Chapter 3 Perfect Phrases for Shadowing Experiences
"Briefly describe the one healthcare experience that has had the most influence on your decision to study medicine."
(University of Miami)
"Briefly describe your exposure to medicine."
(Eastern Virginia Medical School)
How do you know you'll be a good doctor unless you've seen one in action? Shadowing—taking the time to follow a physician through her day to observe what her work is really like—may not be an official requirement for medical school admission, but it's certainly a de facto one. Seeing medicine come alive through the example of an experienced practitioner can tell you whether you'll enjoy a medical career, eliminate some of your false assumptions, and perhaps provide you with a mentor or role model you can turn to as your medical education and career begin in earnest. The following perfect phrases provide some variations on the shadowing theme.
At Dallas Memorial I have had the good fortune to interact with hematologist-oncologist Dr. Mark Gorecki, who early on allowed me to join him on weekend rounds at Irving Children's Hospital. I was immediately impressed with Dr. Gorecki's enthusiastic concern for his patients as well as the rigor and relevance of his research. Through him, I have been given the rare opportunity to interact with patients stricken with sickle cell disease, and I have been stunned by the amount of suffering and myriad complications these patients endure. I have also been humbled to learn that the discovery of the molecular mechanism of this terrible disease almost 60 years ago has provided little improvement in patient care. Most importantly, Dr. Gorecki has shown me that despite the social and economic differences that separate him from his patients, with compassion, enthusiasm, and warmth he can establish long-term trusting relationships with each of them. Through Dr. Gorecki, my attraction to medicine has evolved. While I was initially attracted to the problem-solving challenges it offers and because it would complete my understanding of biology, today I'm drawn to medicine because it gives me an outlet for compassion and caring, qualities inessential to research.
After my volunteer experiences first sparked my interest in medicine as a career, I explored the profession further by shadowing a neurologist, internist, cardiologist, and radiologist in the Bay Area. I saw the hard work and sacrifice I had expected to see, but I also saw how much patience, compassion, and understanding—traits I had associated with the ministry—defined the healer's role. But it was only when I met Dr. Susan Cornelius, the Klongtuey Center's director, that I realized that choosing between the ministry and medicine was no choice at all—I could integrate both my Christianity and my desire to do more by becoming a doctor. A graduate of Scotland's most prestigious medical school, Dr. Cornelius had turned down lucrative jobs in the United Kingdom to come to rural Thailand and serve the leprosy center. She is now famous in Thailand as the brilliant doctor who runs a hospital for patients who can't afford even basic operations. Dr. Cornelius also began a policy of allowing one of the nurses to pray for patients before operations if they request it. (Christian or not, most patients do.) From Dr. Cornelius I learned that it was possible to practice a kind of medicine that treats the patients' emotional as well as physical needs. Under her I first realized that medicine is calling me and that I can handle its challenge.
"In oncology you lose 50 percent of your patients." That is the hard truth Dr. Aaron Rom has been making sure I understand ever since I began shadowing him in 2007. Which half of those "even" odds would the smiling elderly man before me experience I wondered, as Dr. Rom and I entered the Atlanta Health Center exam room last summer. His body ravaged by arthritis and more recently lymphoma, Charles removed his too-large red cap with its "Jesus Saves" logo and smiled beatifically as his wife and son leaned forward to hear Dr. Rom announce the CT results: after two years of treatment, Charles was in remission. The emotion that suddenly filled that small room was unlike anything I'd experienced before. Since high school, I have been following Dr. Rom between exam rooms, hospital rooms, and intensive care units watching, usually awestruck, as he mixes honesty, competence, and concern for patient comfort to help dozens of families like Charles's beat the oncologic odds. Though I have mostly observed, Dr. Rom has taken the time to teach and explain, even allowing me to listen to lungs or feel tumors whenever possible. My time with Dr. Rom has been the source of my certainty that medicine is the only profession I want to pursue.
Through my high school's health professions program, I was able to gain exposure to a different floor of Union Veterans Hospital each week. That was how in late June 2007 I found myself shadowing a pulmonary technician named Atul Reddy. Responding to an ER call one day, Atul hurriedly invited me to join him. We sprinted into Room B–16 just in time to see a doctor thrust a tube down a frail-looking patient's throat. The lifeless woman had already turned pale blue; the monitor's constant buzz announced she had lost her heartbeat. My adrenaline surging, I watched anxiously as the doctor, Atul, and two nurses tried to revive her. After what seemed an impossibly long time, the monitor's high shrill turned into rhythmic beeps—the woman was alive! Exhilarated and relieved, I had to swallow my disbelief at the medical team's miraculous repudiation of death. With everything on the line, they had never hesitated, lost focus, or displayed nervousness at the magnitude of their task. I was awestruck, humbled, and, above all, inspired.
