James Wang ’16, Staten Island University Hospital

As Ed, the other Princetern, and I rolled into Staten Island University Hospital around 8:30 in the morning, I had little idea what to expect from the Princeternship ahead of me. Even though thousands of pre-meds and high schoolers have shadowed doctors in the past, I was not one of them. The outside of the hospital had a fairly modern appearance: glass panes covered the front of the building on one of its irregularly arranged faces as the rest were a seemingly random assortment of white/brown brick and even more smaller glass segments. As Ed and I searched the halls for the ultrasound department, of which Dr. Sanjiv Bajaj ’02 was the head, we wandered for almost 15 minutes because there didn’t seem to be a clearly demarcated section. Lucky for us, that day was not my first encounter with Dr. Bajaj, who actually interviewed me in St. Louis for Princeton as he was completing his fellowship at Washington School of Medicine. Because of that, I recognized him just enough to finally say hi and start our Princeternship.  Easy enough.

After we went hallway-through-hallway in order to reach our final destination, we finally reached his office. The office itself was dim, lit only by the faint glow of Dr. Bajaj’s computer workstation, which had four very-large computer monitors radially positioned. The bulk of his daily work came from this workstation. As we sat down with Dr. Bajaj and his resident doctor Adam, he immediately jumped into his work and pulled up his first CT and Ultrasound images of the day. The first images were of a liver with significant fat residue. Dr. Bajaj explained to us that Fatty Liver was going to be one of if not the largest public health epidemic within the next 10 years. This was surprising to me because I had not heard of this public health issue as opposed to issues like smoking and childhood obesity, but he explained that fatty liver (formally macrovesicular steatosis, but no one really calls it that) was creeping up because it’s a byproduct of our modern diet that develops much later on in life, as opposed to obesity itself which is apparent almost immediately.

After dictating his diagnosis of these images and a few more similar kidney/liver issues through an extremely rapid but sometimes troublesome voice dictation system, something much more serious arose. After examining two ultrasound images of a woman’s uterus with only a few weeks in between, Dr. Bajaj simply stated “this is very bad.” Although in his explanation to Ed and me he never formally used the “m” word, we knew exactly what was happening as we saw that this woman had lost her baby. It was in this specific case that I first realized the human urgency of what Dr. Bajaj was doing, something that can be easily missed by the untrained eye after looking at grey-scale images of livers and kidneys. After hearing more on his diagnoses of things like vein clots, kidney cysts (mostly benign) and possibly HIV-induced bilaterally enlarged kidneys, I became more and more amazed at his ability to almost immediately tell what was happening with any given patient.

However, his job simply wasn’t to look at these images all day. Although many of his photos were taken by the technologists he was managing, he also performed his own ultrasounds one or two times an hour. It was in this that I saw his dual role in keeping the patient informed as well as applying his own clinical experience to the situation at hand. In addition to that, when I asked him what role radiologists had in treatment, he said that imaging techniques like CTs and ultrasounds could be used in real time to better survey physically hard-to-reach treatment areas like the spleen for operations such as biopsies. Finally, he stated that he chose radiology as his specialty because the portion he appreciated the most in the medical process was not necessarily the treatment itself or its follow-ups, but in the onslaught of constant puzzles presented to him on an hourly basis, where it was his specific job to give a keen and precise diagnosis to the puzzle at hand, and then move on to the next person’s illness. I greatly admired his confident medical ability and his essential role in diagnosis. For future students, I would strongly recommend the Princeternship program not just for the opportunity to see what a certain doctor does on a day to day basis, but also for the advice mentors like Dr. Bajaj so readily give to us as we consider the life paths they also considered as they reached this current point in their lives.