You're the smartest guy in the room. But you never tell anyone. In fact, you do everything to play it down... unless of course, you get challenged. Then you bring out the big stick, maybe once or twice a year, and that shuts everyone up. They murmur and nod, and your work is done.. until the next FNG idiot steps into your radonc ring 6 months from now.
Heck, you even try talking like the surgeons so you'll be one of the cool kids. You buddy up with the radiologist, who you keep on speed dial. Sure, you and the medonc can hang a bit, but he's busy and you're not. He makes 2x what you do, but he really earns it. Plus, you have no idea what he's talking about with all those immuno drugs. He often forgets to do a staging scan, which you gently offer.. or even better, orders a PET scan for serial followup.. to which you keep your mouth shut. But at least he knows what radiation IS, unlike your peers who otherwise defer to you like a mage from ancient times, you know, they look at you with a bit of suspicion but still with respect for your magical powers.
This is you. The radiation oncologist.
Hahahahahahahaha
As I say often - I come to SDN because then I know I'm not alone in my experiences.
Though they're retiring, if you take jobs out in the community, you'll find a bunch of established docs in their 60s who are borderline worshipped. As a side note - the dynamics in Mad Men are still very much in play outside of metro areas.
So you walk into the TRULY "Good Ole Boy" club and they're just doing...wacky stuff.
Your mission, which you must accept to have a job, is to tiptoe around a social/power system that has been in place since Carter was president, trying to keep patients within some version of a Category 2B standard of care, without upsetting the frail egos of the elderly white coats still haunting the hallways.
Example: literally 3 days ago I was summoned for an inpatient consult, Stage III lung. I thought I was setting the patient up for definitive treatment.
Nope. Patient presented with acute SOB and respiratory failure, intubated in ED. No chest imaging other than portable X-ray to check tube placement. No D-dimer or anything like that. ECHO was WNL and LE Dopplers didn't show clot so...it's the lung cancer.
So I show up almost a week later (when they first called me). The conversation is palliative XRT or straight to hospice.
Patient at this time has been extubated, sitting comfortably in the chair on the floor. Also had a sputum culture positive for microbial infection around the time of admission.
Me: "Wait...tachycardic, SOB, intubated in the ED, known malignancy, now back at 97% on room air...no CT chest??? How about before we pull hospice out, we get a chest CT?"
Wouldn't you know - it showed a PE even a week later!
#RadOncRocks
