Volunteering at Hospice Days 4 and 5

Day 4: This was going to be my first day on the In Patient Unit (IPU) where all the wards for the hospice are and the end of life patients. I knew this was going to be different from the day hospice, not just because of the patients but the whole dynamic changes. One thing I learned never to say to people today was “how are you today?” What a stupid question that would be to someone in a hospice ward. I have learnt that I have so much left to learn.
This day I was on the IPU reception which was a mainly administration role but I enjoyed greatly being in a medical environment. Having to put calls through to doctors made me slowly aquatinted with those on staff that day. I was getting to know the patients in the ward as well but only on paper
Day 5: On arrival to the hospice I was greeted by the lady I would be shadowing on the ward, she like me was a fellow volunteer but much more experienced. Our first job I was told was to go into every room and collect any dirty dishes from lunchtime. When I say every room I mean the ones we could enter as there were a few that had their blinds closed which means strictly no entry. Having been introduced to some of the patients I felt greatly honoured to be in this place and have this role of talking to these people in their states and just do simple roles like making a cup of tea for them. I cannot wait until the day when I am a doctor and will have an even more intimate and close role with patients. When entering rooms sometimes you could feel some sort of tension between the patient and a visitor they may have. The other volunteer I was shadowing asked me if I picked up on anything when we went into one room with a patient and his wife and I told her my thoughts. She completely agreed with me and explained that when under the stress of the situation it can be very difficult for the both patients and visitors and their relationships can start to pull.
I look forward to my next time on the In Patient Unit and I know it will be the reception again but I think I certainly prefer the ward duties as there is so much more contact with patients.

Volunteering at Hospice days 2 and 3

This was my first full day at Oakhaven  hospice in which I would be on the day patient unit. I arrived that morning not sure what to expect and whether anyone knew I was turning up that day. Luckily they did and I was quickly thrusted into a morning meeting with all the other normal day volunteers and staff. We discussed the patients attending that day, going into some detail with certain patients their conditions.

When the patients arrived at 10:30am my first job was to make the patients comfortable and start introducing myself to them as obviously I was a new face to them. I quickly got chatting to a gentleman who had bowel cancer and was pleased I did as I found his whole approach so friendly and comfortable. Later on I conversed with another gentleman, whilst talking to him he put out his hand to hold mine. This situation really made me realise just what the kind of situations I might face as a future doctor and how important it is to be able to come down to the patients level and empathise with them. I loved holding this persons hand as he told about his life and felt honoured to be in this position where he was happy to tell me so much.
At lunch time I sat next to a gentleman with motor neurone disease. He could barely speak and we had to use a board with a system of colours and letters for him to be able to spell out words to us using his eyes. Despite his horrific condition he was so happy and joyful and always had a smile on his face.
Day 3: This time when I arrived I knew a bit more of what to expect and people knew my face which is always comforting to know. During our morning meeting we were warned that not many patients may come today because of illness. In fact when the patients arrived only four turned up. This was slightly funny as there were more volunteers than patients. However this meant that a practical jobs for the patients could be done very quickly and it gave us plenty of time to talk to the patients. It was great to talk to people in such detail and I remember taking to a lady called Paula. She had such a terrific sense of humour and especially so with her condition.
Whilst there I looked back to my second day with the day patients and realised just how different the people were. From going from a Thursday to Friday, the whole set of patients changes and so does the whole dynamic.
Whilst I have been in the day patient unit I loved it! But now I go onto the next step which is the In Patient Unit. Here I will be meeting a whole new set of challenges which will only be more intense than what I have already come across.

How the body can fight off skin cancer – with some help.

One of the many problems with cancer is it’s ability to cloak itself from the body’s immune system. White blood cells, specifically T-lymphocytes or ‘T-cells’, should recognise foreign material in the body and destroy it. But the tumour has evolved to cloak itself from the t-cells by producing a surface molecule called Ligand. The Ligand fuses with receptors of the T-cells known as PD-1. The receptor is activated and so the T-cells treat the tumour as safe, thus the tumour has fooled the immune system. But if you can stop the interaction between the Ligand and PD-1 then then the immune system should act to destroy the tumour.

