Arence Paasewe ’16, Staten Island University Hospital

Arence-PaaseweThe first day of the Princeternship I walked through the revolving doors of Staten Island University Hospital full of anticipation. This was one of the few times that I had been inside of a hospital because thankfully my friends and family have not been ill enough to require hospitalization. I walked through the long maze-like halls looking for the radiology department while simultaneously taking in my surroundings and wondering if I could see myself working in a medical facility like this later in life. After getting lost a few times and asking for directions, I finally arrived in the ultrasound area of the radiology department and met Dr. Sanjiv Bajaj ‘02. After a short introduction, Dr. Bajaj offered me a seat and gave me a crash course on radiology. He pulled up patient ultrasound scans on the four computer monitors in front of him, rotating the views in order to see different organs such as the liver, kidneys and lungs from different angles. He explained that ultrasound works by focusing sound waves through a person’s body; bright areas on the scan corresponded to solid locations where the sound can not travel through easily while dark areas showed soft or fluid regions. While this seemed simple to grasp, I was completely lost when I stared at the computer monitor. Although Dr. Bajaj and I were looking at the same images, we were seeing two different things. I saw an endless sea of grey while he was viewing detailed images of various organs. Eventually after seeing enough images, organs began to immerge from the grey.

Dr. Bajaj then shifted to explaining the diagnostic ability of radiology, the aspect which had drawn him to this field. After reading the descriptions of a patients discomfort, he was able quickly list possible causes of the discomfort and find the actual cause in a patient’s image. We viewed many patients possessing gallstones, kidney stones, and fatty liver, a problem which was rapidly becoming more prevalent in the United States due to our diets. Although he never came in contact with the patients during my visit, due to a broken leg, Dr. Bajaj played a vital role in their treatments through his diagnoses, showing me the importance of radiology, a field that previously, I didn’t even know existed.

Around noon Ruina, the other Princetern, and I went upstairs to the conference room to have lunch with residents and attend their noon conference focusing on spinal images. Examples of patient images were displayed by a projector, and one after another the residents located minute details and diagnosed the problems present in each image, describing the diagnoses they would log into a Dictaphone. It was interesting to see a different phase of the radiological track and realize the time, effort and repetition needed to go from a medical student to a certified doctor.

The next day of my Princeternship PaaweweI viewed more images with Dr. Bajaj, but I also asked questions about the medical school, the medical field and life in general. He was open and honest with me and gave me the good and bad aspects of the medical field. He explained that being a doctor was a very rewarding experience; his work had an important impact in the lives of his patients and he had a genuine interest in the work that he was doing, but he noted that it took a long time and a lot of effort to reach the point that he was at. He told us that we should find something that we love and interests us and pursue it. If we were just enticed by the money and prestige, there were many different career paths that could accomplish that goal. This information was reiterated by his mother, a retired radiologist who had stopped by the hospital and many of the other doctors and residents who we encountered.

During one of our conversations, Dr. Bajaj came across the amazing ultrasound image of a baby demonstrating a possible case of anencephaly, a disorder in which a fetus develops without a brain and a large portion of its skull. This was a topic covered in Practical Ethics, a class that I had taken that semester and Dr. Bajaj had also taken when he was at Princeton. This led us into a conversation about the moral dilemmas present in medicine such as the available options for an anencephalic fetus and the complexity of the transplant system in the United States.

On the third day of the Princeternship, we shadowed Dr. Omar who was focusing on neurological radiology and Dr. Sperling in the Emergency Room. Both were experienced in the clinical side of medicine but had different views on it. Dr. Omar initially enjoyed clinical medicine but was disturbed by the small amount of time that could be allotted to each patient. He felt that this was a very impersonal system of providing care. On the other hand, Dr. Sperling loved clinical medicine. He enjoyed talking to patients, even if it was for a limited period of time and believed that patients benefited from being able to share their concerns with a professional if even for a short time. Even though we were in the ER for a short period of time, it was obvious that radiology differed from it greatly.

This Princeternship was my first shadowing experience and I am very thankful to Dr. Bajaj, Mrs. Bajaj and the kind staff of the Staten Island University hospital for sharing their workplace, time, knowledge and advice with me. I also appreciate Princeton Career Services for making this possible. I got a lot out of my Princeternship, but the two most important pieces of advice I took from the experience were to find something that interests me and pursue it, and to enjoy my time at Princeton, not allowing pursuit of medical school to dominate my life.

Jacqueline Nicholas ’15, Ganchi Plastic Surgery

Jackie-NicholasWhen I first arrived at Ganchi Plastic Surgery, I was really excited to experience a new specialty in the medical field and get to know Doctor Parham A. Ganchi, a renowned and award winning plastic surgeon from the class of 1987 (see bio).  Although I wasn’t exactly sure what to expect during the two days at his office and tried to go in with an open mind, any expectations that I may have had were easily exceeded.  I learned a lot from Doctor Ganchi, got to know him and his staff very well, and felt very comfortable and welcome at the office.

On the first day of my visit to the office, I met the staff and Dr. Ganchi—all of whom were very friendly and welcoming.  The staff was hard working and dedicated to making the patients’ experience as pleasant and easy as possible while still managing to laugh, joke, and have a great time together.  It was so nice to see an office full of people that both take their work seriously but also love what they are doing.  Following the initial check in and meet and greet process, I followed Dr. Ganchi around and met with new patients, follow-ups, and pre-operation clients.  Coming in on Dr. Ganchi’s day of consultation was very educational and interesting because I was able to meet with patients who had a variety of plastic surgery needs and preferences.  In fact, I find this really fascinating and attractive about the field of plastic surgery—the flexibility—a plastic surgeon is certified and trained to perform hundreds of different surgeries, both reconstructive and cosmetic.

