A Day in the Life of a Pediatric Oncologist

No, not a Beatles song… but rather a look at a typical day for an academic pediatric oncologist. Actually, one of the things I love about my job is that no two days are alike. So there really isn’t any such thing as a “typical day.” Some days, though, see a good combination of clinical work and lab research, so I’ll try to describe what this past Tuesday was like for me.

It’s Tuesday. I get to my office around 9am. The first order of business is checking email (I live on the internet, despite being in my 40’s). Most mornings there are quite a few waiting for me, and this morning is no exception. One email has to do with making some changes to a clinical trial protocol that were suggested by the FDA, so I open that file, make the changes, and send it off to Tammy, my research nurse, so that we can submit the protocol to our Institutional Review Board (IRB). All clinical trials have to be approved by an IRB to ensure that they are ethical, and under certain circumstances (like testing very high doses of a new chemotherapy drug) this can’t happen until the protocol is approved by the FDA.

I answer a few emails, and then I go downstairs to my lab to check on my staff. I spend an hour and a half talking with the folks in the lab about our various research projects. As usual, some are going well, and some are progressing more slowly. I visit each person in turn and we talk about their data from the last week, what it means, how to interpret it, and what we need to do next.

On Tuesdays we have Tumor Board, which is a meeting I run. Tumor Board is the largest regular meeting we have, and is attended by my colleagues in pediatric oncology (including faculty, fellows, nurses, social workers, and pharmacists), as well as by colleagues from surgery and radiation oncology. For the next two hours we will discuss each new patient, review scans that patients have had that require a change in therapy, and talk about the progress of every inpatient. Time permitting, we also have a 20 minute lecture by one of the fellows on a topic relevant to one of the current patients. On Tuesday there were so many scans to review, and the decisions to be made required so much discussion, that we did not have time for the fellow’s lecture. The conversations we had were important, though, because we were able to make treatment plans as a multi-disciplinary group, thus assuring the patients that all of the doctors were in agreement and were communicating well with each other.

After Tumor Board comes the weekly meeting of our bone marrow transplantation (BMT) group. This group typically meets twice a week. On Mondays we talk about upcoming patients, and on Tuesdays we discuss patients currently being treated. As one of my patients is in the ICU, we talk about him for a while. Fortunately, though, he is getting better, and we decide to just hold the course and keep doing what we’re doing.

After the BMT meeting, I stop in to see some of my hospitalized patients. The visit to the ICU is the hardest, because even though the patient is slowly getting better, he is still very sick, and I really want him to get well. I touch base with the ICU staff and discuss his status with them and with the patient’s mother, offering her words of encouragement along the way.

Finally, it’s time to go back to the office. In the last few hours before I head home, I can work on one of the many writing projects I am balancing, including a manuscript describing some new findings from the lab and a draft of a grant application soliciting money to support our lab work. It’s quiet in my office most afternoons, so I get a fair amount done before I go home.

It’s been a long day, so I’m looking forward to being home. Of course, there’s always more work to be done, so after the kids are in bed, I’m sure I’ll get back to work on the grant application. It will be close to midnight before I put that aside and relax for a bit before I go to sleep.