I initially meant to write this post after I finished work on Thursday, but I was in Vermont without internet access until today. When I left the hospital on Thursday, our group had just raised a total of $100,000 since they began keeping track of the funds. This momentous occasion will hopefully help us win a hospital-wide award for innovation of medical care at HUP. If we do win, I will get to come back and accept the award with the other volunteers and Trish. This would be extremely significant because it would make the work public, that we have been doing. Then all of the other divisions at the hospital could adopt our system and begin having volunteers raise money.
My senior project is almost over. This is my fourth week working at HUP and I only wish that my project could continue for another couple weeks. A typical day at the hospital is quite different from my an average school day. At the hospital, I may have a rush of patients and paperwork and be extremely busy for hours or I may have only a few to see and get some free time to catch up on old applications. There are no scheduled classes at scheduled times. The patients are usually in the hospital for a few hours leaving me a large window to visit them. Lunch is another difference. At Westtown, everyday I have lunch from 1-1:45, while at HUP my lunch happens whenever I have a small chunk of free time. I like my life while working at a hospital, more than when I’m at school. It will be initially very difficult to readjust to life at Westtown.
This morning, I arrived at work a little before 8:00 and I went down to get a cup of coffee as I always do. When I came back upstairs, one of the patient coordinators, Carolyn, was in my office with a nurse practitioner and a doctor. Carolyn could not stop coughing and she was practically hyperventilating. After a few minutes of trying to stop her cough, we decided that I should take her to the ER so that she could use a nebulizer to stop her cough and diagnose her problem. One concerning element is that she has tested positive for Tuberculosis three times but does not have an active strand of the virus. She is not contagious and does not have any of the symptoms of the disease and most likely never will. Nevertheless, she was worried that this may have been the cause for her coughing. I was initially scared that I had contracted the serious disease from spending the morning with her but in the end, her chest x-ray showed no sign of TB, pneumonia or bronchitis. I was greatly relieved and later realized that if there was any risk that she had active tuberculosis she would have immediately been quarantined. But if the next time I get a TB test it comes out positive, I’ll know who to blame.
p.s. this is my penultimate post. There will be one more this Thursday.
Today was a good day. It all started this morning on the train ride into Philadelphia. I realized that I had done the calculations incorrectly yesterday. I forgot that I did not work last Friday, so my hundredth hour was going to happen this morning. This reinvigorated me and gave me a mission to start the day off with. I was going to contact all of the organizations that I had applied to the previous week to find out if my patients had been approved for their grants. Unfortunately, most of the places that I called were not open at 8 am so my calls went straight to voicemail. Then Trish arrived and told me to contact the Hope Lodge, a facility that houses patients that to come to the hospital regularly and live far away. I was able to help extend a patient’s stay for 51 days. The approximate cost to stay at the lodge is $190 per night. But the patients don’t have to pay, so we saved her $9,690 in total. Within minutes after I found this out, Trish told me that another patient that I spoke to yesterday would be approved for his respite vacation. This is a $5,000, week-long, all-expense paid DisneyWorld vacation for him and his family. His two children have never gone on a real vacation before and this will be there chance. Our hope is that this will give his children a happy memory of their father before he passes away. I am extremely excited to tell them this news on Friday, when the decision becomes official. This raised my grand total to $22,000 in 100 hours, which is twice my initial goal for the entire project. My next goal is to earn an additional $10,000 during my last week. This is very likely to happen because my other patients will most likely receive the two $5,000 respite vacations and the two $6,700 chemotherapy co-pay assistance grants that I have applied for.
This afternoon while I was looking at the list of patients that were in the clinic, I noticed a familiar name. I had gotten this elderly patient free Philadelphia Phillies tickets this past summer. I was thrilled to know that he was still alive as most of the patients that I saw during the summer had passed away. When I went to his room, he and his wife immediately recognized me and thanked me for the baseball tickets. They told me that he had received proton therapy and was now completely cancer-free. It is amazing to know that the new advancements of medicine are actually elongating patient’s lives and helping to eradicate cancer. This visit only made my day better, it was the icing on the cake. After work, I decided to treat myself to some well deserved ice cream. Today was not a good day; today was a great day.
