The opportunity that medicine provides us to work with and help people during some of the most difficult times of their lives is one of the main reasons I have always wanted to pursue medicine as a career. I am naturally a people person; I love being able to get to know someone deeply and try to make them feel better in times of need. A lot of my past experiences in work or volunteering have revolved around mentoring kids and teenagers. Because of this, I came into medical school thinking pediatrics might be the specialty for me, and I particularly considered pediatric hematology & oncology. I have spent quite a lot of time with this patient population, as I have been a volunteer at an oncology camp called Camp Trillium for five years. At Camp Trillium, volunteers are paired one-on-one with children who have been diagnosed with cancer or whose sibling has been diagnosed. It is a very special and happy place; the purpose of camp is to create a space where every child gets to feel normal, since every camper has been affected by the disease in a similar way and many have gone through the same family processes of regular treatments and check-ups. There is a special bond that you have with the kids you work with at camp. Whether they are younger children just in early elementary school or teenagers, it’s amazing to see that they are still so positive and happy despite everything they and their families have been through. They are superheroes. However, I believe my perspective is somewhat clouded, as many of the kids that attend camp are at a point in their treatment where they are well enough to be there (and not in hospital or in bed) in the first place.
During the first few months of medical school, I did a horizontal elective in a pediatric hematology & oncology clinic. As soon as I walked into the clinic lobby, I saw posters that were advertising for Camp Trillium. I had been really excited for this elective because I knew it must be one of the most rewarding specialties in medicine to work with this patient population. Many of the campers at Camp Trillium had spoken to me about how much they liked the doctors and nurses that treated them, and the older campers especially could articulate the differences the health care professionals made for them.
Throughout the day we saw children in various stages of health and with many different pathologies going on. Some were children who ultimately were cleared of any hematological conditions, some were coming in to keep up to date on their current course of treatment, and some were coming in to be told that they were still cancer free and to continue with routine follow-ups. During these appointments, while I recognized that this was a very emotional experience for these families, I mostly just felt grateful to be able to experience these moments with them, and to see how the doctor was positively impacting the lives of her patients. She was great at making parents feel reassured that their child was receiving all the tests and treatments that were needed, and that things were staying on track. She was also great with the children. She would get down to their level and chat with them about how they were coping, how school was going, their friends, and more.
Later in the day, I saw a last name that looked familiar on a patient chart. It turned out to be a family that I knew well. I had spent a whole week with them at Camp Trillium just over a year ago, playing basketball with their son and practicing hair braids with their daughter. I remembered how the parents were so sweet with their children. I could tell they had a strong family relationship.
Initially, I was excited to see them. However, once I walked into the room with the physician, I could tell something was very different this time. Their son was no longer doing as well, and his parents were worried that the cancer may have returned and spread to his bones. He was coming in today to have a bone marrow aspiration done to investigate this. Although the parents were still very sweet and happy to see me, they were clearly less positive and upbeat than when their son was healthy at camp. They looked drained. Their son still remembered me, but he didn’t jump up to give me a hug like I thought he would. The tone of the doctor had changed too; she wasn’t as bubbly as she was with her other patients and she was providing much more serious details to the parents. When she asked the boy how school was going, his response wasn’t the same as when she asked the exact same question to the boy earlier who was cancer free. This is where it really hit me how tough of a specialty this is. It is incredibly rewarding to work with these children and families, especially when you can ultimately make a child healthy again. You also form a very special bond with families who you’ve been seeing in clinic for years, and they often thank you for the help you’ve given them. For this same reason, however, it is extremely upsetting when these same patients have a relapse or become palliative. You feel like you’ve done everything right and yet things can still go wrong.
Reflecting on this experience, I realize how important for me it is to have a career where I can spend enough time with my patients to develop a relationship with them. Some illnesses are very sensitive or traumatic for patients, which can make the interaction they have with their physician a very important one. But, I need to be careful that the work I do is something that I can emotionally handle every week – that I won’t constantly be “bringing work home” with me. I love children, and I have always loved spending time with pediatric oncology patients at Camp Trillium, but treating these patients as their physician is different. I will continue to be a volunteer at camp of course, but I don’t think pediatric oncology is the right career path for me. I do, however, think that just like their patients, these physicians are superheroes.