I Give People Cancer, Part 2

the-anatomy-lesson

(In Part 1 I discussed being the man who "gives people cancer." I promised that Part 2 would be a little background as to how I got here.)

July, 1977

A hot day during what will be a steamy summer. The elevators in the University of Illinois Hospital are always too slow and too crowded. So I take the stairs up to the 13th floor, catching glimpses of the West Side Medical Center through the stairwell windows as I climb. It's a long way up, but likely to be the only exercise I will see on this day.

It is the fifth day of my medical student rotation in Internal Medicine. There are three others on my team: Jerry, a second-year resident, Madelyn, a newly-minted intern, and my classmate Paul. We are E-Service, one of five trainee groups responsible for the diagnosis and management of all patients admitted to the UIH. Most patients are indigent or close to it; the paying patients in the area are down the block at Rush-Presbyterian-St. Lukes Hospital. We have an attending physician, a "real" doc, as part of the service, but she dips in and out of the ward, eager to get to her Infectious Disease consults at one of the other local hospitals.

The day is a mirror of the last four and presages the rest of my two-month rotation. We care for a  young man who has lost an eye to a muscle tumor and is in for his monthly chemotherapy. A woman with Behçet's Syndrome, suffering from ulcers from her mouth to her colon, gargles viscous lidocaine, without much relief. It is all that we have to offer to her.

In contrast to our Behçet patient, we are having much better luck treating Mr. George, an older fellow with stomach ulcers. We are using an experimental drug named cimetidine, the first of a new class of drugs called H2 antagonists. It is working wonders. By the end of the summer, Mr. George will be pain-free, and cimetidine will be released as the blockbuster ulcer drug, Tagamet.

I sweat throughout the summer. I examine patients. I take medical histories. I draw blood, do EKGs, and hold emesis basins. And I come to a realization. I don't want to be doing this. I am good at book learning, but patient care is "not my forte and not for me."

Following those long, hot, months, I investigated the non-patient care fields; pathology and radiology.  Glass slides seemed more tangible than shadowy images on a piece of film, and I became a pathologist. It was the right choice for me.

I recently queried physicians throughout the US, Canada, and the UK about what led them to pathology. There was a unanimous consensus that a student didn't enter medical school aspiring to be a pathologist, though one respondent had fond memories of a childhood microscope. Analogous to me, some became disenchanted with treating patients during medical school or internship.  One felt that if he had to see one more patient he would wind up "in the stairwell with a straitjacket." Some admired pathology professors and decided to emulate them. Others discovered they wanted to be detectives and learn the truth, and that truth was in the tissue.

All of us admit to liking the lifestyle, with the minimal call and only rare midnight hours. And a good friend tells me she feels like "an angel behind the scenes." Who wouldn't want that?

No, I don't give people cancer, and neither do any of my hard-working pathologist colleagues. We search for the truth, and if at times we help vanquish cancer and other diseases, we can be happy with our lot.

The opinions above are the opinions of the author and not the opinions of Uropartners LLC.

Link to Part 1

Link to Some Thanksgiving Thoughts

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