I finished up my 4th year with an IM elective: Heme Onc! I ended up really enjoying the rotation. The attendings I had were super knowledgeable and eager to teach. Not only that, but the fellows I worked with were great. This was a rotation where the docs and fellows truly asked and cared about the “why” of medicine.
I’ve written about this at length on here, but my biggest gripe with medicine at times is the fact that many people just don’t care about WHY things occur or WHY we treat diseases the way we do. To me, understanding WHY helps me understand WHAT I’m observing/treating. Fortunately, this rotation was a great way to explore this.
For instance, the attending I worked with asked me a question that bothered me when I was an MS1-MS2: if antiphospholipid syndrome has antibodies that are against membrane lipids, and all clotting factors require phospholipids, why do we say it only prolongs the aPTT? Theoretically, it should prolong the PT and PTT. Apparently, when the labs run the PT vial, they add enough phospholipid that ends up overwhelming the antibodies and so your PT is normal but your PTT is prolonged! If someone had explained that to me during 1st and 2nd year, that would have made my life so much easier!
Heme Onc was a great rotation to refresh my knowledge of the coagulation pathway and to learn about different hematologic and oncologic emergencies! The hours were much, much better than the surgical ICU that’s for sure!