As they made the rounds in Larimer County General's geriatrics ward, the way the doctors I shadowed presented themselves to patients varied widely. One elderly woman suffering from dementia threw baleful stares and some choice obscenities at anyone who entered her room. Each physician seemed to have a different approach to gaining her trust, but some were more effective than others. Then Dr. Cydney Platt strode into the room wearing a glowing smile and radiating easy competence. Addressing the woman as if the two had known each other for years, Dr. Platt effectively disarmed the old woman with some salty humor and then listened to every comment she made with an expression of intent interest and concern. Clearly overwhelmed by Dr. Platt's charisma, the woman's combativeness melted away, and she became the model patient, docilely answering every question and acceding to every instruction. Dr. Platt was just as effective with other patients. On morbid patients who acted as if their slightest symptom was a harbinger of death, Dr. Platt would focus a blinding congeniality and air of supreme confidence that left each patient firmly optimistic about his or her condition.
I watched fascinated as the doctors we were assigned to examined patients' lymph nodes and administered bone marrow tests to determine which stage their cancers had reached. Although most had already progressed to later stages, the doctors did what they could, assigning the patients who could benefit from it to chemotherapy or radiation treatment. Most of the time, however, the doctors I saw were only able to answer their patients' pleading looks with kind words and a sigh of frustration that they had waited so long to seek treatment. Despite the obvious differences between the United States and China, when I think about my month in Karamay, I am struck by the basic similarity of Chinese and American doctors. The sacrifices in time they have to make to become practicing physicians, their commitment to their professions and to giving care, their ability to resist feeling discouraged, and the power of hope they instill in their patients—these cut through all the differences.
My career interest in medicine grew out of visits to my family physician, Dr. Thomas Maag. He was always happy to answer my questions about medicine, and with his encouragement I began volunteering at a Boulder-area hospital during my senior year. Knowing I needed to get a better idea of what a physician's career is really like, this past December I asked Dr. Maag if I could shadow him at work. He agreed, and for two weeks I accompanied him on 16-hour days as he treated patients and dealt with the challenges of a family doctor's life. Dr. Maag took time to give me the scoop on medical school, HMOs, and the financial side of the physician's career. More importantly, in everything he did, Dr. Maag showed me the deep satisfaction he gains from his work. He also helped me come to terms with the real side of medicine—human suffering. With his help I have discovered firsthand that death is a difficult but natural part of a physician's world. Yet when Dr. Maag introduced me to a patient whose entire lower jaw had been destroyed by cancer, I found that, though I could handle the patient's shocking appearance, it was deeply disturbing for me to put myself in the patient's emotional place. Sensing my struggle, Dr. Maag helped me see that the personal philosophy I developed for dealing with my sister's car accident was exactly the attitude that would help me deal empathetically with patients' suffering: "There are some situations you can't do anything about," he told me, "but you can always control how you react to them."
I was floored. During a health-care convention late last year, a Boston physician admitted to me that my psychology professor at the University of Houston, Anthony Medin, just might have helped more people day to day then most of the doctors in Houston. Doing clinical work with patients in Houston hospitals in addition to his teaching, Dr. Medin helped them cope with the psychological effects of their illnesses. Watching him, I learned that when patients master their minds, they can help heal their bodies. He showed me how an understanding of patient depression and the mental stages of illness can help physicians provide treatment that is specific for each patient. To truly understand and treat patients fully, we must also be able to understand not only their physical illness but also their mental perception of themselves. This is the lesson I will always remember Dr. Medin for.
"Clear the hall!" the nurse shouted as he rushed Xavier, lying pulseless on a stretcher, down the hall to the OR. On only my first day shadowing Dr. Sid Muroda, I watched as a dramatic effort to save a patient's life unfolded. As nurses and clinical technicians prepared the room for Xavier 's emergency thoracic surgery, I heard someone shout, "He's been down for nearly three minutes." I looked over at Dr. Muroda, but he just waited calmly for Xavier to be brought to the table. As soon as Xavier was hooked up to the heart/lung machine, Dr. Muroda focused on his heart. As I stood transfixed nearby Dr. Muroda worked meticulously for the next seven hours, grafting coronary bypasses and replacing Xavier's malfunctioning left semilunar valve, which was riddled with calcium deposits. After he grafted the last vein, the moment of truth arrived. Would Xavier's heart beat on its own? For an interminable moment we all held our breaths for the answer. "Thu-thump." Miraculously, after seven hours, Xavier's heart began to beat independently again. When the surgery was over, the seriousness of Xavier's procedure was driven home to me when I accompanied Dr. Muroda to update Xavier's family. I could see the initial fear on their faces relax into relief as Dr. Muroda explained that Xavier had survived the surgery. But, he added, speaking gently but firmly, since Xavier was still in the coma that typically follows long surgeries, there was no way to know whether he had suffered brain damage. As his wife's eyes filled with tears, I learned my second lesson of that first day: being a physician not only requires the precise application of a vast amount of medical knowledge, but also the ability to compassionately handle the most painful interpersonal situations. Two days after Xavier's surgery he awoke from his coma with no apparent brain damage. When Dr. Muroda and I arrived in Xavier's room, he was sitting up wearing the kind of smile only a man who has cheated death can display. He shook Dr. Muroda's hand and simply said, "Thank you" while Xavier's family treated Dr. Muroda with a mixture of reverence and gratitude. I had spent only one day with Dr. Muroda, and I was already imagining myself as a physician.
