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Why I became an oncologist
An unidentified patient goes through chemotherapy treatment.
June 3rd, 2011
07:10 AM ET

Why I became an oncologist

Editor's note: George Sledge, M.D., is president of the American Society of Clinical Oncologists, the organization of America’s cancer doctors, whose annual meeting begins today. Treating cancer can be an extraordinarily difficult field, guiding patients on a roller coaster ride of fear, pain and sometimes true exhilaration. Dr. Sledge shares the story of the patient who made him decide to become an oncologist.

Cancer doctors tend to get to their profession in one of three ways. Some are drawn in through their love of cancer science. Cancer has always been something like a cobra to those who study it: dangerous and beautiful and endlessly fascinating. Cancer is a universe. One can spend an entire life exploring it without ever getting bored, for the biology of cancer is the biology of life.

Some doctors are inspired by a great teacher. Medicine is still a profession dominated by old-world apprenticeships, where a mentor’s passion can be transmitted to a new generation. I have known several oncologists whose careers turned on chance encounters with inspiring professors.

Others get there by way of their patients. I’m one of these. When I was a resident, cancer patients were the ones who touched my heart. In fact, I can remember the very moment I started my path to becoming an oncologist.

I was an intern at St. Louis University, a brand-new doctor, with my white coat still fresh and creased, when I first met Carmelita Steele. Carmelita was in her early twenties, married, with (as I recall) two young children. She came to our hospital as a transfer in the middle of the night. She had undergone a routine dental procedure, and after her surgery had first oozed, and then gushed blood. By the time she got to us she was severely anemic, and had a low platelet count. There was a very real concern in those first few hours that she would bleed to death.

We worked through the night stabilizing her. Her veins were hard to access–they had all been used up during her time at the other hospital. In those days (the late 1970's) we lacked modern venous access devices, and I remember it taking a frighteningly long time establishing an intravenous line. Through it all I spoke to Carmie, who was a cheerful if appropriately anxious African-American woman, somewhat overweight, proud of her children and her loving family. We poured several units of blood into her that night, bringing her back from the brink.

We spent the next couple of days establishing a diagnosis. She had Acute Myelogenous Leukemia, then as now a dangerous disease requiring toxic chemotherapy to clear the blood and bone marrow of treacherous cells. I learned the diagnosis shortly after morning rounds. Her staff doctor, an elderly hematologist (or so he seemed then, though I am now about his age) would, I discovered, be off campus until the following morning. I knew that Carmie and her family were desperate for news, so I phoned the staff physician and asked if it was OK for me to speak to her. He agreed.

I had never told a patient that he or she had cancer before. I sat on the edge of her bed and told her that she had a type of leukemia, that it was very dangerous but that it was potentially curable with chemotherapy. I told her that we would be starting treatment the following morning, as soon as her staff physician had a chance to go over the drug regimen with her.

Carmelita had sat quietly while I spoke, a sad look on her face. When I was through she said, almost in a whisper, "Doctor Sledge, who will take care of my children?"

It was the last thing I was expecting, and it was thoroughly devastating. I did not know how to answer. Today I hope I would do better, but at the time I was in my mid-twenties, just a few years older than Carmie, and I did not know how to answer that question. I stammered something, barely maintaining my composure, and then left her room and hid in a stairwell for a half an hour sobbing.

The next day we started her chemotherapy regimen, full of hope. I spoke to her regularly, and to her family. Her husband, a quiet decent man, stood by looking worried. Her mother, a medical technician who understood leukemia, rarely left her daughter's bedside. They were the sort of family we all should have.

For several days things went well. Then, as her blood counts plummeted in response to the chemotherapy, she developed an infection in the area of her intravenous line, followed by sepsis. Her blood pressure dropped, and her breathing became rapid and labored. She was transferred to the intensive care unit, intubated, and treated with broad-spectrum antibiotics. Sometime in the middle of the night, disoriented and alone, she pulled the breathing tube out of her mouth. Though she was quickly re-intubated, things rapidly went from bad to worse, and she died the following day.

I went home that night in a furiously angry mood. I was supposed to be going out with my girlfriend, but in my grief and guilt I simply could not think straight or act civil, so I begged off. I relived every moment of her care: what had I missed, what could I have done differently, what foul-up had I committed that kept a 22 year-old from taking care of her young children? It is the arrogance of interns that they believe that acute leukemia would turn out differently if only they had gotten a little more sleep.

A few weeks later I got a call from Carmelita's mother. She wanted to meet with me. I agreed, with real trepidation. The wound was still too raw, and there was part of me that feared she might hold me responsible for her daughter's passing.

