Interview season has come to a close for me. My interview season was relatively very short and painless; with my husband having a spot at a nearby university for residency, I only applied locally. Let's not talk about what that means for my matching chances, especially given that I am attempting to match in dermatology. We will pretend that this is NOT the scariest thing ever, and move on. Very well.
In any case, I only had five total interviews, and had to travel for exactly zero of them. Given how ecstatic I am that I am all done, I have to wonder--how do people DO this? Most people have 10-25 interviews, all over the country. I was ready to stab myself in the eye after just five. Plus, I actually liked all of the places I interviewed, which makes it even less painful.
However, there is something weird about interviewing only where you have done rotations. It leaves a lot more blank space where there would have been questions, and as anyone who has gone through interviews can tell you, there is already a lot of blank space where they expect questions that don't exist. After you've gone through two or three lectures about the place and met with residents and faculty both formally and informally, there just aren't. Any. More. Questions. But yet they ask, at some point during every individual interview: "Any questions for me? Anything you'd like to know about the program?"
It is especially tough for derm interviews, where you have to meet with essentially ALL of the faculty individually, typically at least 10 or more people. It's nice in these situations to have a Blue Ribbon Pony of a question all picked out that you can parade in front of any faculty member, especially if you care about the answer. My personal Pony was: "What do you see as the most important goals for the future of (fill in name of residency program here)?" Interviewers love this question, and it gives a lot of helpful information to you, too.
That is my one useful tip for today. I have been heavily engaged in recruiting for our MD/PhD program, which is fun but busy and stressful. It is also very weird to have just finished being on the interviewee side of things, and then being on the interviewer(-ish) side of things. Now I have been chained in the garage by my husband to help him sort through the mind-boggling amount of ridiculous crap we have in there. It's nice, but now I need a nap.
I had something else to say, but it's gone now. Will post more when brain working again. Unless I inadvertently put said brain in one of the to-donate boxes in the garage... hmmmm....
Wednesday, January 28, 2009
Friday, January 2, 2009
It's not just good things that must come to and end
Bye, bye, 2008. Please be sure to let the door hit you in the ass on your way out.
This year has had a few nice points for us, but overall, it can go straight to hell. I have a very optimistic eye trained on 2009, and that eye is looking through the laser sight of a powerful rifle, so you'd better watch your step, 2009. It's time to pony up and be good to us.
In other news, I'm all done, and it couldn't have come a day too soon. PICU was definitely the most difficult rotation of medical school for me. I would like to say that unconditionally, without the qualifier of what was going on in my personal life during that time, but I can't. After all, to be fair, the second most difficult rotation was probably OB/Gyn, due not in small part I'm sure to the fact that I had a miscarriage right smack dab in the middle of it (stupid 2008). So, clearly, personal issues cannot be put aside here.
However, I must say that even without the whole husband with cancer thing and the being pregnant thing, PICU is amazingly difficult. I have a whole new level of respect and awe for critical care physicians, particularly those in PICU. There is a new dimension added to critical care when you have children involved.
It's very feast or famine; my first week, we mostly had kids that needed a lot of very careful care but would almost certainly be okay. Then we had weeks where we lost three patients and an additional 30% of our service was about to die.
It blindsides you. There's the kid who comes in with headaches and is found to have terminal brain cancer; the kid who was totally healthy until infection led to meningitis led to stroke; the kid who came in for a simple, common operation and died three days later from massive cardiovascular collapse. I couldn't put it aside like I could with older adults. Losing patients has always hit me hard, but this was something new. The grief of parents of young children is somehow much harder to bear than the grief of adult children of elderly patients.
Then, you add in my current personal situations. Having to go see a family awaiting biopsy results for their child's brain mass every day, for days and days, without having an answer for them--and then having to deliver bad news--was heart wrenching. I had just waited for those results for my husband, and it was the longest and most horrible two weeks of my life (and we got relatively good news at the end). We still have scary waits--PET scan results, blood culture results, etc. etc.--and every minute still kills me.
I was waiting to have our 20 week ultrasound during the majority of the rotation, and seeing a parade of tragic lethal congenial malformations being desperately, and unsuccessfully, treated kept in fresh in my mind just how many things can go wrong with a baby. I went from being excited about the scan to being terrified. Luckily, everything looked great. It didn't stop my obsessive worry, but it took it down a few decibels.
