Daniel Amedu Nduka Adoga1 Nandan Maruti Shanbhag2
1 Medical Student, Metropolitan University, Antigua & Barbuda.
2 Chair, Department of Oncology, Mount St. John’s Medical Centre, Antigua & Barbuda.
Dr Nandan M Shanbhag MBBS, MD , Dip Pall Med , MBA (PhD)
Chair, Department of Oncology
Mount St. John’s Medical Centre
Antigua & Barbuda
Email: [email protected]
As a medical student, I read this somewhere, the best things in life happen unexpectedly. The best stories begin with “and, all of a sudden ….”. The best adventures are never planned. This allows one to free oneself from expectations, for the best would occur when one least expects it. This was my story with oncology. I didn’t plan to do an oncology rotation but found myself enrolled into one. I got to the hospital and didn’t know what to expect, but I was open-minded and ready for the new challenge. I would, later on, find out that I loved Oncology, and it was my most enjoyable rotation thus far.
Being diagnosed with cancer brings about a significant life change. I entered the Oncology Department, my first encounter was with a patient who had breast cancer, and her words to me were, “People think cancer is a death sentence, but look at me sitting right in front of you”. She then remarked, “You have to follow your doctors’ instructions, and you’ll be fine”.
My first week at the Oncology Department was an excellent experience. I got to learn a lot as I met different patients, and contrary to the common belief, they looked happy overall. In my first week, I got to know a wide range of oncological diagnoses and observed many procedures such as accessing chemo-ports in patients. I also read extensively on different topics in Oncology and engaged in lively discussions with my Senior Consultants. This was an exciting experience for me as it helped me learn quite a bit and understand more about cancers.
During my second week of the Oncology rotation, I was exposed to other interventions such as performing a bone marrow aspiration. I also had the opportunity to acquaint regarding the common drugs used at the Oncology Department; I made sure to make of a note of them, learnt about them and subsequently presented to my colleagues what I had learnt.
During the third week of my Oncology rotation, a 68-year-old female walked into the consultation room with an abnormal involuntary, random, ‘dance’ like movements of the upper right extremity. I had never seen anything like this before, and I became very curious to know what was happening to this lady. I followed up with the patient and would later understand that this was ‘Chorea’. Although a hereditary cause was the most important aetiology for chorea, brain metastases, hyperglycaemia or even a stroke are also important differential diagnoses to consider. I also had the opportunity to examine another patient with lower limb paraparesis due to spinal cord compression due to spread of cancer and learnt the importance of emergency radiotherapy and initiation of steroids therapy to keep the patient ambulatory. Procedures such laminectomy with fixation are not currently available in the island where I did the rotation.
I must admit that I did learn a lot of new information during my Oncology rotation, and also found the interaction between the cancer patients and the healthcare professionals so fulfilling. I felt encouraged and supported.
My Oncology perspective metamorphosized from that of someone who never thought of pursuing any studies regarding cancer, to one who would love Oncology at the end of a clinical rotation.
As a Supervising Oncologist,
Cancer’ is a term that many hesitate to discuss even in this day of modern medicine. It is a disease that affects the patient, the family and the healthcare providers. In dealing with a challenging disease, a multi-dimensional approach must be taken. Most importantly, education of the junior doctors is imperative. It is in this perspective that student rotations in Oncology play a significant role, and more so in the developing countries where more often a single specialist manages all care for patients, which instils confidence in students.
Acknowledgements: Dr Samuel Agida Adoga. Dr Bethrand Nwachukwu.
Competing Interests: None
Ethical Approval: Not applicable
Funding: Not applicable
Author Contributions: Daniel Adoga developed and wrote the manuscript. Nandan Shanbhag wrote the Head of the Department perspective and also helped with literature search and references.