Embedded Files
Shadowing Doctors
Shadowing Doctors
Hello, my name is Phoebe George! Next year at Fairfield University, I will be playing D1 soccer and majoring in Public Health in the Egan School of Nursing and Health Studies. After graduating from Fairfield, I hope to attend medical school and pursue a career in medicine.
With that in mind, my goal for this project is to foster my curiosity of the medical world through interviewing and shadowing doctors.
Thank you to the all of the doctors that worked me with me over the course of this project. Your generosity and kindness made this project not only possible, but also an incredible experience that I will continue draw from as I continue my journey in medicine.
Additonally, I would like to extend my gratitude to the Alumni Office, especially Mr. David Allen, for connecting me with so many amazing medical professionals.
Week One
Week One
My first shadowing experience was this past Thursday, April 11 with Dr. Michael Graves ‘02 at his practice Southwest Dermatology & Vein Clinic in South Austin. After leaving the hill, Dr. Graves graduated from Brown University with honors and went to medical school at UT Southwestern Medical Center in Dallas. He completed his dermatology residency training at the Medical College of Georgia and received a prestigious fellowship in Mohs surgery and cutaneous oncology at Scripps Clinic in La Jolla, California. Throughout his career, he has won numerous awards highlighting his talent and capability as a medical professional. Dr. Graves’ impressive professional biography spoke for itself when I shadowed him, but what I found to be equally as impressive was the compassion he had for both his patients and his staff.
On this particular day, I got to watch Dr. Graves treat and consult with patients at varying stages of vein disease in their legs. During many of the consults, patients had symptoms including itching, heaviness, inflammation, discoloration, restlessness, cramps (especially at night), pain, and ulcers in their legs. This is due to the dilation of their veins, whose main job is to carry blood back to the heart so that it can get reoxygenated. These veins are called varicose veins. When the veins are dilated the valves don't work properly, which causes the deoxygenated blood to pool in their legs. Because Dr. Graves only specializes in the treatment of vein disease in the superficial veins, he is able to solve his patients problems by closing the varicose veins.
Animation of EVLA Procedure
One of the procedures I was able observe is called Endovenous Laser Ablation, EVLA, which treats varicose veins using laser pulled through the vein under local anaesthetic (in this instance it was lidocaine). Ultimately, the most painful part of this procedure was the injections of anaesthetics.
Another procedure I was able to observe was an Ultrasound Guided Sclerotherapy with foam, which treats varicose veins via a chemical injection that targets the vein cells. The chemical will disperse throughout the surrounding vein system closing a lot of smaller varicose veins simultaneously. This makes it a better choice for highly concentrated areas, like around the ankle.
The clinic moved at a very fast pace. Not only were the appointments short, but we were constantly on our feet and hopping from room to room. Before entering each room, all relevant people would meet outside the room and go over the paperwork Dr. Graves had formatted that was filled out for the patient. Then they would address any problems or concerns before proceeding with the plan and entering the room. I found it very beneficial to observe the team aspect of everyone in the clinic working together. There were front desk workers, nurses, RVTs (registered vascular technologist), and doctors all working alongside one another towards a common goal.
When I first arrived at the clinic, I met Dr. Riddell Scott, who has been a dermatologist for over 20 years already, and she was also learning from Dr. Graves about vein surgery. Through following Dr. Graves and Dr. Scott, I was able to see how doctors continue to expand their knowledge and expertise throughout their careers in an ever evolving industry.
Additionally, I was amazed when Dr. Graves started speaking spanish to his patients. I asked him if he thought this skill was particularly beneficial for doctors to which he replied that it probably won't be necessary with future technological advancements. Although he stated he couldn't really understand his patients that well, he expressed how useful it is to explain the procedure to his patients so that they feel reassured and know exactly what he is doing.
Lastly, I found it very interesting to see how insurance affected the timeline and care of the patients. I only saw one cosmetic patient during their follow up consultation who came into treat their varicose veins, and that was not covered by insurance. The patients who came in for an initial consultation were required to do some period of time of alternative therapy including compression socks, exercise, and elevation, none of which treated the underlying cause, in order to get the procedure covered by insurance. Many of these patients desperately just wanted the pain and discomfot to go away, which a lot of time caused trouble sleeping. Once they did this, they had to come back in and check in with the doctor, but then they had to wait four weeks for the insurance company to process the request. Earlier during Winter Term when I spoke with Dr. Graves over the phone, he talked about how as a doctor's normally dislike their job because there are limitations to what you can do. Doctors can't single handedly save the world, so they should recognize their limitations and live within them. This, he stated, is the key for happiness, especially with insurance companies.