Intellectually, it was always challenging. These are the most complicated patients around, with multiple life-threatening medical issues balanced against each other like a house of cards; every day you were trying to shift one of the bottom cards without having the whole thing collapse. I never felt that I developed a good grasp of the sickest patients. Yet, looking back, I am somewhat disappointed that I couldn't find within myself the usual regret to be moving on from something before I felt I really understood it. When I finished the rotation, I felt nothing but relief.
I was exhausted, in every sense of the word. At one point my husband spiked his first fever--luckily, he was not neutropenic (Go Go Gadget Neupogen!) but it was still terrifying. Having to be away from him so much was really agony, worse than it had been since his diagnosis, if that's possible.
What got me through it was 1) my deep, deep desire to never, ever, ever ever ever have to go back and do it again; 2) my husband's constant encouragement; and 3) my fantastic residents. Thanks a bunch guys--literally couldn't have done it without you.
And now I'm done, done, done. Though I'm technically on vacation it doesn't feel like it; at least, not yet. Hubby got very very sick a few weeks ago and we had to postpone his chemo. It was the worst week since after we got rolling on the treatments. I was terrified. He had high fevers, night sweats--it was a perfect example of how horrible it is to be newly minted MD when something like this goes down. We knew every possible bad thing that could be going on, but we both lack the practical experience to offset those fears with less frightening possibilities. The one thing I hadn't thought of was relapse, and when the doc pointed out that possibility, I well nigh had a meltdown. There were several nights I just laid in bed next to his sleeping, sweat-drenched form and cried. But he got much better, and today the doc informed us he thinks it is much, much more likely to have been a virus than anything else; sometimes, a little reassurance is magical.
We also found out that one of our doggies has a cancerous mass--can you believe that @)%&@? She has to go back in for a wider excision, and get an ultrasound of her spleen to see if there are any mets. This is the kind of tumor that if her spleen is clear, she will almost certainly be fine; if she has mets to her spleen, she's a goner. So, that has certainly added to my current Climate of Frenzied Panic.
Once I finished, I had about eight metric tons of random life chores to get done, the holidays, the family in town, blah, blah, blah... and I have a solid week of interviews starting Monday.
So, vacation, but not really. Looking ahead I think things will become substantially more sane towards the end of the month, but I've been saying crap like that for a while. Hubby only has three more treatments, then a PET, and if that sucker's clean, it will be the best thing ever (of course we have to await the 3 month PET...). The doggie gets her scan next week and if that looks good it will be a big relief (and if not... LALALA, I CAN'T HEAR YOU!). End of Feb I have to take--and pass, unless I want to cough up an additional thousand clams--Step 2 CS. Then comes the rank list and match. Baby looks awesome, still kickin' me with a vengeance.
So that's it for now. The long update. I am thinking of some ideas for future posts, perhaps about interviewing and ranking, exciting stuff like that. Until then I hope everyone had a wonderful, safe, happy and healthy Holidays, and that you remembered all of the wonderful things you have in your life. They are too precious and delicate not to be treasured.
Except for 2008. That sucker can go into concrete shoes at the bottom of the Hudson.
This year has had a few nice points for us, but overall, it can go straight to hell. I have a very optimistic eye trained on 2009, and that eye is looking through the laser sight of a powerful rifle, so you'd better watch your step, 2009. It's time to pony up and be good to us.
In other news, I'm all done, and it couldn't have come a day too soon. PICU was definitely the most difficult rotation of medical school for me. I would like to say that unconditionally, without the qualifier of what was going on in my personal life during that time, but I can't. After all, to be fair, the second most difficult rotation was probably OB/Gyn, due not in small part I'm sure to the fact that I had a miscarriage right smack dab in the middle of it (stupid 2008). So, clearly, personal issues cannot be put aside here.
However, I must say that even without the whole husband with cancer thing and the being pregnant thing, PICU is amazingly difficult. I have a whole new level of respect and awe for critical care physicians, particularly those in PICU. There is a new dimension added to critical care when you have children involved.
It's very feast or famine; my first week, we mostly had kids that needed a lot of very careful care but would almost certainly be okay. Then we had weeks where we lost three patients and an additional 30% of our service was about to die.
