Confidence Cancer Stories: The Art of Oncology

Confidence by Ash B. Alpert and Bahar Moftakhar. Read by Maggie Sheridan. Two fellows explore the feedback they received during training to develop confidence, or to appear confident.
 
TRANSCRIPT
SPEAKER 1: The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions. Guests on this podcast express their own opinions, experience, and conclusions. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.
[MUSIC PLAYING]
 
LIDIA SCHAPIRA: Welcome to JCO's Cancer Stories: The Art of Oncology, brought to you by the ASCO Podcast Network, a collection of nine programs covering a range of educational and scientific content and offering enriching insight into the world of cancer care. You can find all of the shows, including this one, at podcast.asco.org.
SPEAKER 2: It was my first day as the hematology-oncology fellow on the inpatient leukemia service. I introduced myself to the team of residents and nurse practitioners who had spent the last month circling the sixth floor of the cancer center. The residents were nearing the end of their month-long rotation, and their faces reflected the sheer number of hours they had spent rounding, writing notes, and caring for their patients. They exchanged silly stories about their patients in hushed tones as if they were talking about peculiar relatives.
The senior resident filled me in on their daily routine. "Now's your chance to grab coffee," she whispered to me like it was a secret. "We kind of just wait here until the attending is ready to round."
As if cued, the attending appeared. The team created a semicircle around him. It was unspoken, but he was our leader. I awkwardly tried to figure out where to stand. I was told I was there to learn, but I was also supposed to lead. We spent the morning walking around the unit, and the residents and nurse practitioners took turns presenting their patients. The resident recited his presentation, detailing overnight events, sharing social history, and listing each abnormal lab. "Calcium was 10.3. Glucose was 123."
I felt myself start to cringe, realizing how long rounds were going to take, but I remembered being in his shoes just years before and began to encouragingly nod along. He methodically reviewed each organ system, allotting the same attention to the normal blood sugar as the rising lactate dehydrogenase.
I became aware that the team was looking at me as they presented. I nodded along as they spoke, jotting down notes to ask at the end of their presentation.
The next presentation had only just begun when the attending cleared his throat to chime in. "Did the patient get platelets overnight? Did you notice the elevated uric acid? What day of the cycle are they on?" he said in one breath.
I am sure they were getting to that, I thought to myself. The attending took over as I withdrew, and I noticed the team shift to him. It seemed as though the attending was thinking, "Let me just do this myself."
The morning bled into the afternoon, and eventually, the carousel came to a halt. The team scattered to complete their task for the day, and it was just the attending and me left standing. He smiled at me. "Should we go to the ED and see the new patient?"
The long walk to the emergency department was spent making small talk. He asked me about my family. I asked him about his. He asked about my interests. I asked him about why he became a cancer doctor. I began to feel at ease, although I could not stop thinking about how I felt so small compared with him just moments before. But now, I was an equal.
We claimed a computer in the ED workspace and spoke in raised voices above the chaos and chatter. I told him everything I had read about the new patient-- a young woman who had come in overnight for progressively worsening fatigue, weakness, a