My observations about the role of insurance at the clinic connected with ideas I read this week from The People's Hospital: Hope and Peril in American Medicine by Ricardo Nuila, which was recommended to me by Dr. Monica Patel. The book follows the lives of five uninsured Houstonians as their struggle for survival leads them to the Ben Taub hospital where Dr. Nuila works, connecting all their stories into a singular narrative. This week I was able to read the histories of all the patients and start to see their treatment begin at Ben Taub hospital. My biggest takeaway this week is how insurance companies affect hospital procedures to gain profit rather than helping patients.
Week Two
Week Two
This week, I was able to shadow Dr. Jeffrey Padalecki who is an Orthopedic Surgeon specializing in sports medicine and arthroscopic surgery of the shoulder, knee and hip at the Austin Regional Clinic. He played collegiate basketball and majored in engineering at St. Mary's University. Following his time there, he attended UT Houston Medical School and completed his orthopedic residency at UT Southwestern and Parkland Hospital in Dallas. Additionally, he was selected to attend the renowned Steadman Clinic Fellowship Program in Vail, Colorado. He has treated numerous professional athletes across a wide variety of sports and has served as a team physician to local high school, collegiate, and semi-professional athletes, now serving as the medical director for Ballet Austin. He has also been heavily involved in research, ranging in focus from ACL and cartilage injuries in young patients, to meniscus repair surgeries, and novel techniques for treating complex shoulder injuries. Throughout his career, he received many prestigious awards for his continuing excellence, which, along with his compassion, is translated into his amazing reputation as he is continually recognized as one of the top doctors in Austin. All this being said, I was really excited to shadow Dr. Padalecki this week.
This week was the first time I got to scrub in to observe an arthroscopic rotator cuff repair surgery in an operating room (see my very awkward mirror selfie from the locker room on the left!). Already having a shadowing experience under my belt at this point, I felt a lot more confident going into this week and comfortable in new medical settings. It also helped that Dr. Padalecki and the whole team in the OR were super kind and enthusiastic. Although I spent some of my time this week researching the different surgeries Dr. Padalecki performs, it was incredibly helpful to be walked through the surgery by the sales rep, the scrub tech, and of course Dr. Padalecki himself.
The rotator cuff is responsible for stabilizing the ball in the socket of the shoulder using four muscles, or tendons. When one or multiple of those muscles, or tendons, are damaged, either torn or degenerated, a wide range of symptoms can occur based on severity, but will most likely include inflammation, pain, muscle weakness, and lack of mobility. The diagnosis is made through a physical exam and imaging that can include x-rays, ultrasounds, and MRIs. In mild cases, like small and partial tears or tendonitis, Dr. Padalecki will treat the patient with non-operative measures first consisting of rest, ice, anti-inflammatory medications, physical therapy, and possibly, an injection to reduce the inflammation. If this fails, or if the patient has a full and large partial thickness tears surgery is the elected course of treatment.
The arthroscopic surgery is done through a tiny camera called an arthroscope and tools inserted through small incisions to reattach the torn muscle, or tendon, to the bone. After the room was prepared by the scrub tech and and nurses and the patient was stable under anesthesia, the team runs through what they are doing and double checks everything during their time-out. Before beginning the surgery, the patient's blood pressure dropped concerningly, which Dr. Padalecki noted to me was due to the patients seated position under anesthesia. Once the patient was stable, they started flying through the surgery. The repair involved cleaning up any damaged tissue with a tiny, covered, circulating saw then screwing in anchors and sewing thread threw the muscle, or tendon.
Dr. Padalecki's technique has evolved over the years and now leaves no excess string on the outside of the repaired muscle, or tendon. This decreases friction and allows for a better recovery. Ultimately, as the scrub tech explained to me, all these mechanics will fail, but they will allow the rotator cuff to heal and produce enough scar tissue to hold it in place permanently. While operating, Dr. Padalecki also fixed a damaged bicep tendon. Something he told while scrubbing in that he was anticipating. I had asked if that affected the patient's insurance, which he responded saying he sends in codes for different surgical procedures that might occur during surgery, so that they can get pre approved. Otherwise, they would have to submit them after, and it would take forever and become more of an ordeal.
