David Fischer, MD
About
Biography
David Fischer, MD, has been involved with Yale School of Medicine for nearly 60 years. He was the first medical oncologist in the New Haven community and remained in private practice for thirty years. He was recruited by Dr. Vincent DeVita in 1994 to serve on the Yale Cancer Committee as a three-day-a-week volunteer. He has chaired or co-chaired the Cancer Committee for Yale Cancer Center/Yale New Haven Hospital since 1996. He was Assistant Clinical Professor of Medicine 1967-75, Associate Clinical Professor of Medicine 1975-1981 and Clinical Professor of Medicine 1981 to the present. He has published 30 papers in peer-reviewed journals.
In 1967, Dr. Fischer went into private oncology practice to serve cancer patients in the New Haven area. He introduced the controversial practice of offering to tell his cancer patients the truth about their diagnosis if they wanted to know their diagnosis and he obtained written informed consent forms on all patients given cancer chemotherapy, not just those given experimental drugs. In 1972, he was part of a committee to establish The Connecticut Hospice and in 1974, it was started as a homecare service and he served on the medical board. That same year he received the Ben Harris award for house staff teaching at Yale. In 1980, Dr. Fischer helped The Connecticut Hospice become a licensed inpatient facility in Branford that also served as the base of an expanding homecare service. He ultimately became the medical advisor of the committee that supervised its growth.
Along with Tish Knobf, RN, Dr. Fischer edited the in-house manual for house-staff and nurses at YNHH on how to safely give cancer chemotherapy with dosing guides and references. In 1981, this manual was revised, printed, and distributed by a medical publisher and went through six English editions, an Italian edition, and a Japanese edition and became a standard of therapy in the U.S., Italy and Japan. In 1982, his book, "Cancer Therapy" was very favorably reviewed and recommended by the JAMA. An article in J Clin Oncol cited it as the only one of 16 oncology textbooks to have a chapter on Ethics in Oncology. The next printing of several of the most widely read oncology textbooks had a section on ethics. In 1992, Dr. Fischer and Dr. Thomas P. Duffy were co-guest editors of an issue of the Yale J Biol Med entitled "Ethical Issues in Hematology-Oncology.”
In 1994, Dr. Fischer left his private practice and joined Dr. Vincent DeVita at the Yale Cancer Center. In 1996, he became vice-chair of the Cancer Committee. He has remained in this role along five different Cancer Committee Chairs and has always been a champion of Yale Cancer Center, advocating for greater research, better funding, and excellent leadership.
In 1996, after the death of the Science Editor of the Boston Globe from a chemotherapy overdose at the renown Dana-Farber Cancer Institute, Dr. Fischer and a committee reviewed the toxicity experience at YNHH and found no chemotherapy toxicity deaths after 1980. Dr. Fischer contacted 150 senior medical oncologists at 123 hospitals in 50 states, Canada and Puerto Rico and asked about their experience. Using their and YNHH experience, he published Yale policies and procedures in a J Clin Oncol article entitled "Improving the Cancer Chemotherapy Process" which proved to be the seminal article in the field and it was referenced by most subsequent articles on the subject and became the standard approach to giving chemotherapy in many U.S. hospitals.
In 1999, Dr. Fischer endowed the Iris Fischer Lectureship at Yale Cancer Center. He has said of this lecture, “It is my hope that this lectureship will serve as a lasting memorial to Iris while providing an educational opportunity for our physicians and staff for the benefit of patients at the Cancer Center.”
In 1999, Dr. Fischer was concerned that insufficient funding of the YCCC had led to an inadequate clinical program and facilities that might cause the NCI to remove its designation from the YCCC. He wrote to Dean David Kessler, Yale President Richard Levin and YNHH President Joseph Zaccagnino and advised them of his concerns and suggested more funding and the construction of a cancer hospital (Yale had not added any facilities in 25 years). No apparent improvements were noted so he wrote to President Levin again in June 2001. This time President Levin set up a committee to explore the possibility of building a cancer hospital, made additional University funds available and soon eight new clinical oncologists were hired. At a fund-raising meeting for the cancer hospital, Dr. Peter Herbert, YNHH Chief of Staff and V.P. for Clinical Affairs publicly thanked Dr. Fischer for getting the ball rolling to build the cancer hospital and urged the other attendees to support his efforts by contributing funds to help build the cancer hospital.