But she was as gracious as I could ever have imagined. I have three sons, all in their twenties, and if one of them died of leukemia I do not know how I would handle it. Poorly, I suspect. But she was dignified, pleasant and grateful. She told me that Carmie, before she had died, had told her that, come what may, she wanted to give me a gift to thank me for my care, and for the hours I had spent with her. She then handed me $40 and told me I was to spend it on something fun. Carmie had wanted it that way.

My patients, starting with Carmelita Steele, have taught me so much about what it means to be a good doctor and, I hope, a good person. I am an oncologist because of her, and it is a job I have loved for three decades. But Carmelita's question still haunts me: "who will take care of my children?"

There are some debts you can never repay.

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Filed under: Cancer

soundoff (53 Responses)
  1. Satirev

    Touching story.......

    June 3, 2011 at 08:43 | Report abuse | Reply
  2. Lorry

    A nice story to hear. Having just gone through cancer treatment I can say that during my first visit with my oncologist, I thought he was a monster. He wasn't. He was just doing the difficult task of telling a very scared person everything that was or potentially was, going to happen. He took me to what I felt "near death" and then brought me the difficult road back to "cancer free." He is a hero to me now. I look forward to seeing him. And, I am eternally grateful to him.

    June 3, 2011 at 09:07 | Report abuse | Reply
    • RUth

      I agree with you 100%! Same story for me My doctor is my hero ! He saved my life !

      June 9, 2011 at 02:18 | Report abuse |
  3. Pat

    Imagine how this article would read if oncologists were paid minimum wage.
    Or would there even be an article?

    June 3, 2011 at 09:23 | Report abuse | Reply
    • Ann

      What does that have to do with anything? Oncologists spend years (and hundreds of thousands of dollars) on their education, grueling hours- why should they make the same amount of money as a teenager handing out popcorn at the movie theater? They have a very stressful (and often heartbreaking) job and not everyone has the brains, compassion, or stamina to do it. Kudos to those who can do it.

      June 3, 2011 at 10:25 | Report abuse |
    • Mike

      It takes 4 years of college, 4 years of medical school, 3 years of residency, and 3 years of fellowship to become an oncologist. Essentially, you don't starting getting paid till you're at least 32 years old with about $200,000 dollars in debt. Would you be willing to make that sacrifice for minimum wage? Don't ask such stupid questions.

      June 3, 2011 at 13:34 | Report abuse |
    • Mili

      almost ridiculous comment! i too believe that a good doc is worth every penny! what dr sledge describes is a powerful story, those of us who have ever experienced such feelings, would not dare ask such shallow questions!

      June 6, 2011 at 18:13 | Report abuse |
    • LP

      The only problem with that is that you have to pay the quacks the same amount.

      June 13, 2011 at 21:05 | Report abuse |
  4. martha

    love this story – gives me goosebumps. Thank you for not becoming hard and distant from your pts

    June 3, 2011 at 10:07 | Report abuse | Reply
  5. k8

    a reminder to count your blessing. made me cry

    June 3, 2011 at 10:29 | Report abuse | Reply
  6. Sid

    Very touching and teaching story. We need to learn to start thinking like Carmelita, her mother and become a compassionate person like the doctor. The world can be a better place with patients, care-givers and doctors like this.

    June 3, 2011 at 11:28 | Report abuse | Reply
  7. kerri morris

    good story

    June 3, 2011 at 11:29 | Report abuse | Reply
  8. MICHAEL DEVANEY

    amazing the strength some people possess

    June 3, 2011 at 11:42 | Report abuse | Reply
  9. DoctorsKillEveryDay

    compassion....caring....?
    How about the half million dollar a year paycheck....

    June 3, 2011 at 11:57 | Report abuse | Reply
    • Melissa

      A good doctor is Worth EVERY penny. Even 1/2 million dollars.

      June 3, 2011 at 12:08 | Report abuse |
    • Rick

      less than 5% of physicians make 1/2 a million a year. Most of them are middle class folks paying off massive student loans and a mortgage.

      June 3, 2011 at 13:28 | Report abuse |
    • SoCalDoc

      Not only are most oncologists not making half a milion dollars a year, many of them, between paying off the debt of their education and/or subsidizing the care they feel obligated to give to patients in spite of dwindling reimbursements from Medicare and your insurance companies, are sustaining themselves by delving into the financial reserves of their friends and/or families or closing their practices. If the practice of medical oncology were such a lucrative field, you would see medical oncology offices popping up everywhere; what is actually happening is medical oncologists are either retiriing or closing their practices to join a managed care group(such as Kaiser) or a hospital-based group. I hope you never have to suffer with cancer or a blood disorder, but if you should, I hope there is a medical oncologist still in practice to care for you.

