Perhaps life without the EHR will be unimaginable. However the technology will support and improve medical care only if it evolves in ways that help, rather than hinder, us in synthesizing, analyzing, thinking critically, and informing the whole stories of our individuals.. Lisa Rosenbaum, M.D.: Transitional Chaos or Enduring Damage? The EHR and the Disruption of Medicine A decade ago, a primary care physician I admired seemed to come undone. His efficiency had derived not from rushing between patients but from understanding them therefore well that his charting was effortless and fast.Shows the clinical features of the sufferers in the two groups.004) .01). The unidentified mediastinal metastases were verified by endoscopic ultrasonography or endobronchial ultrasonography . In the conventional-staging group, 18 patients were not offered surgery after last staging. No affected individual was found to possess stage IV disease, but 6 patients experienced stage IIIB disease and 12 experienced stage IIIA disease. Endoscopic ultrasonographic images demonstrated unidentified mediastinal metastases in 7 of the 18 patients. The rest of the 11 individuals with inoperable NSCLC had been categorized as such on the basis of mediastinoscopy. In the conventional-staging group, 38 of 73 patients underwent a futile thoracotomy .002).