I’m glad you had this experience with such a great mentor. I’ve been a practicing Family physician for 20 years. I have also been a cancer patient, surviving Stage III breast cancer at 33yo. I was only 4 years into my career and my daughters were only 5yo & 2yo when I was diagnosed. I am grateful for the excellent care I received from my Medical & Radiation Oncologists and Surgeons, and for the collaboration that went into it. My experience with them has had a profound effect on how I practice & communicate with patients. I was never told what to do. I was not promised anything unrealistic. I was given options, information & support. I chose aggressive treatment because of my young age. I realized through that experience how individualized cancer care is. It is truly a special field. You seem very thoughtful, & that will serve you well in your career. I wish you the best in your journey, wherever that ends up taking you.
If you don't get "sucked" into some of the pain and suffering of your patients you will just be an oncologist that a computer could replace. Today many practitioners look at a suffering cancer patient who says " doctor how can I cope with this pain" and are told to go home and take 2 Tylenol. I know of what I speak since I have practiced medicine 40 yrs and suffered with angiosarcoma for 4 yrs.
At one time I had a very good view of oncologist….not now! I have had both parents and a wife of over 40 yrs terrorized by poisons!…and still passed on!! It would have been better if they never saw an oncologists…a non-political type would have been much better. So why have I thrown politics into this mix you might say….because it is now political science…they forgot about healing by means outside political science! Ivermectin is a perfect example…a safe med which was/is known years ago to help cancer…cheap too…but just like COVID it was tossed to the next century…yet we NOW seem to find it very helpful…but you can bet they these political scientist will not add it until the end when at the beginning is better for the patient. So why not add it early…Big Pharma will not allow it. Who works for who?…Arkansas hopefully will allow over the counter availability…but the oncologists will not allow its early use? I have lost faith in medicine and even worse for oncologists
This explains why VP has so much time to tell other doctors that they should see less patients and get patients coffee in the hospital. He sees 8 patients in a half day clinic and then 7 in the hospital in the afternoon, who have already been rounded on by his fellow and then the orders placed by the fellow after he sees them. Then done by 3pm!
Don't get me wrong, I love VP for the most part and most of his clinical opinions, but his holier than though articles a few months back struck a nerve with me
2.5 years after my husband's death from glioblastoma, we remember his NeuroOnc, a great communicator who never gave false hope, but helped us stay positive and savor the time we had left with him. All the people at his clinic, from receptionists to radiation staff to MDs, were truly special people who had a calling to help families through this horrible time.
As the wife of a cancer patient (NHL currently in remission) I beg you to go into oncology! We need more caring, smart and wonderful physicians treating this horrible disease. My husband’s oncologist is wonderful- she tells him like it is and he needs that. She’s compassionate, listens and then tells him her thoughts and get this- asks him about what HE WANTS. Oncologists are another breed and they are wonderful. Dr. Prasad is amazing- such a great teacher. Best of luck with your education!
I wonder... If oncology divested itself of the fighting cancer myth, and instead helped patients to live as well as possible for the time they had left... recognising that we all die, and that is likely that it is the patient in front of us's time. So many people in their 50s and older seem to assume they're going to live forever... Or at least that is their aim... I'm not sure why try the horrendously expensive cancer drug on a frail old man who is only going to die of something else soon or survive to be demented. If he survives the treatment. Frailty only has one outcome... More frailty. I think of the opportunity cost of those funds... But then I'm someone who'd choose euthenasia in preference to aged care, personally, and I think our animals get better end of life care than we give humans.
Thank you for your interest in helping people with their health, may your tribe increase!
My son is has worked as a PA in oncology for the past 15 yrs; 7 in bone marrow transplant at Fred Hutchinson Cancer Center and 7 as a oncology hospitalist at Swedish. It's tough field!
All medicine is tough and over the long haul every Dr loses many patients, most due to the fact that we all die. For some, the Dr prolongs life and good times, for some the Dr prolongs suffering, and for a few the Dr makes things worse. It's the unavoidable nature of the calling.
