Primary Research Assessment #3

Mentor: ​Tanya Watt

Profession:​ Pediatric Oncologist

Location: ​Children’s Medical Center Dallas

Date:​ February 13, 2018

Time: ​9 A.M. - 10:30 A.M.

Assessment:

This mentor visit, I, once again, went in with an open mind hoping to gain as much

experience as I could. As it was only my third mentor visit, I still had not seen enough to where I

could narrow down my interests in terms of things I would have like to see. Therefore, my goal

was simply to see as many patients as possible, and fortunately I did!

We started off the day by seeing a young boy with acute lymphoblastic leukemia,

basically just checking up on him before the spinal tap that he was going to get soon after we

left. This was a great, light-hearted start as the patient was very happy and energetic and the visit

was short and positive overall, nothing more than a simple checkup! After this, however, I had

one of the most heartbreaking experiences of my life. Prior to going in, Dr. Watt warned me that

the conversation she was about to have with this patient and his mother was going to be very

intense, and that I was welcome to stay behind and shadow another doctor as she saw other

patients. I opted to go with Dr. Watt, as I decided that tough conversations were going to be a

part of the job and it’s better that I experience them now. Thus, I went in with Dr. Watt to

explain to a sixteen-year-old patient and his mother that, basically, he wasn’t going to make it.

Before stepping in, Dr. Watt warned me about a few of his conditions including the lack of
function in his legs that ties him to a wheelchair, the burning sensation that he feels shooting up

his arm, and the bumps that are arising around his head, all of which cause him pain and

frustration. Then, we finally walked in. Dr. Watt began by explaining that none of the therapies

that they had tried had worked, and that there really was no more they could do in terms of

typical treatment. She asked the patient if he wanted to continue with treatment anyway, or if he

was done. He was incredibly hopeful, and he decided that he wanted to stay in the hospital to try

to regain function of his legs as well as to try some new experimental therapies. Dr. Watt,

however, had to warn him of the type it takes to get those treatments approved, implying that he

might not have enough time. He, however, remained resolved. Then, they discussed the logistics

of him going back home intermittently, which included on-call nurses, continuous pain

medication, new accommodations such as a ramp at home, and relocating his room at home as

his wheelchair would not fit through his previous doorframe. Finally, came the most difficult

part. Dr. Watt told him that as his tumor continued to grow, it could eventually impede his

breathing, making it very difficult for him to breath and eventually for his heart to continue to

pump. As Dr. Watt said this, the patient’s mom just shook her head at us as she teared up. Dr.

Watt then explained that if this were to begin to happen, the goal would simply be to make him

as comfortable as he can be and to ensure the best quality of life possible for the time being. We

then pulled mom outside, and asked her if there was anything else she wanted to say or wanted

us to know. She simply asked that Dr. Watt say no more to her son, as she could already see how

bad she was getting and didn’t want to have to make him face that truth as well. She quickly

walked away from us then, evidently avoiding the new reality that Dr. Watt introduced. This was

easily the most heart-wrenching moment of my life. Following this, in an attempt to ease the
tone, we quickly went to see another child who is officially done with his treatment and on his

way towards remission. His case was unique, as he had been treated in Mexico before coming to

the United States and the treatment he had received there was unclear. However, with only a

little bit of chemotherapy here in the U.S., he was completely cured. While this was a more

positive and hopeful case, it was still not nearly enough to ease the heartbreak from the previous

case. Finally, we saw a little girl who is also in remission and would not be coming back to the

hospital for three months following the day’s visit. As Dr. Watt was checking her, she told Dr.

Watt all about her new preschool, and about how although she was excited, she was going to

miss her friends at her old school. Everything looked good, so as we left, the three-year-old said

goodbye to Dr. Watt, repeating “I’ll call you if I need anything!” Once again, as adorable as the

patient was, it was still impossible to lift the heavy feeling in my heart.

Right before I left, I gave Dr. Watt my product proposal, feedback sheet, and product

calendar, all of which she plans to look over and email back to me this week. She also told me

that she is going to talk to the social workers to see if presenting to a support group is a viable

option! If everything goes according to plan, I should be starting on the bulk of my final product

within the next two weeks at most.

Overall, this mentor visit was the most difficult one yet. While I did get to see a patient in

a tough situation as I had hoped I would be able to see, I still cannot shake the heavy feeling

sitting in the pit of my stomach reminding me of this boy, who is my age, who won’t even live to

graduate high school. While it did not shake my resolution to become a pediatric oncologist, it

did make me seriously reevaluate every other aspect of my life. I also was able to note exactly

how Dr. Watt phrased everything throughout, never once using the words “death” or “dying,” yet
still clearly getting her message across. She also did an amazing job in pleasing the mom by not

saying too much while still adequately informing the patient as he should be informed. Truly, I

am simultaneously in shock and in awe of Dr. Watt after the day’s events.

In the future, I would still like to see more procedures as well as inpatients. In terms of

procedures, that is truly mainly fueled by curiosity. Inpatients, however, goes into the same

reasoning behind why I wanted to see a patient in a difficult situation. While it is

heart-wrenching and depressing, it is part of the job and is necessary for me to complete my

research in gaining a full understand of what being a pediatric oncologist entails.