Final Thoughts – Ariel Lee

It’s been a few weeks since I left Beth Israel Deaconess Medical Center and said goodbye to Colorectal surgeon Dr. Cataldo. I am still reeling over how incredible this experience has been and how much personal growth I have achieved throughout the eight weeks of the program. This experience has far exceeded any expectations I had going into shadowing. Before starting the program, I had set a few goals for myself to, including: to develop good relations with Dr. Cataldo and all of the hospital staff, and apply skills and knowledge from my college courses to my observations in the clinic and OR, etc.

Now that this program has ended, I can safely say that I have achieved all of these goals and so much more. The most surprising discovery I’ve made in my experience has been the contrast between the cold, formal atmosphere I expected in the hospital and the actual warmth and relaxed environment of the hospital. Everyone I met, from the OR nurses and nurse practitioners to the surgeons, was very gracious and had a genuine heart for their patients.

This shadowing experience has without a doubt been the apex of my pre-med career, and has only solidified my passion to pursue my own career in health care as a physician. Seeing Dr. Cataldo in practice has given me invaluable insight into the real life of a doctor; and after spending so much time with him, I can confidently say that I have a clear understanding of the life of a doctor and therefore the confidence to pursue this path.

If another pre-med student were to ask me for advice about shadowing at Beth Israel, I would advise him/her to look on the BIDMC website to look up the contact information of the physicians/specialties they would like to shadow. After collecting this information, they should draft a (short!) polite and formal email (personalized, would be best) to send to each of the doctors asking for a shadowing opportunity (be sure to specify dates, times of availability). I would say that most doctors are more willing than one would assume to allow a pre-med student to shadow them because they have been there themselves and therefore understand the importance of shadowing. This advice would apply to any position in healthcare that a student is interesting in shadowing.

I would say that my proudest accomplishment this summer has been putting myself out there and making the most of this incredible opportunity to shadow Dr. Cataldo. I must admit that early in the experience, I was very nervous and shy and worried that I would ask a dumb question or draw unwanted attention from the hospital staff. But as the weeks wore on, I was truly able to come out of my shell and ask relevant questions to learn as much as possible from Dr. Cataldo. I also began to feel a lot more comfortable around the hospital staff and (often intimidating) surgeons. I even met a few Harvard medical students who surprised me by how humble and willing to offer advice they were. By the end of the eight weeks, I truly felt like a member of the Colorectal family and was sad to say goodbye.

I would like to say a huge thank you to the Brandeis pre-med advisors for setting up this program for Brandeis pre-med students and for placing their trust in me to represent Brandeis at BIDMC this summer. It truly means so much to all of us and will be an unforgettable experience for the rest of my life. I would also like to thank Dr. Cataldo and the rest of the BIDMC staff I had the pleasure of meeting this summer for welcoming me with open arms and giving me the best experience I could ask for!

Ariel Lee – Beth Israel Deaconess Medical Center

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Final Thoughts

This program completely exceeded my expectations. I went into the program unsure if I even wanted to pursue health care, but I came out of it really motivated to continue on the pre-health track. After going into the operating room and seeing what work the doctor must do, it was really invigorating, and it made me want to leave the same impact on others by doing the same thing. I sat in on the removal of part of the colon, an appendix, a HUGE hernia (she waited 13 years before getting it removed), and a gallbladder. I thought that I would be fainting left and right at the hospital before actually going in, but after being put in scrubs (and placed a bit of distance away from the action), I kept wanting to get closer to see what was going on. No other thoughts were floating in my head besides wanting to see more.

For those wanting to shadow Dr. Sardinha from Northwell Health, I highly suggest it! The organization is very open, the staff keep things entertaining even if you’re just standing for eight or more hours, and you really do experience new sights and smells. I hope to shadow more in the future, hopefully in other fields. Following a colorectal doctor is kind of jarring at first, since it’s such a private area, so you’ll definitely experience many new things.

I’m most proud of figuring out my direction for my remaining three years at Brandeis. Before shadowing, I didn’t even know if I was going to stay in the pre-health track, but after going through shadowing, I do plan on staying on the pre-health track, and hopefully get into med school to become a doctor or physician’s assistant. It feels great to finally have a goal for the future.

