A view over the intracoastal provides a view of alot of antics. Directly across is the St Augustine airport. The choppers and planes come and go, but what fascinates me this week is a small plane. I hear the acceleration and roar as it flies straight up. Then the silence with the stall and terrifying verticle drop, then again acceleration coming out of the stall. If you are going to get a pilot’s license to fly even a small plane, these exercises are mandatory… and require nerves of steel. I watch as again and again they practice this acrobatic feat. Practice will make perfect. Skill and fearlessness- a winning combination.
We call our profession the “practice of medicine”. Unlike the pilot we cannot practice until it is perfect- ever, because the variables are many and constantly changing. Each patient is completely different from the last in spite of presenting with exactly the same diagnosis. The age, circumstances, genetic profile of the tumor, the tolerance for therapy, the burden of disease. There are detailed well researched written standards, but absolutely no formula can be followed without respecting and investigating the nuances, drilling down to specifics, far beyond the stage of disease or age of the patient.
This is important because, as we are faced with complex medical diagnoses, the path is not linear. You can’t just phone a friend and be confident that their journey will be yours. The woman in the chemo chair next to you may be on an immunotherapy with or without chemo and being treated prior to not after surgery. The man in the waiting room may have had a radical prostatectomy while you are on hormones with radiation even for the same level of disease.
It is important to appreciate these concepts because practices evolve constantly, resulting in better therapies and outcomes. As Chair of the Board of American College of Radiation Oncology, I am blessed with many brilliant contacts. Just last evening, a physician reached out for help with a case and I was able to connect him with an expert at an NCI designated cancer center for advice. How we all treated the case for years is no longer the new standard.
No one wants a Doc with training wheels, but even seasoned physicians who train interns and residents learn daily. My practice of radiation oncology is different today from just a few months ago. This is what is exciting, even as it is challenging. One aspect of care is, however, constant. Our devotion to provide the most up to date, cutting edge, safe treatments with expected best outcomes.
When you lose faith and get frustrated. It’s hard to wait for scans or you can’t get swiftly into a physician for a visit. Be assured that once you do, alot is going in your favor and every effort will be made to evaluate you and your issue thoroughly. We have many patient patients who enter the centers. Their fortitude starts before we even begin their care. The smallest maneuver can make a huge difference in your treatment and so as the world seems to spiral around you with a new diagnosis, trust in the safe landing. The goal in the practice is still perfection.