The MDT Meeting

In my time at the Marsden I sat in three MDT meetings, and they were referred to at least four or five times a day aside from this. From this you can see how integral these meetings are to the daily workings of the hospital.

The "MDT" stands for "Multi-Disciplinary Team" meeting, and essentially it is where everyone that is associated with a patient's care comes together to discuss treatment, review objectives and eat a few biscuits.

Each patient under a consultant is talked about in depth, their latest blood count, their CT (computed tomography - learn more here) scans, their progress through treatment and their general well being is covered.  It was here that I really got a feel for how integral teamwork is to successful patient care. The amalgamation of professor, nurses, registrars, research nurses and other key team members was impressive to say the least, because for each patient a different opinion is heard, and in this way all the information is present at the same time, leading to a streamlined system of care.

However, later in the week one of the registrars and I were seeing a patient (I say seeing, what I mean is that the registrar was seeing the patient, I was mostly nodding and accidentally getting under people's feet). This out patient, I'm calling her Mrs Williams*,  had been discussed in that morning's meeting; she had pancreatic cancer, and had just finished her third cycle. In the MDT meeting it was concluded that she was responding so well, from a medical point of view, that her treatment would be extended for another one and a bit cycles. This all sounded very promising, but later that day I was there when we saw Mrs Williams in clinic (learn more here), and she told us about the side effects she was experiencing. Which I learned vary between chemo treatments, as each plan is tailored for the patient, sometimes different drugs are used, or some are left out all together - hence the diverse side effects. Mrs Williams was alarmed by the size that her ankles had swelled to as a result of the chemo, and she was in pain. The registrar, too, was concerned that there may be clotting in the left leg that was much bigger than the right, but both looked painfully enlarged (similar to in this photo), with the skin stretched uncomfortably. Furthermore, she was suffering from constipation, excess urine and nausea, all very uncomfortable conditions. An ultrasound was proposed by the registrar to make sure there were no clots in the left leg which could lead to more problems. This lady and her husband were frightened of the seemingly alarming side effects, to the point where it was only reluctantly that they agreed to carry on with more cycles of the chemo. The registrar prescribed a cocktail of drugs to deal with the side effects; which for Mrs Williams means another set of pills to take every morning.

Afterwards, the registrar was telling me that there is a major flaw in the MDT meeting set up, because discussing something in a meeting in a boardroom with colleagues and biscuits is very different to seeing the patient right in front of you with hugely swollen ankles who can barely walk. There isn't much that can be done about the problem, but it's there.

Thank you for reading, I wish the brave Mrs Williams a comfortable and speedy recovery.


*All names in my blog have been changed to respect patient confidentiality.