The specialists

For the past two days I have shadowed (followed around) two different specialists. The point of this is to expose me to areas that I wouldn't normally get to see unless I did an elective in it during 4th year. Yesterday, I spent my day split between a Hematologist-Oncologist and a Radiation-Oncologist.

A Hematologist/Oncologist is a doctor that specializes in blood and cancer diseases. The doctor I followed was awesome! She was good at listening to patients and explaining what they had. She was practiced and very adept at giving bad news and handling it when patients and their families cried. Yes, that is part of that job. Pros of the field: treatment changes a lot, there is always something to learn, docs practice is larger areas, you see some pretty cool (cool as in you don't want to be cool if you are a patient because that usually means bad) things. One "cool" thing that I saw was a breast cancer that had actually ulcerated out of the breast and was a 1.5x1.5 inch mass. Beneath her skin it was about 6 inches long and a few inches wide. The sad part was that this woman "wasn't all there in the head." She had actually thought that this growth was there because she had lifted her Christmas tree the wrong way. Can you imagine? She had an ulcerating mass that had completely destroyed her nipple and was bleeding, but she thought it was from lifting her Christmas tree the wrong way.... Another cool thing was an AML diagnosis. The patient came into the emergency room with a bad sinus infection and petechiae on his legs. Those were his only presenting symptoms! Crazy! Now, this doesn't mean that everyone who has this has AML, but it is crazy to think that those were the only things to pick up on. Cons: who wants to tell someone they will die in a few months or years, dealing with rightfully depressed people is hard, lots of drug reps. While I am not discounting this specialty fully, I doubt I will go into it.

Radiation-Oncology - this field has the technology, but lacks the "doctory" feel. You hardly see patients. You memorize anatomy like no other. You get paid A TON. And the lifestyle is a piece of cake. Yes, that sounds awesome, but it isn't what I imagined myself doing. I will not be a radiologist, I like seeing patients too much to do that.

Today, I shadowed a gastroenterologist (otherwise known as a GI doctor). I saw a lot of butts today. Yeah, not my thing either. I like the fact that there were a lot of procedures, but I don't want to do those kinds of procedures. Also, the doctor kind of sucked with patients. He was rushed and didn't seem to listen to the patients. I am sure that the patients picked up on this because at some point, a patient began speaking with me more than him. He also seemed somewhat disgusted with the fact that he was seeing patients in this area. To give him the benefit of the doubt, this hospital is run pretty poorly. Organization and communication are really bad, I know this from seeing it myself and from hearing it from other docs that I meet.

Another thing about the GI doc today was his attitude toward me. Overall, it was nice and fair. There were a few times that he would ask me questions and be surprised that I knew the answer. I am not sure if he was surprised because usually third year medical students don't know the answer OR because I just didn't seem like the kind of student that would know the answer. I would like to think it was because of the first reason, but I wouldn't put it past him to "judge" me and it be the second reason. He also said that I didn't seem like a typical first rotation student, but again, because of what I saw him do with patients and because of his attitude, I don't know if I can believe him. Really, I would like to because that is a boost to my ego, but geez. Do I really want a doctor who is the type I DO NOT want to become (both in specialty and personality) to think that I am good at what I do? Maybe it doesn't matter and I am reading too much into it, but that is what I am thinking.

That GI doc also tried to give me lots of advice. Some of it I would listen to because I have heard it from other sources before, others I will take with a truck-load of salt. Good advice: pick a specialty that allows you to have the lifestyle you want; whether it is being crazy busy all of the time or wanting to have a family and be there for them. Truck-load of salt advice: do radiation-oncology because it gives you the money and the lifestyle.

Make that a semi-truck-load of salt.