Keep on going!
This rotation is at Princess Margaret Cancer Centre, and I couldn't be more excited about having this placement. This is the main reason I applied to my internship in the first place - a rotation in oncology from the largest cancer centre in the country, and one of the top rated in the world for treatment and research efforts. It's also the place where both my dad and my fiance's dad were treated for multiple myeloma, giving them another chance at living. I couldn't wait for the opportunity to be involved in this amazing place and give back to the hospital that has done so much for my family and thousands of others.
I'm working with head and neck cancers, including oral, sinus, pharyngeal (throat) and tongue cancers. Most patients are receiving radiation therapy, and some receive chemo and radiation in combination. The patients who I see are mostly those who are undergoing more intensive treatment: chemorads (combo therapy), or accelerated radiation treatments (instead of going once a day for 5 days/week, they go twice a day for one or more of those days), who are automatically scheduled to see a dietitian weekly to help manage the side effects of their treatment, and keep their weight as stable as possible. This often requires them to have a gastrostomy tube inserted so that they can receive nutrition supplement feeds, water/hydration, and take medications without using the throat. We also see patients on a regular radiation treatment schedule if they or their doctor request it. Usually these are the patients who had a history of alcohol abuse or severe weight loss prior to the treatment starting and are at greater risk of malnutrition and poor treatment outcomes.
It. Is. Awesome.
I was honestly a bit worried coming into the rotation that it might be kind of overwhelming, given my dad's current situation. But, it's been totally fine - it's a completely different type of cancer and very different kind of treatment. I'm doing fine emotionally with being here, but it is admittedly hard to be empathetic without feeling sorry for my patients. In particular, the ones with similar stories to my dad - middle aged men with young families, no history of smoking or alcoholism or much other medical history, who suddenly find themselves receiving radiation for throat cancer. Sometimes cancer just can't be explained, and it can be very sad. But, I know it's my job to make their journey just a little easier, and have one more person they can rely on to provide support, encouragement and hope.
By my second day, I was leading outpatient clinic visits with my preceptor in the room, and week 2 I was completely on my own. I led both the outpatient clinic and managed an inpatient load independently for the majority of my time here, with minimal help from my preceptor. Sure I made mistakes, but she gave me room to make them, learn from them, and correct them (mind you, the mistakes I made were never life threatening or anything, just maybe better advice or a better supplement regimen could have been chosen for the patient and could be corrected the next time they were in). In this rotation, I felt the most comfortable, confident, and competent that I have in any other rotation. Nurses referred to me as "the dietitian" and asked a couple of times if the regular girl (my preceptor) was on vacation or something. When I said I was her student, they looked aghast and said I was "legit" (their words :P). Patients told me they were grateful for the intervention of a dietitian to help them through the journey, and my last few were even a bit sad when I told them that I was leaving and they'd be followed up by someone else. It was truly rewarding to know that I was making a big difference in these people's lives, and I am so, SO grateful that I was able to have this experience in my internship.
Next up - 5 weeks in a community health centre! This rotation is super convenient - I live like 3 blocks away. I won't have to pay subway fare for over a MONTH! And when you're an unpaid intern, that's like, a super huge deal.
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