On this first day at the office, Nicholas 1I listened to Dr. Ganchi talk to his patients about talking care of themselves post-operatively, watched him examine them, and also saw a lip enhancement injection.  When Dr. Ganchi spoke with his patients, he was very clear and made sure to answer all of their questions in a way that was medically informative but also understandable for them.  He was efficient with his time but did not rush through his consultations.  After meeting with his patients, I continued to see people that were pleased with the results and they looked great! The results I saw at Dr. Ganchi’s office were definitely among the best; for example, I thought his Rhinoplasties were pretty flawless.  His fabulous results are not only a product of his medical training but also due to the way he handles his procedures, which will be explained in Day 2.

Below is a link to Dr. Ganchi’s bio page where you can find out more about Dr. Ganchi’s education, training, see his amazing results, and find contact information!http://www.ganchi.com/plastic-surgeon-new-jersey/

One of the most exciting parts of Day 1 was actually when Dr. Ganchi showed me images on his computer from other surgeries he has done in the past and surgeries in which he was involved during his residency.  These surgeries were even more interesting to me because they were reconstructive surgeries that corrected a genetic deformity or a treated a trauma.  I have considered maxillofacial surgery to be one specialty in which I am very interested; therefore, seeing and hearing about some of Dr. Ganchi’s experiences such as cleft pallet repair surgery was really inspiring.

My favorite story was one in which Dr Ganchi. told me about how they took the cartilage from a person’s last floating ribs and skin to reconstruct the shape of his ear, which was missing.  It is truly mind-boggling to think about what can be done today with one’s own body to fix deformities or traumas and even more amazing to think that you or I could be the person responsible for helping such people in need.

The following day, I was able to see four different surgical procedures, all done on the same person.  It was such an amazing and valuable experience in which I learned a lot more about the human body and surgical procedures.  I watched a breast lift and augmentation, an umbilical hernia repair, and a tummy tuck.

The surgery was about 6 hours, which may seem long, but not when you are a surgeon who aims to achieve the best results possible. Dr. Ganchi was extremely precise, careful, gentle, and paid great attention to detail; in fact, before he began, he marked and measured segments and areas of the body to ensure his precision and accuracy.  To me, surgery is like art and plastic surgery is like creating a masterpiece.  Dr. Ganchi was prepared well to sculpt his masterpiece- he had his markings done, pictures up on screens in the operating room, and he prevented mistakes that could have been easily made by counting tubes of liquid he used out loud.  Although counting tubes seems simple, you learn how to count as a young child, many mistakes in medicine happen with simple tasks like giving the proper amount of medications.

Dr. Ganchi explained what he was doing throughout the surgery.  He identified parts of the body and pointed them out to me.  I felt like a medical student receiving a lesson in anatomy and I was glad to be able to have more of the human body revealed to me!

Nicholas 2

Yes… a selfie of Dr. Ganchi and me

After my very rewarding two-day visit with Dr. Ganchi, he told me, “Maybe you’ll now consider plastic surgery.”  At first, going into the Princeternship I felt like it could be an option, but after this experience it has fascinated me and definitely inspired me to keep my mind open to all specialties because each has something beautiful and wonderful to offer our society.Overall, this was an absolutely amazing, eye-opening, informative, and special experience.  I observed the doctor during his consultations with new and returning patients, got to see how his office was run, and was able to watch a 6-hour surgery.  Dr. Ganchi and his staff were so welcoming and kind and I learned a lot including procedural details and Doctor Ganchi’s past work with reconstructive plastic surgery.  I encourage students to take advantage of this great opportunity.Thank-you again to Dr. Ganchi and his lovely staff!

 

Chelsea Mayo ’14, Loyola University

Chelsea-MayoWhen fellow Princetern Morgan Taylor ‘15 and I showed Loyola employees the detailed schedule Dr. Papadakis had made us, they were impressed but not surprised by her attention to detail and careful planning. Dr. Alison Papadakis ’97 is a licensed clinical psychologist and associate professor at Loyola University in Baltimore, Maryland. For the past year I have been researching possible graduate programs in psychology and Loyola University is near the top of my list for Psy.D. programs, so I was pleasantly surprised to find that a Princeternship was being hosted there. I am a senior in the English department, however I have taken several foundational psychology courses with the intent to eventually pursue higher degrees in psychology and become a practitioner in the mental health field.

This was my second Princeternship, and one thing I love about the Princeternship Program is how much the alumni who participate are willing go out of their way to tailor the experience toward what would be most helpful for you. For this Princeternship I was not simply shadowing Dr. Papadakis in her day-to-day activities, but instead she provided me and Morgan with the opportunity for a personalized view of several aspects of Loyola University. Throughout January, Dr. Papadakis emailed us to get a sense of what we each might want to do with the Princeternship: which courses we would like sit in on, which department faculty we might want to talk to, etc. So, on the first day she handed us a full schedule for the three days consisting of psychology courses, both undergraduate and graduate level, meetings with grad students, and informational interviews with professors that she had coordinated for each of us.

