Life Can Be So Unfair

Do you know someone who was diagnosed with cancer? Chances are that you do. Or at the very least, you may know someone who knows someone who was diagnosed. If you answered yes to the previous question, were you in the same room with them when they first found out?

There have been various people in my life who have had to struggle with this evil disease, but never did I once stop and think about the emotions they must have felt when they were first diagnosed. As they actively fought their diagnosis, each of these courageous people seemed to always keep a positive demeanor about them whenever I interacted with them. However, behind this positive spirit lies the pain and despair that consumed them in the moment they first learned about their diagnosis; a pain that was palpable in the rooms of the two patients that my team ended up diagnosing with cancer last week.

Before last week, I had only witnessed one person being diagnosed with cancer. This event had occurred last year during my Pediatrics rotation, and the sorrow that filled the atmosphere in the room was very similar to the sorrow I had felt last week as I watched the family members process the tough news that cancer had unfairly waged a war against their loved one. It was as if time had stood still. Although I could feel their sorrow and despair as they took in the information, there’s no way for me to even begin to describe what it must feel like to hear that your child has cancer. The fact that nobody knows what causes it in otherwise healthy children makes the news that much harder to process.

The good news is that the types of cancer that these patients have are very treatable and are associated with high remission rates. With that being said, the journey towards recovery will not be an easy one. The main treatment has to be given in a hospital setting, so they’ll be in and out of the hospital for a while. This, in turn, will have a direct impact on their everyday lives. They’ll have to complete schoolwork in the hospital, be very cognizant of avoiding infections, and learn how to deal with the many side-effects that the medications come with. It’s so sad and unfair for a child to have to go through something like this. Attempting to live as normal of a life as possible while having to actively battle for it at the same time is such a monumental task. However, the positive attitudes of the patients, coupled with the amazing amount of love and support that has been pouring out from the families and my team, gives me tremendous hope that they will both be able to battle this disease and effectively conquer it, regardless of the hardships that will come along the way.

While on service last week, I got the opportunity to not only watch a lumbar puncture, but to also watch my attending perform two bone marrow biopsies and bone marrow aspirations. It was the first time I had ever seen someone access bone marrow. It looked as painful as I had imagined it would be, but thankfully the patients who underwent these procedures were anesthetized the whole time. In addition, I took the initiative to learn more about neutropenic fever and ended up giving a short and informal lecture about it to my team. I’m glad I decided to do that because: 1) I could never seem to get this concept to stick in my head and 2) we actually ended up getting a real-life example of a patient with neutropenic fever later on in the week.

In the midst of the busy whirlwind of activity and events last week, I just so happened to age yet another year. Although I pretty much worked throughout my birthday, I did get the chance to have a delicious dinner at the home of one of my scholarship donors. He and his wife had graciously invited both my girlfriend and I to their home in order to get to know us better and to celebrate my birthday with dinner and dessert. We ultimately had a wonderful evening with them and I got to learn a lot about the interesting lives they lived. I further celebrated my birthday this past weekend in Charlotte, where I played various games at a bar, had a pleasant dinner at a fancy restaurant, had a night out at the Epicenter, enjoyed brunch, appreciated the Levine Museum of the New South, played some FIFA, rode on the Funny Bus in Charlotte (it was funny how unfunny the bus was) and watched UMiami’s first football game of the season in horror as we proceeded to get obliterated by LSU. Jesus Christ. It was bad. Not the best way to start off a season…but hopefully this loss sets the team straight and motivates them to do better from here on out. But on another note, I got the chance to go to Carowinds for the first time! It had been a long time since I had rode a roller coaster, but it was just as thrilling as I had remembered it being. And shoutout to the fast lane pass for allowing us to fly past the long lines and getting us to the rides in less than five minutes!¬†ūüėéūüėú

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With my birthday behind me and Labor Day weekend now coming to an end, I’m ready to refocus my attention on both my rotation and on finally finishing up my ERAS application once and for all. I’m also ready for all of the events, activities and responsibilities that will be facing me this fall as I continue to trek through my final year of school. I hope that your weekend was a fun one, and that it adequately energized you for this upcoming week!