While shadowing, I also found out that most of the people on Dr. Padalecki's team were collegiate athletes. Jokingly while waiting to enter the OR, the sales rep said Dr. Padalecki only hires athletes, and while these wasn't entirely true, Dr. Padalecki said that being an athlete gives you certain advantages when applying to medical school and in life in general. After shadowing, I decided to dig a little deeper into this topic and found a couple interesting studies
This study aligned with what I had already heard from Dr. Padalecki. The study found six major factors explaining the athletic success of former collegiate athletes in medical school: the ability to set goals and follow through with them, time management and organizational skills, team work skills, effective communication skills, ability to cope with stress and adversity, and the prioritization of personal wellness. The conclusion of the study states that it was the transfer of these factors that were developed playing sports in college that attributed to the success of former collegiate athletes in medical school.
Athletes in medicine: A systematic review of performance of athletes in medicine
This article actually studied test results and performance in medical school of former collegiate athletes, and determined that they do in fact achieve more success than what is commonly referred to as a NARPs (non-athletic-regular-person). My main takeaway from reading this study was how athletes not only perform better, but they also have higher resilience and less burnout during medical school and residency. This was quite comforting to hear since burnout is something I'm trying very consciously to avoid.
This week, I also finished reading The People's Hospital: Hope and Peril in American Medicine by Dr. Ricardo Nuila. Throughout the novel, Dr. Nuila talks about Ben Taub's renowned reputation, especially in cardiology. However, Ben Taub’s model differs from other top hospitals in the country. Suggesting that the model of lower-cost, patient-centered healthcare can yield better results with far less waste than other medical models in the US. Overall, I really enjoyed this book, and appreciated the risk Dr. Nuila took to call out the American healthcare system. The title is "hope and peril," and I feel that sums up the impression this book has left on me. I'm excited to continue my studies of health care next year as I begin my Public Health major.
Lastly, this week I will give some advice to the current juniors considering doing and SIP. This year I was amazed at all the seniors that decided to pursue this project. While I'm excited that the SIP is gaining popularity, I would warn against doing a project you aren't totally invested in. At this point in the year, it's not about finding more things to build your resume, so choose a topic you're really passionate about. This is really important because you'll be doing a lot of work (20 hours is no joke!). I highly recommend doing an SIP, and I look forward to hearing what y'all come up with. Good luck!
Week Three
Week Three
This week I was fortunate enough to shadow twice! The first time was again with Dr. Graves, who you might recall from my first week entry, on Monday. This week, instead of veins, I got to shadow him curing skin cancer. Dr. Graves is specially trained for Mohs surgery, which is a technique used to remove and analyze the skin cancer in real time. Usually, the patient is already referred to Dr. Graves or seen by a dermatologist at his practice and they are prepped for the procedure on the phone before the visit, which allows Dr. Graves to waste no time in treating them as they come into the clinic that day.
After the nurses prep the room, Dr. Graves goes in and marks the cancerous spots with enough room for margins, which were typically on the face due to the high amount of uv exposure. Then they check and make sure this matches the pictures taken on previous visits and the patient's own understanding of their location. Dr. Graves then goes in with lidocaine to numb the area followed by a scalpel to cut the circle he drew at specific depths and angles. Once the circle is up, he lifts the section with a pair of tweezer and then uses scissors to cut out the skin. He then gives this to his pathologist, who takes frozen sections and dyes slides for Dr. Graves to analyze. Dr. Graves let me look at some normal and cancerous slides. He is looking for basal cells or squamous cells, which are more aggressive than basal cells.
Dr. Graves will visit multiple patients for the procedure and then look at the slides. Most of the time the margins are clear, but for a couple patients he did have to go back in and remove more, repeating the whole process over. Once all the margins are clear he will go in for reconstruction, doing deep stitches and then superficial stitches for an almost undetectable scar. Sometimes, as seen with one of his patients while I was shadowing, he will suggest going to a plastic surgeon, who he just texts to get the patient in as quickly as possible before too much healing takes place.
