Osasumwen Benjamin ’13, Stanford University

Osasumwen-BenjaminDay 1: Wednesday, January 23, 2012

The day before my Princeternship was rather hectic. After I finished my neuroscience exam, I quickly packed for my evening flight to San Francisco, where I would be staying in a downtown international hostel. I decided to stay in San Francisco instead of Stanford because I really love major cities and it’s close location to Palo Alto made transportation a breeze! At least, that’s what I expected when I printed out a Google map, left early, but still managed to miss my early train to Milbrae (a Caltrain station – think of Caltrain as a slightly better version of NJ Transit). After a thirty-minute subway ride, I took another thirty-minute Caltrain ride to Palo Alto, the home of Stanford School of Medicine. Since commuting to work is very common, this was a real experience! I ended up arriving right on time and was greeted by a receptionist who told me Dr. Chang was on his way. I spent this waiting time walking around the psychiatry building, absorbing my surroundings: the child and adolescent clinic seemed really warm and inviting, especially with its artwork, children’s games and fish tank.

The clinic’s characteristics contrasted with the serious academic and clinical work of the medical doctors, psychologists and researchers affiliated with the Lucile Packard Children’s Hospital. Dr. Kiki Chang ’88 soon arrived and I followed him to his research group meeting. In a short meeting, Dr. Chang addressed an array of research-related issues for a small group of visiting scholars, research assistants, and lab coordinators. The Comp Lit major I am, I did not understand everything, but learned a little about their research in pediatric bipolar disorder. They use brain scanning as a means of early detection and preventive medicine, especially for children who come from families with a history of the disorder.

After the meeting, I went up to the research wing, where a few assistants showed me several brain images. It was all really interesting! After that, I sat in on one of Dr. Chang’s pediatric consultations while he was supervising a child and adolescent psychiatry fellow. During this meeting, I learned more about the complex nature of PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptoccocal Infections) and PANS (Pediatric Acute-Onset Neuropsychiatric Syndrome). As the mouthful of names sound, these disorders are really complex because they involve a range of symptoms including autoimmune problems, tics, motor difficulties, OCD, depression, anxiety – just to name a few!

Day 2: Thursday, January 24, 2012

Because Dr. Chang was still [technically] on leave, this day was a lot shorter.
In addition to completing some paperwork, he had to undergo a computerized training for the pharmaceutical company that was funding his research. Interestingly, there was a company overseer there to ensure that he was complying with their guidelines. Since the training was all about ethics, I was glad to see how my knowledge of philosophy could be applied to real-world ethical dilemmas! Afterwards, I talked to a few of his research assistants about the clinical projects they were doing. One of them was running a cognitive behavioral therapy group for children and adolescents with bipolar disorder. Another was training a therapy dog named Raleigh.

Day 3: Friday, January 25, 2012

On my last Princeternship day I spent the morning in Dr. Chang’s office for his clinical consultations. Beforehand, I had a great conversation with Dr. Kim, a visiting scholar from South Korea. She told me about the challenges she faced practicing child & adolescent psychiatry in overbooked Korean clinics. As I am interested in comparative international health, our conversation was very enlightening.

At Dr. Chang’s clinic, Dr. Kim and I observed consultations with two families, both with children exhibiting PANS symptoms. At first, I was a little surprised at how murky their illness was. With simpler ailments, doctor’s can make a diagnosis and patients can be assured that the treatment will most likely work. With pediatric psychiatric disorders, there is definitely no cure-all! Diagnosing and treating a pediatric population requires great skill, patience, perseverance and a really great sense of humor. Dr. Chang is definitely the wittiest doctor I ever met and I saw how his humor definitely puts everyone at ease. In such a demanding field, knowing how to communicate with different people is an essential skill. During one of the consultations, a rheumatologist joined Dr. Chang to help address the patient’s autoimmune issues. It was then that I realized how the unique, interdisciplinary approach I take as a comparative literature major could be useful in medicine. Child psychiatry is a specialty that draws on knowledge from other fields, including psychology, neuroscience and pediatrics.
 
Despite all the difficulties and controversy of child psychiatry, the great hope is that symptoms are alleviated, so that the children can enjoy being children. Some of these kids had to be out of school for weeks at a time, which, as a Princeton student, I could never fathom! All in all, I am extremely grateful to have had the opportunity to shadow the talented Dr. Chang. This Princeternship was extremely rewarding because it gave me some insight into a medical specialty I might be interested in pursuing.

 

Jenna Newman ’15, Memorial Sloan Kettering

Jenna-NewmanOn Wednesday, May 22, 2013, I commuted to New York City to shadow Dr. Ariela Noy, an oncologist at Memorial Sloan Kettering Cancer Center specializing in treating lymphomas, certain forms of leukemia and HIV-related cancers. When I walked in at 9 am, Dr. Noy’s kind assistant led me to the place where I would receive my visitor’s card. Shortly after that, I read through the HIPAA training documents, which stressed the importance of confidentiality in medical practice; every patient is entitled to his or her privacy and identifying information must not be disseminated. The remainder of the morning was spent viewing research presentations. The amount of time oncologists spend presenting new findings in clinical research, discussing specific cases and deciding which courses of action to take proved to be higher than I expected, especially when compared to the amount of time spent in the clinic for patient visits. Upon learning that clinic days occurred just twice a week, I was surprised, for I did not realize how much time discussion between doctors would consume. At the research meetings I attended, a recurring theme that I noted was the importance of molecular biology behind each cancer case. As a molecular biology major, I realized that the overlap between clinical and molecular research is greater than I had previously assumed. Mutations in specific genes within pathways that I have studied in the core classes for my major are key players in the development of cancers, and these molecular details are not at all trivial for doctors trying to treat cancer by interfering with its molecular mechanisms. The scientific, critical thinking that doctors employ in their everyday work is truly inspirational; this experience has stressed to me the diversity in cases and importance of creative thinking over formulaic approaches to medicine.

The entire afternoon was spent viewing a marathon of patient Newmanvisits at the clinic; the specific details about patients cannot be disclosed, but I can elaborate on my observations regarding the challenges faced and the rewards earned by Dr. Noy as an oncologist. Earlier, I mentioned the variety in cancer cases and how an oncologist must be able to mold his or her thinking in each case – this flexible mindset must extend beyond a solely medical, molecular context. Differences between patients and their attitudes toward treatment are not negligible. First, there are personality differences between patients; some people are afraid to confront their disease, others are more eager for immediate treatment. Additionally, there are other factors such as health insurance and language barriers that are obstacles in the progress of treatment and in communication between the patient and physician respectively. Dr. Noy was very perceptive of the nuances of each case and would adjust her delivery accordingly to ensure that each patient understood his or her condition and possible courses of action. As someone who has been vacillating between the possibilities of medical school or graduate study in molecular biology, my desire to go to medical school has been reinforced by this experience.