~ Alice G. – North Shore Long Island Jewish Medical Center

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Final Thoughts

Pictured above is Trevor Lee with Dr. Yosef Nasseri of The Surgery Group of Los Angeles.

This experience definitely exceeded my expectations! While I was not able to shadow most of the procedures due to restricted hospital privileges, I learned about the culture of a private practice. At my office, each staff member is assigned specific duties, and we needed to clearly communicate with each other. For instance, if there were patients waiting in the lobby, the front desk receptionist needed to inform the medical assistants to room them.

This experience helped me to better understand careers in the medical field and what type of work that I might be interested in. Before shadowing, I thought that the staff in the operating room consisted mainly of surgeons. For more minor procedures, there were only a few doctors — (sometimes) the anesthesiologist and one or two surgeons (the second assisting the main one). There were a lot of nurses and a few surgical technicians that floated in the room because much preparation is required before and after the procedure. Even if you decide to not become a surgeon, you can still largely observe and understand these surgeries and procedures. My colorectal surgeon jokingly asked for a nurse in the room to watch the colonoscopy screens for polyps due to her sharp eyes, and she did point out a polyp! No role in the medical field, especially in the OR, is unimportant.

In terms of specific work, I would like to explore the realm of primary care. Surgeons certainly see patients in the office, and although that sort of work may not be as intriguing or challenging as surgery, it is essential. Furthermore, surgeons’ schedules can be overly demanding (let alone any doctor!), and I’m not sure if those specialties would be the right fit for me as a future doctor.

For a student interested in shadowing, I would encourage them to take risks. If you don’t understand a procedure, read about it and ask your doctor questions. You can even ask the staff as well since they likely know how to answer them. In my host organization, ask for responsibilities! Interact with everyone (unless they’re occupied and the conditions certainly are inappropriate) and develop relationships, even if they might not “benefit” you in terms of landing another internship. At SGLA, everyone is very friendly and patient.

I’m most proud of all the relationships that I’ve built both in the medical field and outside! Aside from the skills and knowledge that you acquire, you develop bonds with others that you can hopefully cherish onward.

 

Trevor Lee – The Surgery Group of Los Angeles

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Final Thoughts (Taisha)

I decided that I wanted to become a doctor very early in life, even before I knew what that truly entailed. I believe it was after I read one of my father’s medical encyclopedias during a moment of boredom. Over the years, as I matured and gained more knowledge in science, that desire to become a doctor was strengthened by my growing love for science yet I still had no idea why exactly I wanted to go into medicine. Then, the unthinkable occurred in my life. A normal Tuesday afternoon was turned into one of the darkest, if not the darkest day of my existence. My country experienced a tragedy that left many dead, including people who were very dear to me. I witnessed people suffer, die, and become mutilated because of a severe shortage of medical professionals in my country. I knew then beyond the shadow of a doubt why I wanted to become a doctor.

While the tragic losses that I have witnessed made me more resolved to pursue medicine, I still only had a very generic idea of what being a physician is like. In my mind, I imagined only the medicine aspect of it and saving lives. What I learned this summer, is that being a doctor goes far beyond science and the desire to save lives, it requires empathy and tolerance. I am a very reserved person and am often reluctant to show emotions, therefore learning how to take down some of the walls around me in order to understand the patients was no easy task and I am still learning to do so. This summer, I started out the Brandeis Summer Shadowing Program mostly expecting to learn about medicine, which I did, but I also learned the intricacies of the profession that I chose to purse all these years ago on a whim.