I also got to talk more deeply with Dr. Graves this visit and got to hear a lot of great advice. I asked him the upsides and downsides of his job (a question he had advised me to ask to every doctor I talk with when I had spoke with him before this project). He said that his family and spending time with his wife is really important to him, so the career path he chose is very conducive to that. He said that he likes that he can cure skin cancer and treat vein disease every day, significantly improving the health and well being of his patients, and not having to deal with deathily outcomes or terminally ill patients. He also runs his own practice, which he said is very time consuming, but at the end of the day he is the boss and can make sure that the clinic is run the way it should be. Another downside he mentioned was that he is in a super competitive field, and that Austin is specifically a more competitive city.
Lastly, I asked him what advice he would give for someone entering pre-med undergrad. He replied by saying to just work hard. Medicine, he had stated, is a long and arduous journey, so just start working hard now to build a better foundation later. He said it seems super daunting right now because there are so many choices, but with each step your choices narrow, making the process almost easier as it goes on. I found all of this really helpful to frame my mindset for next year.
This week I also took Wednesday off to drive a ~ 6 hour round trip to Victoria, TX to shadow Dr. Leilani Valdes. Dr. Valdes is a board certified Anatomic, Clinical and Dermatopathologist and the Chair of Pathology and Laboratory Medicine at Citizens Medical Center, which is where I shadowed. She also is the Medical Director at Regional Pathology Associates, which serves many hospitals and clinics in South Texas. She serves and holds leadership positions on several boards, which exemplifies her excellence in her field. Although she majored in theater during her undergrad, she is a graduate of the Keck School of Medicine at the University of Southern California and she completed her Anatomic and Clinical Pathology training at Los Angeles County – University of Southern CA Medical Center. This was followed by a Dermatopathology Fellowship at Duke University Medical Center. Also, in 2022, she earned her Executive MBA at the University of Texas at Austin McCombs School of Business in May of 2022, graduating as a Leadership Fellow. This is all to say she is super cool!
This was my first full day of shadowing, which was super exciting, so I learned a ton! I started my day with Dr. Valdes at the groundbreaking for the new ICU at Citizens Medical Center. Dr. Valdes highlighted how important it is for the different departments to support each other, especially her department was getting a remodel as well. I got to look at some slides in her office, then we went to frozen sections, and after while she was going through all her slides for the day, I got to shadow the hospital lab. Then we got lunch in the physicians lounge with a member of the board of the hospital who was at the ceremony earlier, and had a really insightful conversation about the protests at Columbia University (reluctantly I have to thank assigned seating for this skill!). I then spent the rest of the afternoon with Dr. Lapus looking over more slides.
In hopes to not bore you with miles of text, I made a presentation of all the different areas of the hospital lab I got to observe and everything I learned that day (plus photos!):
I asked Dr. Lapus while we were doing gross what she thought the upsides and downsides were of being a pathologist (once again like Dr. Graves advised). Dr. Lapus responded saying that there were a lot of misconceptions about pathologists. One being they aren't all medical examiners, two that they aren't introverts and deal with a lot of people all day, and three that it is actually very hands on. She said that the only downside is you don't interact with patients, although she did say you have an extremely positive impact on their care, and that people don't appreciate or really know what pathologists do.
See to left some stickers Dr. Valdes gave me as I walked out. It is hyperlinked with the websites found on the bottom corner of the stickers.
Week Four
Week Four
Unfortunately, this week I was not able to shadow any doctors due to complications. So, instead of going over my shadowing experiences, I will be switching things up this week. I worked this week on three main things:
Researching any medical professions or specialties I won't be able to shadow for this project.
I started reading a new book called Complications: A Surgeon's Notes on an Imperfect Science by Dr. Atul Gawande (recommended to me by Dr. Monica Patel).
Took a Myers-Brigg personality test and compared it with both my research and shadowing experience and with a few studies I found.
When researching the different specialties and professions, I decided to focus on three main areas: what their daily life was life, what training they had to go through, and what their responsibilities are. Click through the collapsible groups for the culmination of my research:
Cardiologist
Last year in Adv Bio II, Dr. Mohlman arranged a field trip to observe a heart surgery. Looking back, I think this experience was a big inspiration for this project. My experience on that trip helped me write this section as well as the sources listed below.
Daily Life: Cardiologists typically split their time between patient consultations, diagnostic tests (like EKGs and echocardiograms), procedures (such as angioplasty and pacemaker implantation), and rounds. Some also participate in research or teaching activities.
Training: After completing medical school, they undergo a residency in internal medicine followed by a fellowship in cardiology, which typically lasts 3-4 years.
