Ian is a man in his 40s, with a loving family and a fulfilling job. A few weeks of abdominal discomfort and some goading from his wife prompt a visit to his primary care physician. A computed tomographic scan reveals masses in the liver and peritoneum, with a nasty-looking colon tumor. After a colonoscopy, he arrives at the medical oncology clinic with a diagnosis of metastatic colon cancer.

He is the first patient I care for as a July first-year oncology fellow. At my institution, fellows see patients with newly diagnosed cancer in conjunction with a faculty expert. If patients agree, fellows “inherit” the patient, acting as their primary oncologist, with the attending physician following closely. Our meeting lasts an hour and a half. I leave to discuss his case with the attending physician, and we both re-enter the room to finalize recommendations.

伊恩（Ian）是40多岁的男人，有着充满爱心的家庭和一份充实的工作。几周的腹部不适和妻子的刺痛促使他去看了他的初级保健医生。计算机断层扫描显示肝脏和腹膜中有肿块，并伴有令人讨厌的结肠肿瘤。结肠镜检查后，他到达诊断为转移性结肠癌的肿瘤内科诊所。

他是我作为7月的一年级肿瘤科研究员照顾的第一位患者。在我的机构中，研究员与教职专家一起看望新诊断出癌症的患者。如果患者同意，研究员将“继承”患者（作为他们的主要肿瘤医师），并与主治医生密切关注。我们的会议持续了一个半小时。我离开去与主治医生讨论他的病情，我们俩都重新进入房间以完成建议。