#but since my local hospital sucks ass I’m just going to go on my infusion Wednesday and hopefully be able to actually get my infusions even

[thesaltyoncologist]

WTF do oncology fellows do?

WAKE UP: 0630 - 0755

My alarm is set for 0630-0700 most mornings. I rarely, if ever, get up at that time. I usually hit the snooze alarm for at least 30 mins if not nearly an entire hour, depending on the day. I’m actively trying to get better at dealing with mornings but I honestly just suck at it. Today I hit snooze for exactly 55 minutes before rolling over in bed, grabbing my phone, and jumping on my morning conference call at 0800.

MORNING SIGN-IN: 0800 - 0830

I have a research clinic once per week, and Monday is my research group’s day. This is the one day of the week where our patients who are on clinical trials are seen in clinic. We start the morning with kind of a virtual roll call of who will be physically seen in clinic, who is going to the infusion room for treatment, and if there are any people being seen for acute problems. It’s usually pretty quick, consisting something along the lines of: “Mr. X is here for C4D1 treatment with X for his prostate cancer” for each patient. After we run the list, my drag my ass from bed and get dressed. 

RESEARCH CLINIC: 0900 - 1400

What I do during each Monday research clinic varies. Today I had to physically go into the hospital because one of our patients was admitted and was scheduled to start treatment today. I met my boss up on the wards and we headed over to her room to give her and her husband an update on how the day would go. Nothing exciting, just a few hours of infusions. Provided she’s not one of the unlucky sort who have an infusion reaction, it should be a pretty dull day for her. The side effects hit later, especially after the number of cycles accumulates. She looks better today than during our last few visits. Definitely more relaxed and less emotionally wrecked. I’m sure the feelings are all still there, just controlled for the time being. She’s only 50 years old.

After seeing our patient, I head over to clinic where I work with one of our APPs who is working through a stack of papers for a second opinion later this week. It’s painfully slow work, made worse by the fact that no one seems to believe in writing an oncology treatment summary anymore. After a couple of hours we piece together a halfway decent treatment timeline. She’s another young patient who has burned through double digits worth of treatment regimens. Her local oncologist is better than his half-assed progress notes indicate, and he has her on an appropriate treatment. Unfortunately she doesn’t qualify for any of our ongoing trials. She’s only 45 years old.

We end the clinic in a similar fashion to how it begins, with a quick sign out of who was seen and the highlights of what happened. 

1400-1500: ANKI

I head over to the fellow’s office and my cubicle to knock out some flashcards. Oncology boards are looming in November. Anki has always been my go-to during medical school and residency, and it continued in fellowship. All of medicine has a base of memorization. It’s unavoidable. Anki is the best way of helping me pound staging and treatment algorithms into my head. Patients rarely fit into these standard scenarios, but again, having that base knowledge is key. Somewhere in between flipping through my cards, I remember the peanut butter sandwich I stowed away in my bag for lunch. Sandwich gone. Cards reviewed. I pack up and head home.

1500 - 1600: WALK THE DOGGO

It’s a mild but sunny day outside so me and the doggo hit the sidewalks. The actual mileage we cover is pretty minimal. His legs are short, and he has yet to meet a smell that didn’t intrigue him. That’s okay by me. The fresh air helps me clear my head.

1600 - 1800: DATA CRUNCHING

Back to the house where I try to knock out some more work. Today, I’m working through some clinical trial data. Clinical trials take so long to complete that it’s hard for a fellow to work on a singular trial, from start to finish. Most of the time we just work on different parts of different trials. This is a trial that was wrapping up right around the time I joined my research group. I saw the last few patients go on trial (and progress on trial, unfortunately). So now I’m working on compiling the data that will eventually be a new manuscript. Like the majority of research trials, this more than likely a negative phase I/II trial. It’s still a good way for me to learn the mechanics of compiling data and manuscript preparation. It’s been a while since I’ve written manuscripts. I’m rusty.

1800 - 1930: DINNER

My roommate cooks and I clean. It’s a pretty sweet deal. We usually have the news on while we eat, and tonight is no different. Probably the only thing I like about this part of the country has been the politics.

2000 - 2100: 

Time for a quick lifting session followed by a hot shower.

2100-2200: 

Watch an episode of TV with the roommate. Tonight, he’s playing some weird show on Hulu. I spend most of the show scrolling through tik toks. Once we get finished, my phone gets plugged in and retired for the night.

2200 - 2300: WIND DOWN

Normally, I avoid all screens after around 8-9pm. Tonight is a little different since I decided to through my daily routine into a post. Normally, my wind down routine consists of reading my well loved and worn copy of ASCO-SEP... which is basically the Oncology equivalent of First Aid. Then bed. Rinse and repeat.