My first day began a little harried for Chelsea Mayo photo 1me because of traffic and issues finding parking on the Loyola campus, but it quickly turned into a wonderful day. Morgan and I were given a tour of the Loyola Clinical Centers by Dr. La Keita Carter. It’s a beautiful, state-of-the-art facility where the first and second year doctoral students are responsible for intake, assessment, and therapy of the clinic’s clients, all under supervision by their fellow students and licensed supervisors through one-way mirrors and video-recording. Following this, Morgan and I had some free time for lunch (during which I feverishly scribbled down notes on all that I’d learned so far) next-door in Belvedere Square Market before we were met by four first-year doctoral students. As a prospective applicant to a Clinical Psychology Psy.D. program (and possibly this one), the chance to chat with Amy, Jacob, Maite, and Abigail was invaluable. They gave me their perspective on what it’s like being a student, juggling classes and working at the clinic, and tips for applying. I asked them every question I could think of. We had a similar experience the next day when Morgan and I had lunch with third and fourth-year doctoral students Val, David, and Diane at the student center. It was great getting the perspectives of students farther along in the program. They told us about their externships and the process of writing a dissertation at Loyola. All of the graduate students were very friendly, open and honest.

Chelsea Mayo photo 2

Beatty Hall – Loyola Psychology Department

In the interest of brevity, I won’t go into detail about every course I sat in on and every informational interview I had over the three days. What I loved the most was getting a taste of what attending doctoral level courses is like, and my one-on-one meetings with Dr. Carolyn Barry, Dr. Beth Kotchik, and Dr. Sharon Green-Hennessy were all enlightening. It is helpful to learn about the different paths those far along in the field have taken, as well as their viewpoints on academia, teaching, and practicing. Our last day, Dr. Papadakis took Morgan and I to lunch at the superb Miss Shirley’s down the street. She told us about her experience at Princeton and her path in psychology after Princeton. She also gave me great and frank advice about things to consider when applying for and choosing graduate programs.

Chelsea Mayo photo 3

Morgan Taylor ’15, Myself, Dr. Alison Papadakis ’97

This was an excellent Princeternship for me not just because it confirmed my interest in becoming a licensed clinical psychologist in the future but because it showed me that I can see myself doing, and enjoying, all the steps in-between that goal and now: building up experience for applications, applying to programs, taking doctoral courses, providing supervised therapy in clinics, doing externships, writing a dissertation, etc. etc. Though I still cannot be quite sure what path in and out of graduate school and the mental health field I’ll end up on, I feel highly equipped thanks to the insight and advice I received from Dr. Papadakis and everyone she graciously connected me with. A huge thank you to Alison Papadakis as well as to all of the faculty and students who took time out of their busy schedules to make this such an enriching and enjoyable experience!

Katherine Lee ’17, Prescription Advisory Systems and Technology

Katherine-LeeMy Princeternship took place at wonderful new startup on Nassaus Street called Prescription Advisory Systems and Technology (PAST). There, I got the opportunity to work on a project for the company that would go in one of their mock-ups for investors in addition to hearing about the difficulties and advantages of working for such a small company. The great thing, I soon discovered, was that everyone was on the same page, with the same high-level of energy and excitement about the mission of the company.

Kevin and I started off the Princeternship with a wonderful dinner at a small Indian restaurant on Nassaus Street. We got to meet the entire company on the first day and really got to know some of the key players in building the company. Doug and Ahmet sat down with us and told us about the basic business model and the region of the market they aimed to target. The program that the company is developing aims to analyze data acquired from the many dispersed data-centers of pain medication history to alert doctors about when a patient is at high risk for overdose or if the patients are doubling up on their pain medication by visiting multiple clinics. This way, doctors can feel safer prescribing pain medication, and patients can be protected from potential overdose due to conflicting drugs that alone do not cause trouble, but together may cause, most commonly, constricted breathing. After lunch, we parted ways to meet the next morning at 10 am.

Day 1

Bright and early, Kevin, Deborah, and I appeared on the doorsteps of PAST as we listened to puppy footsteps coming up the stairs. Our host, Mr. Joe Studholme ’84, greeted us at the door with his puppy.

On the first day, we settled into the office, but soon convened for a meeting with Mr. Studholme who outlined where the company was looking to go in the future in addition to some of the complications they had faced along the way. Mr. Studholme also told us about his first successful company, Restricted Stocks Company, which he sold in the early 2000s. His experiences at his first company had given him an advantage in creating the second as many already knew he was reliable, dedicated, and successful. He then outlined our project for the three days on the whiteboard and we set out to make it happen.

Our project was to create an all-encompassing equation to estimate the fitness level of a patient with Fitbit data to enable doctors to fully evaluate how their patient was responding to the pain medication and to make adjustments accordingly. We also worked to create a mockup of the data that we would expect from having the Fitbit data.

Day 2

Kevin, Deborah, and I gave a brief presentation to Mr. Studholme in the morning with the results of our previous day’s work. He walked through it with us and made suggestions as to where to go with our work thus far. We spent the remainder of the day working on improving our formula.

Since Kevin, Deborah, and I were more tech-oriented than business, we also got to meet with the tech team in the company to go over how they were creating their software. They walked us through the development process from the very beginning when they joined the team, to where we were today. Along the way, we learned about some interesting programs and software, like Github, that they used as part of their project. They also discussed with us some of the challenges they faced through working with a team that was spread across several physical locations. The solution involved heavy usage of Github and version control.