Daria Koren ’15, Massachusetts General Hospital

Daria-KorenDay 1 – January 28

The large glass revolving doors of the Yawkey Center for Outpatient Care swing into a hub of activity at 9 am. I make my way to the third floor to meet Suzanne Morrison ’89, the program director of Partners Orthopedic Trauma Service working with Massachusetts General Hospital. Suzanne takes me around the multi-building hospital, pointing out the Ether Dome (where the first anesthetic was administered) and the Phillips House 22nd floor (from which one can see a spectacular view of Boston).

Soon afterwards, I sit in on an interview for a new Nurse Practitioner. The current NP, Kathleen Burns, is an amazing point-woman for the orthopedic service but the service has grown to an unmanageable size; the hospital needs a second NP who will work well with Kathy and the rest of the ortho team. Suzanne has gotten permission to hire a second NP and conducts the interview with Kathy. The interviewee talks about his previous experience and describes his ideal work environment. Kathy then talks about what a typical day is like and how the MGH staff respects the NPs – something that is not ubiquitous across hospitals. The interview ends on a good note as Kathy proposes for the interviewee to shadow her in order to better understand the MGH environment.

Suzanne and I have lunch at the hospital cafeteria before I am whisked off to the operating rooms of orthopedic surgery. In my clean blue scrubs, I meet the anesthesia attending Dr. Andrea Torri. His smile is perceptible even behind his surgical mask, and he walks around the OR with me, introducing me to protocols, machinery, and personnel. This particular patient has some loosening around the screws holding her ankle plates together due to bone reabsorption, so the surgical team has made a long incision along the outside of the left ankle. I comment on how there is no bleeding nor suction…Dr. Torri explains that a mechanical tourniquet on her thigh has compressed the blood vessels very tightly in order to stop blood flow. I question if that will cause necrosis, and Dr. Torri points to a timer for the tourniquet.

Suddenly, Dr. Torri’s pager goes off – he needs to counsel a resident for a spinal tap. We go to another OR, and Dr. Torri talks the resident into rearranging her hands for better control of the instruments. The resident does the spinal well, and the patient is laid supine for her total knee replacement. The resident then injects a bit of phenylephrine to counteract the paralysis of the sympathetic nervous system. Without this chemical, the blood vessel dilation might cause the heart rate to become dangerously low.

As he is explaining this, Dr. Torri receives another page – another spinal tap must be performed. This one proves to be more difficult, but Dr. Torri quietly advises this resident and his second try is successful. We run back to the knee replacement OR, and I am shocked to see a cut 4 inches deep through her leg, showing femur, tibia and patella bones. I am even less prepared for what happens next: the orthopedic surgeon takes an inch-wide drill and swoops into the femur. I stand there, transfixed by this brutally beautiful manipulation of bone and flesh; I only notice Dr. Torri when he puts his hand on my shoulder. He asks if I need to step out, and I shake my head, saying, “I just didn’t think bones could …do…that.”

Dr. Torri smiles, accepts my answer, and brings me a stepping stool so I can see the surgery better. The surgeons measure the tibia to properly place the replacement joint, and saws whir back and forth. Dr. Torri frequently checks the monitor reading of oxygen saturation, heart rate, and blood pressure. The EKG looks stable and healthy, and Dr. Torri encourages the anesthesia resident to keep up the good work. He then takes me into another OR, where a spinal operation is occurring to remove malignant tissue surrounding the spinal cord. As with the knee replacement, Dr. Torri stands near me to prevent any dramatic reactions to this sight; I do not have any adverse reactions and Dr. Torri feels confident enough to leave me for a bit as he talks with the surgeons and anesthesia residents. We continue this cycle of going from OR to OR, and Dr. Torri patiently explains how certain anesthetics affect the nervous system, how surgical procedures are being carried out, and how machines work. All the surgeries end around 6 P.M.,pm and Dr. Torri brings me back to Suzanne. He tells me I could shadow him the next day on the labor floor and Suzanne consents to this idea. I excitedly agree as well, and Dr. Torri grins and states, “See you at 6:30 A.M amtomorrow then.”

Day 2 – January 29

Getting up at 5 am is a struggle. Somehow I force myself to get up, get dressed, and successfully navigate the MBTA rail lines to arrive at MGH at 6:30 A.M.am Dr. Torri greets me warmly, and I receive my second set of scrubs. We arrive on the Labor Floor as Dr. Lisa Leffert is organizing the teams; residents read off patient histories and Dr. Leffert makes a couple executive choices about Caesarean sections and induced labors. The most urgent cases are discussed and, at 7 A.M.,am Dr. Torri is already supervising a resident performing an epidural in the labor OR. The resident takes care to insert the needle very slowly, stacking his index and middle fingers together to simultaneously squeeze the needle and press against the patient’s skin. I am amazed by such fine motor control, and Dr. Torri seems pleased with this technique. This approach is successful, and the resident inserts the epidural tube and administers the anesthetic.

The woman is laid down, and a privacy sheet is put around her head. Her vital signs all look good and the obstetrics team begins the C-section. Dr. Torri explains how they cut through skin layer by layer, why certain instruments are used in favor of others, etc. The surgical team works quickly and efficiently, and very soon a healthy baby girl is born. As nurses swaddle and coo over the newborn, the surgeons are still huddled over the mother to start the stitching procedure. Once again, layer by layer, skin is gently pulled together and sewn in place. The mother begins coming out from under anesthesia as the surgeons are almost done, and Dr. Torri makes sure she is comfortable. The epidural is still numbing the abdominal region, so the surgeons continue suturing as the mother is shown her baby girl. The C-section goes smoothly, and in the end both mother and child are well.

As this patient is wheeled out of the OR and into her recovery room, Dr. Torri is taken aside for a consult. Another patient has a low platelet count and so cannot receive an epidural; Dr. Leffert talks with Dr. Torri about whether an epidural poses a risk of bleeding out because so few platelets may not be enough to coagulate blood around the entry wound. Dr. Torri requests the patient medical profile and notices that there is a history of family autoimmune disease. A hematological consult is ordered and soon shows that the patient’s platelets are much larger than normal. Dr. Torri and I open a large volume on anesthetic protocols and flip to the section concerning patients with autoimmune diseases. The textbook advises a hematological consult and caution with platelet counts below 70,000. The next blood analysis shows the patient has 83,000 platelets and so Dr. Leffert seizes the opportunity to perform an epidural. The brief procedure is successful and the patient shows no signs of hemophilic tendencies.

