On Wednesday, May 22, 2013, I commuted to New York City to shadow Dr. Ariela Noy, an oncologist at Memorial Sloan Kettering Cancer Center specializing in treating lymphomas, certain forms of leukemia and HIV-related cancers. When I walked in at 9 am, Dr. Noy’s kind assistant led me to the place where I would receive my visitor’s card. Shortly after that, I read through the HIPAA training documents, which stressed the importance of confidentiality in medical practice; every patient is entitled to his or her privacy and identifying information must not be disseminated. The remainder of the morning was spent viewing research presentations. The amount of time oncologists spend presenting new findings in clinical research, discussing specific cases and deciding which courses of action to take proved to be higher than I expected, especially when compared to the amount of time spent in the clinic for patient visits. Upon learning that clinic days occurred just twice a week, I was surprised, for I did not realize how much time discussion between doctors would consume. At the research meetings I attended, a recurring theme that I noted was the importance of molecular biology behind each cancer case. As a molecular biology major, I realized that the overlap between clinical and molecular research is greater than I had previously assumed. Mutations in specific genes within pathways that I have studied in the core classes for my major are key players in the development of cancers, and these molecular details are not at all trivial for doctors trying to treat cancer by interfering with its molecular mechanisms. The scientific, critical thinking that doctors employ in their everyday work is truly inspirational; this experience has stressed to me the diversity in cases and importance of creative thinking over formulaic approaches to medicine.
The entire afternoon was spent viewing a marathon of patient visits at the clinic; the specific details about patients cannot be disclosed, but I can elaborate on my observations regarding the challenges faced and the rewards earned by Dr. Noy as an oncologist. Earlier, I mentioned the variety in cancer cases and how an oncologist must be able to mold his or her thinking in each case – this flexible mindset must extend beyond a solely medical, molecular context. Differences between patients and their attitudes toward treatment are not negligible. First, there are personality differences between patients; some people are afraid to confront their disease, others are more eager for immediate treatment. Additionally, there are other factors such as health insurance and language barriers that are obstacles in the progress of treatment and in communication between the patient and physician respectively. Dr. Noy was very perceptive of the nuances of each case and would adjust her delivery accordingly to ensure that each patient understood his or her condition and possible courses of action. As someone who has been vacillating between the possibilities of medical school or graduate study in molecular biology, my desire to go to medical school has been reinforced by this experience.