I would like to start out by apologizing for not publishing any posts for the last few days. I have been both very busy and very tired. Yesterday, I spoke with a patient that I had never met before on the phone. I was trying to get his personal information so that I could apply to a few foundations on his behalf. Last October, he was having terrible stomach pain so he came to Penn to figure out what was wrong. The doctor ran some tests and discovered that he had a stage IV cancer diagnosis. The cancer had metastasized to both his liver and his lungs, meaning almost certain death within a year. What troubled this patient the most was the way that he found out that he had cancer. Apparently, the surgeon was extremely blunt when he told the patient, which depressed the him greatly. I was quite saddened by this news. I want to be a surgeon later in my life and I hope that I will be able to use this experience to become a better physician. I will ensure that my time working with desperate patients will stick with me and help shape me into a more well-rounded doctor, who can deliver painful news in the best possible manner. In the end, this patient told me that the surgeon gave him little hope that he would live. He said that every night he goes to bed wondering if he’ll wake up and as a result has begun praying more often. When I called to help him financially, he broke down crying and told me that he thought that I was a sign from God and that I was acting as his messenger on Earth. My offering of help gave him faith that there are people looking out for him, and additional hope that he may be able to overcome the odds and beat his cancer. I was caught off guard and left speechless. All that I could muster out was a thank you. I was unaware of how large the impact my project is having. This patient and other appreciative patients give me the strength to continue trying my hardest and to carry on despite my lack of energy.
Today, I had a discussion about medical ethics with my coworkers. It started when I learned that many doctors have to treat patients even though they may have a rational objection. Trish told me a story of a lung cancer patient that had long hair that began to fall off as he underwent chemotherapy. Once he lost his hair , his doctors, all of whom were Jewish, realized that he had a swastika tattooed on the back of his neck. Nevertheless they gave him the level of care that they gave all of their other patients. I hope that I never encounter a moral dilemma where I have to make a choice like this. As I am not sure if I will have the maturity to make all of the right decisions.
I ate lunch today in CHOP (Children’s Hospital of Pennsylvania) and saw how cheerful and bright everything was. This made me wish that I worked in the adjacent hospital, until Robert, another volunteer, pointed out a sad fact. Where we work, patients are fairly regularly sent to hospice care or simple pass away. This is saddening but often accepted because of their old ages. In CHOP, when a patient dies, this is devastating for both the patient’s family and the medical staff. I do not think that I would be able to handle a month of working in pediatric oncology. This I reaffirmed my belief that I do not want to specialize in pediatric surgery. That field of medicine calls for a stronger willed person than me.
On top of all of that, I passed one milestone and came incredibly close to reaching a second one. Today, I worked my one-hundredth hour and earned $9,500 during that time. To put this in perspective, for every hour that I work, I am essentially raising $95 for patients. That makes this an extremely high paying job, more than 13 times the minimum wage. Hopefully, tomorrow I will pass my goal of raising $10,000 for my patients. My next goal will be to raise $15,000 by March 15th, my last day of work.
Today was a rather uneventful day. I did contact a number of my patients and found out that most of them had been approved for the grants that I applied for last week. I have helped to raise almost $6,000, bringing me more than half way to my goal of $10,000. The most significant event of the day was a lecture that I attended. The subject of the speech was nutritional intervention therapy. I hoped that by attending, I could learn some alternative tactics for helping patients battle cancer.
I immediately knew that it would be an interesting meeting because the speaker spent the first fifteen minutes prefacing the lecture by saying that his research is quite controversial. His research supposedly proved that all animal-based products were a major factor in the development and progression of cancer. In one of his tests, he exposed two groups of rats to large amount of a known cancer-causing carcinogen. He then fed one group a 5% protein diet and the other group a 20% protein diet for 100 weeks or about two years. The results are extremely conclusive; all of the rats in the 20% protein group died and none of the rats in the 5% protein group died. When examining the rats’ on a molecular level, substantial evidence was shown within the first few days. While cancer cells were quickly developing in the doomed group, the other rats were becoming healthier and staying cancer-free. Years later, he tested humans that had different stages of a variety of cancers. His results were almost identical, the less animal-based proteins that were consumed, the better the patient’s outcome was.
This caused him to develop his idea for an unprocessed, whole-food, plant-based diet. To quote the speaker, “casein is the most significant carcinogen that we consume.” Casein makes up 80% of the protein in cow’s milk. This diet is supposed to prevent and/or cure not only cancer but a variety of diseases including both types of diabetes, and heart problems. Now with that being said, I believe that this is completely absurd. The results of his studies were too perfect to be true. Researchers seldom get that conclusive evidence for their thesis. I am not the only person who believes this either. Once I told Trish, she emailed the Penn oncology nutrition specialists and told them about this man’s research. She agreed that the results were most likely not true.