In recent research on 135 people with melanoma, 54 of those had their tumour more than halve in volume when treated with the antibody Lambrolizumab. 57 of the 135 people were given very high doses of the drug and 6 of these people their tumours were eradicated.

With a second antibody, Nivolumab, the tumours more than halved in volume for 21 out of 53 people.

With a third antibody it targeted the Ligand molecule rather than the PD-1 receptor. This also produces impressive results for other types of cancer including lung and kidney cancer.

One of the researchers, Jedd Wolchok of the Memorial-Sloan Kettering Cancer Centre New York, said ‘They [the remedy] treat the patient, not the tumour.’ I think this is looking like a promising start to what might be the future of curative care for cancer sufferers.

Hospice Volunteering day 1

I have started volunteering at a local Hospice serving the community. I would say my first day but it was only a two hour induction but I still loved it. I was placed on the IPU (In Patient Unit) with another lady. Although I was there for only a short space of time I realised this was going to be different from any hospital volunteering. The whole dynamic of the hospice is different to hospitals from the obvious change from curative to palliative care but also how the staff and volunteers relate to the visitors. It was hard to see visitors grieving for suffering relatives and I didn’t know what to say. I wanted to put my arm round them and support them but I knew that wouldn’t help. I can see that if palliative care is a speciality I might consider then it will be something I will have to think long and hard about.

I have also realised that they will want me in the holidays more than I expected. This is a very good thing as the more experience the better but also I might be able to shadow a Doctor which would be a priceless opportunity to have.

The most valuable experience I can take away from the hospice will be the way I will have to learn how to work with those who are suffering from pain or bereavement.

Being a late comer!

One of the hardest things for me about going for medicine is that I only decided I wanted to study medicine about 1 month ago. This means whilst all my friends who plan on studying medicine have been volunteering at the hospital, have work experience with doctors in the summer and study biology, I have non of this.

Luckily I have just set up some volunteering at my hospital now which I start at the end of this month. But trying to sort out work experience is a nightmare. I wonder if I have left it too late. Another problem is that I do not study biology, and whilst this isn’t too much of a problem in terms of UCAS applications, I still lack a good understanding the human anatomy and body functions. This means there is a lot of reading ahead of me over the summer to try and catch up. So on the recommendation of a friend I went and bought ‘Gray’s Anatomy’. When I received it in the post though I knew something was wrong when all the illustrations were hand drawn. It turned out to be the original 1901 edition which has taught me too read the descriptions of products when I buy things off Amazon, or at least for books anyway!

One of the things I have tried to do is to increase my knowledge of medical issues in the media. Using the BMJ student and BBC news websites I am now putting together a collection of articles with all the issues I should know about for medicine, or for my interview at least.

White light and it’s magic…

Physicists at St Andrews University have developed methods of using white light to fight cancer. The idea goes that the light could carry drugs deeper into the tissue allowing the drugs to be place into groups of cells painlessly and instantaneously. And the light could also act as microscopic ‘tweezers’ to move cancer cells around the body and isolate them so that they can be treated. The researchers have already been able to remove chromosomes from a cell. Over Easter I was fortunate enough to meet some of the researchers at St Andrews responsible for this finding and they were telling me how this could, slowly, become a huge tool to fighting cancer.

Research is also being done like this in the US where researches are using light to activate drugs that will then stick to cancerous cells. But the drugs only seem to respond to certain wavelengths of light. At the National Cancer Institute, Maryland, they have used an antibody which targets the proteins of cancerous cells. This antibody has the chemical IR700, which is then activated by Infrared light. Infrared is particularly useful as it can quite easily penetrate several centimetres of tissue.