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Picture 1: Common risk factor cards that are common for most of these cancers, such as age, gender, and diet. The viewer will first choose one of these cards so that they could see their percentage of getting the cancer that they spin on the wheel

Picture 2: The finished spinning wheel of the most common types of cancer by percentage

Picture 3: The beginnings of the full presentation poster board

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Today Julia and I split up and focused on our individual intensive fair presentations. Up above is a quick doodle I used to convey the beginnings of my idea. Inspired by The Big Casino book, I decided to make a game of chance that allows the viewer to see the many variables and chances that cancer treatments. Along with this, I plan to have a poster board outlining what we did on a day to day basis. 

I also did a bit more research on the common causes of cancer I was looking at the week before, as I hope to include them on the spinning wheel. I learned a lot about the little things you can do every day that lower the risk of cancer, such as limiting sun exposure and even watching your BMI, as being overweight increases the production and circulation of hormones that are linked to cancer. 

I’m quite impressed at my idea for the presentation and I hope I can make it into the reality that I envision. For tomorrow I need to gather supplies and work out the logistics and hopefully I can get started from there!

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A Quiet Day ~ 1.17.17

Today was a pretty quiet day for Dr. Sachs. He didn’t  have too many patients in the morning, and everyone--including us and the patients, was a bit tired from the long weekend. It seemed as though there was a general workday lull to the office, and we began to fall into the usual routine. Patient, break, dictation, and back over again. 

The one thing I really like about the job is the slight variants I observe every time we go in. You never see the same cases, never the same symptoms and descriptions. Today we saw a common thread in everyone having low iron levels. Some were prescribed iron tablets, whereas others who were more severe had to get it through an IV. Some agreed to it, while others were wary of taking a supplement or the side effects of getting the IV. CBC (complete blood count) also was a big thing we heard today, leading us to ask questions about, and Dr. Sachs showing us some examples of platelets and delving a bit into the hematology field. 

Along with that, Dr. Sachs taught us about medical school, entertaining us with stories from his fellowship. He told us about patients he saw, what he could and could not do during residency and fellowship, and even how he had to treat his supervisor when he was a senior fellow. It really gave Julia an inside look at what it would be like to go on the medical career path, and we got to ask him our one-on-one questions about it too. I must say, he did quell a few of the fears I had from the days prior with his lighthearted stories and telling us just what the studying and daily life is like. 

Most of today was kind of quiet, but it was just another variant in the real world schedule we get to witness. It also gave Julia and I some much needed time to discuss our project ideas, which we’ll continue to work on tomorrow... so stay tuned for good things in store!

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This is a link to a really interesting and uplifting book I started reading for part of my research, The Big Casino. It’s a collection of stories from America’s most famous and influential cancer doctors, about the patients and experiences that shaped who they are as doctors and as humans. After seeing what I saw thus far in the intensive, I could make connections with this book and the experiences I myself had seen. It hits a note to say that you don't have to be a cancer doctor to learn from the hope and dedication both the doctors and patients share in the field. 

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Yet Another Viewpoint ~ 1.12.17

I can honestly say that today was my favorite day at the office. I was able to draw connections between what we learned from the doctors, what we had researched at school, and the final viewpoint we have not yet seen: the patients. 

We were shadowing a nurse named Kristina, who was very attentive in answering all the unfinished questions we didn't have a chance to ask the doctors. To begin, we saw and older man who had his daughter with him. The nurse made sure to check for his vitals, then went on to teach us about the different medicines she was administering him, starting with the saline, which was used to hydrate him. She taught us about the chemo port, a small subdermal catheter in the chest area used as a place to administer all injected medications for cancer patients. 

Today as a whole I learned a lot about what happens on the other side of the white doors. What the next step is after the doctor has had his consults and follow-ups. We made valuable connections between the real-world concepts and the research we had been doing even in the day prior. The common types of cancer I researched were very prominent today, such as in the gentlemen who had thyroid cancer and was receiving the drug Nulesta to strengthen his white blood cell count when we saw him. The common list of medicines Julia and I studied had been frequently used throughout the day. It wasn't just that, it was the human connections we made as well. We were able to ask the patients their opinions, how they felt, what it was like. We saw the diversity in the patients, the young and old, even a Spanish woman who we practiced our Spanish-speaking skills with. 

In conclusion, it was not only the technical elements of medicine and patient care that i could apply to my final goal for the intensive, it was also the tangible sense of hope in the room, the eminent air of optimism that was almost contagious. It was in the relationships between the patient and nurse, and between the nurses themselves where I took home the real lesson. 

