November 25, 2017, is a day I will remember fondly. It was the day my first patient with acute lymphoblastic leukemia (ALL) took her last dose of chemotherapy and completed cancer treatment. ALL is somewhat unique in that treatment lasts 2 years for girls and 3 years for boys. Because pediatric hematology-oncology fellowship is 3 years, caring for a patient with ALL can be emblematic for the fellowship as a whole.
I met Chilion and her family during my first month of fellowship. Chilion was 8 years old when she was admitted with fever, fatigue, pallor, and weight loss. Blasts were present in her peripheral blood. Her workup showed ALL. My attending asked if I wanted to lead the discussion with the family about the diagnosis and treatment. I said, “yes.”
I’d seen similar discussions take place. I felt ready — and nervous. I did my best to balance providing information with giving space for questions, all while being empathic and hopeful. Despite my nervousness and aided by a few helpful words from the attending, the discussion went well. I bonded with the family. I left the room feeling complete ownership for Chilion and her care.
Caring for Chilion brought many firsts for both of us. My first time to prescribe chemotherapy; her first time to receive it. My first time to admit a patient from clinic as the oncology provider; her first time to miss a week of school. My first patient with cancer remission; her family’s happiness and a joyous return to school. As I journeyed with her through treatment, Chilion and her family taught me how to be an oncologist. I am no longer nervous when I discuss a new cancer diagnosis or treatment plan.
Two years later the “firsts” continue. While receiving cancer treatment, Chilion went to camp for the first time, won awards at school, and ran her first 5k. As a pediatric oncologist, I want my patients to survive their cancer and have a normal childhood. Chilion is the example I point to when someone asks if both goals are possible.
Chilion is still providing educational opportunities: Currently she is teaching me how to transition a patient back to being a normal kid. I’m working to integrate her post-cancer care with her pediatrician. This fall, she smiled when she told me she did not need a needle stick in my office because she got her flu shot at the pediatrician.
As I finish my fellowship, I will take many things from CHOP with me: world-class training, research experience, and a master’s degree. However, the most important thing I will take is the memories of my patients and their families. Last year at Christmas, Chilion’s parents gave me a framed picture of her at a 5k race. It has been on my desk ever since. It will remain there long after I leave CHOP, reminding me of the lessons Chilion taught me and the positive outcomes that are possible for pediatric cancer patients.
Contributed by: Charles Phillips, MD