Day 3

After working on our model, we presented it to Mr. Studholme and the entire company in the morning. We walked through some of our thinking and analysis of the problem with the company. It was really great to know that the problem we had been working on was so important to the company that everyone was present to listen to us present our solution and give us more useful feedback. We spent the afternoon incorporating their suggestions and then talking to Doug and Ahmet about how they got involved in P.A.S.T. and their specific roles in its operation.

The Princeternship was a wonderful way to get deeply immersed in a company for a few, concentrated days. I learned a lot about what it means to be a startup and the dedication and skills that it takes to create something from scratch. I also gained an appreciation for the myriad of different roles people in the company played to make the product successful and for everything to pull together. With just a few people working on creating a company, every one counted.

Finally, a huge thank you to Mr. Studholme, Doug, Ahmet, Rachel Jimenez, and the Career Center for making this experience possible for us. We had a wonderful time working for the company, and learned a lot along the way about entrepreneurship.

Joyce Lee ’17, North Shore-LIJ Health System

Joyce-LeeFor three days over Reading Period, I shadowed Dr. Mitchell Adler ’73, who is Chief Medical Information Officer of the Medical Group at the North Shore-LIJ Health System. In the beginning, I was very excited to meet him for my Princeternship, but I wasn’t too sure what to expect because I had never shadowed anyone before. However, Dr. Adler and his colleagues welcomed me warmly from my very first day and gave me a fantastic experience. In these three days, I definitely became more comfortable and knowledgeable about what work in the health care field can look like.

On my first day, I followed Dr. Adler straight into a meeting involving outpatient care, medical practice and performance evaluation. Although the meeting was long, I was fascinated by how the doctors in the room, each representing one section of the health system like a hospital or a specialty, addressed problems that they face in medical practice and suggested solutions that they might be able implement to address these problems. The way the meeting was conducted made me appreciate how distinct hospitals and specialties come together – discussing, presenting, and sharing ideas and information – to ultimately function as one health system.

I spent the rest of the day observing and shadowing Dr. Adler as he attended important logistical meetings, interviewed applicants for executive positions, and oversaw the operations of the teams that managed electronic health records. I learned about the electronic system that was being implemented and updated at various hospitals to streamline and facilitate medical care. What really impressed me was the scope of these electronic health records: as North Shore-LIJ is a massive health system that includes many hospitals, clinics, and other health facilities, these records were being used and integrated on a very large scale to ensure that patients received the best care possible.

We ended the first day with a dinner with one of the residents that Dr. Adler oversees. The resident specializes in internal medicine at one of the North Shore-LIJ hospitals, and I really enjoyed our dinner discussion because it gave me a glimpse of medicine in the clinical setting. I learned about the basic hospital command structure, the different medical specialties such as cardiology or pediatrics, and the process medical students go through to become board-certified physicians. Most of all, the discussion made me excited and prepared for our visit to the clinic the next day, where Dr. Adler oversees medical residents.

The second day began with a logistics Joyce Leemeeting about how the new features of the electronic system would rollout and operate and to smooth over any foreseeable problems or glitches in the system. With the amount of people there, I could tell that this system took a lot of effort and work behind the scenes from hospital and health system administrative officers and executives to implement, and it made me appreciate the attention to detail that was given. In particular, it was interesting to see how the presentation melded into a discussion of questions and concerns from each of the departments represented before the new features officially came into use.

After a yummy lunch, we headed to the internal medicine floor of the clinic, where physicians provide outpatient care for a variety of medical conditions. The residents would leave the physician room to greet and see the patients, come back with reports of the patients’ concerns, and talk with Dr. Adler or another mentoring physician to diagnose and address those concerns. I watched the electronic health records, which I had learned so much about in the past few meetings, being used live as the interns looked up patients’ basic information and previous visits, inserted diagnoses and prescriptions, and updated patients’ information. The interns even used e-calculators, which evaluated medical indicators like heart risk when different factors like BMI and age were entered. It made me realize the valuable role technology plays in medicine today, where doctors use electronic records and electronic tools to aid them in providing better care to their patients.

The third and final day, I shadowed Dr. Adler during several meetings and conference calls where he addressed the implementation of the electronic health records and set agendas for the next few weeks to meet certain rollout and implementation deadlines. In between meetings, we discussed the current health care system and model, and Dr. Adler introduced me to several medical and health care policy articles, including those in the magazine Health Affairs, which focuses on a topic each issue and provides introductory profiles and different perspectives on that topic. I learned about different aspects of health care ranging from health insurance plans put in place by the government, to the economic implications of hospital systems, to, in particular, the roles physicians play in a health care system and the expectations placed on them by the system.

All in all, my Princeternship was a really amazing experience. Throughout the three days, I shadowed t, observed, and learned a lot. I feel that I went from having limited knowledge of the health care system to having a more comprehensive understanding of what it means to be a doctor. Although I’m still unsure about my plans for the future, this Princeternship makes me want to gain more insight into the health care field and perhaps to even pursue a medical profession after college. I’d like to sincerely thank Dr. Adler for giving me this opportunity to explore the health professions and my goals for the future!