-Taisha Joseph – Cambridge Health Alliance

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Midway Point (Taisha)

While I anticipated that I would feel somewhat nervous on my first day of shadowing, I had thought that my previous shadowing experience would help ease me into this new shadowing position. That was not the case because though it has been only three years since the last time I did this, it feels like a lifetime away. As a senior in high school, shadowing on the surgical floor at the Whidden, I was sheltered and guided in everything that I did. Our instructor who arranged the shadowing experience for us gave us strict instructions on what to do. This shadowing experience turned out to be different in that I was given more freedom to do what I wanted to do. I had thought that I would be only shadowing Dr. Sheth during the summer, but I actually had the opportunity to shadow many surgeons in various specialties. While I have mostly shadowed general surgeons, I have also had exposure to urology, vascular surgery, podiatry, ENT (ear, nose and throat), gynecology, and even orthopedics. Furthermore, because of my interest in neuroscience, I also had the opportunity to shadow a neurologist.

As I progressed further into this shadowing program, I continued to compare it to my experience three years ago. As I mentioned before, my previous shadowing experience was very sheltered since it was a high school program. I did not have the liberty to decide which specialty I wanted to see and I was not able to observe the surgeons directly in the operating room. This summer, I not only was able to meet many patients and observe various unique cases, I was also able to observe many surgeries, some of which were routine surgeries, others were more complicated and interesting. The first surgery that I saw was two weeks after I started, during my OR orientation when one of the PA’s was teaching the do’s and don’ts when I am in the OR. While she was showing me around the operating rooms, one of the surgeons that I have shadowed before during clinic allowed me to stay and watch a laparoscopic appendectomy. Although this was a very routine procedure for everyone else, it was the first surgery that I had observed and the experience greatly strengthened my resolve to go into the surgical field in the future. The most interesting surgery that I watched during my shadowing experience this summer was a laparoscopic Nissen fundoplication, a surgery done to treat GERD. It was performed by Dr. Fellinger in the CHA Everett Hospital. The way the surgery works is by repairing the mechanical dysfunctions around the lower esophageal sphincter that cause GERD symptoms. First, she closed a hole between the diaphragm and the stomach, then she did what she explained as a “hotdog in a bun” procedure in which she essentially wrapped the stomach around the esophagus. It was a relatively long surgery but it was very interesting to watch. I have already learned much from this experience and as I continue to shadow surgeons of different specialties, I am becoming not only more interested in medicine, but I am also realizing that there are many specialties that I would love to do besides neurology which had been my first choice going in.

-Taisha Joseph – Cambridge Health Alliance

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Midway Point

MGH has been an incredibly fulfilling experience. While my experience is focused on the clinical research aspect in colorectal surgery and pelvic floor disorders, I was lucky enough to have my first day be spent shadowing in the OR with Dr. Bordeianou. I was worried that I would feel lightheaded like I did the last time I had shadowed. I felt that I knew what I had to do – put scrubs on, enter the OR, don’t touch the blue sterile area, try not to faint, don’t be a bother – but I was pleasantly surprised when the circulating nurse gave a brief orientation and everyone in the room quickly introduced themselves before returning to the patient. I felt comfortable and was happy to have another undergraduate student shadowing with me in the same room. While the patient was prioritized first, everyone made an effort to make sure that this shadowing experience was a positive learning one too. At one point, an attending radiologist and her team of residents came in to set the equipment up for intraoperative radiation therapy for the patient. The operating room was filled with about 15 people, and every single one of them was doing something, whether it was positioning the patient, clearing the area off, or closing the doors. It was amazing to see this teamwork in action, and it goes to show that healthcare is not a one person job.

Shadowing was a great start to my experience at MGH, but the real duties were focused on the clinical research. Lieba would explain the gist of the project and tell me what exactly had to be done – enter the past 2 years of patient survey responses into the RedCap databases, confirm procedures and diagnoses were done using patient chart records, or prepare and mail out surveys and letters. I was involved in every aspect of the data collection, and while it was mostly grunt work, it showed research at its finest. Research – laboratory or clinical – takes time, and it’s not always time interestingly spent. Because Lieba was always seeing patients, I was fortunate to be able to ask Linda, Lieba’s secretary, or Caitlin, the clinical research manager who sits next to me for help or clarification. There is a lot of independent work, but there is plenty of guidance to ensure that I’m doing things correctly. I’m amazed by how involved the surgeons are in clinical research – they are able to manage and prioritize their work, so that no day is ever really the same and what needs to get done is done. There is no room for procrastination or even time to waste. Every second makes a difference. So far, this experience has been positive and rewarding, and it has reaffirmed that the healthcare field is where I want to be after graduation.