      June 3, 2011 at 13:42 | Report abuse |
    • Ciescokid

      Wow, what a shallow and self-centered comment. Have you ever met this man? Do not be quick to disregard the significance of the training that a doctor undergoes.

      June 3, 2011 at 18:14 | Report abuse |
    • DoctorsSaveLives

      Next time you're sick, then, don't go to a doctor. If you've found a lump somewhere on you, don't go to a doctor. They don't deserve the money they make, so don't pay them. Don't use their services. They should take care of everyone for free, while still paying off their staggering student loans, working up to 80 hours a week, and constantly attending seminars and taking continuing education classes to keep up with the rapidly advancing science of medicine. They should do all their work for free, because you said so. Isn't that right?

      One of my best friends is graduating from med school next week. She put in five grueling years of having almost no personal time, no time for family, no time to relax. This doesn't even count the time she spent in her undergrad, taking extra courses and doing volunteer work just so she'd be ACCEPTED to med school. She had to work a part-time job at one point in the middle of med school to help support her family. All she wants to do is to be able to help people who are sick. She's not a money grubber. She's one of the most compassionate, caring people I've ever met.

      My own doctor is a wonderful person who listens and works with me when there's a problem. I hope she never has to deal with a patient like you.

      Again, if you don't want to use a doctor's services, then don't.

      June 13, 2011 at 09:26 | Report abuse |
  10. Shanette

    Wow... sitting in a public setting reading this article, and trying to choke back the tears. Great article.

    June 3, 2011 at 12:02 | Report abuse | Reply
  11. Jack'sBox

    This story should be front-page! Remind people to start counting their blessings instead of sitting around focusing on should've, could've, would've. Thanks, Dr. Sledge - you are in my "Hero" department along with my parents and a choice few others!

    June 3, 2011 at 12:47 | Report abuse | Reply
  12. Ciescokid

    I am starting medical school this fall. I am from Indiana and I have personally job shadowed Dr. Sledge in the clinic in Indianapolis. Words cannot express how much of a positive influence this man is to thousands of people. He is, undoubtedly, the most sincere and respected doctor I have ever had to pleasure of meeting in my life. He is very thorough, passionate, and loving to his patients. He treats his patients as if he were his own flesh and blood. Please, take it from me who has had a first hand experience in an oncology setting, that this man has deeply impacted my decision to become a successful physician.

    June 3, 2011 at 13:17 | Report abuse | Reply
  13. Raddoc

    As a fellow physician, I can attest that oncologists are truly special people. I personally had quite a struggle rotating through oncology in medical school witnessing many treatment failures and side effects. As a breast imaging specialist, I work closely with oncologists and I have been very impressed, regardless of where I have practiced, by the compassionate care they render. Oncologists may very well be the smartest physicians I have met in the medical profession. The amount of knowledge they must retain is tremendous and there are constant changes in treatment.

    June 3, 2011 at 13:38 | Report abuse | Reply
  14. Jim

    As A Person with rectal Cancer- You Doctors need to go back to school & use the K.I.S.S. Method- Keep It Simple Stupid – I have a tumor 10 cm up from my anus it is 10-12cm long Learn to go in through the natural opening, freeze the damn tumor or some other method & take your worthless Chemo/ Radiation/ Resection surgeries & colostomy bags turn them side ways & shove them up the medical associations A$$. I have been BLEEDING for 6 months, IN PAIN & I will be DEAD in just a few days.

    June 3, 2011 at 14:04 | Report abuse | Reply
    • Raddoc

      Jim, I am so sorry to hear of your experience and outcome. Please don't spend another second on the internet. Spend it with your family, friends, pets, anything else but this. Peace and love to you.

      June 3, 2011 at 17:13 | Report abuse |
  15. Sandi

    As a registered nurse for 40 years, and a Breast Cancer Survivor of 18 years, I would like to thank Dr. Sledge and all other Oncologist. As a nurse who has done Oncology nursing since the late 1970's, I agree that oncologists are the smartest doctors I have ever been fortunate to work for and with. But, I believe that most will tell you that oncology is the most rewarding type of medicine to practice and that they learn about courage, honor, trust, and dying from their patients. Thanks for being the physicians you are.

    June 3, 2011 at 14:27 | Report abuse | Reply
    • Haley

      Love you Mrs. Sandi! I am 23 years old and I just battled stage 4 Hodgkins lymphoma. I am now in remission. Praise the Lord for nurses and doctors like you!

