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.
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.
About this blog
Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.
I was able to find good information from your articles.
treat erectile dysfunction without drugs kayamy erectile pill as shown on shark tank
help with erectile dysfunction slilicy erectile shots
buy erectile dysfunction pills online sicAdofs fast erectile repair
erectile doctor memphis tn kayamy fast erectile repair
erectile disorder articles slilicy erectile therapist
erectile products sicAdofs erectile pills in canada
Good post. I certainly appreciate this website. Keep writing!
erectile pillole kayamy erectile solution ratings
which erectile dysfunction foods work fast slilicy erectile specialist
erectile organ sicAdofs erectile vacuum device
Excellent blog post. I absolutely love this site. Thanks!
Excellent article. I will be experiencing some of these issues as well..
I love it when people come together and share views. Great blog, stick with it!
This is the perfect site for anyone who really wants to understand this topic. You know a whole lot its almost hard to argue with you (not that I actually will need toÖHaHa). You certainly put a new spin on a topic that has been written about for many years. Great stuff, just great!
erectile medicine for men kayamy viagra without erectile dysfunction
erectile blogs slilicy erectile vit e
can erectile dysfunction be mental sicAdofs erectile mastery program
Itís nearly impossible to find knowledgeable people on this subject, but you seem like you know what youíre talking about! Thanks
Having read this I believed it was extremely enlightening. I appreciate you finding the time and effort to put this article together. I once again find myself personally spending a lot of time both reading and commenting. But so what, it was still worth it!
Greetings! Very useful advice in this particular article! It is the little changes that make the biggest changes. Many thanks for sharing!
erectile prosthetic kayamy erectile pictures
erectile tools slilicy erectile after you quit drinking
erectile function after prostatectomy sicAdofs erectile tissue problems
Everything is very open with a very clear explanation of the issues. It was really informative. Your site is extremely helpful. Thank you for sharing!
This is the right website for anyone who wants to understand this topic. You realize a whole lot its almost hard to argue with you (not that I personally will need toÖHaHa). You definitely put a brand new spin on a topic that's been written about for many years. Great stuff, just wonderful!
Way cool! Some very valid points! I appreciate you writing this post plus the rest of the site is also really good.
erectile dysfunction kayamy compare erectile dysfunction medication
erectile d with matt lauer slilicy erectile clinic
erectile doctors sicAdofs online doctor erectile dysfunction
Howdy! This blog post couldnít be written any better! Looking at this article reminds me of my previous roommate! He continually kept preaching about this. I'll forward this information to him. Pretty sure he will have a good read. Thanks for sharing!
I am regular reader, how are you everybody?
This paragraph posted at this web page is in fact nice.
Nice post. I learn something new and challenging on blogs I stumbleupon on a daily basis. It will always be useful to read content from other writers and practice a little something from their websites.
is erectile dysfunction psychological kayamy erectile tissue in the nose
erectile disease quiz slilicy erectile issues in your 40s
erectile aids sicAdofs does erectile dysfunction ever go away
Your style is really unique compared to other folks I've read stuff from. Many thanks for posting when you've got the opportunity, Guess I'll just bookmark this page.
Oh my goodness! Impressive article dude! Thanks, However I am experiencing difficulties with your RSS. I donít know the reason why I cannot subscribe to it. Is there anyone else having the same RSS issues? Anyone who knows the answer will you kindly respond? Thanx!!
Itís hard to find well-informed people about this subject, but you sound like you know what youíre talking about! Thanks
I blog quite often and I seriously thank you for your information. Your article has really peaked my interest. I'm going to take a note of your blog and keep checking for new information about once per week. I opted in for your RSS feed as well.
I seriously love your blog.. Excellent colors & theme. Did you build this website yourself? Please reply back as Iím planning to create my own personal blog and would love to learn where you got this from or what the theme is named. Many thanks!
Having read this I believed it was really enlightening. I appreciate you spending some time and energy to put this content together. I once again find myself spending way too much time both reading and leaving comments. But so what, it was still worth it!
Hello there, I do believe your web site could be having web browser compatibility problems. When I take a look at your site in Safari, it looks fine but when opening in I.E., it's got some overlapping issues. I merely wanted to provide you with a quick heads up! Other than that, excellent site!