One of the main reasons I decided to do medicine, was so that I could somehow be involved in the treatment, management and care of children who developed different forms of cancers. I wasn’t sure yet if I would have been interested in hematology or other non-blood associated cancers. To be honest, it didn’t matter. I felt as if I wanted to help in whatever way I can. I even thought that maybe research would be a great way to do just that; figure out the perfect treatment for childhood cancers or even find cures for them. At the end of the day, it was the driving force and every time I saw one of those St. Jude’s Pediatric Oncology commercials, the drive grew even more.
Fortunately enough for me, the first clerkship I did, was in pediatrics. Obviously, I made sure that I got to sit in, in a couple of pediatric oncology clinics and the lead consultant for the clerkship happened to also be a pediatric oncologist, so it was a given that I was going to get some kind of experience in pediatric oncology. The clinics were very interesting to say the least. It ranged from the stereotypical cancer patient (lack of facial hair or head hair, pale complexion) to the ones who you couldn’t even tell they were previously diagnosed and treated for a pediatric cancer. Even though the sadder of the extremes (the stereotypical appearance of a cancer patient, with no hair, etc.), it still had a positive outcome to it as the individual was in full remission (years), and on their final appointment with the doctor.
I left pediatrics with the reinforcement that I wanted to do pediatric oncology. Every time someone asked me what field of medicine I wanted to go into, I proudly told them pediatric oncology. Obviously, as other clerkships came around, I did find them interesting but I still always had pediatric oncology as number one.
Currently I am on my medical oncology elective, and although it isn’t pediatrics, it still elicits a saddening reality for anyone who observes or interacts with patients with cancer; that some of them are not going to make it. I am going into my 3rd week, but on the first day, I already sat in a clinic where people were receiving bad news (eg: treatments were no longer working). The first day was exhausting and the experience made me realize how lucky I am. Although, the story is always the same when dealing with cancer patients; no one expected this would happen to them. As I go into my 3rd week, I have seen patients who prognosis isn’t good (weeks to months), treatments yet again have been exhausted, the realization that chemotherapy will cause them to lose their hair and many other incidents that just have left me despondent.
After these experiences, I reflected on my past desires to becoming a pediatric oncologist (much more recently, before doing my medical oncology elective, I changed my desire from pediatric oncology to surgery, as it seemed more rewarding and was more a skilled based occupation as well as a knowledge based one), as it was still on my list regardless of my recent change, and have decided that if it is this painful to see the despair in those who are adults, far less for the children and the parents. Not only that, but at least the adults know what’s happening, what about the kids who are too small to really appreciate what is happening to them? How would I be able to turn my emotions off, enough to not be broken down at the loss of a child to an incurable disease?
In reality, that isn’t the life I want for myself. I top my hats off to those who are able and strong enough to make oncology a life long career, whether it is for adults or children. Either way, oncology isn’t for me. This small, limited experience, has opened up my eyes to the realization of my own personal limitations and recognize that I would be better off helping people either heal through surgery (general surgery to be more specific), or through acute medicine.