It blindsides you. There's the kid who comes in with headaches and is found to have terminal brain cancer; the kid who was totally healthy until infection led to meningitis led to stroke; the kid who came in for a simple, common operation and died three days later from massive cardiovascular collapse. I couldn't put it aside like I could with older adults. Losing patients has always hit me hard, but this was something new. The grief of parents of young children is somehow much harder to bear than the grief of adult children of elderly patients.
Then, you add in my current personal situations. Having to go see a family awaiting biopsy results for their child's brain mass every day, for days and days, without having an answer for them--and then having to deliver bad news--was heart wrenching. I had just waited for those results for my husband, and it was the longest and most horrible two weeks of my life (and we got relatively good news at the end). We still have scary waits--PET scan results, blood culture results, etc. etc.--and every minute still kills me.
I was waiting to have our 20 week ultrasound during the majority of the rotation, and seeing a parade of tragic lethal congenial malformations being desperately, and unsuccessfully, treated kept in fresh in my mind just how many things can go wrong with a baby. I went from being excited about the scan to being terrified. Luckily, everything looked great. It didn't stop my obsessive worry, but it took it down a few decibels.
Intellectually, it was always challenging. These are the most complicated patients around, with multiple life-threatening medical issues balanced against each other like a house of cards; every day you were trying to shift one of the bottom cards without having the whole thing collapse. I never felt that I developed a good grasp of the sickest patients. Yet, looking back, I am somewhat disappointed that I couldn't find within myself the usual regret to be moving on from something before I felt I really understood it. When I finished the rotation, I felt nothing but relief.
I was exhausted, in every sense of the word. At one point my husband spiked his first fever--luckily, he was not neutropenic (Go Go Gadget Neupogen!) but it was still terrifying. Having to be away from him so much was really agony, worse than it had been since his diagnosis, if that's possible.
What got me through it was 1) my deep, deep desire to never, ever, ever ever ever have to go back and do it again; 2) my husband's constant encouragement; and 3) my fantastic residents. Thanks a bunch guys--literally couldn't have done it without you.
And now I'm done, done, done. Though I'm technically on vacation it doesn't feel like it; at least, not yet. Hubby got very very sick a few weeks ago and we had to postpone his chemo. It was the worst week since after we got rolling on the treatments. I was terrified. He had high fevers, night sweats--it was a perfect example of how horrible it is to be newly minted MD when something like this goes down. We knew every possible bad thing that could be going on, but we both lack the practical experience to offset those fears with less frightening possibilities. The one thing I hadn't thought of was relapse, and when the doc pointed out that possibility, I well nigh had a meltdown. There were several nights I just laid in bed next to his sleeping, sweat-drenched form and cried. But he got much better, and today the doc informed us he thinks it is much, much more likely to have been a virus than anything else; sometimes, a little reassurance is magical.
We also found out that one of our doggies has a cancerous mass--can you believe that @)%&@? She has to go back in for a wider excision, and get an ultrasound of her spleen to see if there are any mets. This is the kind of tumor that if her spleen is clear, she will almost certainly be fine; if she has mets to her spleen, she's a goner. So, that has certainly added to my current Climate of Frenzied Panic.
Once I finished, I had about eight metric tons of random life chores to get done, the holidays, the family in town, blah, blah, blah... and I have a solid week of interviews starting Monday.
So, vacation, but not really. Looking ahead I think things will become substantially more sane towards the end of the month, but I've been saying crap like that for a while. Hubby only has three more treatments, then a PET, and if that sucker's clean, it will be the best thing ever (of course we have to await the 3 month PET...). The doggie gets her scan next week and if that looks good it will be a big relief (and if not... LALALA, I CAN'T HEAR YOU!). End of Feb I have to take--and pass, unless I want to cough up an additional thousand clams--Step 2 CS. Then comes the rank list and match. Baby looks awesome, still kickin' me with a vengeance.
So that's it for now. The long update. I am thinking of some ideas for future posts, perhaps about interviewing and ranking, exciting stuff like that. Until then I hope everyone had a wonderful, safe, happy and healthy Holidays, and that you remembered all of the wonderful things you have in your life. They are too precious and delicate not to be treasured.
Except for 2008. That sucker can go into concrete shoes at the bottom of the Hudson.
Wednesday, November 26, 2008
PICU
HOLYMOTHEROFGOD...
PICU is like all the hard rotations I've had so far, but put together all at once, at 10x the speed, in a foreign language. And with more sad stories.
