The article prompted me to recall the series of events that made me conclude that oncology chose me rather than the reverse.
In 1972 I was struggling financially as a student at the University of Maine. It was obvious that I needed a source of income quickly. I traveled eight miles to the hospital in which I was born 21 years before and begged for any position.
The clerk said that the pathologist was looking for someone to help with a project. I didn't know what a pathologist was, but I had no other choices. I met Dr. Bernhoff A. Dahl, who hired me on the spot to take photographs while he performed autopsies. It seemed he was tired of taking his gloves off every time he wanted to photographically document a finding.
I had no experience in photography and certainly had never been in a morgue with the freshly deceased. Thinking back, Dr. Dahl performed an act of great charity in providing this job for which I was ill equipped.
After some weeks, the pathologists in the group asked me about my future plans and aspirations. I was a zoology major and had very good grades but a vocation was beyond my imagination. They suggested medical school, a track I had never considered. Since two of the pathologists had connections to the University of Vermont, it was easy to get written material about the curriculum.
The next academic year I completed the pre-med courses and took the requisite exam. My interviews at several medical schools went well, but the University of Vermont College of Medicine resonated with me, and the fit was perfect.
When I started medical school in 1973 it was with the intent that I would be a pathologist—after all, that is all the medicine I had been exposed to.
I recall clearly that day in my second year more than 30 years ago sitting in a large room in the Pathology Department with my classmates, each bent over a microscope, learning about blood cells for the first time.
My bench partners were having a difficult time distinguishing one cell from another, but I found that I could grasp the material easily at first glance. I must say that not anything else in the curriculum was that easy—Don't ask me about the Krebs Cycle today!
I kept going back to my blood cells, amazed that they were identifying themselves as if labeled. One of my professors suggested I read Samuel Rapaport's Introduction to Hematology, and, after doing so, it was clear that hematology was going to be part of my professional life. That notion was reinforced when we advanced to learning clinical diagnosis and how to evaluate and care for real patients, skills that appealed to me.
Hematology seemed like the ideal amalgam of pathology and clinical medicine. I chose a local practicing hematologist, Dr. Michael Scollins, as my faculty advisor.
Unfortunately, Vermont had so few hemoglobinopathy patients I felt that I was missing out on a valuable piece of my education. How can one be a hematologist without ever having seen a case of sickle cell anemia or thalassemia? To compound my concerns, I found out that there really were very few purely clinical hematologists. Dr. Scollins practiced internal medicine and hematology, but most hematologists in the 1970s were in research or also involved in the new field of medical oncology. I needed a change.
The University of Vermont medical students are allowed the opportunity during the final 18 months of school to study at other institutions. One of my choices was Grady Memorial Hospital in Atlanta, where my exposure to ethnic diversity was assured.
I did see more sickle cell than I thought possible, but the variety and volume of other clinical problems fit my requirements. I matched for internship at Emory University and began rotating through its hospitals, Grady included, in 1977.
Early in my internship, I spent a rotation on Grady's oncology floor with Dr. Mel Moore, a superb clinician-scientist with an encyclopedic command of the field of oncology and a deeply compassionate caregiver and a role model for his housestaff.
The synthesis was complete! Clinical hematology-oncology was my calling. After residency I was fortunate to stay at Emory as a fellow, where I was influenced by many wonderful role models and teachers and then started a private practice with my co-fellow, Tony Landis, in a suburban Atlanta county that, amazingly, did not have a hematologist-oncologist in 1982.
Now 33 years after hunger pains drove me to a job in the morgue, I see how oncology chose me and how caring for patients with the spectrum of cure, palliation, and terminal support made me a better doctor and a better person. Oncology gave me perspective about the philosophical and existential questions of illness, suffering, and death. My life could not have turned out any better.
Allan Freedman, MD
Suburban Hematology-Oncology Associates Snellville, GA