Sherry Chen – Massachusetts General Hospital (MGH)

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Midway Point

The first day of shadowing didn’t happen too long ago, but after that first day, I felt pretty put off. The doctor that I’m shadowing is a colorectal doctor, so there wasn’t much I could do to prepare myself for what I was going to see that first day. They jumped right into having me follow them around, without needing to sit around and do paperwork for them or anything, which was pretty exciting. I was pretty surprised by how open the patients were since it’s an extremely private area that the patients come here for. Most of the time, there wasn’t much when it came to bodily fluids, besides occasionally smelling the stool when they emptied out coloscopy bags, but for the final patient, they decided to cut open an infection and sew it back close, and that’s what really put me off. I knew I was kind of weak to blood before, but seeing that much really startled me. Thankfully, no fainting occurred, but that was probably the weakest I felt in a while. I remember going home and not feeling the appetite or energy to do anything.

The second day of shadowing came and it was a lot better. We got to sit in on colonoscopies, and at first I was a bit nervous, thinking about watching the tube disappear into someone and examine their insides, but when I finally saw it happening, it was actually pretty incredible. The doctor even described it as “playing video games”, which didn’t sound too inaccurate, seeing the device used to control the camera. Each colonoscopy was cooler than the last, seeing the doctor remove polyps was really interesting.

As the time went on, I started to really realize how much work doctors truly needed to do. Don’t get me wrong, I always knew it was a big job, but I didn’t know just how much was done. In their offices, there was always leftover paperwork needed to be done and calls to other doctors needed to be made. They didn’t just focus on their own field, they needed to analyze test results from other doctors, call and make sure medications were correct, and much more. In university, I just needed to focus on whatever I was learning, but doctors need to check everything for their patients’ safety, it was pretty incredible.

By shadowing and following the doctors, I’m learning about how I need to properly interact with others to build good relationships, not only for friendship’s sake or anything, but also for the sake of their lives. I also realized how much more focused I need to be in everything. If they’re distracted for one second, they begin falling behind schedule or falling behind more paperwork. I’ve definitely learned a lot more on etiquette in studying and learning.

Next week, I’ll be allowed to actually join them in the operating room, which I’m pretty excited and extremely nervous about, seeing how my adverse reaction to blood was on the first day, I can’t really imagine how bad I would be in the future.

All in all, I’ve become more firm on my decision to join the health field, which is what I wanted to achieve with this program, which is great. Hopefully after visiting the operating room, I can see what I want to do specifically.

~ Alice G. – North Shore Long Island Jewish Medical Center

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Final Thoughts

After four weeks in Philadelphia I returned to my home in the New York suburbs, where every house looks similar, if not in some spans completely identical, where the streets are wide and the sidewalks narrow, and where green is the prominent color in an unwavering day-to-day routine of keeping my mind stimulated amid the lack of fresh scenery to explore. At least, this is what the New York suburbs have become after my recent time spent in Philadelphia. Before I dive into the “scrubs-withdrawal,” that hit me soon after my final day in the hospital, I’d like to address my “Philadelphia withdrawal,” which I only recently uncovered, hidden in the mask of suburban boredom. As much as I’d like to say I became a true “city girl,” that was never who I was, nor who I believe I was destined to transform into. The environment of Philadelphia was unmarked territory for me, it was different and scary, and though I had come to know Boston and New York City fairly well from my time visiting, Philadelphia was never the city I saw myself conquering. My brother, the UPenn student, is a three-going-on-four-year Philadelphia resident. Philadelphia was his city, and a place I never dared visit long enough to explore. Now, however, I find myself missing the trek back to 40th from Thomas Jefferson University Hospital at 10th. I’d walk through the residential areas with the imperfect alleyways and winding cobblestone streets that use to seem like such uncertain paths, such dangerous places to walk when extensively researched on Google Maps. I found coffee shops, I found restaurants, I found parks and benches and people so different when compared to the town I come from. Although I was well-educated in the expansive areas that the topic “diversity” included–my high school made sure we all were–I suddenly was a part of that diversity. I wasn’t looking at it through glass, who I was and the ideas I had were suddenly part of a greater community in which not two people, not two parks, not two houses were similar, let alone identical. Returning home I was greeted by family, friends, and a full fridge, but once I was here, I found myself missing being a part of Philadelphia’s world. There I found a certain confidence in myself and in the world around me that I hadn’t noticed before.