If you have not already done so, I urge you to read Being Mortal Paperback by Atul Gawande. Also Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life by Louise Aronson if you envision yourself working in adult oncology. Both present the life of a Dr in vivid 3D and are well worth you time reading.
I was chief resident in medicine at SFGH back in 1968-69. Much less glamorous then but a lot of fun. It was an old building then (brand new compared to what I was used to in Phillie where I did my med school and internship) when I started my residency in 1966. Independent at first and run by the county but then became part of UC the next year.
I hope, Colton will achieve some success in one of the most messed up fields of "Madicine."
It looks like "treatments" are DESIGNED to "help" for some time in order to justify their costs...
Other than that, most MDs wouldn't accept chemo. In fact, chemo has acquired such a bad name that it even has a new name: immunotherapy.
Let me not get started with mammograms bursting cysts and causing cancer, but let me point out the absolutely rudimentary (on purpose?) state of diagnostics:
Loved this post. Saw my daughter’s mind flipping around as she went through each specialty rotation. Started med school thinking she was going into either IM or derm- having shadowed 2 of my brothers in those fields. For a second she considered addiction medicine psychiatry. She ended up with plastic surgery. Never had a surgeon in the family. Crazy. She loves it. Work hard these next four years. Glad you’ve had a great experience already.
If his colleagues were both shocked and delighted that he made a face to face visit, that means it isn’t a regular occurrence. Maybe a bit of showmanship because you were there?
I’m glad you had this experience with such a great mentor. I’ve been a practicing Family physician for 20 years. I have also been a cancer patient, surviving Stage III breast cancer at 33yo. I was only 4 years into my career and my daughters were only 5yo & 2yo when I was diagnosed. I am grateful for the excellent care I received from my Medical & Radiation Oncologists and Surgeons, and for the collaboration that went into it. My experience with them has had a profound effect on how I practice & communicate with patients. I was never told what to do. I was not promised anything unrealistic. I was given options, information & support. I chose aggressive treatment because of my young age. I realized through that experience how individualized cancer care is. It is truly a special field. You seem very thoughtful, & that will serve you well in your career. I wish you the best in your journey, wherever that ends up taking you.
If you don't get "sucked" into some of the pain and suffering of your patients you will just be an oncologist that a computer could replace. Today many practitioners look at a suffering cancer patient who says " doctor how can I cope with this pain" and are told to go home and take 2 Tylenol. I know of what I speak since I have practiced medicine 40 yrs and suffered with angiosarcoma for 4 yrs.
At one time I had a very good view of oncologist….not now! I have had both parents and a wife of over 40 yrs terrorized by poisons!…and still passed on!! It would have been better if they never saw an oncologists…a non-political type would have been much better. So why have I thrown politics into this mix you might say….because it is now political science…they forgot about healing by means outside political science! Ivermectin is a perfect example…a safe med which was/is known years ago to help cancer…cheap too…but just like COVID it was tossed to the next century…yet we NOW seem to find it very helpful…but you can bet they these political scientist will not add it until the end when at the beginning is better for the patient. So why not add it early…Big Pharma will not allow it. Who works for who?…Arkansas hopefully will allow over the counter availability…but the oncologists will not allow its early use? I have lost faith in medicine and even worse for oncologists
This explains why VP has so much time to tell other doctors that they should see less patients and get patients coffee in the hospital. He sees 8 patients in a half day clinic and then 7 in the hospital in the afternoon, who have already been rounded on by his fellow and then the orders placed by the fellow after he sees them. Then done by 3pm!
Don't get me wrong, I love VP for the most part and most of his clinical opinions, but his holier than though articles a few months back struck a nerve with me
2.5 years after my husband's death from glioblastoma, we remember his NeuroOnc, a great communicator who never gave false hope, but helped us stay positive and savor the time we had left with him. All the people at his clinic, from receptionists to radiation staff to MDs, were truly special people who had a calling to help families through this horrible time.
