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Mysteries of pulmonary nodules, masses and opacities

Recently presented as a online webminar with our medical colleagues in Australia, we are often challenged and perplexed by the uncertainty of pulmonary nodules, masses and opacities. Offering a broad yet detailed strategic approach to diagnosis based on clinical experience and published scientific data, how the body presents with pathology is important to "read" the underlying causation. Obviously, confirmative biopsy is not always possible and risky for the affected individual. Therefore, wisdom and open collaboration with our medical team is essential.

Medicine is very much like the construction of the Great Pyramid of the Ancient Egypt (the "Pyramid Land") which my wife and I have been very fortunate to visit in 2018 before the global covid-19 pandemic of 2020. Supported by our security guards and tour operators (which is a normal practice there for the foreign visitors unless one chooses the more adventurous path of being the "Dr Jones" of the Indiana Jones lineage), we could clearly see how the Pyramids would have been built, i.e. not by what we know of the "normal" human intelligence but of an immense wisdom we are yet to know.

Likewise, scientific and medical knowledge do not guarantee 110% diagnosis of an unidentified pulmonary nodules, masses and/or opacities. The wisdom of the astute Physician requires conversation with the patient, synthesis of the likelihood based on decades of bedside clinical experience and observing from all spherical aspects of illness and disease to arrive at the critical juncture of certainty. But then such wisdom must always obey and respect the wishes of the patient and what is practical or feasible. The way of Medicine is always multi-dimensional and never isolated to a single path for search of an answer.

The above also in dedication of my well-learned colleagues and fellow pulmonologists, Dr. Wayne Kelly FRACP and Dr Simon Bowler FRACP, both of whom I deeply appreciate for their collective service in Medicine and their unwavering dedication to their families and patients.

Enjoy the follow up recording of the presentation:

Sam Kim

Spring Hill, Brisbane

14 August 2020 (Ekka holiday)

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