a day-by-day
susu alkhalili
8/24/2018 1 Comment day 4: hematology research Today I am spending my day at Maumee Valley. I had a few meetings to attend at school, so I figured it would be the perfect day to do some more research, making it easier for me to understand what the doctor is explaining to his patients. The oncologist I am shadowing is also a hematologist, so he gets a lot of patients who are having difficulties with their blood. This often leads to the discussion of bone marrow, white blood cells, red blood cells, platelets, and circulation. My goal for the day is to gain a greater understanding of hematology, or the study of diseases related to blood, so that I can enhance my experience shadowing.
Blood is made up of both solids and liquids. The liquid is called plasma, and is made up mostly of water, salts, and proteins, while the solid is made up of red and white blood cells and platelets. The bone marrow is the “factory” in the bone that creates all of these solids. The function of the white blood cells, also known as leukocytes, is to protect the body against infections and invaders. These blood cells move throughout the body through the blood, attacking invaders along the way. Often, patients will come into the office with extremely low levels of white blood cells. This is known as leukopenia. These low levels of white blood cells can be caused by an infection disrupting the production of white blood cells in the bone marrow. On the other hand, red blood cells, or erythrocytes, are crucial for carrying oxygen and carbon dioxide to and from the tissues and lungs. Red blood cells are made up of folate, iron, and vitamin B12, all of which are crucial for their effectiveness. One woman who came into the office had low levels of red blood cells and was thought to be anemic (iron deficient in the blood). However, Dr. A explained to her that low red blood cell levels could be caused by several different aspects, including a deficiency in folate and vitamin B12, as well as in iron. He suggested that they had to run some blood tests to truly identify the cause of the low red blood cell levels. The function of platelets is to bind together when they find damaged blood vessels in the blood, forming blood clots. Thrombocytopenia is when there are not enough platelets in the blood, leading to easy bruising and frequent bleeding. Thrombocytosis is extremely serious and is when there are too many platelets in the blood, leading to excessive blood clots in the arms and legs and can lead to stroke or heart attack. Both of these terms (thrombocytopenia and thrombocytosis) are used a lot by the doctors, nurses, and patients in the office. Learning all of this medical terminology is important for me to truly understand what is going on in the office. Hearing these terms being used has already allowed me to learn them better, but doing more in-depth research will give me an even greater understanding. Due to this research, I am now more equipped to ask the doctor more inquisitive questions to take full advantage of my shadowing experience.
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I spent the day today at Mercy St. Anne Cancer Center. This center is different than the one I was at yesterday: this cancer center has a treatment area where patients come in and receive chemotherapy or any other treatments they require. I looked forward to seeing this side of oncology. I was also excited to see a bone marrow examination. Finally, I wanted to delve deeper into the effect of the physical environment on the patients.
When you first think about a cancer center, it may seem like an extremely sad place. I noticed that this was not the case with the two centers I had visited so far. The treatment center is decorated with bright wallpaper and beautiful, ceramic birds hanging from the ceiling. The hospital staff are all friendly and cheerful, making the patients’ experience much more pleasant, as a result. I noticed that the majority of the patients were very optimistic and in high spirits. This goes to show that the environment that they are placed in has a major impact on the patients’ treatment experiences and recovery. My favorite part of the day was seeing the doctor perform a bone marrow test. A bone marrow examination is performed when white or red blood cell or platelet levels are too high or too low, and a cause of these abnormalities needs to be identified. As the production of these takes place in the bone marrow, a doctor may extract a portion of the bone marrow from one’s bone to send for further testing. This was a very quick and common procedure that the doctor performed with grace. Because the patient remained awake throughout the duration of the procedure, a medical staff member walked him through what was going on and held a conversation with him until the procedure was completed. Small gestures like this likely make a huge difference both for the patient and the patient’s family, who are likely going through an extremely tough time. This was my first time seeing a medical procedure in real life, and I was glad that it was a pleasant experience for the patient, who was making jokes and laughing throughout and soon after the examination. After only the second day shadowing, I am already exhausted. Doctors have extremely busy schedules every day and they have to be at their best at all times to provide their patients with the best treatment possible. The benefits definitely outweigh the consequences, however. Doctors have the ability to directly change the lives of thousands of people. I can imagine that the satisfaction of knowing that you helped someone fight the battle against cancer is a feeling that sticks with you forever. These past two days of shadowing have shown me that no matter what I end up pursuing in the future, I want to do something that helps people. 8/23/2018 1 Comment day 2: physician or teacher? both. To be completely honest, before coming into the office today, I didn’t know what to expect. All that I knew about the job of a physician was learned through watching Grey’s Anatomy, and I figured that was far from realistic. I hoped to gain a basic understanding of how office visits worked for both the patient and the doctor. I also wanted to closely observe the interactions between the physician and the patient so that I could begin to understand what the environment was like, and some do’s and dont’s when it comes to speaking about a topic as sensitive as cancer.
