Now, the first thing most people say when I tell them what I do is, "Oh, that sounds depressing." I've been hearing that since med school, basically. But really, I was prepared for it. And the way I see it, once you become an MD, there's very few areas you can go into that *aren't* depressing at some time or other. We've all gotta deal with bad situations and diseases from time to time, whether you're in primary care or neurology or psychiatry or yes, even dermatology. Another way of looking at it is that oncology is an interesting field, and I'd get down if I was doing something that I didn't find interesting.
So I was prepared for the grim side of oncology. But as Mike Tyson once said, "Everybody's got a plan until they get hit." And at times, this work can kind of pummel you. On a busy day in clinic, for instance, when you see wave after wave of patients dealing with horrible, horrendous diseases and your options for helping them are limited. And sometimes, there are things like trying to explain a very complex illness to someone who basically doesn't understand what a cell is. It can be time-consuming and frustrating, especially when you're running an hour behind schedule and you know that most of what you say to your poor patient is not sinking in.
And one of the toughest things to deal with is when a patient or family member redirects their anger/anxiety/fear about their illness at you. It actually happens quite a bit, not only for physicians but also nurses and really anyone directly involved in patient care. You can't really blame people for feeling that way, but sometimes it can be tough to deal with. (Check this out - I saw it on the NY Times website the other day.)
So obviously, it's important to have some sort of support network when you work in this field. But to be honest, I haven't had a lot of support here in Mad City. And part of that's my fault, people! I moved here by myself, and figured it wouldn't be too hard to build up a social network like I had during residency. But the situation's different here: fewer people in my program, bigger city, bigger hospital, more impersonal hospital. The director of the cancer center, who in a certain sense is my boss, hasn't said a word to me during my 2+ years in Mad City. I shit you not. And I'm finding that as one gets older, it gets harder and harder to make new friends in a new location, unless you join a church or have kids or otherwise sell your soul (just kidding ...) Anyhow, I thought this would be a friendlier place, but it's not really. It's a very liveable place, just not exactly friendly. Not hostile, but ... it's hard to explain. And it probably doesn't help that work sucks up a lot of my free time.
Don't get me wrong - I can think of a lot of people in a worse situation than mine. Many of my patients, for instance. All the wretched earthquake survivors in Haiti. The people who went through the earthquake in Chile. The impoverished. People without access to health care, or without jobs, or without hope of any kind. The New Jersey Nets. There's a lot of different varieties.
But still, if you want to know what it's like to not only work in a field like oncology, but to more or less do it on your own: well, at times it really sucks. I'm inspired by many of my patients, and there are times when I feel fortunate to be able to do this work, but I just wish I hadn't had to be so isolated. And if it seems like I'm having an off day once in a while - a bad blog entry, or some lame Facebooking, something along those lines - all I can say is that I'm dealing with this stuff the best I can. I like to think that at the very least, I'll come out the stronger for it.