Internal medicine resident plans for oncology career after his own experience with Hodgkin lymphoma

Having survived cancer – twice – would a graduating medical student want to devote his career to treating people with cancer?

As Jordan Ritchie, M.D., prepared to begin an internal medicine residency at MUSC Health in Charleston, he was torn. Becoming an oncologist and treating people with cancer every day might hit a little too close to home. He thought about pursuing cardiology.

Internal medicine residents rotate through a variety of inpatient and outpatient units to gain experience on a broad range of conditions. After residency, they might become primary care doctors, or they might decide to get more training to go into fields like infectious disease, rheumatology or oncology.

Ritchie was rotating through malignant hematology when he knew that he needed to work in cancer.

“Over the course of the year, as I worked on different rotations, I had one patient that I went home that day and told my wife, ‘I think I have to do oncology,’” Ritchie said.

 

“He was a young guy who came in with a new diagnosis of lymphoma. I was on his primary team, and I had to break the news to him. I sat down with him and his dad for a really long time, talked them through all the questions that I had when I was diagnosed. One of those was about fertility. But I think after that conversation, I just was like, ‘I think I need to be in this field because I can relate to what he's going through. I know the anxiety he’s feeling. I know all of the thoughts running through his head.’ And I've done it twice now. So I feel like I have a pretty good idea of what patients are going through, specifically cancer patients.”

High school interrupted

Ritchie was 17 when he was first diagnosed. He had started having night sweats, but the most prominent symptom was swollen lymph nodes.

“I was playing basketball and one of my teammates noticed a lymph node on my neck and was like, ‘Whoa, what's up with the big bump on your neck?’ He was kind of messing with me.”

Ritchie’s parents were also concerned, though his father, a family medicine doctor, and his mother, a nurse, didn’t think it would turn out to be too serious.

A biopsy showed it to be stage 2 Hodgkin lymphoma.

Hodgkin lymphoma, a cancer of the lymph system, is most often diagnosed in young adults between the ages of 20 and 35. No one knows what causes this cancer.

Happily, Hodgkin lymphoma is considered curable, and so Ritchie was scheduled to begin chemo at a children’s hospital in his home state.

All did not go as planned, however. The tube that was supposed to be inserted into a vein to deliver the chemotherapy was instead inserted into an artery. Chemotherapy through an artery is a highly specialized procedure used to deliver cancer-fighting drugs directly to a tumor in specific circumstances, and it's used only for solid tumors, not blood cancers.

Ritchie, who was hospitalized for the first infusion, immediately began reacting with pain, nausea and vomiting to what was supposed to be an “easy” chemo. After being sent home, his symptoms worsened.

“I started to develop this really bad pain up my neck. And then my arm was really tingling, the left arm in particular. I started to get numbness, and the arm started to kind of curl up on me – my whole arm was in horrible pain by three or four days after the chemo,” he recalled.

Ritchie, in fact, had suffered a small stroke.

When his parents brought him back to the hospital, an ultrasound revealed the incorrect placement of his chemo tube.

At that point, his parents began to research other hospitals and decided to bring him to Memorial Sloan Kettering Cancer Center in New York.

“I loved my doctors up there, and actually, they're kind of the ones who first inspired me to want to go into oncology,” he said.

The doctors there decided to give him only one more round of chemo, even though he had originally been scheduled for three, because the cancer had disappeared. Then, the focus turned to recovery, particularly to regain function in his arm.

“At that point I couldn't even pick up a pen and write a sentence. I couldn't tie a shoe. I couldn't do anything,” he said.

Physical therapy and occupational therapy helped, and neurologists agreed that, because he was young and healthy, he should completely recover from the stroke.

The end of one dream but the beginning of another

Pre-cancer, Ritchie had dreamed of playing basketball at college. After cancer, it was clear that wasn’t going to happen.

Still, after treatment, Ritchie was able to return for his senior year of high school and begin to think about college and what he wanted to do with his life.

His dad had never pressured him to become a doctor, and though part of Ritchie wanted to follow in his father’s footsteps, part of him was put off by the intense demands and the strain on family life.

As he continued through college, though, he increasingly felt that medicine was his path. After college, he earned a master’s degree, married his college sweetheart, Olivia, and began medical school in Memphis.

“By four years out, I was in remission and feeling great,” he said. “I still had some left-sided deficits, but I was feeling really good. I was in shape. I was running half marathons.

“And by year five, I was like, ‘It's never coming back.’ Hodgkin’s doesn't tend to come back.”

By his third year of medical school, he and his wife were thinking about starting a family.

But Ritchie was also starting to have all-too-familiar symptoms.

“I started having night sweats again. And I just remember thinking in the back of my mind, ‘This can't be it. This is just stress. This is stress. I'm really stressed out. I'm overworking myself. I just need to get some sleep. I need to exercise – I'm fine.’”

But then he got sick with COVID and the swollen lymph nodes didn’t go away. He was increasingly exhausted, and he lost 10 pounds. Ritchie told his wife that he didn’t feel well, but he didn’t tell her that he feared the cancer had returned. He went to a primary care doctor and asked for a scan.

Not too long after, at the beach with his parents and wife, he got the call. The cancer had returned.

A second bout with Hodgkin lymphoma

The first time he was diagnosed with cancer, Ritchie hadn’t been too worried.

“I knew cancer was bad, obviously, but I was just so optimistic and young. I never doubted that I was going to get through it the first time,” he said.

As a medical student, Ritchie had a lot more knowledge. “I think I was more scared. I mean, I still am. I still think about it,” he said.

This time, he also had more to worry about. There was, of course, the question of his health. But there were also worries about fertility – chemotherapy can damage sperm, and the Ritchies were ready to start a family. And then there were the money worries.

“I'm stuck in med school. It’s my third year – I haven't graduated. I'm not a doctor. But I have all this student debt. I can't stop,” Ritchie recalled.

The deans at his medical school encouraged him to take a break to concentrate on treatment and promised that his spot would be there when he was ready to return. But Ritchie wasn’t sure he’d be able to get back into the grind of medical school if he stopped. He and his wife decided he would simply power through.

It was not easy.

He had more side effects this time around – fatigue, body aches and some nausea. It felt like he was trying to work with a massive hangover. Chemo suppresses the immune system and leaves patients vulnerable to infections, so Ritchie showed up wearing an N95 mask and goggles to rotations on the infectious disease and intensive care units.

But at the same time, seeing patients every day helped him to focus on something beyond the cancer. “It gave me a purpose every day to keep going with this. Because I was depressed when I found out. If I had stopped, I think I would have gone into a depression. But it kept me going,” he said.

Ritchie went through six months of chemotherapy, finishing in November 2022.

He credits his support system for helping him to get through it, especially Olivia, and he noted how difficult cancer treatment can be for family members.

“Watching her go through it was actually really painful at times because caretakers sometimes take the brunt of the stress. It’s just really hard for them,” he said.

In July 2023, the couple arrived in Charleston for his three-year residency. At first, Ritchie didn’t share his medical history. But as he decided to pursue oncology, he began to open up to a few people. He’s started working with Alexander Coltoff, M.D., on clinical trials for leukemia.

On the home front, with the help of IVF, he and his wife welcomed a baby girl this year.

And once he’s into his third year of residency, he’ll begin applying to oncology fellowships.

“I think I’m called to do it.”

Related Links

More MUSC Hollings Cancer Center news

Subscribe to our newsletter

Hollings Horizons magazine