      June 3, 2011 at 17:30 | Report abuse |
  16. beenz

    I am a 3x cancer survivor (2x ovarian, 1x colon/lymph node). My oncologists have been very kind, caring people. They're open to my input as well, and I am in remission today but they keep a close eye on me. Theirs is a job I would never want, but I am still here today!

    June 3, 2011 at 14:30 | Report abuse | Reply
    • itstimetoshout

      Hi beenz, it's inspiring to hear you've survived ovarian cancer twice. Many don't have that story to share. Please have a look at the stories we're trying to shout to the world: http://itstimetoshout.com and consider sharing your story with us too! (itstimetoshout@gmail.com) -Jen (itstimetoshout community manager)

      June 7, 2011 at 09:50 | Report abuse |
  17. donna

    I am a mother watching my adult son fight stage 4 colon cancer. It is almost 2 years now. His chemo treatments last 3 days and he is on his 3rd round. So much pain, so many disappointments, and still he fights on with courage. Pray you never have to watch your own child fight cancer. Thank God everyday for the blessing of good health. You will never complain again, about anything, after sitting one day with patients undergoing chemo. Pray for a cure...educate yourself...stand up to cancer!

    June 3, 2011 at 15:19 | Report abuse | Reply
  18. Mary Bawden

    Dear Doctor,
    My daughters' best friend recently was diagnosed with breast cancer & it's in her lymph nodes. She is 29 years old and lives in NYC. On Tues. she is scheduled for a double mastectomy and after the chemo, radiation. She wants her eggs frozen...She is so young and it breaks my heart but can happen to anyone's child. She would like to be in touch with 20ish 30ish breast survivors. Any ideas? Please anyone respond. Thank you.

    June 3, 2011 at 15:25 | Report abuse | Reply
    • CanSurvivor

      Try 4th angel: a resource to pair cancer survivors with newly diagnosed patients in a similar situation. This is a great program out of Cleveland Clinic

      June 3, 2011 at 15:58 | Report abuse |
    • BreastCancer Doc

      http://www.youngsurvival.org is an amazing resource. Through local support groups and an on-line community, it links young women with breast cancer together. Fabulous organization. As for fertility concerns, you must have her check out http://www.myoncofertility.org which is the website of The Oncofertility Consortium, a national organization dedicated to parenting after cancer. Good luck to your daughter's friend, and please get her to these two sites.

      June 3, 2011 at 15:59 | Report abuse |
    • Raddoc

      The American Cancer Society has great support programs and liasons to help. You should be able to find them with Google easily. Also, your daughter's friend should ask her treating physicians (surgeon, oncologists, etc) for referrals for support they may be aware of in their community as well. Doctor's offices/staff who deal with cancer usually have vast knowledge of these programs..

      June 3, 2011 at 17:08 | Report abuse |
    • Jay

      Please have her look at: planetcancer.org. It is a website like facebook dedicated to YOUNG adults with cancer. They also have a free retreats and give a lot of information. I emotionally survived my brain tumor treatment because of that website and retreat. Also http://stupidcancer.com/ website or on Facebook stupidcancernyc@groups.facebook.com is a great org. They have meet ups in NYC, a radio show and various other events.

      June 17, 2011 at 17:57 | Report abuse |
  19. cc

    Wow. I really have a lot of respect for you.

    June 4, 2011 at 11:01 | Report abuse | Reply
  20. Countryboy

    When will there be a cure for cancer! http://WWW.CDBABY.COM/ALL/NUMONE bye now!

    June 4, 2011 at 11:23 | Report abuse | Reply
  21. bv

    Very touching story from a great, respected doctor with whom I have the honor of being associated. I pray the children have done well.

    June 6, 2011 at 11:05 | Report abuse | Reply
  22. DrHedrick

    As he has been one of my teachers for many years I am biased, but I would say that there is almost no one who demonstrates the dedication and compassion needed to be an excellent physician better than Dr. Sledge. I am proud to work with him and humbled that I will be one of his students.

    June 6, 2011 at 11:48 | Report abuse | Reply
  23. Nickel

    As the husband of a cancer survivor treated by Dr. sledge I can attest to the the fact that he is totally dedicated to his profession, patients, and the patients families. My wife had breast cancer and was fortunate enough to be referred to Dr. Sledge after her mastectomy. I remember him telling me "I work for you", and gave me 3 numbers to reach him night or day. My wife at age 44 asked him if she would make it to 65 and he reassured her that she would. That was 1987 and we will be celebrating her 69'th next month.

