Oncologist Appointment

I had a six month oncologist appointment today. Everything continues to look good. 

As usual, I went to the hospital early to get my blood taken. Phlebotomists tell me that I have good veins, and it seems to be true. I almost never have any problems getting a blood sample taken from my arm, or getting an IV line put in. Of course, today was different. The oncologist's office never sent my paperwork over to the blood draw office, so I had to wait a while for that. And then the phlebotomist completely missed my very large, inviting vein. She apologized a lot, but it was fine. We got it done, and I went to the oncologist's office for my exam.

Before I saw Dr. H, I saw another doctor, one who is receiving specialized training in blood cancer. He did the initial exam, asking all of the questions and feeling around. He seemed nice enough. It's not the first time I've had one of these trainees, and I always ask them the same question before they leave: Why oncology? Of all the specializations in medicine, why focus on cancer?

He said he had received some training already to be an internist -- a general practitioner or family medicine specialist. He thought he'd like to specialize in something, though, and he liked the idea of being able to possibly cure someone. A good answer. But he added a little more information. More on that below.

Dr. H came in next. As usual, we chatted away while he did his physical exam. He asked me questions about work. Asked about some other health issues I've been dealing with. Asked about any movies I've seen lately. I haven't been to a movie theater in 2 years. He hasn't been to one in 6 years. (His kids are small.) He said he's asking about movies because there really isn't much more for us to talk about. Everything looks good for me.

I always ask him what he's excited about in the world of Follicular Lymphoma. He's excited about CAR-T, which he thinks will ultimately cure FL, at least for a lot of patients. And he's excited about bispecifics, which he thinks will be approved for FL within the next year. (I'm still looking for any sessions at ASH this year that look at bispecifics -- if he thinks they are that close to approval, there will likely be some reports at ASH.)

And then he told me I was doing great, and that I should enjoy life. I told him that HE should enjoy life -- get a babysitter and go see a movie sometime. 

I go back in six months.

Now, back to that doctor who is training in oncology. He reflected a little bit on his choice of specialty, and said something that I've been thinking about since then: "I was concerned that I wouldn't be able to disassociate myself. But I think I'm able to."

What he meant was, he wasn't sure if he'd be able to not let his emotions get the best of him. I completely understand -- it's why I ask the question. Why would anyone go into oncology when there's so much possibility of things not going well for your patients?

But it also made me think -- how much do I really want an oncologist that is able to disassociate himself? How much do I want an oncologist that can cut off his emotions? And when does that process start? Is it only after the patient gets bad news? Is that when a doctor starts to distance himself? Because it seems like that's when I would need him most. So is it sooner, when things are going well? Does that mean no more discussions about movies, or how work is going, or where to get the best hot dog in the area (a discussion I have also had with Dr. H)? No sense in making connections like that if you ust need to cut them off later, right?

It can't be an easy job, and I don't know I there's an easy answer to that that question -- how much of an emotional connection to patients should an oncologist have?  I'm curious about how all of you feel about this, and how much of a connection you have with your oncologist.

The bottom line, though -- things look good. It's happy news as we are just a few days from Thanksgiving.