“Your present circumstances don’t determine where you can go; they merely determine where you start.” – Nido Qubein

– Black Man, M.D.

Tori’s Spirit

This past week, I was painfully reminded about just how fragile life could be.

About half of my overall class and I were in the middle of our Health Systems & Policy (HSP) class early Monday afternoon. The other half of my overall class were in the Medicine and Patients in Society class (MAPS) at the same time. I had just come from a Kaplan lunch talk not too long before, where a representative was talking about how great the Kaplan Question Bank was in preparing students for Step 1. My thoughts were drifting back and forth between how I was going to use the Kaplan Question Bank to supplement my ongoing studies, how to make sure that I had the best fantasy football team in the class draft that I had just been invited to, and the financing & distribution of Medicaid in North Carolina, which is what we were currently being lectured to about. It was your typical, sunny Monday afternoon.

Then around 1:30 PM or so, the Associate Dean of Academic Affairs opened the door of the classroom as the professor was in mid-sentence and motioned for him to come over to her with her finger. Puzzled, he looked at her for a couple of seconds¬†and exited the classroom with her. All of us in the class were quiet for a few seconds, and then indistinct chatter started to fill the room. My friend and I started joking around about what the professor must have been thinking as the Associate Dean, of all people, abruptly interrupted his class. After about a couple of minutes, the professor walked back in looking pretty shocked, along with the Associate Dean and about five other faculty members. I suddenly did not like the look of what was happening. I heard my friend behind me whispering “Oh no, this doesn’t look good. This looks like bad news. This is going to be bad.” The Associate Dean got to the podium as the other faculty stood in line facing us and started to break the devastating news that our classmate, and my friend, Tori McLean, had just passed away due to complications from the bone marrow transplant that was supposed to have saved her from her diagnosis of Acute Myelogenous Leukemia. As she said Tori’s name, my jaw dropped. I could hear gasps around the room. As the dean continued to speak, I began to hear my classmates sobbing across the room. A couple of my friends I was sitting at my table with began to sob as well. I was completely dumbfounded. My jaw just hung open for what felt like an eternity as I stared in disbelief at the dean. I don’t even remember most of what was said after hearing the initial news. Just before she finished speaking, she said we were free to take the afternoon off to collect our thoughts and to mourn. I then sat back in my chair and numbly stared at the ground. I had just entered one hell of a daze. I must have sat there like that for about five minutes or so as others around me packed up their belongings and left the room. I then somehow managed to get up, walk out of the classroom, and walk back to my apartment complex where I met up with a few friends¬†in their apartment. I walked in the apartment, set my bag down on the floor, sunk in the couch, looked up at the ceiling and proceeded to stare blankly at it for almost an hour.

As I type this post almost a week later, I still find it hard to believe that she’s really passed on. Like, I’ll never see her on this Earth again. It’s an unreal feeling. I keep thinking about how her closest friends and her family must be taking the gravity of her loss. That thought alone saddens me. The fact that she won’t ever get the chance to become the incredible doctor that she had the potential to be, or to start her very own family, or to just continue with life in general as a 24-year old woman is very difficult¬†to accept.¬†She had been fighting so hard against this cancer that she has been diagnosed with since¬†mid-March, right as we were about to take our first Neuroscience exam. It was so unfortunate, but we all figured, including her, that it was a terrible phase that she would get through before returning to her regular life. It’s terribly unfair that her life on Earth had to end this way, because she was such a great person…she went out of her way to make others feel better, even while she was fighting against the cancer wearing on her body. While I was checking in on her this past summer, she told me that she truly believed that I was not only wise beyond my years, but that she was confident that I would grow into an amazing doctor, especially now that she’s experienced the patient side of things. She said all this after stating how much it meant to her that I was reaching out to check on her when she could only imagine how busy I was.¬†Lol, that was just how she was man, so humbling and appreciative of everything. I had to tell her that I was never too busy to check in on her and that I had been praying for her and her family every day. She also told me that she still had been reading my blog every week throughout her treatment, which really moved me. As a matter of fact, Tori had been a huge supporter of Black Man, M.D.¬†since day one.¬†She was always “liking” my blog posts on Facebook and had told me several times in the past how much she enjoyed reading it as well as¬†how appreciative she was of the quotes I put up every week. When I spotted her at the school back in early August after school had started up again, I tore myself apart from the group I had been chatting with, shouted her name, and gave her such a big hug that I may have lowkey scared her now that I think back on it. My last interaction with her was when she wished me a Happy Birthday a few weeks ago and had hoped that my day was just as wonderful as I was. Man, I’m gonna miss her.

