Marysol Chu Carty/ Dr.Alexandra Gomez Week 1

        This week was an introduction into the hematology/oncology department at Weill Cornell as I shadowed Dr.Alexandra Gomez who works on the bone marrow transplant team. It has been incredible to witness first hand just how many roles she has in her department and what her day to day looks like. I really got all my steps in running around the hospital with her. 
        
         My first day began with a department meeting at 9 am where the team was updated on the current status of each patient that was under the care of the various physicians present. I had a ton of questions when we finished about what all the different medical terms meant and the different treatments they were discussing. The more time I have spent listening to these meetings and going on rounds though has made it all sound more and more familiar and I am able to, in part at least, understand and recognize each patient that is being discussed. We then headed to update the physician assistants that work with Dr.Gomez prior to going on rounds to update the patient and their families. These patients had been diagnosed with diseases like Acute Myeloid Leukemia (AML), Myelodysplastic syndromes (MDS), Aplastic Anemia, and a large portion of them were there due to a complication that occurs with transplant patients called graft-versus-host disease (GvHD). As I followed Dr.Gomez and the team on rounds I couldn't help but feel overwhelmed and honestly heartbroken as I saw the very real struggle these patients and families face and how these diseases have altered their life. In a way, it made me miss the lab where I can just culture my cells and live in that research bubble. But, at the same time, I realized the importance of seeing the reality that as researchers we may not be exposed to or maybe just don't think about as often as we should. As sad and heartbreaking as it is, it can also be a motivator and driver to improve existing treatments and push to find new ways to target these diseases. 
       
        One interesting method that I learned about on rounds to treat GvHD was photopheresis. This didn't seem to be the initial way to treat GvHD, typically patients were put on steroids at first but for one patient photopheresis was the best option. He was connected to a machine that would collect his blood and separate the white blood cells and combine them with a photoactive drug. These white blood cells were then exposed to UV light activating the drug and then the blood was re-infused into the patient. The idea is to stop the patient's lymphocytes from attacking their own body. It was pretty awesome to see the machine at work! Rounds happened every day where I got to see the same patients but it was nice to see patients getting discharged or just the difference that can happen overnight because of the careful attention and care that is given in the hospital. As hard as it was at times going on rounds, I also got to see the joys and rewarding moments of being on the bone marrow transplant team. Wednesday afternoon I went to the clinic where Dr. Gomez had follow-up appointments with patients who were doing well and had previously undergone a transplant. It was great to just see their smiles when hearing that their labs were good and that they were able to come less often into the clinic. One particular patient had undergone a transplant for aplastic anemia and was now 2 years post-treatment and doing wonderfully. 
      
       The medicine part of what I've learned is super important but I think the most impactful part of this week is just seeing how Dr.Gomez and the other physicians advocate and fight for their patients every day. They care for them like family and really build personal relationships with them and their loved ones to make sure they know they're not in this fight alone. Im looking forward to the next few weeks as I continue to immerse myself in the clinical world.

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