This past week, our esteemed colleague Linda Wilson, WVCOM Class of 2007 came to the Veteran’s Hospital in Salem, Virginia for a visit and shadowing experience. Dr. Wayne Wilson, the chief of Surgery was delighted to have another medical student for teaching rounds and clinical duties. He had cleared her visit with the chief of staff who was happy to have her visit.
When Linda arrived, I was covering the clinic for Dr. Choudhury, who is one of our vascular surgeons. The UVa medical students were busy seeing patients and taking care of their clinic needs. When Linda arrived, they dragged her along to see patients and participate in their care. Dr. Wilson explained radiographic studies and even took Linda alone for an exam on a patient. After clinic, she accompanied us on evening rounds and was invited by our chief resident, Dr Joshua Rovin, for mandatory evening Physical Education rounds in the gym. Linda and I popped in for a couple of minutes but opted for some R & R in my quarters.
She accompanied us (the residents) to Mack and Bob’s, a distinguished Salem, Va eating establishment for dinner and some discussion about medicine and careers. After dinner, we collapsed in bed to get ready for Thursday teaching days. On Thursdays, we do not operate but spend the day in teaching rounds with all of the attending physicians. After teaching rounds we participated in Mortalitiy and Morbidity conference where we discussed out treatment and pathology reports for the patients that we had seen on service in the previous week.
After M & M and teaching conference, we headed over to the Canteen for lunch and then to the long-term care building for wound rounds. Linda helped me draw blood on a patient that I would be placing a Perma-Cath for dialysis the next day. We finished with wound rounds quickly and found that Dr. Wilson, had obtained a skybox for the whole team at Thursday night’s Salem Avalanche baseball game with the Winston-Salem Warthogs. He had even thrown in catered food. Linda spent the afternoon listening to a trauma lecture.
We hung out back at my crib for about an hour or two and then headed over to the Salem Avalanche field. The Avalanche is our minor league baseball team. The entire surgery department came to this event. We were recognized as a group (The VA Hospital Department of Surgery) on the big scoreboard marquee. The evening was a total blast. We had beer, hotdogs, burgers, slaw, potato salad and soft drinks. Linda made a very special friend at the affair. (I will let her tell you from her standpoint).
The Avalanche won in extra innings and we headed back to the crib for some sleep. I was on-call and got a 2am wake-up from a nurse who didn’t know that an order had been discontinued. She didn’t read the chart.
The next day, Linda accompanied the surgery team on morning rounds and then helped me with consults. We pulled a chest tube and did a work-up on a patient who had a very large tumor. After that, Linda came into the OR to observe my Perma-Cath insertion. (I will leave it up to her to describe her experience).
To Linda: Alfa says “hi” and hopes that spending a day with the team doesn’t scare her away from medical school.
It was a blast having Linda and I hope that she had a good experience. We certainly enjoyed having her.
To other pre-med folks, we have a shadowing experience (at University of Virginia) that is up for bids. You will have a chance to spend a great deal of time with a nationally famous pediatric surgeon, Dr. Eugene McGahren, III. You will shadow him in clinic and in the OR. He give great career advice and can assist you in your application as he has been involved in the admissions process that the University of Virginia School of Medicine. You will get a chance to see some cutting edge pediatric surgery procedures. You will also get a chance to participate in Grand Rounds with the entire surgery department. Here you will meet two past presidents of the American College of Surgeons and several authors of book chapters in Sabiston’s. You will also meet the author of the most popular textbook on Cardiothoracic and Vascular surgery, Dr. Irving Kron who is our department chairman. (Think of the high powered letters potential here folks!) You will have accomodations at my apartment in Forest Lakes just outside Charlottesville (complete with an six-computer network that is linked to UVa library and radiology department) complete with miles of jogging trails, a lake, any food that you can heat in the microwave (I don’t cook these days), gormet coffee, a 24-hour fitness center complete with Jacuzzi and lots of beagle dog-love as my two beagles can’t have anyone in the house without making sure that they feel welcome.
Wow… that sounds like an awesome experience.
First of all, let me say thank you to Natalie for arranging with Dr. Wilson and the surgery team to allow me to shadow and for letting me stay with her. Staying at Nat’s place was a lot of fun. She has a great collection of CD’s, with which we managed to annoy her upstairs neighbor a time or two! And, my meals were mostly covered with either her meal tickets or those of students who had already gone back to Charlottesville for another rotation. Let me tell you, there is absolutely no reason to go hungry!
Second, let me say that ‘awesome’ just doesn’t begin to describe the total experience I had while there! And a great deal of that is due to how Natalie, Josh, and Dr. Wilson all made me feel totally at home and comfortable.
Third, I would have posted this sooner, but I got home last night to discover a violent storm had left us without electricity. We got it back late last night, and I should have gotten up right then, but somehow it felt good just to relax and talk with my family about my week.
So okay, what did I do? Well the very first day, during clinic, I was able to feel an aneurysm. Yep! The med student showed me where to press on the gentleman’s abdomen and you could actually feel the weakening in the wall of the artery. A pretty good sized aneurysm at that!
Later, with Dr. Wilson, I was able to assist him as he examined a patient, and he was absolutely wonderful about explaining what I was seeing as he did the exam. He is a great teacher, and several times I would catch a minute alone with him and ask questions, which he never hesitated to answer and explain to me.
