The Assumptions That Delayed Detection

PATIENT PERSPECTIVE

Psychiatrist Jenna Taglienti, MD, had never smoked鈥攁nd is now a lung cancer survivor

By Betsy Piland
July 7, 2026 | VOLUME 4, ISSUE 2

Psychiatrist and residency director Jenna Taglienti, MD, had every reason to believe she wasn鈥檛 at risk for lung cancer.

She had never smoked. She was healthy, active, and young.

Jenna Taglienti, MD
Psychiatry Residency Training Director, Mather Hospital

So when a lung nodule first appeared on a CT scan for an unrelated gastrointestinal issue in 2021, her pulmonologist showed little concern.

鈥淗e said, 鈥楾hese incidental findings happen all the time. It could have been there your whole life. You never would have known, so don鈥檛 worry about it,鈥欌€� Dr. Taglienti said. Her doctor reviewed her scans two more times over the next 10 months and reported no further growth, giving her the all-clear.

鈥淚 trusted him since it鈥檚 outside of my field,鈥� she said. 鈥淚f he says that I鈥檓 good, I鈥檓 good.鈥�

Four years later, just before Thanksgiving in 2025, Dr. Taglienti headed to the emergency department with what she assumed was a kidney stone.

鈥淚t was like somebody was stabbing me in the lower back,鈥� she said. 鈥淚 called my husband and said, 鈥業鈥檓 driving myself to the ER; I can鈥檛 take it anymore.鈥� It was excruciating.鈥� The pain turned out to be a pleural infection around that same lung nodule.

Doctors still reassured her that the lesion was 鈥�99% not cancer,鈥� but surgery was recommended once Dr. Taglienti shared that she had recently coughed up a small amount of blood. Following a right lower lobectomy in January, pathology revealed stage 2B adenocarcinoma.

鈥淚t shocked everybody,鈥� she said. 鈥淚ncluding myself.鈥�

“I trusted him since it鈥檚 outside of my field. If he says that I鈥檓 good, I鈥檓 good.”

The privilege and burden of knowing

As both a physician and patient, Dr. Taglienti explained that her medical knowledge was both an asset and a burden.

鈥淚t鈥檚 both helped and hurt,鈥� she said. 鈥淗aving all that knowledge鈥攕ometimes you wish you didn鈥檛. Putting my trust in other doctors is hard. We鈥檙e trained to question everything, so giving up control was challenging.鈥�

At the same time, Dr. Taglienti acknowledged that being a physician granted her privileges that many patients do not have, including having her physicians鈥� personal cell phone numbers. Despite those advantages, there were still hiccups throughout her care delivery experience, one being that she first learned of her cancer diagnosis through a 20-page pathology report in the patient portal before speaking with her physicians.

鈥淚 think that鈥檚 a horrific way to get news like that,鈥� she said. 鈥淚f I didn鈥檛 have their cell phone [numbers], I would have had to just sit with that all weekend.鈥�

The experience changed how she thinks about patient communication and emotional processing, and even how she practices psychiatry.

鈥淚t gave me a better perspective of how you can鈥檛 predict how anyone is going to respond to this kind of news,鈥� she said.

“Putting my trust in other doctors is hard. We鈥檙e trained to question everything, so giving up control was challenging.”

Acknowledging bias in health care

As Dr. Taglienti reflected on her experience as a patient, she was candid about what she believed shaped her care trajectory from the beginning鈥攁nd it wasn鈥檛 just clinical guidelines.

鈥淲e all have bias in the back of our heads,鈥� she said. 鈥淚 think that the fact that I wasn鈥檛 a smoker, that I looked healthy, I work out, I take care of myself, have a reasonable diet, all played into how likely or unlikely it was that I had an actual cancer diagnosis.鈥�

She now knows that the demographic profile of lung cancer is shifting. In a 2024 article, the US Centers for Disease Control and Prevention reported that . Dr. Taglienti鈥檚 pulmonologist in 2021 wasn鈥檛 wrong to be unconcerned based on the data available at the time.

But she wonders whether her appearance and demeanor worked against her in other moments, particularly in the emergency department for what ultimately was not a kidney stone.