The Hospital of St. Raphael gave him the Award for Teaching, Service and Leadership in 1995 and the Leukemia-Lymphoma Society made him their First Physician Honoree in 2002. In 2012, he published, "The Clinical Cancer Program at Yale." In 2013, he received the Richard Blumenthal Patient Advocate for Life from the Connecticut Hospice.
Appointments
Medical Oncology
Clinical ProfessorPrimary
Other Departments & Organizations
Education & Training
- MD
- Harvard University (1955)
Research
Publications
2024
Clinical Implementation of fMRI and EEG to Detect Cognitive Motor Dissociation
Bodien Y, Fecchio M, Freeman H, Sanders W, Meydan A, Lawrence P, Kirsch J, Fischer D, Cohen J, Rubin E, He J, Schaefer P, Hochberg L, Rapalino O, Cash S, Young M, Edlow B. Clinical Implementation of fMRI and EEG to Detect Cognitive Motor Dissociation. Neurology Clinical Practice 2024, 15: e200390. PMID: 39473967, PMCID: PMC11515113, DOI: 10.1212/cpj.0000000000200390.Peer-Reviewed Original ResearchCognitive motor dissociationTask-based functional MRIMotor dissociationLanguage functionEvidence-based guidelinesBehavioral evidenceFunctional MRIEEG assessmentClinical careBrain injuryEvidence baseClinical assessmentPatient selectionClinical implementationPatientsReports lessonsEEGFMRIUnited StatesEffective strategyAssessmentEthical implicationsCareBrainQuantitative and Radiological Assessment of Post-cardiac-Arrest Comatose Patients with Diffusion-Weighted Magnetic Resonance Imaging
Van Roy S, Hsu L, Ho J, Scirica B, Fischer D, Snider S, Lee J. Quantitative and Radiological Assessment of Post-cardiac-Arrest Comatose Patients with Diffusion-Weighted Magnetic Resonance Imaging. Neurocritical Care 2024, 1-10. PMID: 39164537, DOI: 10.1007/s12028-024-02087-y.Peer-Reviewed Original ResearchAnalysis of apparent diffusion coefficientRadiological assessmentMagnetic resonance imagingQuantitative analysis of apparent diffusion coefficientCardiac arrestSubgroup analysisComatose patientsMultimodal approach to prognosticationQuantitative ADC analysisResonance imagingMagnetic resonance imaging reportsDiffusion-weighted magnetic resonance imagingCerebral Performance CategoryDiffusion-weighted imagingAnoxic brain injuryApparent diffusion coefficientDeep gray matter structuresADC analysisRadiological evaluationRetrospective studyADC mapsClinical outcomesAnoxic injuryDiffusion abnormalitiesImaging ReportingAltered Mental Status at the Extreme: Behavioral Evaluation of Disorders of Consciousness
Dhadwal N, Cunningham K, Pino W, Hampton S, Fischer D. Altered Mental Status at the Extreme: Behavioral Evaluation of Disorders of Consciousness. Seminars In Neurology 2024, 44: 621-633. PMID: 39102862, DOI: 10.1055/s-0044-1788807.Peer-Reviewed Original ResearchAcute care settingCare settingsMinimally conscious statePatient's current levelMental statusDisorders of consciousnessComa Recovery Scale-RevisedHealthcare providersGlasgow Coma ScaleAssessment of consciousnessVegetative state/unresponsive wakefulness syndromeAltered mental statusAssessment measuresScale-RevisedState/unresponsive wakefulness syndromeNeurological examComa ScaleConscious stateWakefulness syndromeStatusAssessmentHealthcareSetsMultiple limitationsProvidersComa Prognostication After Acute Brain Injury