Despite what I and some of the other doctors believe, this raises a few very important questions. What if? What if he is right about everything that he researched? What if I just learned the remedy for some of the worst diseases afflicting humans today? This is obviously worth pondering. The benefits clearly outweigh the almost non-existent risks. In the future, I would like to try to only eating a whole-food, plant-based, not processed diet for a period of time. Who knows what benefits it could have for me and the worst thing that could possibly happen would be that I don’t like the diet and I switch back. That doesn’t seem too bad.
(Despite the title, this entry is not very morbid; I promise.) Today was an unusually quiet day. Monday is the day where I am the only volunteer and on top of that, Trish had a number of meetings. I spent a majority of my time with two patients but saw six in total. One of the people who I only visited for a brief amount of time had just found out that his cancer was more serious than he had previously anticipated. As a result of learning that he was terminal, he was more anxious than he normally was (His doctor told me that he had a history of anxiety). Trish and I gave recommended him a few different types of counselors and some group therapy sessions. Later on, I saw a different patient and gave her a five wishes from. This form instructs the medical staff what to do if a patient is not able to make educated decisions for themselves. It gives certain trusted family members the power to make decisions about the patient’s future, for example whether or not doctors should try to resuscitate them when they die. This also deals with taking patients off of life support or “pulling the plug”.
This made me think about if I was in my patient’s situation. I am not sure how I would handle receiving the news that I had terminal cancer. I’m pretty sure that I would be anxious too and I would not want to fill out the five wishes form because it would make death seem more immediate, more real. Understanding what my patients are experiencing will be my most difficult task during my senior project by far. Almost every patient is in a similar situation. Every case of Gastrointestinal cancer is serious. There is no stage zero cancer. Even the most optimistic patient must occasionally wonder if at their next appointment, they will be told that the cancer has won. I need to always remember this when I am with patients. They are constantly battling for their lives and simultaneously trying to achieve a state of normalcy. To quote a patient that I saw today, “I just want to get to here (she moved her hand horizontally). I don’t care if it’s up here, down here or somewhere in the middle. I just want to plateau.” That is my job, my only job. To provide raise them money, get them respite vacations and to sit down and talk with them. I just want to get their minds off of cancer and illness and alleviate all of their other problems. I just want to get them “here”.
Today, I finished my first week of work at HUP. I have never worked a 45 hour week before so this was a very new experience for me. Including travelling on the train and driving to the train station, my actual work week was 55 hours long. I helped to raise $2,500 (I’m on track to meet my goal of $10,000) and I submitted applications for a number of patients so the money should continue to roll in next week. Needless to say, I am quite tired; but I am very happy that I chose to work at Penn for my senior project. It has allowed my to make a more educated decision whether or not I want to go into medicine. This has only reaffirmed my faith that medicine is the career for me. One thing that I realized today is that hospitals never close. I’m sure that as you are reading this, you’re thinking yeah of course hospitals never close. But this never exactly clicked for me until I was leaving at 5:30. As I was walking out of the front door of the hospital with a fair crowd of people, there was another group of people walking in, ready to start their day. There is no mass exodus from the hospital, there will always be a staff of people working there and that thought comforts me. As a doctor, I won’t be the last person in the office and I love that.
I have been regularly attending meetings and conferences as a part of my job. It is very nice because not only will this help me accomplish my goal of learning about the oncological branch of medicine, but there is always great catered food there. I attended one on how to treat VIP patients (fabulously wealth ones), one on hospice care and terminal patients and a few others. I couldn’t believe what I heard at the VIP patient meeting, apparently there are people that come to an outpatient part of the hospital and are surprised that they have to wait at all. Understandably, this can be nerve-wracking for nurses and doctors. But there is another special aspect to these patients. When the pass away, they have the potential to make large donations back to the hospital. This is how new buildings are built and how hospitals grow and develop. The meeting on hospice care amazed me and almost brought me to tears at one point. It discussed whether or not to tell people that they are going to die and the involvement of the family. Some people brought up cases of patients at CHOP as young as three years old. I am sorry that I can’t tell the stories that they told. HIPAA law makes it a federal crime to break patient-doctor (or me) confidentiality. I can not imagine telling the family of a three-year old child that they are going to die so I will not go into pediatrics. People discussed whether or not to tell the child that they were terminal and at what age can children comprehend the concept of death. This brought the reality of dying right in front of my face. It occurs all the time in a hospital and could happen to anyone at any point. I will have to learn to accept this better or this will be a difficult four weeks.