While Dr. Leffert is doing this, Dr. Torri is called by one of his residents to assist with an IV for an obese patient. The resident has already tried a couple times without success, and Dr. Torri personally attempts to put in the IV. It takes several more attempts, an ultrasound machine, and a nurse to finally pierce a vein. Dr. Torri apologizes to the patient for the lengthy duration and compliments her patience. His pager goes off just as he finishes – he is called into the labor OR again for another C-section. This case has already been tubed and sedated, but now her oxygen levels are getting low for an unclear reason. The resident wants to be extra cautious and requests Dr. Torri to look over the charts to see if he has missed anything that could explain this. Dr. Torri analyzes the situation and cannot find any outstanding reasons for why this is occurring; he notes that while the oxygen saturation is lower than normal, these levels are nowhere near alarming. He asks for the nurse to bring a second pillow for the patient and the slight elevation of her head brings the oxygen levels up to a good range. Dr. Torri is pleased with his resident’s astute attitude and mentions that laying supine sometimes creates more difficulty breathing when there is another person pushing on internal organs.

The day goes on, and around 3 P.M.,pm another anesthesia attending rounds up the 4 residents for a presentation on the ethics of post-partum tubal ligation. This procedure involves cutting the fallopian tubes after a C-section to prevent any future pregnancies; since the mother already has a deep incision to in her uterus, it makes sense in terms of time, cost, and recovery period to perform this operation right after her assisted birth. However, the attending cautions presents the argument that the mother isn’t in a state of mind to decide this much of her future right after labor and that some women may regret this decision to limit the family size. The general guidelines for even offering a post-partum ligation are announced to the residents, and they acquiesce. The attending wraps up the presentation and we all file out of the room down to the cafeteria for lunch.

I contact Suzanne to tell her how my day is going, and we decide that I will spend the next day shadowing Kathy Burns. Dr. Torri sits with me and explains a few more concepts for anesthesia, and I determine that if I do go forward with medical school, I will most likely decide to do anesthesia as my specialty. The descriptions of the analyses, procedures, and cooperation with surgical teams really appeal to me, and it is thanks to Dr. Torri that I now have a true representation of this profession.

Day 3 – January 30

Another early rise – I am at the hospital again at 6:30 A.Mam. I meet Kathy the nurse practitioner in the main lobby, and we sprint to the grand rounds meeting. Here residents present the cases that have come in over the past 24 hours, and the attendings decide where to slot them in relation to the previously known cases. Kathy, as the sole NP for Orthopedic Trauma, has her hands full with 2 lists of patients: Trauma Red and Trauma Purple. As the attendings argue about urgency order, Kathy makes small notes on her lists to help her remember patient problems and diagnoses.

After the meeting, Kathy and first-year residents go to a computer cluster to input medicine, food, and general treatment orders for their patients. This takes quite a while as previous medications, allergies, and other restrictions must be taken into account. Eventually, Kathy and I visit our first rounds patient who has ileac problems after an operation to fix slight prosthetic problems. Kathy wears a biohazard apron and gloves to prevent a contagious accident. She checks EKG and blood pressure, as well as asks the patient how he is feeling. After verifying that there is nothing more she can do to make his recovery more comfortable, Kathy leaves the room and we go into another rounds meeting.

These interdisciplinary rounds are much shorter, due to the specialization of the departments. Kathy also acts as point-man for the department doctors here, listing the grand rounds decisions for each patient. The other doctors and nurses respect Kathy for her clarity and efficiency in detailing the most salient points about a patient. Kathy conducts three of these interdisciplinary rounds, each with different departments and separate patients. She then takes some more notes and inputs for patient charts.

The next patient we visit has a shoulder fracture and is anxious about surgery. Kathy does her best to conform the patient and even orders a psych consult to see if there is any way that department can allay her fears. Another patient has a ruptured quadriceps tendon but cannot receive Atenolol to relieve blood pressure and ease swelling due to an allergy. Kathy contacts the primary care physician and works out that hydrolozine may possibly work. The chemical is administered through the IV, and it seems to do the trick without any negative effects. Kathy remains worried about this patient due to a slight deviation on his EKG chart.

The final patient I come in contact with is a man with a strangely curved neck. His anatomy is already deviant, and a fall has exacerbated the weakness of the neck. The staff are trying to restrict his movements in any way possible while they search for an unequal neck brace. In the end, Kathy and the hospital personnel decide to combine two different neck braces and set upon the task as I am brought to the Orthopedic Research office.

I am introduced to Jordan Morgan, a recent college graduate, who works on compiling data retroactively to produce papers on the efficacy of certain orthopedic operational and treatment protocols. He talks about how difficult it is to read certain angles of X-rays and how it’s amazing when his data shows statistical significance. I am amazed by some of the minute classifications he must do in order to group certain fractures, and Jordan is happy to explain his research.

As I leave MGH that last day, I am saddened to leave a place that was so friendly and inspiring. Suzanne Morrison was a wonderful alumni host, and I am really grateful for her ability to pick people that could show me the diversity of the hospital. I keep wishing I had more time to spend with Dr. Andrea Torri because his bright attitude and clear explanations made my first visits to an OR that much better. I hope that Kathy Burns get a second NP that compliments her perfectly, for she really deserves a capable partner to run the orthopedic trauma unit with openness, grace, and efficiency. In addition, I hope that Jordan Morgan’s research goes well and I am thankful for his willingness to explain it to me. Overall, I am hugely grateful to all the MGH staff that were courteous enough not only to let me see their hectic work but to actually slow down and explain it to a pre-med student. Their attitudes and abilities definitely make me want to become a doctor – not only for the knowledge, but for becoming a better person as well.

Clara Kerwin ’16, Massachusetts General Hospital

Clara-KerwinDay 1 (1/8/13)
I left my hotel at 8 o’clock and walked across the street to the vast expanse of buildings that makes up Massachusetts General Hospital.  I made my way to the main lobby, and from there navigated through a maze of doors and hallways to the Yawkey Center for Outpatient Care, in which the Orthopaedic Trauma Division is located.  At 8:30 my host, Suzanne Morrison ’89, escorted me to her office.  Suzanne is the program director for Partners Orthopaedic Trauma Service, which is a combined program that includes Mass Gen, Brigham and Women’s Hospital, and Harvard Medical School. 

Suzanne immediately struck me as someone who was both genial and assertive.  I enjoyed hearing about her path to medical administration.  She graduated in 1989 from Princeton with a degree in sociology.  After spending time working at a travel agency, she became interested in public health and obtained her Master of Public Health degree at Boston University.  She began working at Mass Gen as a patient advocate and then switched to her current position in 2000.  We talked for a while about the hospital and her career and reminisced about Princeton.  We discovered that she had lived in the same entryway in Rocky College! 

