Saturday, June 25, 2011

Special Kids

All of the kids I take care of are special.  Is that cliche?  Maybe so, but it's true.  I truly have learned something from each and every one of them -- though not always what I thought I would learn.

Some kids stand out.

My first "real" patient, who was 13 at the time, and is now, at the advanced age of 27, joining the military.

The patient who got a transplant for her horrible leukemia... who was so sick going into her transplant that I said to her during her "consent conference"... "Well, if your kidneys fail during the transplant, at least your donor can give you one of his, too, and since your immune system will be his, you won't have to worry about rejection."  Not only did her kidneys not fail, but she is alive, well, in remission, and sometimes takes her hormones.

Marta also stands out.  Marta was a teen mother before I met her, though she was finishing her freshman year of college.  That, alone, impressed me.  But as I got to know Marta, first during her initial treatment, and then while we were unsuccessfully treating her relapse, I got to know a warm, caring, wonderful mother.  A young woman who faced adversity with grace, never complaining about her fate.  A young woman who made mature decisions, including continuing college through all of her treatment.  A young woman who accepted hospice care when she needed it, but continued to do what she could to extend the time she would have with her child.

From some kids, I learn about a disease.  From some kids, I learn compassion.  From some kids, I learn grace.  From Marta I learned how to face life, no matter what life has in store.

I'll miss her.

15 comments:

Anonymous said...

Thank you for continuing to post on this website. When I first came across your blog a few weeks ago, I was so excited to read a real and refreshing account of the life of a pediatric oncologist. I have seen many kids, most recently my sister, fight cancer. I hope to become a pediatric oncologist one day and this blog is a great reminder of what I am working towards.

Thanks,
Erin

Dawn said...

I'd never thought about childhood cancer leaving orphans. Another heartbreaking angle on this. Thanks for the post -

Anonymous said...

I, too, am so happy that you're still posting on this blog. I'm about to start my third year of medical school and have had 6 months of clinics but I really feel like I'm hitting a wall. I want to be a pediatric oncologist, but sometimes I feel totally burnt out in medicine and I don't know if I can continue. Your blog gives me so much hope and reminds me why I went to medical school in the first place.

Thank You,
Future Kids' Cancer Doctor!

Juvie3 said...

Dr. David...today I decided I want to be a pediatric oncologist and that's what led me to find your blog. It is so informative and well written. Thanks for sharing your thoughts and stories. I'll periodically come visit as I take this journey into this amazing specialty =)

Kimberly Jett said...

I always enjoy reading your blog Dr. Loeb. You'll always be my favorite doctor! Love, your favorite patient!

online doctor said...

It is good to be like Marta. Complaining about life will never do any good. It is better to take life as light as possible

Thanks for sharing that. Really awesome.

robert taylor said...

“Unnecessary risks are being taken by patients seeking the liberation treatment.” says Dr. Avneesh Gupte of the CCSVI Clinic. “It has been our contention since we started doing minimally invasive venous angioplasties nearly 6 years ago that discharging patients who have had neck vein surgery on an outpatient basis is contra-indicated. We have been keeping patients hospitalized for a week to 10 days as a matter of safety and monitoring them for symptoms. Nobody who has the liberation therapy gets discharged earlier than that. During that time we do daily Doppler Ultrasounds, blood work and blood pressure monitoring among other testing. This has been the safe practice standard that we have adopted and this post-procedure monitoring over 10 days is the subject of our recent study as it relates to CCSVI for MS patients.”

Although the venous angioplasty therapy on neck veins has been done for MS patients at CCSVI Clinic only for the last 18 months it has been performed on narrow or occluded neck veins for other reasons for many years. “Where we encounter blocked neck veins resulting in a reflux of blood to the brain, we treat it as a disease,” says Gupte. “It’s not normal pathology and we have seen improved health outcomes for patients where we have relieved the condition with minimal occurrences of re-stenosis long-term. We believe that our record of safety and success is due to our post-procedure protocol because we have had to take patients back to the OR to re-treat them in that 10-day period. Otherwise some people could have run into trouble, no question.”

Calgary MS patient Maralyn Clarke died recently after being treated for CCSVI at Synergy Health Concepts of Newport Beach, California on an outpatient basis. Synergy Health Concepts discharges patients as a rule without in-clinic provisions for follow up and aftercare. Post-procedure, Mrs. Clarke was discharged, checked into a hotel, and suffered a massive bleed in the brain only hours after the procedure. Dr. Joseph Hewett of Synergy Health recently made a cross-Canada tour promoting his clinic for safe, effective treatment of CCSVI for MS patients at public forums in major Canadian cities including Calgary.

“That just couldn’t happen here, but the sooner we develop written standards and best practices for the liberation procedure and observe them in practice, the safer the MS community will be”, says Dr. Gupte. “The way it is now is just madness. Everyone seems to be taking shortcuts. We know that it is expensive to keep patients in a clinical setting over a single night much less 10 days, but it’s quite absurd to release them the same day they have the procedure. We have always believed it to be unsafe and now it has proven to be unsafe. The thing is, are Synergy Health Concepts and other clinics doing the Liberation Treatment going to be changing their aftercare methods even though they know it is unsafe to release a patient on the same day? The answer is no, even after Mrs. Clarke’s unfortunate and unnecessary death. Therefore, they are not focused on patient safety…it’s become about money only and lives are being put at risk as a result.”

Joanne Warkentin of Morden Manitoba, an MS patient who recently had both the liberation therapy and stem cell therapy at CCSVI Clinic agrees with Dr. Gupte. “Discharging patients on the same day as the procedure is ridiculous. I was in the hospital being monitored for 12 days before we flew back. People looking for a place to have the therapy must do their homework to find better options. We found CCSVI Clinic and there’s no place on earth that’s better to go for Liberation Therapy at the moment. I have given my complete medical file from CCSVI Clinic over to my Canadian physician for review.” For more information Log on to http://ccsviclinic.ca/?p=866 OR Call on Toll Free: 888-419-6855.

bliu94 said...

Dr. Loeb, this post was heartbreaking yet encouraging. I observed you a few times in peds onc clinic and it is very inspirational to read about the emotional approach behind your care that complements the scientific aspect of being a physician.

Lee lomoljo said...

Dear Dr. David

It’s a great pleasure to read your blog. I find your post very interesting. Children must receive attention and affection to develop in a healthy manner.

As a reader, I consider your writing to be a great example of a quality and globally competitive output. It would be a great thrill and honor if you could share your genuine ideas and knowledge to our community, Physician Nexus. With this you can gain 1000 physician readers from over 62 countries on Nexus.

We would love for you to visit our community. It's free, takes seconds, and is designed for physicians only - completely free of industry bias and commercial interests.

Best,

Lee Marie Lomoljo
On behalf of the Physician Nexus Team
www.PhysicianNexus.com

Kathy Garolsky said...

Good post here.Thanks for sharing this info.

Paul said...

I have read just a small part of your blog so far - it is a bit close to the knuckle right now, but incredibly helpful too. My baby boy has just started treatment for an undifferentiated spinal sarcoma, and I have started my own blog of our experiences, realliferollercoaster.blogspot.com I would be extremely grateful if you might find the time to add it to your list of relevant blogs, and maybe even have a look at it yourself from time to time.

I will read the rest of your blog as I find the courage to do so

Many thanks

Paul

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Mimi said...

You're such an inspiration doctor!

blogcar said...

I hope to become a pediatric oncologist one day and this blog is a great reminder of what I am working towards.

Sally said...

I have so much respect for what you do. It must be an insanely difficult job that requires an incredible amount of fortitude, I look forward to reading more and wish you the best.