Lisa Kojima ’15, Newton Wellesley Primary Care

Lis-KojimaDay 1:

I arrived at Newton Wellesley Primary Care around 8:20 am to meet Dr. Janine Pardo ‘01. She introduced me to a few of her colleagues and then we went to her office. We had a few minutes to talk about why I was interested in medicine and what I study at Princeton, but she had her first patient at 8:30 am, so we did not talk at length. The first patient was coming in for an annual physical. Dr. Pardo had just joined the Newton Wellesley Primary Care practice last year, and she was meeting this first patient for the first time. (It turned out that all the patients that she was seeing today were all new to her.)

Having read in the media about how primary care physicians (PCPs) are in great need and how the average amount of time that a PCP spends on one patient is 15 minutes, I was surprised to see that Dr. Pardo spent on average at least 30 to 40 minutes. Part of this may have been because she was meeting her patients for the first time, which necessitated her asking many more questions than in a short follow up. She would first ask the patient whether there were things that he/she wanted to let her know, and most patients had a few things that they wanted to mention. Then she would go on to ask about the medications that they were taking, their family history, and their lifestyle. A healthy diet was a major topic for several patients, and instead of just telling the patient that they needed to incorporate more vegetables and fruits and cut down on animal protein in their diet, she also talked about the most recent studies that showed evidence of the benefits of certain diets. She took that extra step to make sure that the patient felt really comfortable with the information and would feel compelled to adopt a healthier habit. She would often print out a handout that the patients could bring home with them.

What was really interesting for Kojima 1me was that Dr. Pardo had her patients come into her office (as opposed to the exam room) and sat face to face at a desk with the patient. She had her computer so that she could jot down some notes as she spoke with the patients. I was always used to talking to the doctor in an exam room and although Dr. Pardo was typing on her computer, it felt like she was having a conversation rather than merely answering whatever questions the patient had and supplying a long list of facts.

Between each patient visit, Dr. Pardo gave me the opportunity to ask questions about the patient interaction or medical school or anything else I was wondering about. She talked a little bit about her rotations in medical school and how practicing in NY differed from practicing in Boston suburbs. She also filled in some more details on the patients’ medical records during these short breaks between patients.

One patient came in with a complaint that she had rashes isolated to the trunk of her body and during the physical exam, Dr. Pardo allowed me to look at how the rashes looked. Based on the location and the appearance of the rash, Dr. Pardo made a diagnosis and gave me some literature that I could read regarding the rash. During a different patient’s physical, we had a happy surprise—the patient found out she was pregnant!

Dr. Pardo really focuses on preventive medicine – maintaining a healthy diet, performing regular exercises, etc. —which I found very nice because I believe modern medicine is still very much focused on fixing people’s conditions and diseases as quickly as possible with medications after the problem starts but not much about what we can do to prevent the condition entirely. Before going into the Princeternship, I was interested in surgery because it’s clearer as to what is going on in the body. When you look inside the body, there is much less speculation as to what might be happening and less guessing as to what the X-ray or MRI or CT scans might be indicating. However, after today, I realized that PCPs can really affect the patients even long before the disease or condition begins. When patients visit a specialized doctor, it is usually not for preventive measures. It is usually after some problem has already been detected and needs to be checked more thoroughly by a specialist. Dr. Pardo’s newer approach to primary care, by focusing on preventive medicine, can totally change the way primary care is run.

At the end of the day, after all the appointments were done, a physician’s assistant came into the office asking for some advice about one patient who had chronic pain, for which none of the exams helped to determine the cause. Most of the day consisted of talking to patients, but this interaction with the PA allowed me to see the collaborative nature of primary care as well.

Day 2:

I arrived again at 8:20 am before the first patient came at 8:30 am. Similar to yesterday, the morning consisted of four annual physical exams. Dr. Pardo spent close to one hour with the first patient, who had multiple conditions that were all feeding into one another. Instead of focusing on one piece of the puzzle, Dr. Pardo thoroughly explained the importance of trying to improve all of the conditions simultaneously because ignoring one condition will inhibit the patient from improving other areas of his health.

Dr. Pardo and I talked a little bit about the nature of primary care and how they can be different from specialized areas. Primary care is very much diagnostic in the sense that you put different pieces together to determine the diagnosis. However, in specialized areas, the condition is often already determined by the time the patient sees the doctor, and the doctor then focuses on that one problem. PCPs, on the other hand, are the go-to doctors—they are the first person in line to look at all the symptoms, and then the patients are referred to specialty doctors.

We had more time for lunch on the second day, so we spent that time talking a little bit about Princeton. In the afternoon, there were five appointments, two of which were physicals and the rest were shorter follow-ups. In between patients, we talked about the flexibility that is allowed as a PCP.

This Princeternship gave me the opportunity not only to see the doctor’s routine in the office/exam room, but also to ask questions and have conversations about the pros and cons of being a doctor. Thank you Dr. Pardo for opening a window into the days in the life of a doctor!

Cindy Johnson ’15, Richmond ENT

Cindy-JohnsonSpending two days shadowing Dr. Michael Armstrong ’85 at his Richmond ENT office was a truly eye-opening experience. As someone who held an idealized and dramatized vision fueled by episodes of “House” of the day-to-day practice of a physician, this Princeternship afforded me the opportunity to actually witness not only doctor-patient interactions and surgeries but the actual business side of owning a practice and the daily operations that go with it. Dr. Armstrong also answered all of the questions I had pertaining to his journey to becoming a doctor, and what he enjoys the most and least about his job, among other things.