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Diving Deeper ~ 1. 11. 17

After talking to one of the advisors, I rechecked the S.M.A.R.T goals Julia and I made from the beginning and realized that we needed to redirect our approach to research a bit; just to stick within our goals. I felt as though we knew enough factually, but it was really the reflecting that I personally needed to work on. 

We began the day by doing more research, as per usual on a school day. Julia made a quizlet on the list of common medications prescribed in the office and we did a but of studying on that, as well as created some questions to ask later about them.  It was quite complicated we both saw, there was so much to remember and each medicine had different side effects and usages, some varying ever so slightly from the next. It was somewhat overwhelming, but I think once we really read into the differences and did some more research to understand what these drugs target and affect, I felt a bit more confident. 

After this, I was somewhat inspired to look a bit more into the most common types of cancers. I spent a lot of the day doing research on that, creating small excerpts explaining each of the 12 common types of cancer that affect our world today, for example:

Bladder cancer: Bladder cancer is a cancer of the hollow organ that stores urine in the lower part of the body. “The most common type of bladder cancer is transitional cell carcinoma, which begins in urothelial cells that line the inside of the bladder. Urothelial cells are transitional cells, which are able to change shape and stretch when the bladder is full. This type of cancer is also called urothelial carcinoma” the risk of bladder cancer is highly increased in smokers.

Breast cancer: Breast cancer is the cancer of the breast tissue. “The most common type of breast cancer is ductal carcinoma, which begins in the cells of the ducts. Breast cancer can also begin in the cells of the lobules and in other tissues in the breast.” Other types of breast cancer can include invasive breast cancer and cancer of the lobules which transport milk through the breast.

Colorectal cancer: Colon and rectal cancer (or colorectal for short) is the cancer of the colon or rectal systems, mostly in the form of polyps that become cancerous. According to the source, “most colorectal cancers are adenocarcinomas (cancers that begin in cells that make and release mucus and other fluids).” Colorectal cancer often begins as a growth called a polyp, which may form on the inner wall of the colon or rectum. Some polyps become cancer over time. Finding and removing polyps can prevent colorectal cancer.

Though we were on to more complicated levels of research, I'm glad I did this, as it gave me a little more confidence that we were sticking to our goals (doing cancer research) and did something that really could be useful in our final presentation. Today I also realized that it’s not in the large amounts of research but in what I learn from day to day. For the most part today was a time for me personally to stop and make sure I was on the right track for the intensive, redirect this track, and start back from the foundation to make sure I reach the final goal in the intensive: to research and explore the field of cancer, while learning the ins in outs of the medical field as a whole. 

Links for today:

     1. Colon and Rectal Cancer

     2. Bladder Cancer

     3. Breast Cancer

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A list of commonly prescribed cancer drugs we saw in the office, today we decided to research them and their effects in the various cases we heard about in the days prior 

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Back at It ~ 1.10.17

It was nice to be able to know what to expect as we walked into the office today-- or so we thought. As soon as we got into Dr. Sachs’s office, we were greeted by a new scribe named Nicole, and another scribe in training, Alyssa. It was nice seeing new faces and learning their perspective aside from Bree’s from last week. 

Dr. Sachs was quite busy today, and the addition of all of us was added. It was nice however, not only because of the varied opinions and levels of knowledge in the room, but also because this rushing around showed Julia and I the small things you could only learn in this real-world experience, such as being ready for anything. 

Though we had to sit a few out, we saw quite a few patients today, and luckily all with good results. We saw a different variety of cases, such as a woman with thyroid cancer and a man who experienced quite a few blood clots as some of his symptoms. In between, Dr. Sachs taught us a bit about how and why these blood clots are formed. They could be from cancer, obesity, or even flying in an airplane. Blood seemed to be a common thread today, as all of these patients were sent away told they should take a blood test as soon as they could to monitor their progress, such as a woman with abnormally low hemoglobin (a red protein responsible for transporting oxygen in the blood).

Today for the most part showed us a bit more intense side of the field from the cases we saw to the hustling around the office. I look forward to seeing a brand new perspective of things from patients and nurses on Thursday. 

