Jasmine Kamboj, MD
How It All Started
After attending a family event in California, I was landing in Chicago, the city I did my residency in, when my cell phone gained a signal and messages and e-mails started to pour in. It is amazing how technology captures our attention and plays a large role in day-to-day life. I had already been feeling anxious and restless during the flight, being disconnected from my phone. As I opened up my mailbox, there it was, an acceptance into one of the country’s best hematology/oncology programs at Baylor College of Medicine. Despite having just landed on the ground, I felt as if I had taken off into the air, much higher than the actual flight’s altitude. There was a sense of exhilaration as tears gathered in my eyes with deep satisfaction welling up my heart. My first thought was that “Dreams do come true.”
Deciding on a subspecialty during my medicine residency was not easy. In fact, my brother was the first one to prompt me to opt for hematology/oncology, as he himself was practicing surgical oncology and felt this would be a great option for me. A few close friends, however, disliked the idea because of my jubilant and perky, yet very emotional, personality. Everyone who even faintly knew me felt that I would become depressed when I would see my patients dying because of this ghastly disease, often regarded as, “The Emperor of All Maladies.” Nonetheless, I weighed my options and after putting much thought into it, I did finally make a decision to pursue hematology/oncology.
There It Comes
As I started my fellowship in January of 2013, every passing day and every single patient that I met with, strengthened my determination to master this subject. Fortunately, I had the privilege of connecting with indomitable faculty at Baylor and ever inspiring seniors and friends who helped me learn the fine details of the topic material and the art of managing patients with cancer.
Patients Are Your Biggest Teachers and We Must Learn to Befriend Them
At the end of the day, however, I must say that the most important teachers in this field are your patients. Beginning with their first scan, when a mass “concerning for malignancy” shows up, patients experience profound anxiety and curiosity. Physicians disclose the scan findings to patients, who then undergo pathologic diagnosis and are referred to medical oncology for consideration of systemic therapy. The first visit with a medical oncologist is the most crucial. The appointment can last anywhere from 45 minutes to an hour and a half. The patient will have a million relevant questions to ask about the exact diagnosis, staging, and their treatment options.
And, of course, the patient will ask the worst and most difficult question, “Doc, how much time do I have?” As a physician in training, I found responding to patients’ questions very difficult in the beginning. Beyond questions on diagnosis and stage, I struggled with how to answer questions related to prognosis or questions on the category-1 treatment options recommended for their cancer type. Slowly, however, I found that you do get a grip on how to handle these situations. It took me around 6 months to become comfortable establishing myself as a confidante and a friend to my patients.
When patients with cancer are waiting inside a clinic room, they are normally filled with a swirling storm of thoughts and emotions related to their diagnosis and prognosis. If they are an established patient, they are more concerned about treatment response and the possibility of disease progression. Therefore, it is of tremendous importance that we are not only good physicians, but also good friends with our patients.