Day 1

The first day started a little after 8am when Dr. Armstrong met with his first patient. Much like many of the patients he met with that day, the patient had a problem with their sinuses. Here I witnessed the first of many nose examinations wherein a camera at the end of a tube was placed within the nose as Dr. Armstrong examined the sinuses and turbinates (one of the new words I learned during my shadowing experience). Most of these were checkups and the patientsphoto 4 were fine, but some patients had signs of potential sinusitis and may have needed balloon sinuplasty. This is a procedure usually used to treat sinusitis, where a small balloon is inflated within the sinuses, which may be inflamed or narrow, opening them.  Because no surgery is required it is much less invasive than traditional procedures. What was most rewarding about this experience was seeing the doctor-patient interactions. Dr. Armstrong was extremely patient and caring and actually described the anatomy of the medical issues in terms that the patient understood and gladly answered any questions. The rooms even had mirrors so that the patient could view the monitor showing the interior of their noses. Even when a patient experienced discomfort Dr. Armstrong or Amy, one of the nurses, reassuringly comforted her.

In my downtime, I spent most of my time with a future med student who worked as a scribe for the office and a nurse in training, Sud and Kara respectively. They were just as invaluable to my experience as shadowing Dr. Armstrong. Sud helped me to realize just how real it is, in terms of what it actually takes to get into medical school and gave me advice on how to study for the MCAT. Kara gave me insight into the transition from school to the workforce. That afternoon I was able to ask Dr. Armstrong a few questions about his profession and his journey to said profession. The doctor’s interest in the complexity of gynecological oncology lead him to the ENT specialty because while he enjoyed the challenge of the complex anatomy and engaging in certain emotional aspects that went into that specialty, he realized that the demand for male gynecologists was decreasing and the ENT specialty was also complex and involved facial plastics. Dr. Armstrong said that Princeton prepared him for medical school because of the thesis process which entails engaging in detailed original research and reaching out to people.

Day 2

On the next day I was able to witness two surgeries, a CO2 laser treatment, and other appointments with patients. For my first surgical experience I was expecting this super serious environment, but surprisingly everyone involved was relaxed and happy and even talked during the surgery. It was a tonsillectomy and I was able to see right over Dr. Armstrong’s shoulder while he performed the surgery; it was quick and afterwards the patient awakened with no difficulty and could even talk. The next surgery was a corrective rhinoplasty. This took a bit longer but I really got to see Dr. Armstrong as a photo 7sculptor of an actual human body. It was incredible to see him expertly reconstruct someone’s nose while mentally envisioning what the outcome would be. Throughout the surgeries the nurses and anesthesiologist were extremely gracious and eased any anxiety I had about the experience through their kindness and willingness to explain the procedure and their roles within them. After the surgeries, I accompanied Dr. Armstrong to his next procedure, the CO2 laser treatment used to cosmetically treat deep lines or wrinkles in the face with penetrating lasers. After watching the lasers being systematically applied to the patient’s numbed face for approximately five minutes I got to observe more patient appointments with Amy. Amy had the same reassuring confidence as Dr. Armstrong and had the ability to make the patients feel comfortable through her excellent communication skills. Interestingly, throughout these two days I saw the entire process of preparation for and recovery from rhinoplasty in three different patients. The first patient had already had the procedure and came in for a check-up, the next patient was the morning surgery that I witnessed, and the last came in to get his sutures removed. For my last shadowing experience I followed Dr. Giordano, an associate of Dr. Armstrong. After an eye-opening discussion about the usefulness of organic chemistry for a doctor, I witnessed my first ear tube procedure. I was able to see the ear drained and the tube being inserted in the eardrum. Finally, before saying goodbye Dr. Armstrong showed me a CT scan of the sinuses and the mucus within the sinuses.

Overall this was an amazing experience where I got to see doctor-patient interactions that showcased the importance of communication and thoroughness. I saw another side of the practice as Dr. Armstrong participated in TV interviews, dealt with paperwork, and made executive decisions in terms of the office and patients. His beautiful analogies to art put his practice in terms that were familiar, with me being an Art History major. Dr. Armstrong stated that surgery, specifically rhinoplasty, was his favorite part of the job, which was evident in the way he skillfully performed his procedures. In fact, seeing those surgeries was my favorite part of the experience. Thank you to Dr. Armstrong, Dr. G, Amy, Gina, Sud, Kara, and the entire staff at Richmond ENT for being so hospitable and making this experience amazing!

 

Yende Grell ’16, Massachusetts General Hospital

Yende-GrellDay 1

We met Suzanne Morrison ‘89, our Princeternship host at 9 am sharp. As we commenced our “2-cent tour” as Suzanne likes to call it, and walked through the bustling halls of the Yawkey Center of Massachusetts General Hospital (MGH), I could imagine myself, chart in hand, comfortable scrubs on, one day roaming the halls of a great institution such as this one. The presence of residents and students was refreshing, and it reminded me that both as an aspiring and actual physician you are continually learning. Suzanne showed us the Lunder, Ellison and White buildings of MGH.  From the 22nd ‘VIP’ floor of the Ellison Bbuilding we saw a magnificent view of Boston and Cambridge. The highlight of our tour was when Suzanne took us to the Ether Dome, which served as the operating room of MGH and was the sight of the first anesthesia administration by Dr. W. Morton using Ether.

