A CANCER DIAGNOSIS DURING MEDICAL SCHOOL: BECOMING THE PATIENT

Cancer. "Surviving" med school took on a whole new sentiment in my third year rotations when I was diagnosed with not one, but two cancers.

Cancer. People always joke about surviving medical school. With the long hours, tons of information, fatigue, and emotional up and downs – often times you feel like you’re drowning. Third year is even more notorious for this as you transition to clinical work in fields such as surgery, obygn, internal medicine, etc. “Surviving” took on a whole new sentiment as I wrapped up my third year rotations when I was diagnosed with not one, but two cancers.

Guest post by Blade Hargiss

JUST A MOLE

I was on my surgery clerkship in late February in the frozen tundra of Minnesota. I was at the hospital most days by 5am and home who knows when after the sun had gone to bed. Things were wrapping up on the clerkship when I started noticing on a daily occurrence little blood spots on my right scrub leg just below my knee. I didn’t think much of it initially. After a couple days of this happening, I started noticing a little growth that I didn’t recall being there before.

I’m quite a moley person. My mom use to connect the dots and draw characters using the moles as way points for her art…only when extremely bored while sitting in waiting rooms for dental and doctor appointments. I have had plenty of skin checks with even more moles taken off due to “weird boarders”, “funny coloration”, or any other number of things. Both my parents also have had many moles whacked off. It just comes with the territory of being pasty white and covered in spots.

I watched this bump grow and bleed over the next week. As I transitioned to my psychiatry rotation, I had a friend in my class help me photograph it and send it into my dermatologist, just to be safe. It didn’t look dangerous. It was just weird. I got a message back that they would see me for my yearly scheduled skin check, which happened to be just a few days later, but not to worry about it as it didn’t seem scary to them. I guess Google photos has a way of filtering out the bad.

Eventually, I went to my skin check. The growth continued to increase, was pink, and bled on a daily basis. Pyogenic granuloma was what they said. I didn’t remember ever hurting my leg to cause one to pop up, but whatever. We shaved the sucker right off. Nothing to worry about. I had other moles they photographed for completeness sake, and then off I went. They said I would hear back from pathology within the next few days.

NOT JUST A MOLE

Well…I didn’t hear back for weeks. Honestly, I had forgotten about it. It crossed my mind a time or two to follow up as maybe my online portal hadn’t synched up with the results properly. But, I was busy, and now on my internal medicine rotation, meaning complicated patients with lots of learning to do.

On April 20, finally, my phone pinged with an email about a pathology report sitting in my portal. It was near the end of the day. I checked it. It said, “These abnormalities, in conjunction with the proper clinical and pathologic findings, may support a diagnosis of malignant melanoma. However, this result is not diagnostic of malignant melanoma. Clinical and pathologic correlation is required.”

Malignant melanoma. Not something you want to read.

When I got home, I told my wife. We spent the evening in a somber mood with the thought of “I most likely have cancer” just looming over my head.

We went a whole day waiting for more answers. None came. It wasn’t until April 22. I had gone into clinic and my phone rang.

I will never forget the first call.

CANCER

The resident asked if I was busy. I was, being that we had patients scheduled all that morning to be seen. Typically I try to pick up any call with the Mayo Clinic number on it just in case it’s a prescription change or whatever. I had five mins to chat.

The resident proceeded to drop the C word.

Now, you wouldn’t think melanoma, or the cancer of a mole, would be that dangerous. I mean, moles seem pretty pesky and pathetic on the skin, what harm could it do? The problem is they grow, and they do so fast. If it spreads, then you have a problem. Lots of melanoma, in my limited medical school understanding, like to spread along the skin surface first, growing out, before they burrow down. It is how far down the mole gets before you catch it and cut it out that really sets you up for an easy fix or a long road. The Breslow Depth they call it. Deeper equals bad.

Cancer diagnosis chapter two. "Surviving" med school took on a whole new sentiment when I was diagnosed with not one, but two cancers.

The resident went on to say that my mole had skipped the radial growth phase and went right to the diving stage. I guess my mole was somewhat of an overachiever. 2.6 mm deep. Tumor staged at T3b, partly influenced by how far down it had gotten and because it was ulcerated, hence the bleeding.

With cancer stages you are playing golf…the closer you are to one, the more times you win. The resident said mine was super aggressive and I would need to meet with surgical oncology and medical oncology ASAP. I went and told my physician, who kindly said go home, and off I went, not knowing if that morning’s patient prep was going to be the last time I would do so again.