Responsibilities: Cardiologists diagnose and treat heart conditions such as coronary artery disease, heart failure, and arrhythmias. They may also provide preventive care and lifestyle counseling to patients at risk for heart disease.
Sources: American College of Cardiology (ACC), American Heart Association (AHA)
Internal Medicine
Daily Life: Internal medicine doctors may work in outpatient clinics and/or hospitals. Their day-to-day activities include seeing patients for routine check-ups, managing chronic conditions, and coordinating care with other specialists.
Training: After medical school, internists complete a 3-year residency in internal medicine. Some may choose to pursue additional fellowships in subspecialties like cardiology or gastroenterology.
Responsibilities: They diagnose and treat a wide range of adult diseases, from something common like hypertension and diabetes to rare and complex conditions such as autoimmune disorders and cancer.
Sources: American College of Physicians (ACP), American Board of Internal Medicine (ABIM)
Anesthesiology
Earlier this year, in my Adv Chem II class, Ms. Livsey brought in a guest speaker annesthologist to speak with us, so some of my findings were influenced by Dr. Helen Heymann's presentation.
Daily Life: Anesthesiologists work in operating rooms, labor and delivery units, and intensive care units. They administer anesthesia to patients undergoing surgery or other procedures, monitor their vital signs during anesthesia, and manage pain post-operatively. It involves a lot of math! Dr. Heymann said she likes how her hours are stable and predictable.
Training: After medical school, anesthesiologists undergo a 4-year residency in anesthesiology. Some may pursue additional fellowship training in areas like pain management or critical care.
Responsibilities: Anesthesiologists ensure patients are safely sedated and comfortable during surgical procedures. They also manage patients' airways, monitor their cardiovascular function, and provide pain relief as needed.
Sources: American Society of Anesthesiologists (ASA), Accreditation Council for Graduate Medical Education (ACGME), and Dr. Helen Heymann
Nursing
I think it's important to note this isn't an option for me because the nursing clinicals and lab times conflict with practice at Fairfield, so I'm not allowed to go into nursing. I still think it was important to learn more about since they are the backbone of healthcare and since I see them a lot while shadowing.
Daily Life: Nurses work in a variety of settings, including hospitals, clinics, schools, and community health centers. Their duties may include administering medications, monitoring patients' vital signs, providing wound care, and educating patients and their families.
Training: There are several paths to becoming a nurse, including earning an associate degree in nursing (ADN), a bachelor of science in nursing (BSN), or a diploma from a nursing program. All nurses must pass the NCLEX-RN exam to become licensed. A lot of nurses will pursue further training, like the registered vein technicians at Dr. Graves clinic or scrub nurses in Dr. Padelecki's OR for example.
Responsibilities: Nurses play a crucial role in patient care, collaborating with other healthcare professionals to promote health, prevent illness, and manage chronic conditions. They advocate for patients and provide emotional support during times of illness or injury.
Sources: American Nurses Association (ANA), National Council of State Boards of Nursing (NCSBN)
Dentistry
I chipped my tooth pretty bad in 2nd grade and ever since then have been to many dentists, and so this is a field I'm very open minded about.
Daily Life: Dentists work in private practice, community clinics, or sometimes academic settings. They perform oral exams, cleanings, fillings, extractions, and other procedures to maintain oral health and treat dental conditions.
Training: Dentists must complete a bachelor's degree and attend dental school for 4 years to earn a Doctor of Dental Surgery (DDS) or Doctor of Dental Medicine (DMD) degree. They must also pass national and state licensing exams.
Responsibilities: Dentists diagnose and treat conditions affecting the teeth, gums, and mouth. They educate patients about proper oral hygiene and may refer patients to specialists for complex procedures like orthodontics or oral surgery. Orthodontists or oral surgeons undergo different, more extensive training.
Sources: American Dental Association (ADA), American Dental Education Association (ADEA)
Physical Therapist
Similar to my blurb before the dentistry section, being and athlete has exposed me to a lot of physical therapists. This is on the back end side of patient care. I'm also very open minded about this career path.
Daily Life: Physical therapists work with patients of all ages to improve mobility, reduce pain, and prevent disability. They perform assessments, develop treatment plans, and teach patients exercises and stretches to restore function.
Training: Physical therapists must earn a Doctor of Physical Therapy (DPT) degree from an accredited program, which typically takes 3 years to complete. They must also pass a national licensing exam.