Next, Suzanne gave me the “two cent tour” of Mass Gen.  It is truly a vast complex and consists of so much more than what would normally come to mind when one thinks hospital.  Suzanne led me through the key buildings and centers of the hospital, frequently pausing to greet a colleague or friend and introduce me.  We passed the effective hubKerwin2 (the coffee shop of course), and ventured into Bulfinch, the sole building that comprised Mass Gen when it was founded in 1811.  I was surprised at the amount of history contained in the hospital.  It was in the iconic Ether Dome (the original operating room within Bulfinch) that surgical anesthesia was first employed in a public demonstration.  Another memorable aspect of the tour was going to Phillips House, the exclusive patient care unit on the top three floors of the Ellison building.  It is here that Mass Gen’s numerous VIPs stay.  While I sadly was not entitled to any first-class treatment, it was wonderful to see the panoramic views of Boston.  Suzanne pointed out some of the interesting buildings and neighborhoods of the city.  I appreciated the beauty of the icy Charles River, the gold-domed capital building, and Mass Gen’s helicopter pad! 

We then made our way back to Suzanne’s office where she had a meeting with the orthopaedic division’s director of research.  Various studies are being conducted simultaneously on a wide variety of topics:  the effectiveness of surgical treatment of elbow fractures; the improvements that result when a geriatrician contributes to the treatment of elderly patients;  how a lack of vitamin D can serve as a predictor of treatment failure.  It was interesting hearing about the procedures involved in initiating a new study including the writing and review processes. 

After eating lunch with Suzanne in the hospital’s cafeteria, I met with the unit nurse leader and spent the afternoon in the clinic.  The amount of patients was apparently startlingly low that day, but I still enjoyed finding out how the clinic operates.  Some patients are easy follow-ups.  Others have to be admitted to the operating room.  Many different kinds of staff are active in the clinic including doctors, residents, nurses, nurse assistants, etc.  The day confirmed that the hustle and bustle of hospital life greatly appeals to me.  I love being around such a wide variety of people and asking questions about the specifics of their jobs. 

Day 2 (1/9/13)  
Early morning today!  I was at the hospital at 6:15 am to go on morning rounds with the nurse practitioner, Kathy Burns.  We began by gathering with the residents and fellows to go over the X-rays of the approximately twenty-five patients who spent the night in the hospital for orthopaedic problems.  There is truly a diverse spectrum of cases that orthopaedics encompasses including tibia fractures, hip replacements, and joint dislocations.  After each of the residents presented any developments with their patients, I accompanied Kathy and one of the physicians to check on some of the patients themselves.  We then met up with the residents from the other teams to make sure everyone was on the same page for all the cases.  It was great to hear about some of the newly-admitted patients who I had encountered yesterday in clinic.

After a quick coffee break, I went with Kathy to several interdisciplinary meetings in which Kathy updated non-orthopaedic staff (including nurses, physical therapists, and administrators) on the progress of the various patients.  It was very clear to me that Kathy’s job entails many different types of activities and there is always something that needs to get done. 

We then checked in at the nurses’ stations on the two different orthopaedic floors.  Kathy showed me the results of various blood tests, which are performed to ensure that the patients are stabilized.  I also learned about the processes involved in repairing fractures.  It was impressive to see the X-rays that displayed the intricate network screws and plates that had been surgically placed into the pelvis or the tibia. 

Kerwin1Kathy then took me on a tour of some of the critical care center including the intensive care unit, the emergency room, and the recovery room.  It was interesting to hear about the daily proceedings in other parts of the hospital.  Kathy, who used to work in the general surgery department, knew many insights regarding the treatment of patients with unforeseen ailments.  She also pointed out and explained what CT scanners and MRI machines are used for.  Kathy then headed off to do some paperwork.  Because Suzanne was at Brigham and Women’s Hospital today, I had the afternoon off.  Time to study for finals!

Though the morning was long, I had a very valuable experience.  It was amazing how many activities were crammed into the short hours I spent with Kathy.  Seeing some of the other facets of the hospital made me consider how many possibilities exist within the medical field.  At this point, I do not think that I would enjoy working in orthopaedics in the long-run.  However, I really like the people who work in this field.  The hospital personnel all sincerely want to see patients get better.  Even though there are sometimes conflicts with family members or complications brought on by a patient’s carelessness, everybody loves seeing positive results.  Its inspiring knowing that the work done by the medical staff at Mass Gen directly affects the long-term health of patients.

Day 3 (1/10/13)
This morning, I met Suzanne in the main lobby at 7:50 to go to Grand Rounds.  The term “rounds” refers not only to walking around to see patients, but can also describe any conference in which clinical cases or problems are discussed.  Grand Rounds consisted of a fairly formal lecture given by an expert geriatrician that was intended to educate hospital staff on the merits of an interdisciplinary approach to dealing with fractures in elderly patients.  The lecturer was from a hospital in Rochester, and he was espousing the success of their Geriatric Fracture Center.  In addition to helping their patients, hospitals want to be efficient and keep costs as low as possible.  The presenter explained how having an elderly patient be examined by a geriatrician as well as an orthopaedist allows for both higher quality care and a reduced length of stay.  These improvements simultaneously increase patient satisfaction and reduce costs.  Mass Gen’s Orthopaedic Trauma Service has recently initiated a similar interdisciplinary program and has already seen positive results. 

Sitting in on Grand Rounds was very interesting and educational.  I learned a great deal about the special care elderly patients need even for minor fractures.  Unlike younger patients, those over 60 years of age have weakening bones, fragile skin, slower recovery times, and may suffer from dementia when in an unfamiliar environment for extended periods of time.  For all of these reasons, it is greatly beneficial to reduce the amount of time an elderly patient is in the hospital.  Hearing about this program made me realize how pertinent research and development are to modern day medical facilities.  There are advances being made every day, and new ideas are constantly being tested and put into play.  I find it exciting and appealing to know that medicine is still a very dynamic field and there is always room for improvement.

Back in Suzanne’s office, she told me more about the work she had done as a patient advocate.  No case is black and white. At times she had to deal with patients who were mentally unstable, and also with those who had legitimate complaints. Nevertheless, patient advocacy, as well as general faith in the hospital experience, contributes to the healing process, which in turn makes medicine such a rewarding field.

I then went with Suzanne to a conference with the geriatrician from Grand Rounds along with other heads of the orthopaedic departments at Mass Gen and Brigham.  I listened attentively as they discussed the emerging program and the details of how the program will continue to be developed.  There are many factors that must be considered and many different departments that must be brought up to speed on the advances.  The meeting was largely focused on strategizing on how hospitalists will be recruited for geriatric care and how the economics of the program should play out.

At lunch I asked Suzanne more about her time at Princeton.  In many ways, her experiences seem very similar to what I have encountered so far at Princeton.  She really enjoyed her time at Princeton and is actively involved in various alumni programs.  Suzanne also reaffirmed the importance of networking and the role that chance plays in terms of career decisions. 

