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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

It has been more than five years since a New York City police officer put Eric Garner in a fatal chokehold during a struggle between Garner and police. After years of frustration, Garner's family applauded NYPD and Police Commissioner James O'Neill for firing Daniel Pantaleo.Emerald Garner, the daughter of Eric Garner, said she will continue fighting against police brutality. "Eric Garner was killed 5 years ago - it took 5 years for officer to be fired, " she said. "I don't want another Eric Garner. I will do everything in my power to never see another Eric Garner, I don't want to see another video of a person being choked...it wasn't supposed to happen to him and it wasn't supposed to happen."Emerald Garner thought the decision should have come sooner."Regardless of however you came up to your decision, you finally made a decision that should have been made five years ago," she said about O'Neill's decision. O'Neill said the decision behind Monday's announcement has been one he has thought about since being installed as commissioner in September 2016. "It's not something that I can make over a few hours - I have been thinking about this since the day I was sworn in as police commissioner," O'Neill said. "The decision was made in the last couple of days."Gwen Carr, Garner's mother, had a message for Daniel Pantaleo and his lawyer Stuart London."Pantaleo, you, your regime, London, you can appeal all you want. But I'm still out here, I'm out here for the long run. You come out here against me, I'm out here. And you cannot scare me away," Carr said. "I lost my son," Carr added. "You cannot replace that. You can get another job. Maybe at Burger King."Although Pantaleo was fired, he was not criminally charged for the fatal chokehold. The US Department of Justice decided earlier this year not to press charges. London confirmed with CNN that he plans on appealing NY{D's decision on Pantaleo's behalf. 1938

In updated guidance issued by the CDC on Monday, it recommended that all cruise ship and river boat travel be avoided anywhere in the world during the spread of the coronavirus. The announcement comes as nearly 150 countires worldwide have reported a confirm case. The recommendation is especially important for older individuals, and those with a serious chronic medical condition. The CDC noted several recent examples of where the the coronavirus spread among passengers on board cruise ships. Recent examples include 696 cases and 8 deaths on the Diamond Princess cruise ship in Japan and 28 cases on the Grand Princess cruise ship in the United States, the CDC said. The CDC issued the following recommendations to tell patients who plan on going on cruise ships and river boats:Advise patients to defer all cruise ship travel, including river cruises, worldwide.Explain that their return travel to the United States may be impacted, and formal quarantine procedures may be implemented if confirmed cases are identified on board.Explain that appropriate medical care or medical evacuation may not be available internationally.Explain that some countries may refuse docking or disembarkation if there are known or suspected cases on board.For patients who still intend to cruise, advise them to practice social distancing and monitor their health both during travel and for 14 days from the time they disembark. Social distancing means staying out of crowded places, avoiding group gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others, when possible.The guidance came on the same day that President Donald Trump and leading health officials suggested that gatherings of 10 or more people pose a risk to older and disabled people. The CDC also said all gatherings of 50 or more people should be outright postponed amid the spread of the coronavirus. 1895

In the wake of Hurricane Dorian, a lot of animals in the Bahamas are left without owners to care for them and without homes to shelter in. The International Fund for Animal Welfare (IFAW) sent a crew to the Bahamas, trying to find and save those animals that survived the Category 5 hurricane. Alex Johnson with IFAW spent days in the throes of Dorian’s aftermath.“It was apocalyptic, catastrophic, whatever you want to call it,” he describes. “It was, it was just, it was just devastating.”Johnson is part of a rescue team sent to Abaco to help stranded animals. “We have set up in Nassau a dispatch, a dispatch center, where people it's almost like a crisis hotline where we have someone getting calls from desperate pet owners looking for pets that were left behind,” he says. Johnson describes the visit as “eerie” as he walked through areas devastated by the storm.“You would just walk by these areas and just kind of get a whiff of like some foul stench,” Johnson describes.For the animals the group would find, they would classify them as being an urgent situation or not. Johnson describes a dog he encountered that needed urgent medical attention. However, soon after finding him, the dog passed away. “And that's just like the sad reality of how the situation is going,” he says.Johnson says he and his crew are trying to offer refuge. “People like me and my other teammates are there to kind of give these animals a fighting chance, because they're often forgotten and these type of situations,” Johnson says.The IFAW team says their top priority is getting animals out of the hardest-hit areas and reuniting the ones they can with their owners. IFAW says it will be on the ground as long as they’re needed. 1732

In a world suffering a pandemic, cash is no longer king. A growing number of businesses and individuals worldwide have stopped using banknotes in fear that physical currency, handled by tens of thousands of people over their useful life, could be a vector for the spreading the coronavirus. While public officials and health experts have said that the risk to transfer the virus person-to-person through the use of banknotes is small, it has not stopped businesses from refusing to accept currency and some countries from urging their citizens to stop using banknotes altogether. 592

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