I woke up early to go to the Memorial Sloan Kettering Center in New York City. It is a world-famous cancer center, and Dr. Noy is a highly recognized specialist in cancers of the lymphoid immune system, especially lymphoma. I was warmly greeted by her secretary. The first day was a pretty long one simply because there was a long registration process that I had to go through in order to be able to interact with patients. Her secretary was so hospitable and made me feel comfortable in the office during the registration process. When I was finally allowed to enter the clinic around 3pm, I had unfortunately missed many of the patients, but I still got to see the last three patients and sit with Dr. Noy as she reviewed patient charts with a fellow. It was a very cool experience because I got to see what goes on behind the curtain as the doctors prepare to meet the patients, how they present the information to the patients, and then how they discuss patient responses afterwards. I learned that how you present the same information (framing) has a strong influence on the patient’s understanding of the information and their subsequent decisions based on that information. I also learned that in most cases, if you lay the options out in a logical, simple manner, patients are more confident about making a decision on what treatment to take. So even though it ended up being a very short day in clinic, it was still a valuable experience.
The second day I attended a lecture by Dr. Groopman and his wife Dr. Hartzband in the Rockefeller Research Laboratory adjacent to the Memorial-Sloan Kettering main building. It was on medical decision-making, which was a very interesting topic for non-specialists and pre-meds like myself. Dr. Groopman was applying game theory to the medical setting, which made me interested in perhaps taking game theory before I graduate Princeton. I was able to understand everything in the lecture without any medical training, which I think made it even more interesting to me. Following the lecture, I followed Dr. Noy to do rounds with her. I then followed another Attending, and ended up doing rounds until noon. This was a very useful time for me, seeing the in-patients and also having time to talk to the interns and residents that were rounding with me. In addition to several MD’s, one of them was an MD/PhD, another an MB/PhD (she got her medical degree from China, hence the MB), and I also met a clinical pharmacologist. It was great to interact with doctors who have followed different tracks to get there, and I was able to get their contact information in case I had questions later. I remember the MD/PhD intern telling me that she had taken the non-traditional route in doing MD first then transferring into an MD/PhD program, and inspiring me by saying something along the lines of: “ You don’t need to be so hung up on trying to plan out the next 10-20 years of your life. If you have a clear dream and goal, then even if it isn’t the traditional route, you will be able to achieve it if you put in the effort.” The rest of the day I spent with Dr. Lamanna in clinic. Her specialty is in leukemia, particularly in chronic lymphoycytic leukemia (CLL). It was interesting that patients with CLL tend to be older, and therefore they age with the disease and do not usually die of the disease, but with the disease. I loved that she has a very charismatic style of interacting with the patients; she was very outgoing and energetic when speaking with them.
The final day, I did rounds again, then attended a multi-disciplinary conference between various specialists in which they discussed two patient cases. Then, I spent the rest of the day in clinic with Dr. Noy. I witnessed a lumbar puncture, two bone marrow procedures, and longer patient-doctor discussions than on Monday. I felt that Dr. Noy has a very calm and witty way of interacting with the patients, and that she made the choices very clear for the guardians and patients in deciding which treatment path to take. It was very good to know that you can have real interactions with patients; not just 10-minute short encounters, but 30-40 minute sessions to really get to know the patient better. Also, there was a foreign couple who came in, and so a translator was on the phone translating between Dr. Noy and the patient. It was a very unique experience truly realizing what a global world we live in.
I am so grateful to Dr. Noy for this opportunity. She not only found time to allow me to shadow her, but also went out of her way to try to fill up my schedule so that I could meet different doctors and experience the various elements that make up a doctor’s day-to-day life. She was very friendly and down-to-earth with me. I was happily surprised that in addition to being so accomplished in her career, she is also a singer and an artist. I was worried that I might have to give up my hobbies of singing and drawing if I become a doctor, but it was great to see a real example of someone who has managed to do all.