28: Pulmonary Embolism

After several years of menopausal quiescence, Mrs. J's 60 yr old uterus erupted a few days before Christmas. What was the stimulant--stress hormones? More likely estrogen produced by adipose cells, of which Mrs. J has in excess. Whatever the source, too much stimulus can cause cancer, necessitating a biopsy, obtained last week.

Tonight I called her to explain the results: hyperplasia with atypia, just one stop short of cancer. I needed to tell her about my referral to a local gyn oncologist who will certainly recommend major surgery. Her husband answered, and I asked for Mrs. J. He paused and then slowly and quietly explained that she had gone to the ER last night, short of breath. And then died there. In the ER.