This confidence grew not only from being part of the city itself, but from shadowing Dr. Isenberg in the operating room and the office. In the operating room, I knew the least out of everyone around me. I was the only person who could have walked out and nothing would have changed. Due to this, not everyone was keen on filling me in. During the first week I would find my corner in the OR, some place where I wouldn’t be in anyone’s way and I could still (sort of) see what was going on. Most of the surgeries were laparoscopic, so I was able to watch on a screen, but that did not mean I knew at all what the objective of the surgery was. If I asked, I might be told that they were performing a “Laparoscopic Low Anterior Resection with a Colostomy.” Now I understand what that means, but in my starting week, I was clueless. Asking someone to explain what all that meant seems simple enough, but I had to muster up all my courage, shuffle–my scrubs were a size too big–over to a nurse, or resident, and say “I’m sorry to interrupt, but I have a quick question, would you be able answer it?” If they were called by the doctor, it was a failed mission, if they said “no” or were too busy, I would quickly abort and apologise. If they said, yes, however, I would need to proceed with: “What is going on?” Not exactly the “quick question” they had in mind, but making it this far, they would kindly explain to me what it all meant. In my head it seemed so slim a chance they would have time to explain, but in reality I just needed to learn 1) who would best be able to answer my question, 2) the right time to ask, and 3) how to best phrase my questions. Quickly I caught on, and soon, without hesitation, I would ask questions, and hold conversation with the nurses, the anesthesiologists, the medical students, and even the doctors in the OR. Once I was even able to explain what a “Colectomy with a J-Pouch and a temporary Ileostomy” entailed to another visiting college student. As I learned more, my questions became more complex and specific. By the end I was confident enough to guess a patient’s diagnosis. When two different surgeries were going on, I understood enough of each to choose which one I wanted to observe.

Now it seems I’ve come to the topic of “scrubs withdrawal.” “Scrubs” in this case stands for “the feeling of wearing scrubs inside and outside of the hospital where many others are also wearing scrubs, and of knowing that you are, in fact, part of a medical community.” I miss that feeling tremendously. I don’t think that I could explain how incredible my experience was. People ask me if I liked it, and I respond with “I loved it,” but they hardly ask for more. Even if they did, how would I explain to them that this experience changed my outlook on medicine, that this experience showed me what being a doctor was like, what it was about, that I was able to observe something so remarkable, something that saved people’s lives, that I was, for a brief moment, part of these doctors and nurses lives just as they are so briefly part of their patients lives. I had never been witness to something as important as this. As human beings, I believe that we all feel confined to insignificant activities and actions. In the OR, however, I was part of something so impactful, so simply biological, yet so impactful on that patient’s life. In the midst of blue scrubs and white coats and masks with “fog guards” that only lasted a minute, I didn’t realize how much I wanted this to be my future. I didn’t realize that someday I might play an active role in what I could only watch and be in awe of now.

-Rachel Saunders, Thomas Jefferson University Hospital

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Midway Point

This new environment was definitely much different than I had anticipated it to be. My surgeons conduct their pre and post op visits in their clinic (and surgeries at outpatient centers, or in nearby hospitals like Cedars-Sinai), and from day one, the pace varied each day and even hour. Even if there was a large influx of patients, the staff maintained a calm yet efficient composure throughout their shift. Moreover, their easygoing and patient personalities were important because they could easily connect with their patients and provide quality care. For the surgeries and operations, the surgeons and nurses still remained lighthearted and organized, even if a few errors occurred in the operating room.