I gained more clinical insights by shadowing Dr. Ralph Tehrani, a cardiologist, for three weeks in Nairobi, Kenya, in the winter of 2007. By observing him, I saw how doctors and patients interact, and I also witnessed the paradoxes of Kenya's health-care system. Dr. Tehrani's patients at Kenyatta National Hospital were the country's more affluent, but he also volunteered at a primary care clinic in Kibera, providing services to Nairobi's destitute. Although he was a specialist by training, he was able to generalize his knowledge because it enabled him to serve a larger segment of people in Kenya's health-care system. My experience shadowing Dr. Tehrani crystallized my motivation to become a doctor. As a physician, I also intend to find ways to provide my services to all segments of society, including those who need it most but can afford it least.
What truly fascinated me about Dr. Goldberg were the memories of Dr. Hashemian that he revived in me through the compassion and caring he showed his tobacco-addicted patients. Through words of reassurance and patient answers to every kind of question, he tried to make them aware of the harm they were inflicting on themselves, yet without ever sounding judgmental. In other words, Dr. Goldberg was not only trying to heal his patients' physical ailments but, like Dr. Hashemian, trying to educate them with kindness. I began to envision myself as a physician like Dr. Goldberg—a doctor not only of the physical heart but the emotional one as well.
Whatever misgivings I had about medicine after my father's death were dispelled during my internship at the cardiology department of Austrian Saint George Hospital in Istanbul, Turkey, earlier this year. As I followed Dr. Souroujon on his daily rounds, Mr. Demiray's bony body, covered with wires and tubes, always caught my eye. Mr. Demiray suffered from myocardial infarction and a failing respiratory system. He couldn't talk, but from the sound he made when he struggled to breathe and the look of defeat and hopelessness in his eyes, I could almost feel his pain. Several times, ready to give up, he resisted treatment, but Dr. Souroujon would speak to him patiently and encourage him to defeat the pain and trust in him. Dr. Souroujon never gave up. When Mr. Demiray left the intensive care unit two weeks later with his voice restored, he didn't say anything but, "sağ olun, doktora! [thank you, doctor]." Through his care and enthusiasm, Dr. Souroujon rejuvenated his patients, but he also revitalized my passion for the medical profession. He showed me that I can aspire to be a doctor who not only has a brain but a heart as well.
My interest in medicine has been profoundly affected by Dr. Patricia Capen. Before I met Dr. Capen, I was pursuing a medical career largely because I wanted to apply science in a "meaningful" way—though I wasn't quite sure I knew what that way was. Although I gleaned some insights into the profession from my father, it wasn't until I spent this past summer making rounds at the University of Minnesota Neurosurgery Clinic that I understood the real reason why Dr. Capen and my father had made such a commitment to medicine: they genuinely love what they do. I realized that I was no longer pursuing a career but a passion. And one reason why a physician's work doesn't seem like work is the gratitude patients show compassionate and competent doctors. I was inspired watching Dr. Capen, the brilliant and busy chairperson of the department, take the time to speak and listen to each patient as if there weren't another concern or person in the world. By showing patients this same attention and compassion, I can look forward to a medical career that's as enjoyable as it is fulfilling.
"Take that to the lab, and let me know what kind of tree it came from!" Dr. Young joked as he handed me a leaf that he had just pulled from the helmet of the motorcyclist lying on the gurney before us. In an instant, the trauma surgeon's jest relaxed everyone in the room, including the patient. I then knew with clarity what being a good doctor is all about.
My grandfather, Jarvis Kennedy, was a general practitioner who intuitively understood the connection between the psychological and physical realities of his patients' health. He practiced medicine in Deerfield, Illinois, for over 50 years and got to know each of his patients, watching many of them grow up and bring in their own children for treatment. Last year, I listened with fascination as a neighbor of my grandparents told me of the time my grandfather treated a child with acute appendicitis. To save the child's life, Dr. Kennedy had to operate in his own house with minimal equipment. To help the child understand the necessity of this painful surgery, my grandfather talked to him at length until he was emotionally prepared for the surgery. It was Dr. Kennedy's ability to understand the child's anxieties and perceptions, and not only his physical and mental abilities as a doctor, that saved that young boy's life. For the past three Decembers I have also shadowed Dr. Elizabeth Scanlon in her orthopedic surgery practice in Seattle, watching her do everything from casting broken ankles to operating on fractured hips. Her efficiency and medical knowledge and the positive regard her patients have for her deeply impressed me. But I truly understood her devotion when she spent the good part of a Sunday afternoon exhaustively explaining and showing me how to cast up a broken leg. This summer I will be spending time with physicians in Cleveland and Detroit to learn even more.