Heme/Onc: Tumor Board patient

This entire week I'm at the Center downtown, and I spent yesterday and today working with Dr. MR. He's one of the heme/oncs who seems to like having a student around b/c he can teach while we're in the patient's room. Sometimes, however, he talks as though the patient isn't there and uses a lot of medical terminology which has the patient feeling (and looking) left-out and confused. With him around, I'm introduced as Dr. ____, which feels anticlimatic b/c in less than 2 months I will be Dr. ____. It's a scary, yet exciting thought. Tumor Board was this morning, and as expected, Dr. MR had me present our patient from last week. I hit the important points and then asked the other oncologists whether they'd treat my lung cancer patient, who is not a surgical candidate, with radiation only or radiation plus chemo. His mets were in three isolated regions, so they COULD be hit by radiation only, but the chances of micrometastases was also high. Ultimately, the doctors thought that a combination of both chemo and radiation would give the patient the best shot at survival (aside from CAD, he's a pretty healthy 78-year-old). Afterwards Dr. MR said I did a good job in presenting our patient, and I was happy to hear it. Now if only Dr. RP could have seen me; that could have helped my grade. But he'll learn about it if he asks the other doctors for feedback.

We saw our patient and his (neurotic) wife later this afternoon, and when Dr. MR brought up the topic of chemotherapy, they looked surprised. "We met with Dr. L (the radiation oncologist) earlier this morning, and he didn't say anything about chemotherapy," said the wife. "We thought he only needed radiation." This led to about 5-10 minutes of confusion as Dr. MR tried to explain where we were coming from while the wife was indignant over hearing two different things from two doctors. "I don't think we should have chemo," the wife said, and Dr. MR, obviously wanting to avoid an argument, said that we could try radiation first and if that doesn't work, then consider the chemo. The wife seemed satisfied with this, and so did the patient. But when they left, Dr. MR shook his head. We had another patient come in whose wife was in late-stage dementia, and Dr. MR commented that he would rather be dead than in that state. Not the first time I've heard comments like that from doctors.

I told Dr. MR that I'd matched in Philadelphia. He didn't respond to the name "Drexel" but as soon as I said "Hahnemann University Hospital" he knew exactly which program I was talking about (HUH didn't merge with Drexel until a few years ago). "That's an excellent teaching hospital," he said. "You'll learn a lot there." The other doctors overheard us talking about Philadelphia so I told them I matched there, and they offered their congrats. Dr. BR offered to get in touch with some of his friends up there and ask them about places to live in Philly for me, which I thought was nice of him. "City of Brotherly Love," he said. Dr. MR added, "Just be sure you get off at the right stop at the subway," meaning that Philly can be dangerous. Yes, I know.