My last inpatient rotation was Oncology, back in VUH. Even though many of our patients were quite sick or had very poor expected outcomes, I really enjoyed this part of the rotation; in fact, it might have been my favorite part. For one, I felt like my team was fabulous. For the first part of this two weeks, I worked with the intern who’d been on my team for the first week at the VA and the 2nd year resident who’d been with us briefly on Morgan. I felt like I worked very well with and learned so much from both of these residents, so I was quite excited to come to a team of familiar faces. In some ways, I was able to better adapt to this service because I did not also have to figure out how to interact with a group of new people on my first day. In addition, the attending I worked with was one of the most compassionate physicians I’d ever worked with. Even when we were running late on rounds, she treated each patient as if we had all the time in the world to listen to them. She wasn’t afraid to speak honestly about her interests and dislikes in the field of oncology as well as her feelings about what the patients and families really needed from our team.
The oncology service itself is highly specialized, which was more than a bit overwhelming. While rounding with the team on the first day, I heard so many acronyms and names for cancer treatment regimens that my head started to spin. In addition to studying for the shelf when I could, I also spent time trying to at least know the mechanism of action of some of these drugs so I wouldn’t be completely clueless on rounds. I’m glad I did this, because my attending usually expected us to include some of this information when presenting new patients each morning.
These two weeks didn’t feel terribly hectic to me, partially because my residents were fairly laid-back and partially because I got 4 days off for Thanksgiving in the middle of the rotation. Our patient list stayed a manageable size. I picked up one new patient just about every day, but I spent less time on the notes than I had before. Because the daytime admissions were somewhat more predictable (patients were often admitted from clinic or expected to come in specifically for chemotherapy), I didn’t stay on campus as long as I did on Morgan.
As expected, this was one of the more emotionally taxing services I rotated through. Each day, our team interacted with 30 year olds with stage IV cancer and families who were faced with the realization that their loved one’s prognosis was poor. I was surprised that these cases didn’t seem to consciously affect me. In fact, although my time on the wards has involved some somber environments (the NICU, the Palliative Care Unit, the neurology stroke service, etc), I feel like I haven’t “dealt with” what I’ve experienced in a tangible way. I’ve recently been spending some time thinking about what that says about me as a person and how that will lend itself to my role as a physician. I haven’t figured that out yet. But I’ve got some time, I think.