Heme/Onc

Today I started the second week of adult outpatient Hematology/Oncology. I have a normal 9-5ish schedule and see patients in the clinic for visits regarding their cancer or blood disorders. I have seen many things from breast cancer to colon cancer, polycythemia to pancytopenia, anemias, leukemias, myelomas and lymphomas. I have spent some time in the hospital's infusion center with patients getting chemotherapy treatments and time with the pathologists looking at certain cancers under the microscope.

It has been an interesting rotation so far and I have enjoyed reviewing all these different disorders. However, I totally miss pediatrics. Adults just aren't as patient and fun to work with. Most adults don't expect you to make them laugh and giggle when you listen to their heart and lungs. A lot of them roll their eyes and ask when the actual doctor is going to be in. One very interesting thing about this rotation is seeing the various ways people deal with difficult diagnoses. I have seen patients who are so optimistic and so prepared to do whatever is necessary to defeat their disease. They are motivated and inspirational. I have seen other people who succumb to the disease and act defeated before they even have a complete diagnosis.

The physician is an integral part of these people's lives. I was present when a physician encouraged her patient to mend her broken family so she could have support during her illness. I have seen another physician lecture his patient about putting his life in order so he wouldn't lose his health benefits. These are very complex diseases and affect more than just the body - they affect the patient's entire life. It is exciting to realize how much trust and confidence these patients give to their doctor. It is humbling when patients open up and share the most intimate and private parts of their lives in order to fix their problems.

In other news - we finally got the snow we have been wishing for!! I love the snow and am so excited for Christmas. The snow makes it feel like Christmas is actually on it's way. This week is match week for me!! I should know where I will be doing residency by the end of this week. I'm so anxious it's all I can think about. Luckily I have a normal work schedule that allows me to get to the gym and deal with my anxiety that way.

Can't say no

I finally finished my crazy 3 month block of Pediatrics. One month in Texas, one in Dayton and one here in Toledo. It was exhausting and I worked some fairly long hours. I did managed to find time for fun on the days I was off. I knew I was going to need a break after those three months and I can't believe that that break is over! My two weeks of "flex" time allowed me to recuperate and get some things in order. However, I got roped into presenting an "interesting case" that I saw earlier this month. The Pt was only on my service for one day and decompensated quickly. He spent 2 days in the PICU (different service) and when I found out I would be presenting his case he was being transferred to the University of Michigan for some intense therapy. He survived (I thought he would die for sure) and now I have been busy trying to pull information from the PICU, Michigan and his Primary Care Provider. I finally pulled it all together this morning (I present tomorrow) and I no longer care how this presentation turns out for several reasons: He never had an actual diagnosis, I'm totally done with the rotation, the presentation will (should) not reflect on my evaluations, and the Military has already convened and my residency fate is already decided!! I should find out in 2 weeks where I will go. Needless to say, this presentation tomorrow should not affect me. It just has taken up a lot of my flex time to put together (grrrr). I need to learn how to say "no" to attendings!! I hope to get a good letter of recommendation from her - I don't need it, but maybe I can keep it in my journal or something.