Dr. Michael Fratkin is getting a ride to work today from a friend. "It's an old plane. Her name's 'Thumper,'" says pilot Mark Harris, as he revs the engine of the tiny 1957 Cessna 182. Fratkin is an internist and specialist in palliative medicine. He's the guy who comes in when the cancer doctors first deliver a serious diagnosis. He manages medications to control symptoms like pain, nausea and breathlessness. And he helps people manage their fears about dying, and make choices about what treatments they're willing — and not willing — to undergo.