me, because I struggled afterwards thinking about where she did belong. I felt like we were both there together. I was a few months down the road from her, but basically, our commonality was far greater than our difference. And she was sort of treating me like I was back together again, and she wasn’t, which of course was not the case.

Just a couple of thoughts on the survivorship care plan, which I read about and was elated about as I mentioned earlier, and have now had another few hours to think about it. And particularly for those of us who were in this last session, the very provocative, and even in some cases knotty, issues about what is entailed in this effort. I began thinking, sort of stepping back from the technicalities and the problems of “Is this a treatment plan?” or “Is this a patient guidance plan?” or “Is this some sort of cheerleading after the fact plan?” What exactly might go into this document or these documents? Or was it a document at all? And saluting the complexities of all of that. I tried to think in my experience, what longstanding documents, or what documents I had engaged that helped me either as a physician or as a person. First, in terms of practice in pediatrics, there is something known to some of you I suspect, the Denver Developmental Screening Test, the DDST, which was developed in Denver some years ago to provide a way of measuring pediatric development, or child development in a fairly simple, fairly straightforward way. But it has been kind of dumbed down and has been made pretty straightforward. It is an excellent tool for taking on what can be a difficult field of how is a child doing. So, a DDST kind of thing for cancer survivors. Now, immediately the image falls apart, because cancer is a family of diseases, and there are different stages. But a document of that sort that would be a standard part of an oncology chart might be a thought.

A second common pediatric item is the shot record. The shot record bears things in common, of course, with oncology care, although again, it is far simpler. But you have got shots that are given over time for people who are moving around, for a disease or a vaccination portfolio itself that is evolving. And the standard shot record, of course, was some piece of paper carried by the parent, usually yellow, often tattered, most often incomplete. Recently, as part of a CDC initiative, there is now, and I don’t know the extent of its use, there is a computerized record which is light years better than the paper record. This group needs no exhortation that if whatever the material that is to be tracked is computer available, it is just ever so much better. And having lived through the yellow tattered record into the computer record, it is just a world of difference. And that again, I commend to those deliberating this.

And a final provocative but perhaps totally irrelevant example comes to mind. When I step back in my life and think about what is the most interesting record about myself that I stumble on from time to time, there



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