Remember waaaaaaaaaaay back when I posted this about not understanding medical abbreviations and jargon? Well, I look back on that post and laugh, it's so second-nature to me now. But PICU is like starting right back there. Most of the time I just either stare vapidly or, when that gets old, I nod. But I have no idea what people are talking about at least 30%, and probably more like 50% of the time.
I picked up a highly recommended book about the rotation which I will be reading in between bites of turkey. At least I get Thanksgiving off, which is good, because I need to sleep for at least 24 hours straight. I will let you know if said reading helps me understand what the #$(*& is going on in that place.
Until then, happy Thanksgiving!
PICU is like all the hard rotations I've had so far, but put together all at once, at 10x the speed, in a foreign language. And with more sad stories.
Remember waaaaaaaaaaay back when I posted this about not understanding medical abbreviations and jargon? Well, I look back on that post and laugh, it's so second-nature to me now. But PICU is like starting right back there. Most of the time I just either stare vapidly or, when that gets old, I nod. But I have no idea what people are talking about at least 30%, and probably more like 50% of the time.
I picked up a highly recommended book about the rotation which I will be reading in between bites of turkey. At least I get Thanksgiving off, which is good, because I need to sleep for at least 24 hours straight. I will let you know if said reading helps me understand what the #$(*& is going on in that place.
Until then, happy Thanksgiving!
Friday, November 21, 2008
'Round and 'Round
A random brief post about rounds... some new 3rd years have asked, so here is what to expect:
SURGERY ROUNDS
Start time: 6am
End time: 6:15am
What to know about your patients: If they have eaten, pooed, or started bleeding from any orifice
What to present about your patients: If they are still alive
How many seconds attendings usually listen to your presentation: 0 (To be fair, they are not usually present.)
PEDIATRICS ROUNDS
Start time: 8 or 9am
End time: 11am
What to know about your patients: Medical stuff plus their birth history, growth and development history, grade in school, favorite subject, teacher's name, pets, names of pets, stuffed animal's name, symptoms expressed by stuffed animal (if present)
What to present about your patients: Significant overnight events, abnormal vitals, lab results
How many seconds attendings usually listen to your presentation: Usually to the whole thing (!), unless the attending is a cardiologist, in which case, 5
PSYCHIATRY ROUNDS
Start time: Between 10am and whenever everyone feels emotionally ready to round
End time: Depends directly on the quantity of both the patients themselves and the amount of crazy present in each individual patient
What to know about your patients: If they still think that you are an alien and they are communicating with the reincarnation of Elvis through a transmitter in their teeth
What to present about your patients: If they fought off the 8pm dose of Haldol
How many seconds attendings usually listen to your presentation: Often the whole thing, while nodding thoughtfully
MEDICINE ROUNDS:
Start time: 8am
End time: 5pm (on a short day)
What to know about your patients: Every health issue or experience that has happened to the patient and the patient's relatives or close acquaintances from when they were in the womb until now.
What to present about your patients: Any overnight event, including what time patient turned over, all vitals including trends in vitals since admission or possibly before, lab results for patient and patient's first degree relatives, or as much of this as you can get in before someone on the team interrupts you
How many seconds attendings usually listen to your presentation: They may pretend to listen for up to 60, but often not well enough to avoid asking you a series of questions which were answered in the first 60 seconds of your already given presentation
SURGERY ROUNDS
Start time: 6am
End time: 6:15am
What to know about your patients: If they have eaten, pooed, or started bleeding from any orifice
What to present about your patients: If they are still alive
How many seconds attendings usually listen to your presentation: 0 (To be fair, they are not usually present.)
PEDIATRICS ROUNDS
Start time: 8 or 9am
End time: 11am
What to know about your patients: Medical stuff plus their birth history, growth and development history, grade in school, favorite subject, teacher's name, pets, names of pets, stuffed animal's name, symptoms expressed by stuffed animal (if present)
What to present about your patients: Significant overnight events, abnormal vitals, lab results
How many seconds attendings usually listen to your presentation: Usually to the whole thing (!), unless the attending is a cardiologist, in which case, 5
PSYCHIATRY ROUNDS
Start time: Between 10am and whenever everyone feels emotionally ready to round
End time: Depends directly on the quantity of both the patients themselves and the amount of crazy present in each individual patient
What to know about your patients: If they still think that you are an alien and they are communicating with the reincarnation of Elvis through a transmitter in their teeth
What to present about your patients: If they fought off the 8pm dose of Haldol
How many seconds attendings usually listen to your presentation: Often the whole thing, while nodding thoughtfully
MEDICINE ROUNDS:
Start time: 8am
End time: 5pm (on a short day)
What to know about your patients: Every health issue or experience that has happened to the patient and the patient's relatives or close acquaintances from when they were in the womb until now.