This past week has been a rough one, with losing Tori and simultaneously having to study for our Cardiology exam that we’re taking tomorrow. However, the school has been absolutely wonderful in responding to the tragedy. In a matter of less than five days, many emails were sent to our class from various faculty members, including from the Dean of the Medical Center himself, the medical class under us worked to console us by providing us snacks and a memory tree for Tori where we can write & hang our memories with Tori from the tree, a memory book for Tori’s family was purchased, and a memorial was planned to honor Tori’s life. This memorial service took place this past Friday in an auditorium at the former medical center next to the hospital. I’m happy to say that the auditorium was packed to the brim and that the service was phenomenal. Her whole family was present as well as many of the faculty, our classmates, and others that either knew her personally or knew of her. There were songs sung & played on the violin/cello/piano, prayers given, stories shared by her friends and family, tears dropped, and laughs shared between the people present. It’s incredible to realize that even after her time in this world had ended, she was able to bring so many people from all walks of life together in one place. I felt, and continue to feel, honored to have been friends with such an angel who has touched the lives of many.

There were many organizations on campus that Tori was a part of, but one thing she was absolutely passionate about was Project Teach, a¬†program¬†within the Student National Medical Association (SNMA) here at Wake where we help to tutor both middle and high-school students from the community around us on Tuesday nights. We¬†had both been very involved in this program last year, but it was very¬†obvious to me how important the program was to her. Her love for the kids shined so bright that she was made the Community Service Co-Chair alongside me so that she would have full control of how the program was run. Sadly, soon after obtaining that position, she received her diagnosis. She then reached out to me a couple of weeks after her diagnosis and asked for the “big favor” of temporarily assuming control over the program as she began to fight off the cancer threatening her life. Of course I obliged and began to do so alongside another friend who was also invested in the program who also happened to be the new Vice-President of SNMA. Her and Tori had been working to expand the program to high-school students in the community, for at that time only middle-school students were coming for tutoring. When this school year¬†started, my friend and I continued to work on expanding the program and eventually got a nearby high school on board to participate. This past Tuesday was the very first day of Project Teach for the year and I’m happy to say that it was a phenomenal success! We had about 25-30 volunteers and just as many middle & high school students show up. And the number of students is expected to increase for this Tuesday as well! I really wish Tori was able to have seen how well the first day went and how much bigger the program is going to get this year. But I know she’s watching from high up above and smiling down proudly on all of us.

Life can be very rewarding and at times you may feel invincible. But life can also be just as fragile, for one moment you’re on top of the world and in the very next moment you can be on the ground¬†suffering. If there’s one thing I’ve learned from this unfortunate event and from medical school in general, it’s that nobody is invincible. Disease & Tragedy can strike any one of us at anytime, even if we mean well and do our best to stay healthy. However, as the late and great Maya Angelou once said, “people will never forget how you made them feel”. I’m sure that just about everyone¬†who¬†has been touched by Tori’s presence can comfortably say that they will never forget how she made them feel, and that although she’s physically gone, her spirit will continue to live on in them forever. Her spirit will¬†surely continue to live on in me.¬†We¬†all only have one life to live, so let’s shape¬†our lives the way we want to shape them. Believe it or not, we have the power to do so. And while we work on shaping it, let’s find a way to make a positive difference in someone else’s life. It can be as big as funding a full scholarship for somebody or as simple as genuinely telling someone that they are beautiful. Even something as small as giving someone a smile can do wonders for another person. You just never know.

