The Fellowship

Since the fellowship ends in just two weeks, I figure I better get around to posting about what I've actually been doing out here. The experience has been fantastic. Challenging and interesting, I have been learning so much.

My office is in a Georgetown building, and I see patients in a separate office at the hospital. I'm going to miss my office. Its larger than the one I shared with my classmates during grad school, and it has a large window overlooking a forest area and a playground for the British elementary school next door. Its silly, but I love that it has a name plate outside the door; it reads "McKinsey Goodenberger, GC Fellow".

Right from the start the other genetic counselors were very welcoming. They are great at giving me autonomy but at the same time helping to continue my education. The very first week I started scheduling my own patients for two weeks out. In the meantime I observed the other counselors and they observed me. When my first autonomous patient arrived, I was surprised by how nervous I was!! I suppose most new GCs feel this way, but I couldn't believe I had volunteered for so much responsibility. Luckily my first patient was a very sweet elderly woman who was wonderful, so everything went fine. Since then things have been going well, I'm seeing about three to five patients a week. I am astounded by how much time just 3-5 patients take up. During grad school when I heard about my supervisors staying late or coming in on a weekend to catch up on work I swore that that wouldn't be me. But within in a week of seeing my own patients I was doing the same thing. I have to laugh at my nativety. Despite the work, I have very much enjoyed it.

At Georgetown, the genetic counselor are very involved in clinical research as well as seeing patients. Learning the protocols and how to fill out the various paperwork for the different studies was one of the hardest things at first. The studies are looking at different ways and times to provide counseling, as well as exploring different ways of providing information. They take up alot of the counselors' time, but its wonderful the way they can advance knowledge without really hindering the patient's care. I'm also participating in writing the papers, so finally I'll have a real publication to my name!

Since it is a fellowship, I have other responsibilities than seeing patients. I work on different learning activities, primarily a casebook the counselors prepared before I came. I work through these cases (which are very tough) and then discuss them with one of the counselors. Its challenging, but has really expanded my knowledge of counseling techniques as well as using primary literature in the counseling session. I also spend some time observing different areas of cancer care and screening. I've spent two days in clinic with a medical oncologist where I observed women newly diagnosed with breast cancer figuring out their chemo and radiation regiment. I did get to observe a mastectomy with reconstruction, which was incredible. I actually had to "scrub-up" for the procedure. I stood right at the head of the bed throughout the surgery, so I had a great view, being I was only like two feet from the action. It was long (I stood there from 11am to 4pm), but amazing. I couldn't believe how many misconceptions I had about surgery. Fascinating. If you want further details you have to ask in person, because if I start describing it Wade won't be able to spell check for me.

So, things are going well. These last couple weeks I'm primarily meeting with patients to give results and seeing a few new patients that I can do follow up via telephone even after I get back to MN. It really has been incredible, and Wade and I are both having a wonderful time.