    June 6, 2011 at 17:14 | Report abuse | Reply
  24. Anita Wilhelm

    Dr. Sledge is one of the most caring and knowledgeable doctors I have ever met and I have met several in my time since, I was diagnosed wtih Hodgkin's Lymphoma at the age of 20, I met Dr. Sledge as a result of breast cancer from the radiation from the Hodgkin's , I thank God that our paths crossed, I needed his knowledge and I trust him the in the utmost.

    June 12, 2011 at 00:39 | Report abuse | Reply
  25. Andy Anderson

    I am NOT ashamed to say that my eyes were WET when I read this story. I am a cancer SURVIVOR in Northern Ireland ... I've walked the walk, gone through the cancer tunnel and I'm one of the lucky ones to reach the other end and emerge into daylight. Surely the crucial point is the number of cancer patients you have been able to save in the intervening years – and, whether they know it or not, they ALL owe a massive debt to Carmelita Steele. Bronze statues and fine marble headstones have their place, but Carmelita has a vastly more fine memorial in the lives she saved. Carmelita did NOT live her life in vain!!

    June 16, 2011 at 17:30 | Report abuse | Reply
  26. katherinembc

    Dr Sledge and his Indiana colleagues hosted the 2010 National Metastatic Breast Cancer Network Conference. Dr. Sledge was both educational AND uplifiting–now that is a rare combination. You can see Dr' Sledge's speech and the other presentations at http://www.mbcnetwork.org.

    Dr. Sledge: Here are 10 Things My Oncologist Will Never Say:

    http://ihatebreastcancer.wordpress.com/2011/05/15/10-things-my-oncologist-will-never-say/

    June 17, 2011 at 08:13 | Report abuse | Reply
  27. Tami Boehmer

    I am very fortunate to be a patient of Dr. Sledge. He is the real deal. He really cares about his patients and his knowledge is invaluable to me, helping me live a happy, healthy life despite a stage IV cancer diagnosis.

    June 17, 2011 at 09:13 | Report abuse | Reply
  28. dan pezz

    You miss that oncologist makes huge amounts of money and capitalize from dying patients (clients), they make more than a million dollars a year and about 80% of their clients die. So they are aware that they are not in medicine to help people but to help themselves. God will judge them as their are judge in the bible: killers and thieves.

    August 14, 2011 at 12:47 | Report abuse | Reply
    • Bob

      You are a disgrace to humanity. These people devote their lives to helping others fight debilitating diseases. Have some damn respect

      July 16, 2014 at 00:52 | Report abuse |
  29. Katie

    Dr. Sledge is everything you need and want from your doctor. Dr. Sledge you certainly are a good doctor and most certainly a good (wonderful) person.

    April 1, 2012 at 05:35 | Report abuse | Reply
  30. indiainternet2012

    Cancer Known medically as a malignant neoplasm, is a broad group of various diseases, all involving unregulated cell growth.we generally use helpingdoc.com for Cancer Specialist in Delhi

    September 25, 2012 at 08:08 | Report abuse | Reply
  31. Nori

    I am a cancer survivor. You are a doctor with heart and emotional intelligence and conscience. I do hope you read this. I had leukemia/lymphoma non-hodgkins type b. My oncologist saved my life but, I wish more professional and will leave it at that if you know what I mean? I still see this doctor and pray for his professionalism every day!

    January 10, 2013 at 21:22 | Report abuse | Reply
  32. Robbin Goal

    I know this if off topic but I'm looking into starting my own blog and was wondering what all is required to get set up? I'm assuming having a blog like yours would cost a pretty penny? I'm not very web smart so I'm not 100% sure. Any suggestions or advice would be greatly appreciated. Kudos Robbin Goal http://www.robinhoodchina.info

    January 31, 2013 at 05:09 | Report abuse | Reply
  33. Rodney

    Dr. George W. Sledge Jr. at Stanford University is among the most polite, educated, learned, experienced, admired, and trusted physicians I have ever spoke to. He has my spouse's life in his hands and I am OK with this. Thank you Dr. Lisa Lee of Stanford University. Your care and treatment for what is my only real necessity in life has left me speechless

    September 12, 2013 at 01:19 | Report abuse | Reply
  34. duaa

    Thanx doctor George sledge ..iam very impressed by your words
    i want to be an oncologist but iam worried about the deppressive conditions i may face.

    January 28, 2014 at 15:41 | Report abuse | Reply
  35. Saba Arshad

    Hey i am a final year MBBS student.I want to become an oncologist too!your story inspired me more towards my goal.thankyou!

    April 26, 2014 at 15:51 | Report abuse | Reply

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