Victoria “Tori” McLean

January 6, 1992 – September 12, 2016

May your phenomenal soul rest in eternal peace.

“To live is the rarest thing in the world. Most people exist, that is all.” – Oscar Wilde

– Black Man, M.D.

Therapy & Service.

Well, it’s one of those weeks again. I have two tests coming up: one on Tuesday that covers Viruses, Fungi, Autoimmunity, Hypersensitivity & Parasites and a cumulative final on Friday that covers everything from Biochemistry to what I just finished learning now. So that means everything I’ve learned since I finished Anatomy back in November.

Needless to say, I’ve been forced to excessively grind in my studies for the past week. And I’ll be continuing to grind for the next couple days. If I can at least do just as good as I did last test, I’ll be perfectly happy. As for the final, well…we’ll see what happens. After this week though, I’ve got a couple weeks off until my next big block of material, which will be Neuroscience. I don’t really even know what to expect going into that block…but I’ve decided not to¬†think about it until the end of my Spring Break.¬†ūüėä

While I was studying for this upcoming test, I came across a concept that I thought was cool as hell. I’m gonna warn you though, I’m about to sound like a straight-up¬†nerd. But anyway while I was learning about therapies for tumors, I came across this technology that has the potential to become revolutionary when it comes to cancer treatment. This new approach, Chimeric Antigen Receptor (CAR) T-Cell Therapy, literally takes your immune cells and makes them attack tumor cells in your body. How, you may ask? Well, your T-cells (one of the fighters in your immune system) are first collected from your blood and then engineered to produce unique receptors on their surface (CARs) that allows the T-cell to bind to whatever antigen or protein that we want it to bind to. After letting them multiply¬†excessively¬†in a lab, the CAR T-cells are returned to you¬†and continue to multiply in your body while recognizing and killing cancer cells that have the¬†antigens that match the CAR on your T-cell. So to put it simply, tumor cells have some things that normal cells¬†don’t have. So after being trained to look for these little differences, your fighter cells go and kill these tumor cells without hurting any of your normal cells. Isn’t that incredible? I think it is! The whole treatment is still in its early days and is being tested in clinical trials, but results so far have looked promising for those people that didn’t respond well to chemotherapy and don’t have any other choices. Side effects are being studied as well and have been managed so far with steroids. Scientists have said that more research is needed before it can become an option to the general public, but what they’ve seen so far is promising. With time, the therapy can only improve and hopefully eventually expand to treat all types of cancer. For any of you that have been officially¬†mind-blown¬†and are¬†interested in learning more about this therapy, here’s a link describing it in better detail:

http://www.cancer.gov/about-cancer/treatment/research/car-t-cells

Turn up for cancer research!

On another note, I’ve officially started¬†volunteering for the Ronald McDonald House. You know, I used to see them around here and there growing up, but I never knew what they were. As a matter of fact, I didn’t know what¬†the purpose of the house was¬†until only a couple of months ago. If you don’t already know, the RMH serves as a home away from home for those out-of-town families that have children that are staying in the hospital for¬†an extended period of time. The house provides food, shelter, and community bonding between families that find themselves housed there while keeping the families close to their loved ones in the hospital. Here at Wake’s hospital, there is a RMH Family Room on the pediatrics floor where family members can stop by and grab snacks or coffee, and just rest for a while. That’s where I’ve been placed and I had my first day last Friday. I saw first-hand how appreciative the parents of the sick children were of me being there that morning, for if there isn’t a volunteer available for any given 3-hour shift, the room is closed for that time period. I’m just happy that I can be of useful service to a population of people that are going through a tough time, and am grateful that I am able to interact with families in a perspective different from the one I will be trained to have¬†when I become an actual doctor. I’m hoping that this experience will help influence the way I think about patients and their families in the future so that I can become that much more caring as a doctor.

That’s it for today! I’ll leave you with this:

No matter how bad you may think you have it, someone else in the world has it WORSE than you. Remember that.

Have a splendid week! And Happy Valentine’s Day! Special s/o to my valentine¬†ūüėČ.

 

– Black Man, M.D.

P.S. S/o to the First Couple!

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