After a quick meeting, Suzanne and I got into scrubs to pay a visit to the operating room.  I was pretty excited to see a surgery in person (as opposed to on TV) and felt very professional in the surgical garb.  One of the residents explained the case: a boy who had badly fractured his left fibula at the ankle when he slipped on ice that morning.  While examining the X-rays of the ankle, the resident explained the standard procedure of correcting the placement of the bones and inserting screws to bind them in place.  I stood by as the patient, still conscious, was brought in.  Once the leg was numbed, the patient would be put into a light sleep. 

Unfortunately, at that point I felt lightheaded and went out of the room with Suzanne to get some air.  It was there that I fainted (for the second time in my life)!  It was the ideal location to do so, as a bed was close by, and I spent about fifteen minutes resting and munching on graham crackers!  Surgery had been a branch of medicine that I was (and still am) eager to explore.  While I sadly had to forgo that surgery, I am hopeful that I will have another opportunity in the future.  Apparently, it is fairly common to faint the first time one sees a surgery, and plenty of people acclimate and go on to work in the OR daily.  So there’s still hope for the future!

After that minor diversion, Suzanne and I went back to her office.  We took some quick photos and then changed out of our scrubs.  Then it was time to go.  Though my time at Mass Gen was brief, there were plenty of people to say goodbye to and thank.  After promising Suzanne I would keep in touch, I headed out.  

I would definitely recommend this Princeternship to other students.  I gained valuable insights into the intricacies of hospital life and the vast network of fields and subfields that any department encompasses.  So many different kinds of staff are involved in every step of patient care and program development.  I know I am much more informed about the realities of medicine, but at the same time, there is so much more to learn and investigate.  Although this hospital experience was too short to confirm my intentions to become a physician, it definitively reaffirmed my interest in learning about realms of medicine like public health, patient advocacy and integrated patient management.  I now know that if I do choose a path in medicine I will have a much better idea of what it could entail.  I am very appreciative of Suzanne, Kathy, and all the other Mass Gen personnel for making time for me in their busy lives and giving me the opportunity of a lifetime to explore medicine at its best.

Grzegorz Nowak ’15, Ganchi Plastic Surgery

Greg-NowakThe first day of my Princeternship at Ganchi Plastic Surgery was an “office day” during which I shadowed Dr. Parham Ganchi ’87.  We saw patients for anything ranging from a first-time consultation to a Botox/Juvederm injection to a post-operation exam less than 24 hours after surgery!  With a rainy/snowy morning, Dr. Ganchi humorously said it always threw the rest of the day off.  The down time, however, gave me the wonderful chance to get to know Dr. Ganchi.  It was inspiring hearing Dr. Ganchi talk about why he decided on doing plastic surgery.  Dr. Ganchi described his typical patient as someone with a small insecurity that bothers them.  All of the procedures Dr. Ganchi performs, whether a breast augmentation or liposuction, are generally not very invasive (anesthesia used still allows you to breathe on your own) and are performed only on patients in generally good health.  With a minimal risk if done correctly by a board certified plastic surgeon, plastic surgery helps these patients live a happier life. 

What was even more incredible is seeing this reflected in Dr. Ganchi’s interaction with his patients because it truly reflected his passion.  Dr. Ganchi spent a lot of time talking to each and every one of his patients to help get them looking the way they want.  Dr. Ganchi explained that patients come in with an idea of what procedure they think will get them where they want, but the doctor really knows best and by talking they can figure this out together and make the procedure specific to the patient.  Since rest is a key part of every procedure, Dr. Ganchi made sure to carefully emphasize this to his patients because, in plastic surgery, the result depends almost 50/50 between the job that the doctor does and how the patient rests.  However, the patient isn’t aware of this unless the doctor takes the time to make it very explicit since many patients either come in with the idea that they’ll be in great pain or be able to go dancing the next day, both of which are common misconceptions. 

On the second day of my Princeternship, Dr. Ganchi was performing three surgeries:  a breast augmentation followed by two liposuctions and lipoinjections.  Nowak 1Seeing live surgery being performed for the first time was a very fun learning experience.  The atmosphere of the operating room with Dr. Ganchi, his two surgical assistants, Carly and Tara, and the anesthesiologist, Dr. Lee, helped me fully realize that this was something I would love to do one day. 

Altogether speaking, I can honestly say that my Princeternship experience was not only an invaluable experience for my future in medicine, but also a very fun two days with a great doctor and even better person.  Just getting to know Dr. Ganchi was motivating because he emulated the type of doctor I hope to one day be.  Moreover, the fun he had from learning was infectious, for example, we would trade phrases in Spanish as he has been teaching himself the language after going on a trip to Spain with his kids.  It was rewarding learning not only from Dr. Ganchi, but also the team that makes everything happen so flawlessly.  I am so glad and grateful someone as caring and welcoming as Dr. Ganchi was there to share his experiences and work with me.  I love helping others achieve their dreams because there were so many people along the way that helped me achieve mine. I am proud to say Dr. Ganchi has inspired me in this way, which is what makes the Princeternship program so special!

Michael Chang ’16, Ganchi Plastic Surgery

Michael-ChangDay One – January 7, 2013

This morning, I arrived early to Ganchi Plastic Surgery in Wayne, NJ, operated and run by Dr. Parham A. Ganchi ’87. I was welcomed by Karen, who later gave me a tour of the facilities, including patient rooms, waiting rooms, and operating rooms, and oriented me to the day’s schedule. I soon met more staff members, including Michelle, Carly, and Leyla, before finally greeting Dr. Ganchi.
 
As today was a Monday, their longest “Office Day” of the week, I was told that I should expect to see a rush of patients, especially later in the afternoon. Fortunately, some patients were either late or early, so the appointment schedule was more staggered and less congested than we originally anticipated. Patients came in for many different and interesting reasons: the most common was for Botox or filler treatment, while others included breast implant repair, buttocks implants, liposuction, breast augmentation, gynecomastia, rhinoplasty, and face-lifts. It was so fascinating to be able to witness such a variety of consultations, as I was able to learn more about the many different kinds of opportunities there were in plastic surgery. I also particularly enjoyed seeing such a diverse group of people, each with their own backgrounds and needs, and hearing their personal stories.

In every appointment, I was impressed by how compassionate and informative Dr. Ganchi was with his patients. He made sure that everyone who came into his office felt comfortable and at ease, and fully understood the ramifications of their procedures and even why he was taking a certain approach. As Dr. Ganchi explained to me when I asked about the difference between operating a small, private practice versus working in a large, academic hospital, he is more able to spend time with each individual patient and cater to his or her personal needs. I picked up on this immediately when I realized how careful and attentive he was with his examinations and treatments. He later told me that he takes before and after photographs of every patient to track their progress and to remind them of how much their appearance has changed over time. More importantly, he said, this collection of photographs is a guide for him to learn from, so he can personally track his progress and improve in the future.

