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Fellows’ Forum Forgotten?

M.D. Anderson Cancer Center, The University of Texas, Houston, TX

To the Editor:

Jennifer Armstrong was a new oncology Fellow in Manhattan (New York, NY) when the Sept. 11 World Trade Center tragedy occurred. In the November 1, 2004, issue of the Journal, she describes how the war against cancer in which she had become entrenched prevented her from mourning, grieving, and commiserating with the rest of the nation and half the world.¹ Her experiences with patients dying of cancer were too overwhelming for her to feel the loss at "Ground Zero."

After learning how her own war was affecting her, she found articles in the cancer literature about programs that had been designed to aid in this process.^2,3 She then sought administrative help in setting up a program to help Fellows cope with dying, pain, and suffering in their patients. By July 2003, she launched a Fellows' forum that she described as follows:

Twice a month, we invited the medical oncology fellows to a lunch-time forum to discuss the psychosocial aspects of clinical oncology.⁴ We encouraged fellows to share any clinical encounters that had remained with them for more than 24 hours. The sessions were cofacilitated by me and a fellow in psychiatry, with supervision from an attending physician in psychiatry. The initial sessions were gritty. Fellows appeared in great numbers and recounted stories about patients they had cared for who had stayed with them for months or even years. One fellow explained the outpouring as, "We're thirsty for this venue."

The obvious need was translated into a successful program for the Fellows that has continued to this day.⁵

What's striking to me is that the same need was observed during my Fellowship a third of a century ago, and a nearly identical solution was provided.⁶ The sessions were held weekly exclusively for the Fellows and co-facilitated by a psychiatrist and an oncologist. Dr. Armstrong may have missed the first iteration of such a forum, perhaps because it was too long ago. In medicine, as in all endeavors of life, history does repeat itself. Most hopefully, we have learned from history to avoid a repeat of the event that occurred elsewhere in Manhattan 3 years ago.

Author's Disclosures of Potential Conflicts of Interest

The author indicated no potential conflicts of interest.

REFERENCES

1. Armstrong J: Fellow suffering. J Clin Oncol 22:4425-4426, 2004[Free Full Text]

2. Maguire P, Booth K, Elliott C, et al: Helping health professionals involved in cancer care acquire key skills: The impact of workshops. Eur J Cancer 32A:1486-1489, 1996

3. Jenkins V, Fallowfield L: Can communication skills training alter physicians' beliefs and behavior in clinics? J Clin Oncol 20:765-769, 2002[Abstract/Free Full Text]

4. Armstrong J, Shim J, Lederberg M, et al: Fellows' Forum: A workshop on the stresses of being an oncologist. J Cancer Educ 18:32, 2003 (abstr 79)

5. Armstrong J, Reznik I, Lederberg M, et al: Fellows' Forum difficult discussions: A workshop on the stresses of being an oncologist. Presented at Am Psychosoc Oncol Soc 2004 Meeting, Orlando, FL, 2004 (abstr 1240A14713)

6. Artiss KL, Levine AS: Doctor-patient relation in severe illness. A seminar for oncology fellows. N Engl J Med 288:1210-1214, 1973

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This Article Full Text (PDF) Purchase Article View Shopping Cart Alert me when this article is cited Alert me if a correction is posted Services Email this article to a colleague Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Save to my personal folders Download to citation manager Rights & Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Bleyer, A. Search for Related Content PubMed PubMed Citation Articles by Bleyer, A. Social Bookmarking                            What's this?