As the wife of a cancer patient (NHL currently in remission) I beg you to go into oncology! We need more caring, smart and wonderful physicians treating this horrible disease. My husband’s oncologist is wonderful- she tells him like it is and he needs that. She’s compassionate, listens and then tells him her thoughts and get this- asks him about what HE WANTS. Oncologists are another breed and they are wonderful. Dr. Prasad is amazing- such a great teacher. Best of luck with your education!
I wonder... If oncology divested itself of the fighting cancer myth, and instead helped patients to live as well as possible for the time they had left... recognising that we all die, and that is likely that it is the patient in front of us's time. So many people in their 50s and older seem to assume they're going to live forever... Or at least that is their aim... I'm not sure why try the horrendously expensive cancer drug on a frail old man who is only going to die of something else soon or survive to be demented. If he survives the treatment. Frailty only has one outcome... More frailty. I think of the opportunity cost of those funds... But then I'm someone who'd choose euthenasia in preference to aged care, personally, and I think our animals get better end of life care than we give humans.
Thank you for your interest in helping people with their health, may your tribe increase!
My son is has worked as a PA in oncology for the past 15 yrs; 7 in bone marrow transplant at Fred Hutchinson Cancer Center and 7 as a oncology hospitalist at Swedish. It's tough field!
All medicine is tough and over the long haul every Dr loses many patients, most due to the fact that we all die. For some, the Dr prolongs life and good times, for some the Dr prolongs suffering, and for a few the Dr makes things worse. It's the unavoidable nature of the calling.
If you have not already done so, I urge you to read Being Mortal Paperback by Atul Gawande. Also Elderhood: Redefining Aging, Transforming Medicine, Reimagining Life by Louise Aronson if you envision yourself working in adult oncology. Both present the life of a Dr in vivid 3D and are well worth you time reading.
I was chief resident in medicine at SFGH back in 1968-69. Much less glamorous then but a lot of fun. It was an old building then (brand new compared to what I was used to in Phillie where I did my med school and internship) when I started my residency in 1966. Independent at first and run by the county but then became part of UC the next year.
I’m so jealous ❤️❤️
Spirit lifting, wonderful essay.
Thank you ,Colton. Whatever you chose to do, I venture a guess that you will be excellent in our field
I am a retired physician, have a dark view of the state of affairs in medicine
Dr.Prasad is my huge hero, who along with other rare luminaries gives me hope that medicine and humanity may still have a chance
Just curious, how you managed to get a chance to shadow Dr.Prasad; excellent choice!!
I wish med professionals in training at any level would learn about Dr. Prasad and follow his writings, sub stacks, etc.
love the pic of you and Dr Prasad!!
I hope, Colton will achieve some success in one of the most messed up fields of "Madicine."
It looks like "treatments" are DESIGNED to "help" for some time in order to justify their costs...
Other than that, most MDs wouldn't accept chemo. In fact, chemo has acquired such a bad name that it even has a new name: immunotherapy.
Let me not get started with mammograms bursting cysts and causing cancer, but let me point out the absolutely rudimentary (on purpose?) state of diagnostics:
https://rayhorvaththesource.substack.com/p/how-do-you-know-you-are-sick-or-how
Prostate "cancer"?
https://unbekoming.substack.com/p/the-great-prostate-hoax
Lol. 8 patients in the morning . Thats the first hour -6 to 7 am for cardiologist ...kidding -not really
Loved this post. Saw my daughter’s mind flipping around as she went through each specialty rotation. Started med school thinking she was going into either IM or derm- having shadowed 2 of my brothers in those fields. For a second she considered addiction medicine psychiatry. She ended up with plastic surgery. Never had a surgeon in the family. Crazy. She loves it. Work hard these next four years. Glad you’ve had a great experience already.
If his colleagues were both shocked and delighted that he made a face to face visit, that means it isn’t a regular occurrence. Maybe a bit of showmanship because you were there?
Dr. Prasad appears to be a good physician as well as an accomplished scientist. My career was positively impacted by similar men and women.