When we had down time, Dr. Ganchi and I discussed an array of topics, ranging from the mechanisms of his procedures to my academic and career related questions. We discussed Princeton and how Dr. Ganchi majored in Molecular Biology, a concentration I am highly considering. His main piece of advice was that I must pursue and study what I genuinely like, which applies to everything beyond college as well; otherwise, the process will not be as fun or as rewarding as it should. Another particular insight that struck me was when Dr. Ganchi said that even after surgeons are finished operating on their patients, they are still responsible for them when they leave. He noted that at times this could be particularly frustrating, especially in plastic surgery where recovery and post-operational instructions are essential. Dr. Ganchi also discussed the diverse field of medicine as whole. He explained the difference between medical doctors, who are typically more analytical, and surgeons, who are typically more tactile, as well as growing political concerns surrounding health insurance. Through discussing the benefits of cosmetic plastic surgery with Dr. Ganchi, I realized that while this field may not have the same curative aspect as other surgeries, patients are still “cured” in an equally important way when they gain more self-confidence. Having a physical abnormality your entire life can be emotionally debilitating and difficult to overcome; after seeing patients in their follow up appointments, I realized the power of making someone happy and confident in their physical appearance. 

Day Two – January 8, 2013

I was especially excited for today’s events because I would be able to sit in on surgeries in Dr. Ganchi’s operating room. Carly provided me with scrubs and, after I finished changing, I met Dr. Lee, the anesthesiologist. The staff had told me the day before about how well versed Dr. Lee was in his field, so I was particularly excited to learn about his work.

Dr. Lee first showed me his cart of chemicals that he used to prepare the Chang 2anesthesia for his patients. He told me that, unlike most hospitals, they developed a combination of drugs that was unique to each patient, based off their blood work, medical history, and reactions to a small, prepared sample of anesthesia. I watched as Dr. Lee hooked up the IV to the second patient of the day, who was coming in to have work redone on his previous gynecomastia surgery, which treats abnormal development of mammary glands in males. The first patient was a woman who came in for labiaplasty, which I was not able to witness, given the sensitive nature of the procedure and the fact that she would be awake during the surgery.

During the operation, it was interesting to see how careful Dr. Ganchi was with his patient. He told me he made as small of an incision as possible so that there would be less scarring during recovery, even if it meant having to perform a more difficult operation. Overall, I enjoyed seeing the many different steps Dr. Ganchi took in this procedure: scrubbing the patient with betadine, detaching fat from the muscle, injecting numbing medication, liposuction of the breast area, cauterizing blood cells to prevent bleeding, and excising hard “lumps” or glands that the patient wanted to be removed from his chest. I also noticed how carefully Dr. Ganchi stitched together his patient after operating; he explained to me how he uses dissolvable stitches from the inside out, mostly for the patient’s benefit. Aside from explaining the details and choices he made in his procedures, we also discussed our hobbies and interests. I learned that both Dr. Lee and Dr. Ganchi enjoy traveling, and that Dr. Ganchi has been learning Spanish in preparation for his vacation to Costa Rica and to communicate better with some of his patients. As someone who has studied Spanish in high school and college, I enjoyed speaking with him and discussing different Spanish vocabulary words, such as scalpel, cheek, eyelid, etc. Lastly, I liked how, throughout the duration of two hours, there was an element of teamwork between Dr. Ganchi, Dr. Lee, and the medical assistant Michelle, all of whom worked together to make sure the operation was smoothly run and successful.

After having some lunch, I went in again to observe the second operation of the day, which was a face-lift for a woman that flew in from another state. Dr. Ganchi told me how even though most of his clients come from the tri-state area and nearby states, he has had clients from Texas, Florida, and other parts outside the US. After doing similar preparations as the first surgery, such as betadine scrubbing and markings, Dr. Ganchi used liposuction to remove some fat from the patient’s abdominal area. He told me he would use this fat by injecting it into her cheeks so that they would have a more youthful, round appearance. Then he started the actual face-lift with an incision under her chin that would allow him access to parts around her jawline. After reshaping the outline of her jaw and chin by removing some extra fat, he then cut alongside the area of the cheek that touches the ear on both sides of her face. Subsequently, he separated the fat from the tissue, and began stitching underneath the skin to create a tightened appearance for her cheek. Dr. Ganchi told me that many other plastic surgeons would instead pull the skin upwards to create this “lifted” look. He expressed two concerns with this: one that it looked too tight and unnatural, and the other that this would ultimately give out and lose its appearance over time. Dr. Ganchi finished the face-lift by carefully cutting away the extra loose skin after tightening, repeating on both sides, and stitching in a very careful zig-zag manner to promote faster healing. He finally put gauze on areas that would bleed, wrapped her head with cloth, and left in a draining tube under her chin to prevent build- up of blood and fluid. I was amazed by how beautiful and flawless the end result looked.

After the second surgery, which took approximately four hours, Dr. Ganchi took me into his office to show me photographs from his previous surgical and training days. While showing me before and after photographs of patients who had lost hands and even faces in accidents, children with abnormal finger or brain growth, and cancer victims with missing muscles and tissues, he explained in great detail not only physiology, but also different procedures surgeons use to solve these issues. He told me that you have to be creative in reconstructive surgery, and provided examples of solutions he came across in his training. For instance, I learned that muscles, which have great blood flow capacity, could be relocated to different areas of the body to replace missing parts; one man had his calf muscle moved to cover a missing area above his kneecap.

Chang 1Overall, I truly enjoyed this experience. It gave me a comprehensive glimpse into the daily routine of Dr. Ganchi and his staff, and solidified my interest in pursuing a career in medicine. I learned a lot about the human body, the field of health care, interacting with patients, surgical operations, Princeton and academia, and myself, as well. I would like to thank Dr. Ganchi and his entire staff for providing me with this amazing opportunity, and highly recommend this Princeternship to anyone eager to learn more about plastic surgery and medicine as a whole.

Jordan Lubkeman ’16, Dominion Fertility

Jordan-LubkemanDay 1:
Dr. John Gordon ’85 picked me up in the afternoon during his lunch break and took me to the Dominion Fertility office in Arlington, VA. When we arrived, he introduced me to the other doctors, nurses, and lab technicians. Everyone was very welcoming and friendly. He also gave me a tour of the office, which was comprised of much more than one typically sees on a visit to the doctor’s. There were also hundreds of baby pictures on the walls: smiles and happy faces that showed the clinic’s success in creating families. I then got to watch a few ultrasound inspections, where Dr. Gordon would inspect the thickness of his patients’ endometrial linings and the size of their follicles, if present. He was always sure to explain what he saw to his patients (and myself) which was very beneficial. Later, I got to watch Dr. Celia, the lab director, perform ICSI, intracytoplasmic sperm injection. It was very interesting to learn how a healthy sperm is selected for injection into the egg: many different morphological and physiological factors must be taken into consideration. After I sat in on a consultation that Dr. Gordon gave a new patient couple about possible reasons for infertility, the different sorts of treatment options that his clinic offers, and what the next steps in their treatment could be. He was very adept at explaining everything to his patients and answered any questions they might have. After, we went back to Dr. Gordon’s house because his family was very kind and offered for me to stay with them. On the drive back, we talked about reproductive endocrinology and how Dr. Gordon decided to pursue the field. At his house, I really enjoyed talking with his family and playing video games with his youngest daughter. It was nice to see that although Dr. Gordon is in the medical profession, one notorious for lengthy working hours, he still found time to spend with his family.