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Getting Technical ~ 1.9.17

Today we actually got into the nitty gritty in start for this busy week of visiting not only doctors but actual cancer patients and chemo nurses. We began by researching tumor markers that we heard being referred to a lot the week before (such as the arguable CA125 which is a cancer antigen that is supposedly found in higher concentration when there is a tumor present) for a large part of the day, analyzing where and what could possibly cause them. That doesn’t even begin to describe the plethora of ways they can be detected, from blood tests to even chemicals in the hormones in males and females. By the afternoon we realized we had only just scratched the surface. There were tons of reasons and circumstantially based ideas to look at. For example, they could come from everything from mutated genes to even defects in the chromosomes. We tried looking at them in alphabetical order but even that grew exasperating after awhile. After taking a little break, we decided to get more into our plan for the week. 

In the afternoon after our busy morning of research we just discussed our progress after week one and where we plan to this week, as well as adding onto that list of questions for the week ahead from Friday. Julia shared her thoughts on the trials and tribulations of the medical field as did I, and we began looking up a little bit into medical schools and the process going into them, such as the MCAT test and good requirements for medical schools. We formed some questions about that topic to ask the doctors later in the week. Last week, we had learned a bit about this with Dr. Mowat. A significant thing I remember him saying was that “The mark of a good doctor is how many years of training they have... that’s all that matters; working in the real-world”. This week we plan to dig a bit deeper into that

For the most part like Friday, we did some intense research on some loose ends from the week previous and discussed our thoughts thus far. That’s what I think is nice about our intensive and being able to do it with someone, we get to reflect every step of the way. With the doctors, with Julia, and even on this blog you’re currently reading. It allows for us to gather our thoughts, get a different opinion, and reach our overall goals for the entire intensive. 

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Recapping the Week ~ 1.6.16

Aneesa Shaikh - Day 4

After all of the experiences we had in the week, Julia and I decided to use our time at school today to gather up what we had learned and discuss it. We created a list of questions for next week, did some research, and outlined our objectives for the week ahead. 

Questions for Week 2:

1. What are some of the patient’s opinions and outlooks on chemotherapy?

2. What are some new updates on drugs and treatments in the field?

3. What does a busier day for the doctors look like?

4. What are some other viewpoints now that we have seen some cases and will see new varied ones?

5. What are diagnoses and treatments for less common types of cancers or spreading cancers?

Next week we hope to get more of a look from the patient's perspective so that we can compare and contrast it to the doctors'. We will be working with the Chemotherapy nurses on Thursday, so we hope to have time to ask both them and the patients some of our questions. 

For the most part today was a chance to regroup with each other, discuss our week, and do some of the reading the doctors recommended such as how to become an oncologist (the difference of being a DO or an MD, and what career path one must take). In the second half of the day, we outlined some of our objectives, looked up some key terms, and got ready for the exciting week ahead.

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Dr. Mowat at work at the office, showing us the logistics and every day paperwork in between patients 

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Another Perspective ~ 1.5.17

Aneesa Shaikh - Day 3

I came in thinking that it would be another day of seeing patients, but as quickly as we entered, Julia and I were pleasantly surprised by Dr. Mowat’s high-intensity personality. He was quick in jumping from room to room and was ready just when we came in around 9. It was really interesting to see the difference in how he handled the patients as compared to Dr. Sachs yesterday. Analyzing this, we jotted down a little list:

Comparing and Contrasting Physicians 

Differences:

1. Dr. Mowat is much faster and more high energy

2. Dictates notes the “old fashioned way”

- Prefers paper to computer system

- Uses voice recorder for dictation

3. Dr. Sachs seemed to like to take a break between patients when possible to gather notes, whereas Dr. Mowat did all appointments and used second half of the day to get paperwork and notes done 

Likes: 

1. Both are lighthearted and joke and relate to alleviate anxiety 

2. Both asked certain questions to new consults 

3. Both were extremely dedicated and took time to answer our questions and discuss terms and each patient with us

Dr. Mowat took a generous amount of time to teach us the little things that are extremely important about health care. We learned a lot about what is important in medical school (he said the main thing is “simply just showing up”). We were also given a look into what the American health care system is, as a few of the patients we saw were on medicare and Medicaid. Along with this, Dr. Mowat gave us a few resources to watch and read for our at-school days, such as a movie on what it means to be a doctor and some reading material on the cases we saw today. 

The patients we saw today were just as interesting as those from the day before. It’s never a redundant task in that office, and as the day grew on I realized how amazing it was that each of these people have a complex and interesting story, such as a couple who've been married for 5 decades and both had cancer and even lost one of their children, or a woman who was diagnosed just before she was married and now a few years later she is a survivor and doing well. I found myself feeling almost sad as the patients left, watching them schedule their next appointments, wanting to know what happens next in their stories. 