Responsibilities: Physical therapists help patients recover from injuries, surgeries, or illnesses affecting the musculoskeletal system. They use techniques like manual therapy, exercise prescription, and modalities such as ultrasound or electrical stimulation.
Sources: American Physical Therapy Association (APTA), Commission on Accreditation in Physical Therapy Education (CAPTE)
Psychologist
Daily Life: Psychologists work in various settings, including private practice, hospitals, schools, and research institutions. They conduct assessments, provide therapy and counseling, conduct research, and may teach or supervise other mental health professionals.
Training: Psychologists typically earn a doctoral degree in psychology (Ph.D. or Psy.D.), which requires 5-7 years of graduate study and supervised clinical experience. They must also pass state licensing exams.
Responsibilities: Psychologists assess and treat mental health disorders such as depression, anxiety, and schizophrenia. They use evidence-based therapies like cognitive-behavioral therapy (CBT) or psychoanalysis to help clients improve their well-being.
Sources: American Psychological Association (APA), Association of State and Provincial Psychology Boards (ASPPB)
General Surgeon
Daily Life: General surgeons work in hospitals or surgical centers, performing a variety of procedures on patients with conditions ranging from appendicitis to cancer. They may also conduct pre-operative consultations and post-operative follow-up care.
Training: After medical school, general surgeons undergo a 5-year residency in general surgery. Some may pursue additional fellowship training in subspecialties like vascular surgery or surgical oncology.
Responsibilities: General surgeons diagnose and treat a wide range of surgical conditions affecting the abdomen, breast, skin, and soft tissues. They may perform procedures such as appendectomies, hernia repairs, or mastectomies.
Sources: American College of Surgeons (ACS), Accreditation Council for Graduate Medical Education (ACGME)
Neurosurgeon
Daily Life: Neurosurgeons specialize in surgery of the brain, spinal cord, and nervous system. They perform complex procedures such as tumor removal, spine fusion, and treatment of traumatic brain injuries.
Training: After completing medical school, neurosurgeons undergo a 7-year residency in neurosurgery. Some may pursue additional fellowship training in areas like pediatric neurosurgery or functional neurosurgery.
Responsibilities: Neurosurgeons diagnose and treat conditions such as brain tumors, stroke, and spinal cord injuries. They work closely with neurologists, radiologists, and other specialists to provide comprehensive care to patients.
Sources: American Association of Neurological Surgeons (AANS), Congress of Neurological Surgeons (CNS)
EMT
Daily Life: EMTs provide emergency medical care to patients in pre-hospital settings, responding to 911 calls and transporting patients to medical facilities. They assess patients' conditions, administer first aid, and perform basic life support interventions.
Training: EMT training programs vary in length and requirements, but all EMTs must complete a state-approved training course and pass a national certification exam. EMT-Basic training typically takes about 6 months to complete.
Responsibilities: EMTs stabilize patients with traumatic injuries, cardiac emergencies, or other acute medical conditions. They perform interventions such as CPR, bandaging wounds, and administering oxygen while en route to the hospital.
Sources: National Registry of Emergency Medical Technicians (NREMT), National Association of Emergency Medical Technicians (NAEMT)
Trauma Doctor
Daily Life: Trauma teams work in emergency departments or trauma centers, providing immediate assessment and treatment to patients with severe injuries. They triage patients, perform emergency procedures, and coordinate care with other specialists. Triage is a form of assessing and categorizing the severity of patients.
Training: Trauma teams typically consist of emergency physicians, trauma surgeons, nurses, and other healthcare professionals with specialized training in trauma care. Many trauma surgeons have completed fellowships in trauma and surgical critical care.
Responsibilities: Trauma teams stabilize patients with life-threatening injuries, such as gunshot wounds, car accidents, or falls. They may perform surgeries to control bleeding, repair fractures, or treat internal injuries to save patients' lives.