I finally began to realize what my daily life would look life during my Senior Projects. Wake up at 6 am, leave the house at 6:45 before the sun rises, arrive in Philly at 7:50 and begin work immediately, leave work at 5:15, take the 5:29 train home, drive home after the sun has set, arrive home at 6:20 for dinner, go to sleep, then start all over again. Lather, rinse and repeat. This is going to be a long four weeks. I hope that I can make it. During the past three days, I have worked almost 30 hours, spent five hours in transportation between my house and Philly, drank almost 100 fluid ounces of coffee, and helped to raise $1,500 for patients. I am on track to raise (and maybe even surpass) my goal of $10,000. Nevertheless, I am having a great time. This is a teaser of what the life of a resident or doctor is.
Yesterday and today, I met more of the other volunteers that I will be working with. For the most part they are nice and I plan to get along with them all just fine. That is always a good thing. I met with more patients and heard some amazing and terrible stories. One patient was from Liberia and has personally witnessed militant activity. This has left him scarred with post traumatic stress disorder. I also met with a number of people who have no means of income whatsoever and are left to pay outrageously expensive medical bills for their necessary cancer treatment. However, there is always light in the darkness. Despite all of the sadness there is still some humor and some laughter. I saw a small sticker that had a picture of Wile E. Coyote holding a sign that said health tip. It said, “If you can’t afford a doctor, go to an airport – you’ll get a free x-ray and a breast exam and; if you mention Al Qaeda you’ll get a free colonoscopy.” All of the doctors and residents that I have met are always cheery and positive. I am fortunate enough to attend a catered luncheon conference every Wednesday, where all of the interdisciplinary doctors come together are discuss their more difficult patients. They come to an educated decision on the best course of action to take. I am able to learn about cancer and the entire radiation oncological field of medicine. I am also able to meet with surgeons and ask them my questions. One of the patients that I am looking after will be getting a esophagectomy to treat his esophageal cancer. I learned that they stretch the stomach after removing the esophagus. This is really interesting to me but may seem disgusting to you. Sorry.
Today, when I was leaving work I realized how tired I was. I was standing on the train because there were no available seats. I forgot that I wasn’t holding on to anything and as the train began to stop, I began to lose my balance. However, I did not realize that I was falling, so I didn’t catch myself. Then when I was about to fall over, I finally caught myself, but unfortunately I slammed my heel into a small woman’s foot. I apologized profusely and then when she had left, I went to sit down and forgot I was holding a drink. So I spilled my cream soda all over the floor. Ugh. I’m going to need a second spring break after this spring break.
Yesterday, I started my project. I took a 7:17 train from Elwyn to University City and then made the two block walk to HUP. Then I met up with Trish. She was happy to see me after my 6 month hiatus from work. I learned that many things had changed during this time. She was no longer a patient support specialist, she was now a manager and nurse navigator. This gave her more responsibilities but gave her less time to work on each of the many different facets of her job. I also learned that of the patients that I saw during the summer, only a few were still around. I had expected this answer before I asked the question. It is important to remember that the people that I work with are extremely ill. The survival rate is low even with the advanced medicine that Penn has to offer.
We then began to discuss what my job would entail during these four weeks. She said that she wants me to become as knowledgable as possible about this oncological branch of medicine. There are multiple different conferences and educational classes that will be happening during my time working here that Trish and I will be attending. They are all in Philadelphia so it should be no problem attending them. Trish told me that my main job would be to raise as much money as possible for the patients in need. I will also be working on a system that helps the patients continue to get money from foundations after I am gone. This is especially important with Trish’s new more executive job. She will have more responsibilities and will have less time to write grants. There will be other volunteers coming once a week certain days of the weeks and Trish told me that I will taking a leadership role and will be in charge of them.
After we finished our talk, I spent a majority of the day researching the organizations that I will be in contact with. I read through all of the applications and went on the websites to see what patients are eligible for which grants. I did see one patient and presented her with a $50 Wells Fargo Visa Gift Card. I am excited for what is yet to come and the surprises that I will face during this month.