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.

-Matt

(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”.

-Matt

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.

-Matt

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.

-Matt