Sources: American College of Surgeons Committee on Trauma (ACS COT), American Trauma Society (ATS)
Complications: A Surgeon's Notes on an Imperfect Science by Dr. Atul Gawande is a collection of essays written by the Dr. Gawande during his general surgery residency at Brigham and Women's Hospital. I was able to get through roughly half of this novel this week with my extra time. So far, Dr. Gawande explores the multifaceted nature of medicine, delving into the challenges, uncertainties, and ethical dilemmas that healthcare professionals face. He approaches medical professionals as humans that are bound to make mistakes, which is why I believe he picked the title of the novel. He tries to destigmatize the notion of perfection to create culture of openness and learning in medicine. He shares a series of engaging narratives drawn from his experiences as a surgical resident, offering insights into the complexities of medical decision-making and the impact of errors and unexpected outcomes on patients and providers. He examines topics such as the fallibility of medical professionals, the role of technology in healthcare, and the importance of empathy and communication in patient care. One of the chapters I found most interesting was "The Pain Perplex," which delved into the complexity of pain management during an opioid crisis. I find his emphasis on the need for humility, continuous learning, and a commitment for the improvement of the quality and safety of medical practice very insightful and profound. It reminded me a lot of the new model at UT Dell Medical School here in Austin, TX that centers health care around compassion.
I didn't want to take the 60 dollar official MBTI personality test, so I decided to take a knock-off one instead. The principles remain the same: there are 16 personalities that stem from the four Myers-Brigg Preference Pairs (see left). There is a series of questions testing these different categories that rely on self-reported answers.
The first section is whether or not you are an extrovert or an introvert, aka how do you recharge. The next is sensing or intuition, aka how do you take in information. Thinking or feeling is the next comparison on how you decide things. Lastly, how you can perceive the world is broken into perceiving and judging.
My results were ENFJ, or otherwise called the Protagonist. (I think it's meant to be if the picture is of a soccer team!) To my left is a link to a detailed outline of my personality, but here are the key points:
It says I'm a natural leader and speak up for my values. My strengths include being receptive, altruistic, passionate, charismatic, and reliable. My weaknesses include unrealistic, overly idealistic, condescending, intense, and overly empathetic.
Furthermore, it says I would excel in a people-oriented career and would be extra motivated if I was guiding or helping others. Because of this, I want to witness positive change and step back at the big picture in my work. It says I have a strong worth ethic and love to collaborate with others, often trying to prove myself or impact my community.
Personally, I think that the personality test strengthens my resolve to become a doctor and affirms my belief in myself that I will fit in in this field. A study I found compared the findings of the MBTI to different specialties. Here is the link. The study looked at both attendings and junior doctors to do a cross analysis.
Week Five + Conclusion
Week Five + Conclusion
Hello one last time! This week I scheduled to shadow Dr. Graves again on Wednesday afternoon looking at veins (see my Week One post for more information regarding what goes on). My most valuable takeaway from this shadowing experience with Dr. Graves was him surprisingly admitting to me that shadowing was boring. Since everything was mostly new to me throughout this whole process, I found it quite exhilarating, but to be frank, after shadowing Dr. Graves multiple times, I was a little bored. He said that while it might be boring to watch, doing all the procedures and making all the decisions is very engaging. He spoke to me about his strong internal dialogue that is made up of decades of education and experience. He said that everything is more meticulous and precise than I can even realize. While it might seem like he dumping of the whole shadowing concept, he also stated that it is how he figured out what he wanted to do. This was very validating and reinforced my goal for this project in the final stages. I'm so incredibly grateful Dr. Graves let me shadow so many times so I got to see multiple days of what it was like to doctor.
I have some really disappointing news though. I had planned to shadow Dr. Monica Patel twice this week, once making up for my lack of shadowing last week, but plans fell through because of a cyber attack on Ascension Seton. With the hospital's visiting rules tightening and the inability to check my visiting badge against their system, I was forced to cancel my plans to shadow Dr. Patel. I was, however, able to interview with Dr. Patel instead! While this isn't the clinical shadowing I had hoped for, I was really happy to speak with Dr. Patel again.
Here's a little insight to the chaos at the hospital. This also provides som insight into the instability of America's healthcare system.
Dr. Patel is a pediatrician that specializes in newborn medicine at Ascension Seton Medical Center. She's been in practice for 17 years, and is an assistant professor at UT Austin's Dell Medical School where she teaches medical students and residents. Dr. Patel graduated from the Plan II Honors Program at UT Austin, went to Baylor College of Medicine, and completed her residency training in general pediatrics at Children’s Medical Center, located in Dallas. Currently, she is the Education Co-Director of ASMCA Newborn Nursery and sits on the Pediatric Residency Program Evaluation Committee, which focuses on the pediatric resident education curriculum and program development. Her dedication to education in medicine has definitely carried over into my project, and although this is my first time introducing her, she has helped me tremendously with my project by answering silly questions like "What should I wear when I shadow?" and recommending me several articles and books.