We then spent the rest of the day with Bobby Lucas ’13, a research coordinator and Princeton alum. Go Tigers! Bobby and his research partner Jordan were working on a variety of studies including the PROMISE program aimed at effectively and efficiently collecting patient reported outcome measures,and the Radiostereometric Analysis (RSA) Distal femur study. I really enjoyed learning about the RSA Distal femur experiment that tracks the movement of beads in patients with distal femur fractures to measure healing. These beads are inserted at time of surgery when the bone is still soft and spongy. We had the opportunity to see the set up of the process that uses X rays to measure the healing of these fractures. A shot is taken of the femur, then one with pressure against the femur. The beads in both films are observed, and based on how much they move, one can see how much the bone has set since the last films. This method is being used currently in hip replacements, and it was great learning about such an innovative approach.

Day 2Grelle 1

My day started bright and early at 6:30 am. I met my host for the day, Dr. Torri an obstetric anesthesiologist, and was immediately struck by his warm, bubbly personality and beautiful Italian accent! He took me to rounds with his other attending Dr. Leffert and a few of his residents. Although a lot of the medical jargon flew right over my head, Dr. Torri took the time to explain the terms that had just been thrown out. He would do this throughout the course of the day, also showing me diagrams in anatomy textbooks, incisions on models, and diagrams on a white board.As an obstetric anesthesiologist Dr. Torri’s day consist mainly of administering epidural and spinal analgesia to women in labor. I saw at least 4 of these procedures done, and the extreme intricacy and dexterity involved. A local anesthetic is first given to the area in the lower back, and then the actual opioid analgesic must be inserted into the epidural space. This space is tricky to locate and is found between the lumbar bones, between the yellow ligament and dura. Once the epidural space is found a catheter is placed in it to allow for the continuous supply of the drugs. I also had the opportunity to observe 2 cesarean sections, one of which was the delivery of twins. These twins were forced to be delivered by C-section since one of the two was breached and there was an obstetric complication called vasa previa which increases the risk of fetal vessel rupture. This was my first time seeing a surgery firsthand, and instead of feeling queasy or uncomfortable, I thought it was amazing, and even got teary eyed when the babies were pulled out.

Day 3

My day started again at 6:30 am with rounds on the orthopedic trauma service. I spent the morning with nurse practitioner Kathy Burns checking up on patients and attending interdisciplinary meetings. I was not familiar with the nurse practitioner specialty before then, and was amazed by the great amount they can do, including prescribing and diagnosing. Kathy has been in healthcare for almost 29 years and is great at her job. We saw patients with external fixators, fractures and those in need of knee and hip surgery. The interdisciplinary meetings were very interesting to me. During these meetings members from various services like orthopedics, occupational therapy and physical therapy all report to each other about patients and come up with decisions on course of treatments and discharge. It makes sense that orthopedic patients need to be assessed and treated by physical and orthopedic therapists since having injuries to your bones affects your motor skills which in turn affect your basic life functioning.

I spent the afternoon in Pediatric Orthopedics with nurse practitioner Allison and Dr. Rebello. I was surprised by the variety of cases we saw. I went in expecting pediatrics to involve things like children with broken arms and feet and simple fractures. Yet I saw a neonatal case where a swollen fetus foot was being explored as an indicator for other complications and a post-surgery cerebral palsy patient was being treated for left leg spasms. The cerebral palsy patient was an anomaly for Dr. Rebello who had never in his career seen a response like this to the surgery. This patient was in a great deal of pain, and the pain service had to be called in for a consult. Despite some of the difficult things I saw, I found that working with children was very uplifting. Most of them were bright and funny even when in pain, and come on, they’re so cute!

Dr. Rebello and I then chatted about a children’s book that he recently published called Dare Bone’s Big Break. I would recommend it to anyone with children or who works in childcare. He uses humor and rhymes to explain what actually happens when a child breaks a bone, and how it is treated. He explains that his aim with this book is to help children become familiar with and comfortable in using medical language and terms. He believes that if this sort of language is introduced and understood at an early stage in life, then children will be better versed in their understanding of the body and less frightened to go to the doctor. Writing this book was his passion, and he says it is the first of many such works to come.

I ended my day by accompanying Dr. Rebello to check up on a post-surgery patient. This patient was born with no arms and had surgery to correct a hip complication that would allow him to walk more comfortably. When we visited he was cheerful in spirit and was excited by the thought of soon going home. I loved seeing the interaction between this patient and his caregivers and his great optimism despite his circumstances.

All in all, being at MGH for 3 days was an eye-opening learning experience for me about the field of medicine.  I learned so much from the physicians and nurse practitioners that I shadowed, and I want to thank them for being so patient with me, a pre-med student who was not accustomed to the medical jargon. This Princeternship has shown me that medicine is multi-faceted, and requires a team-based approach. I have also come to see the more personal side of medicine, hearing the stories of physicians and seeing their interactions with their colleagues. I would definitely recommend this Princeternship to anyone interested in medicine. This experience has only confirmed my interest in medicine and my commitment to pursuing it. A big thank you to my host Suzanne who gave me the opportunity to come to MGH and shadow these amazing physicians, and to Bobby for all his help.

Christine Ha ’16, The Children’s Hospital of Philadelphia

Christine-HaI delved right into observing surgical urology during the first day of my Princeternship at the Children’s Hospital of Philadelphia with Dr. Howard Snyder III, MD ‘65. I was able to scrub into three operations and throughout the day, the residents and fellows explained the specifics of the procedures taking place and told me about urology as a larger medical field.