Day 2:
The next day, we got to Dominion Fertility’s Fair Oaks office at 7 am to start ultrasound inspections. Some of the patients were at the stage in their pregnancy where the embryo develops a heartbeat. Hearing and seeing the heartbeat via the ultrasound, as well as the joy on the patients’ faces, can only be described as magical. Dr. Gordon was truly creating families for his patients. We then headed back to the Arlington office, where Dr. Gordon had more consultations with returning and new patients. Dr. Gordon was terrific at tailoring the conversations to his patients. For instance, he used a lot more medical terms with a couple of doctors than with other couples who were not. We then went to a meeting with all the doctors and nurses to discuss all the patients and their procedures to make sure that everyone was up to speed on every case. After, I got to go back into the lab to watch Dr. Celia vitrify nine eggs, which was a very complex process that required a lot of care. We also talked about how Dr. Celia decided upon his profession and complex issues such as “embryo homicide,” where labs accidentally thaw embryos, and also about the dilemma of when patients whose embryos are in storage mysteriously disappear. Later, Dr. Gordon had more consultations with new and returning patients, and in between consultations he would phone patients to tell them their test results. He was incredibly busy, but never seemed to get annoyed, tired, or frustrated. At around 5 pm we went back to his house and discussed some of the ethical issues around IVF, why most clinics do not offer natural cycle IVF (Dominion Fertility does) and also life at Princeton.

Day 3:
On the third day, we started at the Fair Oaks office. Some of the patients who were undergoing follicle inspection had been seen on my first day, and it was amazing to see how the follicles had grown in that short amount of time. Lubkeman 4I also got to see Dr. Gordon perform a mock IUI, where he performs the artificial insemination procedure, just without the actual sperm, to ensure that the patient’s cervix or uterus are in no way blocked. After, a lady who was 12 weeks pregnant came back to Dr. Gordon to thank him. All of Dr. Gordon’s patients really appreciate his work. He then had some more consultations. One of them was with a Hispanic couple, and one of the nurses acted as a translator between the doctor and patients. It is really remarkable that the office is able to office this service as well to its patients. I also really enjoyed learning the Spanish medical terms for a lot of what Dr. Gordon was explaining to the couple. Dr. Gordon had many consultations with diverse problems and potential solutions. Fertilization and the achievement of pregnancy are such complex processes where so many issues can arise. I had no idea that even the average “fertile” female will actually only get pregnant 25% of the time when she tries to. Because the future of one’s family is such a sensitive topic, Dr. Gordon also had to be very knowledgeable about the emotions of his patients. While some tears were shed in a consultation, every patient left with a smile and hope for the future. After work, we went to Dr. Gordon’s medical book publishing company, a business he has on the side, to mail some of his books to buyers. He calls it his hobby, and it was nice to see that doctors really do have time for activities outside the office!

Day 4:
During the last day, I got to observe more ultrasound inspections and hear more beautiful fetal heartbeats. Dr. Gordon also had more consultations with patients, many of who had visited other infertility clinics in the area without success and were hoping Lubkeman 1Dr. Gordon would be able to successfully treat them. It was interesting to learn about what makes Dominion Fertility different from the others: chiefly, their use of Natural Cycle (instead of Stimulated Cycle) IVF, where the patient produces one eggs by herself, instead of multiple eggs with drugs. This procedure, understandably, has a lower success rate. Because of the way the government makes clinics publish their success rates, offering Natural Cycle IVF diminishes a clinic’s overall success rate so clinics are less likely to offer the procedure. But often Natural Cycle IVF is the best solution because it is more financially attractive and doesn’t require fertility drugs. Dr. Gordon had been especially busy this day because one of the other doctors was at home due to illness and an inspector from the FDA had stopped by to make sure that their labeling procedures of patients’ sperm, eggs, and embryos met standards and that no disease transmission was occurring. Dr. Gordon was really working hard to balance the clinical, technical, and business aspects of his practice. Later, he performed an actual IUI and then a follicle retrieval procedure and I got to watch in the lab as Mark, one of the embryologists, found the eggs in the solution that Dr. Gordon had retrieved. After, we went to the Fairfax hospital where Dr. Gordon performed six hysterosalpingograms (HSG’s) – Where Dr. Gordon uses x-rays and fluorescent dye to see if the uterus or fallopian tubes of the patient are blocked in any way.  One of Dr. Gordon’s residents, Stacia, was also there. She was very helpful in explaining what Dr. Gordon was looking at in the X-ray pictures, and we also talked about her experiences as a medical student. Dr. Gordon performed the 6 HSG’s with remarkable efficiency – it took him under an hour to complete them all. But they were in no way rushed; he was very careful in carrying out the procedure, making sure that the patients were comfortable, and always took time to explain to the patients what he was seeing in their X-rays. After the HSG’s, Dr. Gordon drove me back to Union Station so I could catch a train back to Princeton.

I really enjoyed my Princeternship with Dr. Gordon at Dominion Fertility and would highly recommend the experience to fellow students. It was clear throughout every procedure and consultation that Dr. Gordon wanted to make sure that the patient was as informed as possible and that he was helping the patient in the best way possible. He practices medicine in a truly open and selfless way, and it was very inspiring to watch him work with this office and patients every day. If I decide to become a doctor, I will certainly try my best to practice with the same high care standards as Dr. Gordon’s. I am incredibly thankful that Dr. Gordon gave me the opportunity to learn so much about his life as doctor, ethicist, counselor, businessman, and father.

Jooeun Kang ’14, Dominion Fertility

Jooeun-KangEntering Dominion Fertility was like entering an entirely different universe. With pictures of radiating couples with their child and the beaming doctor visible at nearly every turn, the office environment made it very clear that this is a place where baby dreams come true.