What to present about your patients: Any overnight event, including what time patient turned over, all vitals including trends in vitals since admission or possibly before, lab results for patient and patient's first degree relatives, or as much of this as you can get in before someone on the team interrupts you
How many seconds attendings usually listen to your presentation: They may pretend to listen for up to 60, but often not well enough to avoid asking you a series of questions which were answered in the first 60 seconds of your already given presentation
Sunday, November 16, 2008
Like a 12 step program
One day at a time. And so time has moved along, and for the most part, been good to us.
My husband had his PET scan, and it was good news. He still has enlarged nodes, though they are smaller, and none of them took up the label, so they consider the therapy a success. 6 months of chemo instead of 8, and most likely no radiation needed (thank God). I finally feel like I can breathe again.
On the bad side, chemo sucks so much. I guess I have realized how caviler we are with prescribing things for our patients, how quickly we are to dismiss them as "not too bad", when really they are pretty horrible and life-changing. To be fair, we were basically warned pretty accurately about the chemo, but there are parts of it that were downplayed to a ridiculous degree. For example, Mr. Dr. Dr. VonB had to get a central port, which they really blew off as not a big deal. In fact, the VIR (vascular interventional radiology) guys who did it didn't even prescribe pain medicines, they told him that Tylanol would be more than sufficient. What a joke! He was absolutely miserable for at least three days after that procedure, unable to sleep, unable to be comfortable, and in lots of pain. It was so much worse than his lymph node biopsy that he was using the pain medicine they'd given him for that (which he used once right after his surgery, and then had gotten by fine with Tylanol).
It's still a struggle to try to find something that doesn't make chemo so horrible. He just feels awful for 4-5 days after each treatment (and each one is getting a little worse). We keep switching around his medicines to help treat the nausea but most of them make him feel bad too. It is indecribably sucky to watch your partner suffer like this and be completely powerless to do anything.
In other news... OldMDGirl was actually right, though not about what my worst nightmare is. I found out the day after my husband's official diagnosis that I'm pregnant. It isn't that I'm not happy, it's just... nice timing, right? The first trimester was just... well, it was pretty miserable. I was worried about the baby, worried about my husband, worried about how much I was worrying (anyone else catch the study published right around that time linking maternal stress in the first trimester with schizophrenia in the child?), and oh yeah, yacking every single day while trying to continue rotations. Good. Times.
But things are better now. We got the Happy PET Scan News, the scary 1st trimester is behind me, along with the yacking, and I'm 5 short weeks from being essentially done with medical school. I took and passed Step 2, and surprisingly managed to to better than OK, which really blew my mind. I am done with my AI in three days (well, almost four, since one of those days is a call day) and it was pretty good even though I reaaaaaaaaaaalllllllllly didn't want to be working. Then I have four weeks of PICU and I'm outta there. Well, there's this crazy two week long course we all have to take in March. Oh, and I have to drive to FREAKING ATLANTA to take the Biggest Rip-Off in Existence (aka Step 2 CS) in February. But other than that... done.
And did I mention the baby is due the day after graduation? I don't care if I have to wheel myself, in labor, across the stage... I WILL ATTEND GRADUATION AND BE HANDED MY FREAKING DEGREE AND BE HOODED AND ALL THAT. This little munchkin is either going to have to be a little early, or a little late. Hear that, munchkin?
Anyway, that is a quick update of stuff here. I had actually meant to write more about the AI and what that's like, but I will have to do that another time. Here's a preview: overall, it's pretty awesome.
Until then... thanks so much for all of your thoughts, prayers and well-wishes. For those of you in graduate or medical school, keep the faith, because I am proof that even with random hideous life curve-balls, you do eventually get through it and move on.