Out of the workplace, I definitely needed some time and planning to adjust with the transition. For instance, the bus schedule isn’t always reliable, and there are a few buses that vary in terms of frequency and speed. Thankfully, I spend a chunk of my weekends with my church and friends, and being with them has helped me settle in more smoothly.

The medical field differs from university and academic life in terms of busyness. In reality, surgeons are constantly managing their busy schedules, often answering calls and working back at home and on the weekends. They might even call other doctors in their cars and likely will work on something whenever there is free time. At least in university, it is not overly difficult to schedule fun activities with friends and walk around. However, one of my surgeons reminded me to not take my time for granted and to truly explore the nearby LA area (as he often talks about places with his patients, not just medicine and procedures).

One of the biggest skills that I am building is productiveness, which is generally transferable to any area of my life. Since the surgeons are often thinking about patients’ cases, they might forget that you’re present and to bring you into the next room. This is one small scenario out of many others. You need to constantly communicate with others and be ready to shift gears. Moreover, it is important to be comfortable with those around you. Even if you think that you might be overstepping boundaries, it is OK to make mistakes by taking risks; aside from using common sense (like not touching equipment), the staff will emphasize certain rules (avoiding blue draped areas in the OR, closing the exam room doors, etc.). You might not know the exact protocol and have numerous unanswered questions, but that should not deter you from chatting with patients or moving closer in the procedure to see the targeted area.

Overall, my shadowing experience, so far, has definitely confirmed my interests and involvement in medicine.

–Trevor Lee, The Surgery Group of Los Angeles

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Midway Point – Ariel Lee

Today marks my fourth week of shadowing Dr. Cataldo in the Colo-Rectal Surgery department. It amazes me that I have already spent over eighty hours in the OR and clinic, and also that I oddly feel at ease with observing surgeries and seeing patients firsthand.

On my first day of shadowing, I recall being awestruck by the environment of the operating room, when I first step foot into the OR. After overcoming the initial shock of seeing a patient being operated on before my eyes with the internal organs clearly in view, I quickly acclimated to my new surroundings and even began to feel at home in the hospital environment. What surprised me the most has been observing all of the moving parts in the hospital—just within a single OR room, there are anesthesiologists, the attending surgeon (Dr. Cataldo), assisting residents, medical students, scrub techs on hand, and OR nurses all working together to ensure maximum efficiency and the best care for the patient undergoing operation. I have heard horror stories in the past of patients being treated without respect when under anesthesia, but to my pleasant surprise, I have only seen the patient being treated with utmost respect even while unconscious on the operating table.

Being in the hospital has definitely been a vastly different experience from campus life. Although one may argue that there are many similarities between the two—including high levels of stress and the constant need to learn and grasp new information, the medical field as a whole is a very different institution. For one, as I mentioned earlier—it consists of countless healthcare providers who work in unison and highly value communication in order to achieve the best care for their patients. In the hospital, the patient is always first priority—and doctors and nurses are always making absolute sure that the best care is being provided. Of course, at a renowned institution like Beth Israel Deaconess Medical Center, one would expect no less.

In the short span of time that I have shadowed Dr. Cataldo, I have been surprised by how much information I have learned by simply observing and asking an occasional question. I have learned so much about the difference between a hemorrhoid and a fistula—common misconceptions about hemorrhoids (such as that they are a completely natural part of human anatomy), as well as what laparoscopic surgery is and the benefits of laparoscopy over open surgery. Shadowing so far has taught me to be more inquisitive and observant as a student in order to get as much out of the experience as possible. I believe that more than the technical information I have learned; I have begun to truly understand what it means to be a doctor and healthcare practitioner. As Dr. Cataldo always says, a good doctor/surgeon always puts the patient before all else. This means spending extra time on the phone with patients to follow-up with them and answer any of their questions. It also means taking the time to explain all of the surgical and nonsurgical options for treatment to patients and their families in the clinic. Even though I am only four weeks into the experience, already I have learned so much about this medical field that I have chosen to make a career in, must say that shadowing has only bolstered my resolve to become a doctor myself one day.

Ariel Lee — Beth Israel Deaconess Medical Center

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