“You got to see lots of different personalities today,” was the first thing the doctor told me after we had finished with his rounds for the day. He was right. Some of the patients that came in liked to crack jokes and were more light-hearted, while others were more reserved and didn’t like to talk much. I also noticed that some patients brought family or friends with them, while others came to their office visits alone. For example, the first patient that we saw this morning was a pregnant woman who attended her appointment alone. However, our last patient for the day was a woman who had just been diagnosed with stage III breast cancer, and all six of us piled into the exam room. A common theme I noticed among a lot of the patients was that they often came into the office looking for answers. Many of them felt that their previous doctors did not fully explain their sickness, leaving them confused about the medicines they were being given. The most surprising part of my day was observing just how much teaching Dr. A had to do throughout the day. He sat down with each and every patient and thoroughly walked them through their treatment options, the reasons behind their sickness, the scientific aspect of their sickness, and the prognosis. He always ended up drawing out diagrams, whether it was of a bone or an esophagus, writing down key words. When whiteboards were not available, Dr. A would write on the disposable paper covering the hospital beds! Three different patients (Yes, I counted!) said the same thing afterward: “That makes a lot more sense now!” When I asked Dr. A about this, he told me that a lot of the times doctors have so many patients that they just gloss over the problem with their patients, not taking the time to walk them through. He told me that the patient fully understanding what was going on was extremely important. My day overall was extremely hectic, hopping from exam room to exam room. It had many up’s and down’s as well. One older man was told that he might have esophageal cancer that could have spread to other parts of his body, while a woman came in for her annual checkup who had spent nine years cancer-free! Today, I also realized how important it was to completely explain concepts to the patients so that they fully understand the risks of certain treatment options, the reasons behind diagnosis, etc. However, this can be utilized outside of the medical field, and I will likely apply this to whatever career path I choose. I also found that Dr. A tried to maintain a light-hearted environment, making jokes every once in a while. That way, they felt more comfortable to ask any questions they had. Overall, my first day shadowing an oncologist was full of several different emotions, but I look forward to what the next few weeks hold. 8/21/2018 0 Comments day 1: housekeepingToday, August 21, I am spending my day at Maumee Valley, where I am figuring out the nooks and crannies of my independent study. I will be shadowing an oncologist with the Toledo Clinic starting Wednesday, August 22nd. I have laid out some of my goals for my independent study:
1. Observe the interactions between patients and doctors. Applying these new skills to my everyday life, I will be able to listen to and empathize with others more readily. 2. Figure out if oncology (and medicine, in general) is something that I want to pursue as my career. I will be able to ask the oncologist in-depth questions about his occupation, seeing that I will be shadowing him for three weeks. 3. Learn how to manage my time wisely. Doctors have very busy and tight schedules, and they have to manage their free time extremely well. I will be able to apply these skills to my school routine, better preparing me for my senior year. |
AuthorSusu Alkhalili, senior at Maumee Valley Country Day School. ArchivesCategories |