鈥淓ven when I was in horrific pain in the ER, I was still trying to smile, hold a conversation, be polite, and they weren鈥檛 treating my pain adequately, even though I was asking them to,鈥� she said. She sees this as a broader clinical blind spot.

鈥淲omen especially can easily get blown off as dramatic,鈥� she said. 鈥淪o, yes, appearance is part of the assessment, but you have to realize it could bias you.鈥�

“It gave me a better perspective of how you can鈥檛 predict how anyone is going to respond to this kind of news.鈥�”

What the system got right鈥攁nd wrong

One positive interaction with her oncologist especially stood out to Dr. Taglienti. Shortly after diagnosis, she asked whether she could still take a long-planned cruise before starting treatment.

鈥淢y husband鈥檚 looking at me like, 鈥楻eally?鈥欌€� she recalled. But her oncologist encouraged her to enjoy her trip and scheduled treatment around it.

鈥淚t just showed that sometimes you鈥檝e just got to meet the patient wherever they鈥檙e at, whatever their priorities are. It makes a huge difference,鈥� she said.

She also pointed out something simple that made her care experience better. A real person always answered her phone calls at the cancer center instead of having to deal with 鈥渉orrific phone trees鈥濃€攁 small detail that 鈥渕akes a huge difference when you鈥檙e dealing with something really stressful,鈥� she said.

On the flip side, Dr. Taglienti has strong feelings about test results being released in the patient portal before a clinician has reviewed them.

鈥淥ne woman who reached out to me, she learned she had breast cancer during her son鈥檚 hockey game, on an app on her phone,鈥� she said. 鈥淚 really don鈥檛 think that these things should be released to the portal until their doctor has had a chance to take a look and have a proper discussion with their patient.鈥�

“It just showed that sometimes you鈥檝e just got to meet the patient wherever they鈥檙e at, whatever their priorities are. It makes a huge difference.”

The road to recovery

Today, Dr. Taglienti has completed four rounds of chemotherapy, and her latest repeat scan came back clean. She now receives immunotherapy infusions every three weeks and expects to return to work this summer, she said, with 鈥渁 new perspective and better boundaries.鈥�

She hopes her experience will do more than raise awareness of lung cancer in people who have never smoked. Her story underscores the importance of diagnostic humility, open communication, multidisciplinary collaboration, and true partnership with patients鈥攅specially when symptoms persist or a clinical picture doesn鈥檛 fit expectations. By listening carefully, questioning assumptions, and working together, clinicians can improve the chances of reaching the right diagnosis sooner.

鈥淚t鈥檚 really important to remember that the appearance of the patient doesn鈥檛 always tell the whole story.鈥�

Reflective practice: Questions to revisit every patient encounter

Dr. Taglienti’s story is a reminder that even experienced clinicians can be influenced by cognitive biases, evolving evidence, and the assumptions that naturally arise during busy clinical practice. Reflective practice isn’t about second-guessing every decision; it’s about creating moments to pause, reassess, and remain open to new information. Asking a few deliberate questions can help clinicians recognize when a patient’s story may warrant a fresh look.

Questions for reflection

Am I anchoring on the first diagnosis or an earlier assessment? Have I accepted a previous conclusion without fully considering whether new information changes the picture?
Has anything changed since the patient’s last visit? Are there new symptoms, test results, or changes in severity that deserve a different evaluation?
Could my assumptions about this patient’s age, health, appearance, or risk factors be influencing my clinical judgment? Am I allowing stereotypes or expectations to shape my assessment?
Have I fully listened to what the patient is telling me? Do their concerns, intuition, or lived experience suggest I should investigate further?
Should I reconsider imaging, additional testing, or referral? Would another opinion or a multidisciplinary discussion provide helpful perspective?
Have I partnered with the patient in this decision? Have we discussed uncertainty, next steps, and what symptoms should prompt reevaluation?
If this patient returns in a week with the same complaint, what would I do differently? Is there anything I should do now to avoid delayed diagnosis or unnecessary suffering?

Reflective practice doesn’t eliminate uncertainty, but it can help clinicians recognize when it’s time to pause, question assumptions, and see a patient with fresh eyes.