture for one thing.”Naito has stage 4 pancreatic cancer, and as a doctor himself, he knows full well what that means. It can mean a person only has months to live.“Of all the major cancers, the one with most dire of all prognoses is probably pancreatic,” Naito explains. “Particularly what I have, which is stage 4. And I don’t think he felt comfortable telling me or discussing it.”Not only was one specialist unwilling to discuss the severity of his illness, but Naito found out about the size of his tumor from a second specialist in a less than optimal way, as well. He overheard the doctor talking to a medical student just outside his open exam room door.“They were walking this way and they said, ‘5 centimeters.’ He told the medical student. Then, they were walking the other way,” he recalls. “And I heard the words, ‘very bad,’ and I knew it was me, obviously. I know that pancreatic cancer if they exceed 3 centimeters, it’s a negative sign.”The doctor never did talk to him face to face about the precise size of his tumor.Naito says he didn’t think it was “very professional,” but even so, he has no anger toward his doctors. Instead he says it highlights how easy it is for a doctor to be careless.“They’re not uncaring. It’s just that they don’t have any experience or training. Nobody’s there to guide them,” Naito says. “And there’s no book on this. I mean you can’t go to the medical school library and check out a book on how can you deliver a dire diagnosis to patients. That book does not exist. I don’t think.”That’s why Naito not only choosing to speak out in the months he has left--despite his weakness--but it’s also why he’s given Oregon Health and Science University’s Center for Ethics in Healthcare a grant so people like Dr. Katie Stowers can teach the next generation how to better deliver news to someone who’s dying.“Unfortunately, Dr. Naito’s experience is not an anomaly,” Stowers says.Stowers is the inaugural “Ronald Naito Director of Serious Illness Education” at OHSU. Medical students under Stowers’ guidance must now pass a unique final exam, delivering grim news in mock scenarios.“It’s not that doctors don’t want to do better. It’s not that doctors are bad or inhumane, it’s that they just haven’t been taught how to do this the right way,” Stowers says.Naito, who has outlived his prognosis but estimates he may only have about six months left, says doing it the right way all comes down to one thing.“When you’re talking to your patient that has terminal illness, you have to realize your doctor and patient roles become a little bit blurred,” he says, fighting back tear. “Because, basically, you’re just two souls. You’re two human beings meeting at a very deep level. You’re in charge with giving this other person the most devastating news they will receive in their lifetime potentially.”It’s a very crucial moment, Naito says. 3314

In a major reversal, the Justice Department told a federal judge in Maryland on Wednesday that it has been "instructed to examine whether there is a path forward consistent with the Supreme Court's decision, that would allow us to include the citizenship question on the census."The shift comes after President Donald Trump tweeted earlier on Wednesday that "we are absolutely moving forward, as we must" on the citizenship question, despite statements Tuesday from both his Department of Justice and 513

It took him six weeks, 150 semi-truck loads of snow and 12 people working full time. But in the end, a Canadian man was awarded a Guinness World Record for creating 177

Just hours after Secretary of State Mike Pompeo said that President Donald Trump wants a reduction in American troop levels in Afghanistan before the 2020 election, the US military announced that two US service members had been killed in that country on Monday.No additional details about the deaths were released and the names of the service members were withheld so that next of kin could be notified. They are the fourth and fifth American service members to be killed in Afghanistan in a little over a month.In remarks at the Economic Club of Washington, DC, earlier in the day, Pompeo said that Trump had "been unambiguous" in his directive: "end the endless wars, draw down, reduce. It won't just be us."Pompeo has repeatedly stated that reducing US troop levels would be conditions-based, but has typically shied away from discussions around timing for a withdrawal."I'd love to get to a place where I felt like we had enough counterterrorism posture still in the region and in the country that we could substantially reduce the number of soldiers and sailors and airmen and Marines that are at risk there every day," he said in an interview with Fox News last week, noting that US and NATO forces would be "leaving together."Pompeo's comments came a day after a deadly attack in Kabul, which left at least 20 people dead and 50 wounded.In a June visit to Afghanistan's capital city, Pompeo said that the US had made it clear to the Taliban that they were "prepared to remove our forces," but had not yet agreed on a timeline. Pompeo and US special envoy Zalmay Khalilzad, the top US official in negotiations with the Taliban, have stressed that all four conditions -- counterterrorism assurances, troop withdrawal, participation in intra-Afghan dialogue & negotiations, and a permanent ceasefire -- must be met for a comprehensive peace agreement.During his Kabul visit, Pompeo voiced optimism that a peace deal could be reached by September 1, but said last week "these things have a way of slipping days and weeks." On Monday, he said there had been "real progress" in negotiations. Khalilzad was still in Afghanistan on Monday after more than a week of meetings."We think there's a path to reduce violence, achieve reconciliation and still make sure that the American counterterrorism effort in Afghanistan has a value and the potential to reduce risk here in the states," he said.In discussing a troop withdrawal, the secretary of state noted that the US wanted to reduce the "tens of billions of dollars a year in expenditures and enormous risk to your kids and your grandkids who are fighting for America." Pompeo also said that achieving the President's directive "would be job enhancing."Trump has publicly voiced his desire to bring an end to the US presence in the 18-year conflict. He recently stirred outrage by suggesting that he could bring a swift end to the war by obliterating the nation."I have plans on Afghanistan that if I wanted to win that war, Afghanistan would be wiped off the face of the earth, it would be over in literally in 10 days and I don't want to do that -- I don't want to go that route," the President said last week. "We're like policemen. We're not fighting a war. If we wanted to fight a war in Afghanistan and win it, I could win it in a week. I just don't want to kill 10 million people."In a meeting in Kabul between the US special representative for Afghanistan reconciliation, Zalmay Khalilzad, and Afghan President Ashraf Ghani, Afghan officials said Trump's comments were "unacceptable." 3559

Italian Premier Giuseppe Conte says he is restricting travel nationwide to try to stop the spread of the new coronavirus. Conte said Monday night a new government decree will require all people in Italy to demonstrate they need to work, have health conditions or other limited legitimate reasons to travel outside their home areas. He said the restrictions will take effect on Tuesday and like those in northern Italy will last until April 3. Pubs had been closed in northern Italy, with eateries and cafes also ordered to close at dusk. Now that crackdown is extended to the entire country. 604