My husband had his PET scan, and it was good news. He still has enlarged nodes, though they are smaller, and none of them took up the label, so they consider the therapy a success. 6 months of chemo instead of 8, and most likely no radiation needed (thank God). I finally feel like I can breathe again.
On the bad side, chemo sucks so much. I guess I have realized how caviler we are with prescribing things for our patients, how quickly we are to dismiss them as "not too bad", when really they are pretty horrible and life-changing. To be fair, we were basically warned pretty accurately about the chemo, but there are parts of it that were downplayed to a ridiculous degree. For example, Mr. Dr. Dr. VonB had to get a central port, which they really blew off as not a big deal. In fact, the VIR (vascular interventional radiology) guys who did it didn't even prescribe pain medicines, they told him that Tylanol would be more than sufficient. What a joke! He was absolutely miserable for at least three days after that procedure, unable to sleep, unable to be comfortable, and in lots of pain. It was so much worse than his lymph node biopsy that he was using the pain medicine they'd given him for that (which he used once right after his surgery, and then had gotten by fine with Tylanol).
It's still a struggle to try to find something that doesn't make chemo so horrible. He just feels awful for 4-5 days after each treatment (and each one is getting a little worse). We keep switching around his medicines to help treat the nausea but most of them make him feel bad too. It is indecribably sucky to watch your partner suffer like this and be completely powerless to do anything.
In other news... OldMDGirl was actually right, though not about what my worst nightmare is. I found out the day after my husband's official diagnosis that I'm pregnant. It isn't that I'm not happy, it's just... nice timing, right? The first trimester was just... well, it was pretty miserable. I was worried about the baby, worried about my husband, worried about how much I was worrying (anyone else catch the study published right around that time linking maternal stress in the first trimester with schizophrenia in the child?), and oh yeah, yacking every single day while trying to continue rotations. Good. Times.
But things are better now. We got the Happy PET Scan News, the scary 1st trimester is behind me, along with the yacking, and I'm 5 short weeks from being essentially done with medical school. I took and passed Step 2, and surprisingly managed to to better than OK, which really blew my mind. I am done with my AI in three days (well, almost four, since one of those days is a call day) and it was pretty good even though I reaaaaaaaaaaalllllllllly didn't want to be working. Then I have four weeks of PICU and I'm outta there. Well, there's this crazy two week long course we all have to take in March. Oh, and I have to drive to FREAKING ATLANTA to take the Biggest Rip-Off in Existence (aka Step 2 CS) in February. But other than that... done.
And did I mention the baby is due the day after graduation? I don't care if I have to wheel myself, in labor, across the stage... I WILL ATTEND GRADUATION AND BE HANDED MY FREAKING DEGREE AND BE HOODED AND ALL THAT. This little munchkin is either going to have to be a little early, or a little late. Hear that, munchkin?
Anyway, that is a quick update of stuff here. I had actually meant to write more about the AI and what that's like, but I will have to do that another time. Here's a preview: overall, it's pretty awesome.
Until then... thanks so much for all of your thoughts, prayers and well-wishes. For those of you in graduate or medical school, keep the faith, because I am proof that even with random hideous life curve-balls, you do eventually get through it and move on.
Sunday, October 12, 2008
Not supposed to happen
Here it is.
My husband has cancer.
Though we've known now for almost 2 months it is still blowing my mind. The worst part was the two weeks of waiting for a diagnosis. See, he woke up one morning and his armpit was sore. He was worried it might be something bad (always the optimist, that hubby of mine), and I made fun of him and told him he'd over-used his arm. A week later he called me from the kitchen.
"Hey, honey... wanna check this out?"
I sighed and put down my book.
"Look at this," he said, holding down the collar of his shirt.
On left side of his neck, right above the collarbone, was visibly swollen compared to the right. My stomach dropped.
"Feel this," he said, pushing around with is fingers.
I was almost shaking as I did to my husband what I've done to probably hundreds of patients--palpated for lymph nodes.
I've never felt a left supraclavicular node on a person before, but I've answered lots of test questions about what a firm, non-tender node in this area usually means: cancer. And there it was. A firm, non-tender left supraclavicular node.
On my husband.
My heart started pounding.
Strangely, at this point, he got more optimistic, while I began sinking into despair. "Maybe I have a weird infection," he said. "I've been taking care of a lot of dudes with TB, maybe I have that."
"Maybe," I said. I didn't mean it.
"Or Cat Scratch Fever."
