Finally, it's the long anticipated summer immersion in NYC. The first week has been hectic at times, but definitely fun and educational. Now I know why everyone loved the immersion and why Dr. Shuler said it will be a worthwhile experience.
My mentor is Dr. David Nanus, who specializes in genitourinary (GU) cancer. I met with my mentor on Monday to discuss my perspectives on the immersion and what I hoped to accomplish. He immediately informed me of a conference in the afternoon, which I should attend. For those who don't know, a conference is where doctors meet to discuss difficult cases. This conference was definitely an eye-opener. Radiologists, pathologists and nurses were also present. Various cases were presented, and doctors give their opinions as to how they should proceed to diagnose a patient to determine whether he or she actually has cancer, and whether the cancer is metastasis or primary tumor. Possible treatments were also discussed; special attention was given to the age of the patient (which affect the type of treatment and recovery the patient could undergo) and the patient's willingness to undergo specific treatment. For example, one of the patients could have undergone a simple surgery, but he did not want to because he took a long time to recover from his last surgery. As such, the treatments available to him were limited. There were definitely many things I didn't understand in the conference, especially terminology and what to look for in histochemical slides and MRI/CT scans. Nonetheless, it was an interesting experience in which I could see the process in which doctors go through to diagnose and treat the patients as well as the potential problems they must overcome.
The next day, Dr. Nanus took me to his clinic, in which I shadowed him while he was seeing patients. The three-hour experience was definitely one of the most busiest moments I have had in my life. It was definitely interesting to see from the doctor's perspectives as opposed to patient's perspectives in which they wait for the the doctor in a room impatiently. During the entire period, Dr. Nanus was preoccupied in which he had to move between three different rooms, saw different patients with different diseases and gave them appropriate treatments. It was also interesting to see how my mentor interact with different patients and give them appropriate attention and care. The system of the hospital is also worth mentioning. All of the history (records, scans, and visit memos) are stored on a computer system, in which the doctor can access with the patient's ID. This system makes everything so much more convenient; no longer does the doctor need to flip pages and search for files, instead, everything is just a click away.
Dr. Nanus is also involved in research projects, one of which is to analyze circulating tumor cells. On the same day of the clinic, a patient was starting chemotherapy. He also agreed to join in the research in which blood samples were joined to isolate for circulating tumor cells. The sample was taken by one of Dr. Nanus lab member, Gunjan, who showed me the procedure to process the sample. This procedure would allow for the staining of the cells for specific markers to identify them as circulating tumor cells.
On Wednesday, I had a meeting with Dr. Nanus and Dr. Kirby (professor at Cornell that is on sabbatical in Weill Medical) to discuss my research project. Since they have been in touch with my PI, my project will be somewhat related to my research interests for my PhD and to what Dr. Nanus and Dr. Kirby are interested in. Exact details have not been decided yet, but more to come next time, I guess!
Friday was another clinic day, in which I followed Caryn (NP) and Dr. Tagawa, also in GU oncology. Similar process as Tuesday with Dr. Nanus, but it's always interesting to see different patients and how they are dealing with their disease and chemotherapy, or how they are recovering. It is always depressing to hear that someone is going to die soon, but it is also fascinating to see how other patients are optimistic and still laugh and make jokes although they are suffering from chemotherapy (with hair and nails falling off, skin problems etc.)
All in all, this week went by quite fast, and much still needs to be done to organize my schedule. Hopefully I can see some surgeries next week, but I definitely had learned a lot already.
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