Each day in Dominion Fertility began with the busy bustling of patient’s getting their ultrasounds or intrauterine insemination procedures done before heading back to their workplaces. As a pre-MD/PhD student, I was excited to see how research and medicine is synthesized in the context of infertility. Entering the embryology lab made me feel at home with its incubators and large microscopes. Whether it was an embryo implantation procedure or an egg collection procedure, it was very clear that the small size of the laboratory belies its importance in the fertility clinic; it is where the ‘magic’ of conception happens. The main procedure done inside the lab is the Intracytoplasmic sperm injection (ICSI), where the sperm is physically injected inside the mature egg with a fine needle. Dr. John Gordon ’85 explained how amazing it is that this procedure works, since it is quite different from nature’s way of having the sperm head penetrate through the egg’s outer ‘shell’ and fuse with the egg. When I heard that nobody knew why it works, the researcher inside me immediately wanted to find out. I asked the embryologists whether they conducted any research, and it seemed that they were more focused with figuring out the best conditions for the egg and embryo maturation process that would yield the best results. These precious seeds of life that are taken care of in the lab are surprisingly tiny—its vulnerability and beauty reminded me of the reason I was drawn to medicine in the first place: the intricate machinery of life that somehow makes us who we are.

Another unique aspect of this experience was the amount of administrative power that Dr. Gordon has since Dominion Fertility is a private clinic, while all my other research experiences were in large academic centers, such as the NIH. Dominion Fertility had another office in Fair Oaks, so a fair amount of time was spent on the road. During those times, Dr. Gordon and I were able to talk about a variety of topics from the problems of health insurance to the ethical problems that arise as doctors try to cater to patients’ needs. But the most informative conversation I had with him was about medical malpractice. I used to believe that medical malpractice is there to protect the patients from incompetent or greedy doctors who seek to profit from the vulnerable patients who know no better, and if I practice medicine with the kindest intentions, focusing on the patient’s needs before my own, I would not have to be concerned. It turns out, I couldn’t have been more wrong. Dr. Gordon told me of cases where the patient was aware of the risks involved in a procedure through both the doctor and the consent form, yet had sued claiming that their consent had been coerced and that they were being manipulated by the doctor. In another case, a patient deliberately sued the doctor even when he did nothing wrong as a way to gain quick money. Dr. Gordon himself was not able to evade these ‘med mal’ suits, and showed me the medical news journal where the majority of the content was discussing different med mal cases. It was clear that malpractice suits are a painful yet ubiquitous experience for all doctors, some specialties more often than others, regardless of the quality of medicine they practice. This was the reality of physician’s life that I wouldn’t have perceived otherwise, and contrasting the doctor’s side of story with our own family’s experience as patients who at times felt injustice in our treatments gave me some food for thought.

And of course, I loved observing Dr. Gordon’s interactions with the patients, whether it was a new consultation, a returning couple expecting their second baby through IVF after a successful childbirth, a frustratedKang 2 couple rejected by other fertility clinics, or a couple that are nearing the end of their options. By the third day, I could recite Dr. Gordon’s consultations verbatim. The repetitive lifestyle of a specialty used to be what made me uncertain about committing to medicine. The actual number of procedures that are done in a fertility clinic may be limited, but each day is far from monotonic. Shadowing Dr. Gordon made me realize that no two cases are ever identical, simply because we are all human. Every patient comes with a different history, a different background, and in the case of IVF, different sets of life philosophies. Being a doctor is not about just diagnosing the condition of the patient, it is about helping them through the journey of recovery. This is especially important for infertility because sometimes even the doctor cannot pinpoint the exact cause of a certain couple’s infertility problems, because there is a myriad of variables that all need to line up perfectly to result in a healthy baby.  For some, the journey may be convoluted, physically and emotionally draining, and end up in a redefinition of a family, but Dr. Gordon with his humor and easy-going character, made the patient sure that he was going to be there with them through it all.

I am very thankful to Dr. Gordon for these enlightening three days in Dominion Fertility. It made me realize how much I love the human-to-human interactions, whether that is between colleagues or doctor and a patient. Even during my short stay there, I felt the strong sense of community, as exemplified by Dr. DiMattina’s surprise birthday party thrown by the entire staff member on my last day of Princeternship. It reaffirmed my growing realization that good science/medicine is done through teamwork. Such lessons of human interactions, of decision-making, of comfort and of guidance are those that I would not have gotten anywhere else. I cautiously dream of being in his position one day, at the frontier of a new technology or knowledge so radical that it redefines how we have been thinking of life and death, and show some future Tiger the mysterious beauty of it all.

 

Stephanie Tsai ’16, Baylor College of Medicine

Stephnie-TsaiI arrived at Texas Children’s Hospital on the first day of my Princeternship experience with Dr. Debra Palazzi ’92, excited for the days to come. Before we began our day with rounds, we discussed the planned schedule for the week, and I also had the opportunity to hear more about Dr. Palazzi’s experiences at Princeton, clinical and teaching work in pediatric infectious diseases, research, and career path.

Throughout my Princeternship, I was also fortunate to work with Dr. Palazzi’s team, which included Dr. Lindsay Hatzenbuehler and Leigh Sweet (fellows), Cristina Lilagan (resident), and Ravi Raju (intern). Being able to learn from doctors in all stages of medical training was a fantastic opportunity. I am grateful to Dr. Palazzi and her team for not only taking the time to explain the various cases we saw but also sharing their experiences and answering my questions about medical school, the process of becoming a doctor, and choosing a specialty.

I had the opportunity to see many interesting and complicated cases during rounds. Dr. Palazzi and her team see patients in a variety of departments in the hospital, including the NICU, Texas Children’s Pavilion for Women, and the Orthopedics center. The cases we saw were therefore very diverse, ranging from neonatal HSV to patients with osteomyelitis, pyelonephritis, and orbital cellulitis. I also had the chance to visit the labs for micro-rounds, where I learned more about the process of identifying bacteria from tests and cultures.

I was surprised by the huge role of teamwork in medicine. During rounds, Dr. Palazzi and her team analyzed the conditions and treatments of every patient. Each offered ideas, questions, and suggestions, OLYMPUS DIGITAL CAMERAwhich were then followed by intense discussion. I was extremely impressed with the depth of their knowledge and experience, as well as their skill in clearly expressing ideas. The importance of teamwork and sharing ideas was further highlighted in the conferences I was able to attend. At both a fellow’s case conference and citywide conference, doctors presented unusual cases and findings to their colleagues. I also attended a presentation on pediatric environmental health and lead exposure. Through these experiences, I saw that working in the medical field involves ongoing learning and collaboration.

I would describe my Princeternship with Dr. Palazzi as incredibly immersive, eye-opening, and probably one of the most rewarding experiences of my academic career. I learned more about pediatric medicine and the medical training process and workplace environment. My Princeternship definitely reinforced my interest in this career field, and I would very much recommend the Princeternship Program to my peers. I came away from this experience excited and inspired to continue to pursue my goal of becoming a physician. Dr. Palazzi continuously amazed me with her ability to problem-solve, analyze situations from all possible angles, and connect with her patients and their families. I am very thankful to have had the opportunity to learn from someone who displays true dedication to her work. To say that Dr. Palazzi cares about children is a gross understatement; her compassion for her patients is unparalleled. With her thoroughness, attention to detail, kindness, and acute mind, Dr. Palazzi is an amazing doctor, educator, and role model.