Putting together the Puzzle Pieces

Recently I’ve had the opportunity to widen my horizon further beyond the Urology department. I’ve done rounds with Dr. Cooke in the ICU and followed Dr. Tagawa in the Medical Oncology clinic. Although both of these areas are very different from my general experiences in Urology rounds and clinic, at the same time, they are all related.

In the ICU, I experienced two different types of care. Many patients had come in the night before or the day before with an acute symptom (ie nausea, disorientation, shortness of breath). These patients were quickly being moved through diagnosis, treatment and recovery either in the ICU or in another unit of the hospital. Other patients though had more devastating diagnoses which left them in the ICU for a lengthier period of time. Many of these cases were due to the severity of disease or the patients’ inability to breath on their own.

In the Oncology clinic, we visited with patients who had metastasized cancers generally from the bladder, prostate or kidney. Additionally, many of these patients had been through either a surgical procedure to treat their primary cancer site or had undergone chemo or radiation. In general, the patients were visiting Dr. Tagawa in order to alter chemo, enroll in a clinical trial, start hormonal therapy or get general consultation as to what to do next. I was amazed by the variety of patients he saw and how thorough he was with each patient. Each case definitely required customized care and Dr. Tagawa was able to provide not only the standard options for care, but also the numerous clinical trails that were going on under a variety of clinicians.

So now to putting all the puzzle pieces together… My research project with Dr. Scherr is analyzing data from radical robotic cystectomies. Included in the database is detailed information for each patient which allows us to analyze the outcomes with regards to prior surgeries or treatments and complications that occur afterwards. Having looked at this data for a while now, visiting the ICU brought new life to the complications of re-admittance due to sepsis or pneumonia. As well, visiting the Oncology Clinic gave me an idea of what patients go through if their cancer returns. I had visited patients after their cystectomy in Dr. Scherr’s clinic and often the difficulties are with incontinence at night, but the patients in the Oncology Clinic with recurrence deal with many more challenges as they weigh their options for further treatment.

Finally, I’d just like to make a comment about the many roles I’ve seen Dr. Scherr play over the past few weeks. He is both a physician administering personalized care, a surgeon with technical skills, a researcher always asking questions and even an entrepreneur looking for new developments to change the way treatment in administered. I’ve been amazed to see him put on these different “hats” and even more astonished to see just how well each one fits.