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First Day in the Office ~ 1.4 .17

Aneesa Shaikh - Day 2 

Upon Julia and I first getting into Dr. Sach’s office,  we were introduced to one of his scribes, Bree, who is currently in medical school. her job is taking notes for Dr. Sachs in the exam room, and offered us some pointers and told us how our day would be. She related to us on a friendly level, as did Dr. Sachs when he came in at around 9:30. From there all four of us were introduced and quickly familiarized ourselves with our first patient, an initial consultation of a woman who was referred by her doctor for some abnormalities in her white blood cells. Following Bree’s example and listening to Dr. Sachs initial questions to the patient, a middle-aged woman, we took some notes ourselves to discuss later when it was the four of us back in Dr. Sach’s office: 

Patient 1

Patient was referred by their doctor because of high white blood cell count

Ordered blood work as a precautionary

Hasn’t had tests for other symptoms (sleep apnea etc.)

Family has colon + skin cancer (maternal side)

Asks about allergies, changes in weight, recent illnesses, family history, menstrual cycle, medication

Chronic high white blood cell count

Myeloproliferative

Checking iron level in blood

Conclusion: Nothing stands out in consult, next step is to do blood work and come back in a month

After this first patient, we headed back to Dr. Sachs office to discuss our findings and ask him any questions we had such as those about the family history of the patient, what other problems she has, or what the next step in her treatment is. After this discussion and a bit of free time, it was back to the Exam room for another patient. 

Dr. Sachs had a total of 7 patients today, which is less than half of his normal. In fact, the doctor we were supposed to shadow tomorrow had to schedule us with another because he was booked to have 30 patients throughout the day, a crazy amount. This low number was nice for our first day, because we got to have time in between to gather our thoughts, discuss, ask questions, and familiarize ourselves with the daily routine. 

All in all the day today was quite interesting and I found myself not only learning a lot about cancer, but also the small details you can't get without integrating yourself into the physicians’ daily life. The fast moving from room to room, the fun moments to look at Dr. Sach’ family photos, and the one on one questions we were able to ask both the patient and the physician really colored the day. It was definitely a great experience. For the days ahead, I look forward to meeting the other physicians and exploring the differences in the way they talk or take care of their patients, as Julia and I both loved how relaxed yet motivated Dr. Sachs was today. 

As for the patients themselves, we found it so interesting how each patient compared and contrasted from the last, not only in their symptoms, (Julia and I found it interesting how each patient said they were really tired all the time) but in the way they handled their illness, the ways they came to each appointment, the common thread of hope they all shared.  

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Introducing Ourselves ~ 1.3.17

Aneesa Shaikh - Day 1

1. My S.M.A.R.T goals for the intensive: 

Specific - I hope to perform cancer research and learn about the diagnosis of different types and stages of cancer.

Measurable - By the end of the intensive, I want to have learned the diagnosis and treatment of different cancers and the new discoveries there are.

Attainable - I will be working under an oncologist and observing their daily routines and what research they perform, which is very attainable.

Results- During intensive fair, I will present the different types of cancers I learned about and what new developments there are in the field

Time-Bound - This is possible to achieve during the three-week intensive

2. What’s the purpose? 

I want to get to know the field of oncology on a deeper level and better understand cancer itself through research alongside oncologists.  Through that I hopefully will be able to see what efforts it takes to treat a cancer patient from both the student and patient perspective. I plan to do research with our doctor sponsors and my fellow student on what new developments are in the field and what medical training is like in order to better understand what I would like to do as a career in the future.  

3. What were my goals for today?

My goal for today was to get my feet on the ground with the intensive and introduce myself to some of the topics that we will be addressing over the course of the intensive. Along with beginning our blog and meeting with advisors, we also plan to do some introductory research to get ready for our first day at the doctor’s office tomorrow.

4. What did I learn today? 

Today, through research and discussing, I learned about some common types of cancer along with some introductory topics such as how the disease comes that will prepare us to go tomorrow. 

5. Reflecting...

Today was a general introduction day for Julia and I. We first met with our advisor and from there planned out the small tweaks in our intensive. After regrouping and creating our blogs, we did some research on common cancers and who they affect and what the disease is as a whole. We read through some material as well that’ll help us be ready to go to the office and meet with the doctors for the first time tomorrow. In the afternoon, we planned our schedule on the days we will spend at school moving forward. All in all, I think today both Julia and I are confident that we will reach the goals and objectives we planned out for our intensive. We used our time today productively by introducing ourselves to topics we will need moving forward.