Oncology

Well, I'm back in WI, starting my 4th year out with Hematology/Oncology, working with the doctor that I previously did research with. I'm already halfway done, and it seems to be crawling by. I will admit this is not my favorite rotation. The days go very slowly. I'm working on some research as well: a case study on a patient. I forgot how much work goes into writing up a research article. My preceptor seems flustered in how to deal with me. And that's how I feel this last paragraph was written: flustered.

I'll just write about a few things that stick out in my head from the last two weeks.
1. I had to tell a patient the other day that his prostate cancer treatment is not working and that his cancer is progressing. It's hard to keep eye contact with the patient, but I did. That way I could see the look of absolute shock in his wife's eyes, yet the careful control in his face.
2. A 40 year old male who was just diagnosed with stage 4 lung cancer- Seeing Dr. O for the first time, both he and his wife admitted to still smoking. Dr. O laid into the wife. It actually made her cry. I was actually really happy to see a preceptor spend so much time on smoking cessation. Often times I feel that the doctors get resigned to the fact that patients are still smoking. Not Dr. O. We talked about it after the appt, and he said that he spends at least 5-10 minutes discussing it. When we saw them again 1 week later, she was down to a few cigarettes per day!
3. A bone marrow biopsy. For those of you who have not had the pleasure of observing one of these, I'll describe it here. I actually think this is one of the nastiest procedures I've seen. First, the skin is numbed with some lidocaine, and then a deeper injection of it, all the way down to the bone. Then this hugeass needle is driven into the hip, where he aspirates some bone marrow. Then he starts grinding the needle and spinning it to get a piece of bone. Now, this takes some effort. Dr. O is putting some muscle into it. Then he pulls it all out and cleans up. The noise is gross. You can hear the bone scraping and crunching.
4. Radiation oncology- I got to spend some time over there to check out how it works. I honestly had no idea what to expect. Well, there is this HUGE machine that focuses it's photon beam at, and radiates the tumor. The room is lined by 6 feet of cement and 1 foot of lead. They take radiation exposure seriously. As they were explaining things to me, I seriously just sat there wondering what language they were speaking to me. Honestly, it was like this horrible physics nightmare! This is the first time since my first year of school, where I really felt like I had absolutely no clue what was going on. I couldn't understand what they were saying, I couldn't think of any intelligent questions to ask, fearing that I would look like a complete moron.

Oh, and in good news, I passed those boards I had to take in PA. Phew. Next up, my written boards on Aug. 23rd.

Oh and in some other good news, the program director from my audition rotation invited me to come back and rotate in his private practice. I may or may not have been jumping up and down.