Fischer D, Edlow B. Coma Prognostication After Acute Brain Injury. JAMA Neurology 2024, 81: 405-415. PMID: 38436946, DOI: 10.1001/jamaneurol.2023.5634.Peer-Reviewed Original ResearchMagnetic resonance imagingPrognostic markerAcute brain injuryLife-sustaining treatmentBrain injury etiologyPatient's current levelPrediction of neurological recoveryHealth care costsBrain injuryPatient valuesInjury etiologyCare costsPrognostic utilityComa prognosticationSerological markersClinical guidelinesComputed tomographyNeurological recoveryNeurological examinationDisorders of consciousnessNeurological assessmentNeurological functionPredictive valueResonance imagingNeuroprognosticationDisclosing Results of Tests for Covert Consciousness: A Framework for Ethical Translation
Young M, Kazazian K, Fischer D, Lissak I, Bodien Y, Edlow B. Disclosing Results of Tests for Covert Consciousness: A Framework for Ethical Translation. Neurocritical Care 2024, 40: 865-878. PMID: 38243150, PMCID: PMC11147696, DOI: 10.1007/s12028-023-01899-8.Peer-Reviewed Original Research
2023
Come hell or high water: climate change through the lens of neurocritical care
Fischer D. Come hell or high water: climate change through the lens of neurocritical care. Intensive Care Medicine 2023, 49: 1526-1528. PMID: 37982823, DOI: 10.1007/s00134-023-07253-y.Peer-Reviewed Original ResearchNeuroimaging in Disorders of Consciousness and Recovery
Xu L, Hampton S, Fischer D. Neuroimaging in Disorders of Consciousness and Recovery. Physical Medicine And Rehabilitation Clinics Of North America 2023, 35: 51-64. PMID: 37993193, DOI: 10.1016/j.pmr.2023.06.017.Peer-Reviewed Original Research
2022
The biomechanical signature of loss of consciousness: computational modelling of elite athlete head injuries
Zimmerman K, Cournoyer J, Lai H, Snider S, Fischer D, Kemp S, Karton C, Hoshizaki T, Ghajari M, Sharp D. The biomechanical signature of loss of consciousness: computational modelling of elite athlete head injuries. Brain 2022, 146: 3063-3078. PMID: 36546554, PMCID: PMC10316777, DOI: 10.1093/brain/awac485.Peer-Reviewed Original ResearchConceptsAssociated with higher forcesBiomechanical effectsHead impactsLoss of consciousnessTeam medical personnelDystonic posturingDiagnosis of concussionAthletic head injuriesHead injuryStrain rateHigher forcesFootball gamesHigh-fidelity finite element modelHead accelerationAmerican football gamesEvidence of neurological signsMedical personnelAbnormal postureHigh strain ratesPostureFinite element modelVideo signsImpact kinematicsFootball impactsMaintenance of consciousness
2016
Human Sleep- and Wake-Promoting Networks Are Anticorrelated (S13.005)
Boes A, Geerling J, Fischer D, Saper C, Fox M. Human Sleep- and Wake-Promoting Networks Are Anticorrelated (S13.005). Neurology 2016, 86 DOI: 10.1212/wnl.86.16_supplement.s13.005.Peer-Reviewed Original ResearchA Human Brain Network Linking Arousal to Awareness (S35.004)
Fischer D, Boes A, Demertzi A, Evrard H, Laureys S, Edlow B, Saper C, Pascual-Leone A, Fox M, Geerling J. A Human Brain Network Linking Arousal to Awareness (S35.004). Neurology 2016, 86 DOI: 10.1212/wnl.86.16_supplement.s35.004.Peer-Reviewed Original Research
Academic Achievements & Community Involvement
News & Links
News
- December 18, 2024
In Memoriam: David S. Fischer, MD
- January 31, 2021
Winners Announced for Annual Yale Cancer Center Conclave Awards
- August 15, 2009
West Haven VA Cancer Center wins Outstanding Achievement Award