A Summer in the Shadows of Medicine

Hello dear readers!

Last summer marked my first in college not doing research. Wow! So what did I do last summer? I finished a two-month program as a student observer / volunteer at Einstein Medical Center in Philadelphia. It sounds like it could be pretty dull, right? I mean, all day I watched doctors do what they do at work. Zzzz. But it actually was incredibly fascinating and thought-provoking. Below, I hope to dismantle some of the vague ideas people have about being a physician and give three important insights that I made during my summer of shadowing!

A view down the hall of an emergency unit, just before patients started arriving.

#1 The daily life of a doctor requires huge mental and physical stamina.

Each physician has a different specialty that he or she has chosen – specialties include the more commonly known like surgery, family medicine,  anesthesiology, obstetrics/gynecology, to the lesser known like urology, nephrology, infectious disease, and pediatric endocrinology. At Einstein, a teaching hospital that includes residency programs for “resident doctors” (aka students who have graduated medical school but are still doctors-in-training until they’ve become officially licensed to become attending physicians), I shadowed physicians in four specialties: emergency medicine, cardiology, internal medicine, and radiology.

In the first month, I discovered that emergency doctors lead very odd hours even as attendings — they work about 7 hours a day, 4-5 times a week, but their shifts in any given week include daytime, nighttime, and weekend hours, making it hard to stick to a regular daily schedule. After talking to many of them, they said that they chose to work in the ER because of the constantly surprising nature of their work. Every day, they deal with someone / something different, and the need for spontaneous, on-the-spot judgment makes them like the “problem-solvers” of the hospital. The downside is that it makes for a stressful environment because a new patient is coming in every five minutes with a different illness, and you have to rack your brain for the correct information within a few seconds. Whereas ER doctors need to know a lot about every part of medicine to do the initial diagnosis, doctors in other specialties (like cardiology) need to know a huge amount of specific information in their one area of focus after the ER doctors have whisked the patient away to be consulted in another part of the hospital.

In contrast, the Cardiology Fellows (no not fellows, Fellows: doctors in a three-year fellowship program after residency to gain more training in a specialized field) whom I shadowed worked in various parts of medicine too, but all their work was related to diseases of the heart. Some of them were responsible for analyzing the results of echocardiograms (ultrasounds of the heart) and some performed cardiac catheterizations in the “cath lab” which help visualize arteries around the heart, both of which ultimately help diagnose whether patients have cardiovascular conditions. During procedures in the cath lab, physicians have to don very heavy lead vests to protect themselves from the x-rays being used to visualize the patient’s blood vessels. For more extensive heart surgeries in the operating room, physicians might need to stand for 8-9 hours without breaks for sitting, eating, or going to the bathroom. Talk about physical stamina and endurance.

In terms of tangible knowledge, I learned about all kinds of medical conditions: acute and chronic, mild and severe, complex and simple. I also learned about the daily routines of medical work: taking patient histories, looking at medical records, dictating findings from physical examinations, discussing with supervisors, and prescribing appropriate medication and care for health improvement. In addition, I gained some pretty important insights (#2 and #3 below) that I would otherwise not have realized had I not spent eight weeks with medical professionals.

A page from my medical textbook while I studied abroad in Copenhagen, Denmark.

#2 The patient population heavily dictates the type of work a doctor does.

What I mean by “patient population” is the demographics of the patients that you serve. The patients at Einstein were radically different from the patients whom I saw at the Children’s Hospital of Philadelphia, where I volunteered in the spring semester. Unfortunately, the patients who generally came to Einstein were from tough neighborhoods around North Philadelphia and many had little access to primary care doctors (like the family doctors that you see for check-ups), and depended on the hospital network to help them through their illnesses. Thus, a lot of the work for doctors at Einstein included educating the patient about their conditions and helping patients find a social environment that would help them recover best, whether that was a nursing home or a substance-rehabilitation clinic. I have a lot of admiration for the physicians who work at Einstein, because though at times the patients they took care of may have been rude or irresponsible, the physicians continued to be calm and helpful every step of the way. It’s easy to do your job when your patients are sweet, appreciative people, but true compassion stands out when your job and patients are difficult.

Einstein medical publications
A few medical journals found while exploring the library at Einstein.

#3 Perhaps most importantly: You don’t need to be pre-med in college to become a doctor.

“Pshhhh Iris, you’re crazy. I need to do X and Y now and get Z and Q done before I graduate.” Well, no. One of the best parts in my experience at Einstein was that I was exposed to a huge, diverse group of people who were interested in medicine. That group of people included third-year medical students from nearby schools who were on their clinical rotations, first-year interns who were only one day into their residencies, nurses, ultrasound technicians, physician assistants, chief medical officers, etc. The most valuable thing that I took away from talking to these people was not the anatomical or physiological science behind the various diseases that they were treating, but instead the reason(s) that they decided to do the profession that they were doing.

Though a sizable percentage of people was decidedly “pre-medicine” in their college years, a sizable percentage also studied something totally different and did not make the decision to pursue medicine until years after they had graduated. I met a medical student who studied psychology and worked in research for six years until she decided that she truly wanted to become a physician. It was then that she took her required pre-med courses and her MCAT, meaning she took eight years between the time she finished undergrad to the time she started medical school. I met an attending physician who worked in the pharmaceutical industry for four years before deciding to switch to medicine. I even met a Swat alum from the Class of 2012 who worked as a research analyst in public health and policy for two years before enrolling in medical school.

Essentially, there is no need to rush to whichever profession you’re thinking of pursuing, whether it’s medicine or something entirely different. Dip your toes into the wide pool of interesting courses and extracurriculars that exist at Swarthmore. Enjoy the turtle-like slowness instead of racing to the future, just like the old Aesop fable. The people whom I talked to this summer reminded me that it is more important to live each moment in the present than to worry about the future.

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