I was extremely excited when I walked into the bright lobby of Staten Island University Hospital. The lounge chairs, the giant teddy bears in the display window of the cozy gift shop, and the helpful staff at the information center instantly made this a pleasant place. However, I was still a little scared since I had no idea what to expect: I have never shadowed a doctor before.
Lucky for me, Dr. Bajaj, the Princeternship host, is one of the most friendly and easygoing doctors I have ever met. He is the head of the ultrasound department at SIUH, and he actively engaged us in interesting conversations while he read his ultrasound and CT images.
On the first day of the Princeternship, I met Dr. Bajaj and Arence, the other Princetern, at 9 AM in Dr. Bajaj’s office. It took me a while to find his office, since it’s inside the ultrasound section, which is inside the Radiology Department. His office’s space is mostly taken up by four large computer screens positioned vertically next to each other. He explained to Arence and me what the colors on the scans mean as well as how Doppler’s effect works in these scans. I found it fascinating that what I’ve learned in physics in the past semester is actually applied here. Dr. Bajaj delved right into his work list, looking at multiple ultrasound images of livers, kidneys and gallbladders. He worked very efficiently, with the help of a voice dictation system (which worked most of the time. It was a laughing moment when Dr. Baja found that it wrote down “pelvic leg” instead of “pelvically.”) Dr. Bajaj explained to us that since sound does not travel well in solid, stones appear bright with dark shadows behind them. At first, I could not recognize anything but black and white blobs distributed randomly on the screen. But with the help of Dr. Bajaj, I learned to recognize a bright spot as a gallbladder stone after several images. Dr. Bajaj also explained to us that macrovesicular steatosis (fatty liver) would be one of the leading causes of health concerns by 2020. I was surprised to hear that because most of the health issues brought constantly to our attention were breast cancer and cardiovascular diseases. Fortunately, one can lose the fat on his or her liver by having a healthier diet and exercising more.
After looking at some abdominal images, Dr. Bajaj moved on to ultrasounds of fetuses. He found out that the technicians have mis-measured the fetal heart rate. A little later, he saw a fetal ultrasound image and paused for a moment. He looked carefully at the head of this fetus, and concluded that the dark region either indicates severe hydrocephalus or anencephalus in a serious manner. Dr. Bajaj recognized this extremely unfortunate event, and subsequently raised a controversial ethical question of whether to suggest termination of pregnancy or to encourage the birth of this baby in order to harvest its organs after it’s born. He said that it is a hotly debated topic in the medical community, and encouraged us to think about what we would do.
Dr. Bajaj sent us to a residents’ noon conference, where the residents learned to read images. I thought the diagnosis process is very interesting, and it reminds me somewhat of Sherlock’s thought process. Everything follows logic. Dr. Bajaj told us that normally, he does some ultrasounds and other small procedures himself. Unfortunately, he was hit by a car several weeks ago and consequently is unable to do those tasks with a broken leg. Dr. Bajaj took us to another Radiology Reading Room in the afternoon. Arence and I had a chance to talk to two other attendings and a third-year resident there.
On the second day of my three-day Princeternship, I arrived at SIUH at around 2 PM because Dr. Bajaj had a late shift that day. We looked at more CT and ultrasound images. Dr. Bajaj told us that ultrasound actually has a higher resolution than CT, which most people don’t realize. I never would have expected that because the CT images seem a lot clearer to me, but I guess it is due to the way the images are taken, not their actual resolution.
The last day was very exciting. In the morning, I found Dr. Bajaj at the Verrazano office. This office gives a very different feel than the one in the main hospital area. This outpatient imaging center is very cozy, with a spacious lounge area outside. The wall colors follow a dark orange theme, which renders this place friendly and welcoming. Dr. Bajaj worked on more CT and ultrasound images in the morning. Later, he sent us to the neuroradiology reading room in the main hospital building so that we could get a sense of what other branches of radiology look like (I mentioned on the second day that I really loved my neuroscience class. I was surprised that Dr. Bajaj actually remembered this and thoughtfully worked out something for me so I could learn more from this experience. Thank you Dr. Bajaj!) I found the brain images absolutely fascinating. I have a basic idea of the brain anatomy after dissecting two sheep brains in my neuroscience class, and this general knowledge really helped me appreciate neuroradiology. Dr. Arnuk, a friend of Dr. Bajaj, kindly shared his stories of switching from internal medicine to neuroradiology with us.
In the afternoon, Dr. Bajaj introduced us to Dr. Sperling, who works in the ER. Dr. Bajaj wanted to give Arence and me an opportunity to experience other branches of medicine because radiology only represents a tiny portion of it. Indeed, the two hours I spent with Dr. Sperling in the emergency department was drastically different from my time shadowing Dr. Bajaj. Dr. Sperling checked up on three of his patients while we shadowed him. He greeted his patients and their families warmly, chatted with them, and explained what was going on patiently. I loved the doctor-patient interaction, which was rather rare in radiology.
I am extremely grateful to Dr. Bajaj and his co-workers, Staten Island University Hospital, and Princeton Career Services. I’ve learned a lot during these three days. In addition to helping me decide what I want to study at Princeton, I also observed how the theoretical knowledge that I learned in class is applied in real life. I am sure that this will become a motivation for studying harder in the future.