"Yeah, maybe."
I wanted to go to the doctor right away, but this was a Friday afternoon, so we had to wait until Monday. We were there when the office opened Monday, but as he was a new patient, they wouldn't see him until Tuesday. Those days were awful, but they weren't anything compared to what was coming. Tuesday morning the resident examined him and said he probably had an infection. A trial of antibiotics, he said.
"I'm worried about cancer," I said, trying to sound like I was wondering if it would rain or not. "Specifically, lymphoma or testicular cancer."
The resident shrugged. "Well, we could do a chest x-ray just to be sure."
"Great," I said. "Thanks."
The report came back showing a mediastinal mass, a large one. Just like how, though most people might have blown it off, I knew that his node was bad news, I knew what this meant. I had been sort of rooting for testicular cancer, something that had a pretty darn good prognosis. But a mediastinal mass meant lymphoma, and that was the kind of diagnosis that could carry less than a 50% 5-year survival rate.
It was another week and a half of CTs and lymph node biopsies before we had a diagnosis. Each test looked more like the diagnosis was lymphoma, and it was more wide-spread than we had realized. The problem is that there are lots of types, and some are pretty OK, prognosis-wise, and some are horrific. So I tried to hope, but it was hard, knowing that it was more likely he had a horrific kind (they are more common) than a pretty OK kind.
And that's what life was: hoping for the least horrible kind of cancer.
Finally, we got a diagnosis. Hodgkin's Disease. It was the best diagnosis I could have hoped for given what we knew. His labs came back--again, the best labs we could have hoped for, given his stage. They started Chemo the following week.
I never even really had much time to think. How did this happen? He's 31 years old! Healthy! Never smoked, excersises, eats well, hardly ever drinks, and then only one or two beers. This isn't right. It isn't fair. I take care of people all stinking day who have abused their bodies maliciously for 50, 60, 70 years, and they are still hanging around, complaining that they cough (You're kidding, Mr. 100-pack-years? You COUGH??).
I'd find myself thinking a lot when I had to tell people, "My husband has lymphoma." Husband doesn't really say it. It's not right. It doesn't mean to everyone what it means to me. I wanted to say, "The love of my life, my best friend, my soul mate I never thought I would find, has cancer. He could die. And I'm supposed to keep showing up to clinic, keep doing laundry, keep eating and sleeping like any of it matters."
I would overhear people talking about their problems and want to cry. "My wife got in a fender-bender, my computer died, and I lost my wallet," I heard one person lament. "Could my life get any worse?"
For your sake, buddy, I thought--I hope not.
That's all I can write for now. Things are going as well as can be expected. He's tolerating the chemo okay. Having to watch him go through so many horrible procedures, tests and therapies is torture. Waiting for his PET scan, where we find out if his cancer is responding to the chemo, is hell.
But I am still doing my rotations (on his insistence... he always makes me do the right thing). I am studying for Step 2, which I take in two weeks--just days before his PET scan. I'm still going to clinic, and doing laundry, and eating and sleeping, because I guess that stuff does matter, somehow.
Just not as much as it used to.
My husband has cancer.
Though we've known now for almost 2 months it is still blowing my mind. The worst part was the two weeks of waiting for a diagnosis. See, he woke up one morning and his armpit was sore. He was worried it might be something bad (always the optimist, that hubby of mine), and I made fun of him and told him he'd over-used his arm. A week later he called me from the kitchen.
"Hey, honey... wanna check this out?"
I sighed and put down my book.
"Look at this," he said, holding down the collar of his shirt.
On left side of his neck, right above the collarbone, was visibly swollen compared to the right. My stomach dropped.
"Feel this," he said, pushing around with is fingers.
I was almost shaking as I did to my husband what I've done to probably hundreds of patients--palpated for lymph nodes.
I've never felt a left supraclavicular node on a person before, but I've answered lots of test questions about what a firm, non-tender node in this area usually means: cancer. And there it was. A firm, non-tender left supraclavicular node.
On my husband.
My heart started pounding.
Strangely, at this point, he got more optimistic, while I began sinking into despair. "Maybe I have a weird infection," he said. "I've been taking care of a lot of dudes with TB, maybe I have that."
"Maybe," I said. I didn't mean it.
"Or Cat Scratch Fever."
"Yeah, maybe."