One of the operations, an appendicovesicostomy, demonstrated how far we have come in using technology in medicine. This procedure involved repositioning the appendix to use as a passageway from the bladder to the skin for patients who are unable to manage their bladders, sometimes because of greater neurological disorders. This was done using the da Vinci surgical system (a robot that I was actually familiar with from watching Grey’s Anatomy), which allows for small incisions on the surface of the body and greater dexterity than a human could accomplish with an open surgery. During this surgery, I also had time to speak with the anesthesiologist about the difficulties which women in medicine face and her decisions in medical school that led her to her current occupation.

After the long day, we were given the opportunity to sit in on a weekly conference for the urology, radiology, and nephrology department surgeons and residents to discuss some of their most challenging cases and receive feedback from their colleagues. Though I didn’t understand most of the medical jargon, I am grateful that I was able to witness the multidisciplinary aspect of medicine.

During the second day at the hospital, I shadowed Dr. Snyder during his clinic. We met with patients who came in with concerns ranging from bed-wetting habits to duplex bilateral kidneys. This time with Dr. Snyder opened my eyes to the types of patients that pediatric urologists meet on a daily basis.  In addition, speaking with Dr. Snyder and his assistant also taught me about healthcare in general, including difficulties in communication among primary physicians, specialists, and patients. From my time with Dr. Snyder, I was able to observe the mastery and eloquence that results from decades of practicing and teaching medicine.

On the third and final day of my Princeternship, I shadowed both a nurse practitioner and an attending urologist. It was interesting to see the different patients Dr. Snyder and these two physicians met with during the day.  Though these three days flew by, I was able to experience much more than I had anticipated. I observed operations that used the most progressive technology today and shadowed the leading pediatric urologists in the field. I am grateful to Dr. Snyder and his assistant, Sharon Brown, as well as the rest of the pediatric urology department who made my Princeternship an enlightening experience.

Sofia Gomez ’16, Memorial Sloan-Kettering Cancer Center

Sofia-GomezDr. Ariela Noy ‘86 is a hematologist and medical oncologist at Memorial Sloan-Kettering Cancer Center in New York City, NY, who focuses on treating lymphoma patients and researching HIV-related lymphomas. After reading about her work, I finally arrived at her office on the morning of January 22 to begin my day-long Princeternship. Dr. Noy greeted me with enthusiasm, and quickly began updating me on her daily routine and current patients. Stories rolled off her tongue about patients’ diseases and platelet counts, but the stories remained centered on their personal experiences as patients, demonstrating how much she truly invests in her patients’ care and quality of life. Before even seeing any patients, Dr. Noy had shown me a new perspective on medicine by making it clear that treating a disease is different from treating a patient.

Soon after arriving, I followed Dr. Noy to a clinical research meeting with about twenty of her colleagues, where they presented and discussed prospective clinical trials and specific patient cases. The doctors challenged one another, asking presenters tough questions about the data they displayed, and tossing out ideas about how to improve trials or individual patient treatment. I was surprised by the exchange of ideas and debates that constituted the meetings. Observing their interactions made me realize that these meetings are truly what guide their daily work in research and medical care. Those who presented ideas welcomed the criticism: it seemed to be something they knew would only strengthen their abilities as doctors and researchers.

Dr. Noy and I left the meeting early, as she was working at the clinic that day, and had her first patient coming in at 12:15 pm. We arrived at the clinic, where she began responding to the dozens of e-mails she had received in the last few hours—messages from hospital administrators, fellow doctors, assistants, nurses. Her work ranged from analyzing patients’ PET scans to rearranging meeting times due to her busy schedule. She seemed to be working on hundreds of things at once, but kept me updated all along. At this point, it seemed to me that Dr. Noy’s job was both exciting and overwhelming, but she seemed constantly enthralled by her work.

For the rest of the day, I shadowed Dr. Noy as she interacted with patient after patient, quickly absorbing the background information she gave me about each before walking into his or her examination room door. The spectrum of patients she saw was wide: some had just been diagnosed with lymphoma, others were in the middle of their treatment, and still others had been in remission for years. Dr. Noy welcomed patients to her office, performed the necessary exams and procedures, and gave them time to tell her of any health complaints. She was consistently honest and frank with patients who asked her about their diagnosis. She expressed to me the importance of retaining a calm and relaxed persona while interacting with patients suffering from lymphoma, but said the truth was always shared openly. Although it was hard for her to share bad news, she did so whenever she had it. She was candid with patients who she felt had a cancer that was life threatening, emphasizing that making sure patients fully understand their condition is crucial.

After observing her with a few patients, I asked Dr. Noy if she ever feels overwhelmed by the bad news that seems to inevitably come up in her job. She responded, “Yes, but that’s why I come to work every morning.” I realized, after hearing her response, that the work she does is difficult and heart-breaking, but it’s importance extends beyond that. Her attitude towards her work is one I would like to have in my future career endeavors. The Princeternship made me confident that I would like to pursue a career, perhaps similar to Dr. Noy’s career in medicine, that challenges me daily and that rests on a commitment to help others. My experience at Memorial Sloan-Kettering Cancer Center was incredible and eye-opening, exposing me to a field of medicine in which I have always been interested.