Here is the list of interview questions I used previously and expanded upon for the interview this week:
What inspired you to pursue a career in medicine?
How did your journey unfold from high school to becoming a medical professional?
Why did you decide to become a doctor in another medical profession?
What led you to choose pediatrics, and more specifically newborn medicine?
How has your experience been working with newborn medicine?
What advice do you have for someone considering a career in your specific medical specialty?
Are there aspects of the job that you wish you had known more about before entering the field?
Why did you decide to become a professor?
Can you describe a typical day in your current role as a medical professional, including your responsibilities and key tasks? What does a typical week or month look like?
What skills or qualities do you believe are most important for success in your specific medical role? How did you develop or enhance these skills throughout your career?
What aspects of your job do you find most rewarding, and conversely, what challenges do you face in your day-to-day work?
With your roles at the hospital and as a professor, can you speak to the work-life balance in your field and any strategies you employ to maintain a healthy balance between your professional and personal life?
Can you share a memorable experience or case that had a significant impact on your approach to medicine or your perspective on patient care?
As a professor, can you share your experiences with the pre-med track both from a teaching and student perspective.
What’s a common mistake or pitfall you wished you had known about?
How did you approach gaining clinical experience and exposure to the medical field during your undergraduate years? What opportunities do you recommend for building a strong foundation in healthcare?
How do you feel you could help contribute to my project? Is this something you can see yourself helping me with during the spring?
How does shadowing work with HIPPA?
Are there any books or documentaries you would recommend that have impacted your view on medicine and healthcare?
One of the reasons I found conversing with Dr. Patel so beneficial was that she studied Public Health at UT and she is super excited that's what I'm going into. I found it comforting that she didn't really like stem classes and struggled with that material. In such a competitive major and career, her advice was to close of all competition and focus purely on your own studies and journey. She really loved my project and thought it was extremely beneficial for me considering she was a strong advocate for having an open mind and trying lots of things. She says in medicine you will have very distinct, visceral reactions and to follow those, and if you don’t then you will end up being unhappy. Following this same methodology, she said to go into undergrad with a guided plan instead of a specific focus. One of her other Public Health friends went to graduate school instead of medical school, and she said this was a very tough decision for her to also make. Ultimately, she said she wanted get out of academia, and even went to a third world country to treat communities after college. She eventually landed on newborn pediatrics because she figured out the following things:
She liked the idea of dealing with healthy babies and liked guiding new moms
She liked that it was a finite amount of information
She enjoys seeing repeat patients
She likes the public health aspect of newborn medicine
Furthermore, I asked if why a doctor and not another medical professional, to which she replied that she enjoys being the ring leader and she likes touching every aspect of the process.
Since I couldn't shadow her this week, I decided to read a blog she recommend called The Pediatrician Mom. Dr. Krupa Playforth is the pediatrician and mom who runs the website. She has tons of articles and collections designed to aid moms and calm fears. This was super interesting to me because it was a way to branch out in medicine that I might be interested in. I also read the following New York Times articles that Dr. Patel reccomened to me because I'm going into Public Health:
Lastly, I finished Complications: A Surgeon's Notes on an Imperfect Science by Dr. Atul Gawande. He continues to grapple with the ethical dilemmas and problems with medical decision-making, urging the reader to consider the balance between patient autonomy and the goal to provide optimal care. Throughout the entire book, he emphasizes the need for compassion in medicine. This was particularly prevalent in the concluding chapter "The Patient Experience" where he empathetically details the emotional impact medical diagnosis on patients and their families. While a lot of the book is daunting, he gives a optimistic message in the chapter "Innovations and Advancements" that gives hope for improvement in health care and would decrease risk in medicine. This book has a profound impact on my understanding of medicine. The eloquence and accessibility of his writing made really challenging topics easy to digest and fully understand.
Overall, I have really enjoyed this project. It definelty has not been easy to balance with school and soccer, and I hit a few road bumps, but I feel very satisfied with the outcome. I feel I've reached my goal for expanded my knowledge and increasing my exposure. It has been wonderful to shadow these doctors, and they all say I'm welcome back anytime. I think I will continue to shadow over the summer, especially with Dr. Patel who I haven't gotten to shadow yet. Stay tuned for my presentation, which I will have someone record, which I will put up on the website. Thanks for tuning in!
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