Making rounds each morning and evening with the doctors and med students is both interesting and educational. Seeing how the med students have studied their assigned patients, watching how they work with the residents, and following the continued care of these patients was a great insight into how the educational system works.
Wednesday evening, with Natalie, Josh (chief resident and a very interesting person), and Megan (a second-year resident and a lot of fun), I felt very comfortable as we ate a really great dinner at Mack and Bob’s. As we sat around talking about medicine and, particularly, surgery, I found that I did not feel insecure or out of place at all. And I had fun! Listening to stories from their own experiences was really the epitome of how to have a great evening out with friends and colleagues!
Teaching rounds Thursday were astounding. As the three attendings asked questions of the med students about each patient and his condition, diagnosis, treatment, physiology. . . the whole shebang. . . I was amazed at how these 3rd year students were able to readily answer. And, if something came up that they didn’t know, the attendings would help them out. And you know how sometimes you hear the horror stories of how they make you feel really stupid? Well that never occurred. The doctors worked together like a well-oiled machine. It was fantastic to see and feel a part of!
Then after lunch, going with Nat to draw blood was fun. This coming from a former med tech who thought I could draw blood from anybody, given enough time. I mean, after all, the IV teams used to call me to start their IV’s when they had trouble. However this gentleman had been so ill with end stage renal disease for so long, his veins have been used to the point where finding one to draw from was extremely difficult. But I watched as Nat found it, drew the blood with one quick stick, and on we went. Amazing!
Trauma lecture was fun. I had spent part of the evening before studying a book Nat had loaned me (Mont Reid on Surgical . . . ), which had a whole section on trauma. So, as Josh ‘pimped’ the med students I was excited to see that I had learned enough from that little book to know that I could handle part of the questions with no hesitation at all. It feels great to know that I will be able to handle the ‘pimping’!
The baseball game was great fun! There were all of the med students, the four surgical residents, several attendings, and a few wifes, friends, etc. Dr. Wilson had reserved a covered special deck area right behind home plate! And he supplied all the food, which was really good! Everyone sat around, cheered the team, laughed and had a good time. But the highlight of my evening wasn’t the run in the bottom of the tenth that gave Salem the win, but rather the time I spent with one of the attending’s (Nat, I don’t remember his name. Can you help me here?), daughters. Three years old and a bundle of energy and personality. We played all kinds of little games. . . . you know bouncing on my knees, helping her jump from her seat over the back of the seats in front, eating ice cream dots. . . . why, she even went to the ladies’ room with me instead of her mom! And on the way back, we ran into the team mascot, Mugsley! She was so excited as she hugged this great big floppy eared dog suit and shared high fives with his big paws (uh, hands?). Lydia was quite the little charmer!
So back to Nat’s place for a little rest, and then up and off to the VA. The perma-cath insertion Nat talked about was fascinating. This same gentleman that she had drawn the blood from on Thursday had removed the femoral line put in for dialysis, so a perma-cath was going to be inserted into the internal jugular vein. Nat very carefully located all the landmarks that would tell you where it is, but no matter how she inserted the catheter, it just wouldn’t go. So the attending, Dr. Ledesma (spelling, Nat?), decided to give it a try. After about five or so attempts, they decided to go for the subclavian instead. So Natalie was able to get the catheter in, but as she tried to thread it through, it kept bending back on itself. Again, in steps Dr. Ledesma to give it a try, and the same thing happened. So, at this point they did a cutdown. The internal jugular vein, which usually sits next to the carotid artery, was hiding! It was so far posterior and lateral from where it was expected that it took a while to locate it. When they did, Natalie and Dr. Ledesma let me see just what they had found, and Natalie then proceeded to insert the perma-cath. Actually seeing the open neck, with the musculature, tendons, ligaments, and blood vessels was unbelievable! Great job, Nat!! Anyway, from what I understand, the procedure usually takes about 30 minutes, but this time it was almost 2 1/2 hours long!
To Natalie: Please give Alfa my best! He is going to make a great doctor one day! And tell Kristy, John, Tim, and Traske (did I forget anybody?) how much I enjoyed meeting them. Wish them all the best and let them know that not a single thing any of them said or did would scare me away from med school! And please give the OR staff my thanks. They were all great about letting me be in the OR and keeping me from being underfoot!
All-in-all, this experience was certainly one of the very best I can imagine having! While I have devoutly said that I want to go into family practice, I can certainly see how keeping an open mind is imperative. My experiences in the surgical unit were outstanding! I look forward to more experiences in my third and fourth year of med school as I do my clinical rotations!
NOW, as to the auction prize at the raffle!
If you are a pre-med looking for shadowing experience, I don’t think you can top that prize! And the letter of recommendation you could receive would be invaluable, possibly gaining you acceptance at institutions you would not normally have considered.
If you are currently a med student, and beginning to think about where to apply for a residency, just think how invaluable a letter from Dr. McGahran could be! Not to mention the wonderful experience of being able to observe and learn f
rom him as you spend time at UVA.
I have to admit that I will probably buy a couple of those tickets myself, even though I’m just starting out in August! I would absolutely love the opportunity to meet Dr. McGahran and Dr. Kron, to attend Grand Rounds, and to shadow in clinic and the OR is a prize that you can’t really put a dollar value on!
Finally, to Nat, thanks again for arranging this time for me. It was an experience I will value forever!