I wanted to go to the doctor right away, but this was a Friday afternoon, so we had to wait until Monday. We were there when the office opened Monday, but as he was a new patient, they wouldn't see him until Tuesday. Those days were awful, but they weren't anything compared to what was coming. Tuesday morning the resident examined him and said he probably had an infection. A trial of antibiotics, he said.
"I'm worried about cancer," I said, trying to sound like I was wondering if it would rain or not. "Specifically, lymphoma or testicular cancer."
The resident shrugged. "Well, we could do a chest x-ray just to be sure."
"Great," I said. "Thanks."
The report came back showing a mediastinal mass, a large one. Just like how, though most people might have blown it off, I knew that his node was bad news, I knew what this meant. I had been sort of rooting for testicular cancer, something that had a pretty darn good prognosis. But a mediastinal mass meant lymphoma, and that was the kind of diagnosis that could carry less than a 50% 5-year survival rate.
It was another week and a half of CTs and lymph node biopsies before we had a diagnosis. Each test looked more like the diagnosis was lymphoma, and it was more wide-spread than we had realized. The problem is that there are lots of types, and some are pretty OK, prognosis-wise, and some are horrific. So I tried to hope, but it was hard, knowing that it was more likely he had a horrific kind (they are more common) than a pretty OK kind.
And that's what life was: hoping for the least horrible kind of cancer.
Finally, we got a diagnosis. Hodgkin's Disease. It was the best diagnosis I could have hoped for given what we knew. His labs came back--again, the best labs we could have hoped for, given his stage. They started Chemo the following week.
I never even really had much time to think. How did this happen? He's 31 years old! Healthy! Never smoked, excersises, eats well, hardly ever drinks, and then only one or two beers. This isn't right. It isn't fair. I take care of people all stinking day who have abused their bodies maliciously for 50, 60, 70 years, and they are still hanging around, complaining that they cough (You're kidding, Mr. 100-pack-years? You COUGH??).
I'd find myself thinking a lot when I had to tell people, "My husband has lymphoma." Husband doesn't really say it. It's not right. It doesn't mean to everyone what it means to me. I wanted to say, "The love of my life, my best friend, my soul mate I never thought I would find, has cancer. He could die. And I'm supposed to keep showing up to clinic, keep doing laundry, keep eating and sleeping like any of it matters."
I would overhear people talking about their problems and want to cry. "My wife got in a fender-bender, my computer died, and I lost my wallet," I heard one person lament. "Could my life get any worse?"
For your sake, buddy, I thought--I hope not.
That's all I can write for now. Things are going as well as can be expected. He's tolerating the chemo okay. Having to watch him go through so many horrible procedures, tests and therapies is torture. Waiting for his PET scan, where we find out if his cancer is responding to the chemo, is hell.
But I am still doing my rotations (on his insistence... he always makes me do the right thing). I am studying for Step 2, which I take in two weeks--just days before his PET scan. I'm still going to clinic, and doing laundry, and eating and sleeping, because I guess that stuff does matter, somehow.
Just not as much as it used to.
Sunday, September 14, 2008
Life throws Dr. VonB a big ol' curve ball to the face
You know, I casually throw around words like "survive" around a lot on this blog. It seems kind of silly now.
Unfortunately I can't tell you a lot about this curve ball except that it is basically one of my worst nightmares come true, and I probably won't be writing much for a while.
In the future I may, however, be in a position to talk more about real survival, and being on the other side of medical care.
Until then... keep believing in wondrous advancements in medicine. For those of you in med school/grad school/mudphud adventures, keep believing in what you do. It matters, and it changes people's lives.
Thanks for reading, everyone, and please send Mrs. Dr. and Mr. Dr. VonB all the positive vibes you can spare. I'm off to face my nightmare.
Unfortunately I can't tell you a lot about this curve ball except that it is basically one of my worst nightmares come true, and I probably won't be writing much for a while.
In the future I may, however, be in a position to talk more about real survival, and being on the other side of medical care.
Until then... keep believing in wondrous advancements in medicine. For those of you in med school/grad school/mudphud adventures, keep believing in what you do. It matters, and it changes people's lives.
Thanks for reading, everyone, and please send Mrs. Dr. and Mr. Dr. VonB all the positive vibes you can spare. I'm off to face my nightmare.
Subscribe to:
Posts (Atom)
