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Medical Education, SMS Unplugged

“Us” and “them”: Losing the patient perspective

“Us” and “them”: Losing the patient perspective

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

holding hands - smallThis past Saturday, I received a call from a close friend from college that went something like this:

Friend: “Hey… so I’m in the ER right now, and I didn’t know who else to call.”
Me: “WHAT?! OH MY GOD WHAT HAPPENED?!”
Friend: “They think I have appendicitis.”
Me: “Ohhhhh – oh my gosh, thank goodness. I thought it was something really bad.” (nervous, relieved laugh)
Friend: “Wait, why are you laughing? I’m freaking out right now. What if my appendix explodes inside me? I’m so scared.”

A flush instantly spread across my face. I felt terrible.

In my head, appendicitis was relatively low on the list of all the possible horrible things that could have happened to my friend. I knew it was a common condition, that an appendectomy was a straightforward procedure, with minimal risk, and that of all the body parts to lose, the appendix wasn’t the worst by far.

When my friend mentioned that he might have appendicitis, my mental reaction was to think of all the factors that go into that diagnosis, and I was bursting to ask if he had guarding or rebound tenderness, and if the doctor’s said anything about McBurney point. (Side note – I’m currently studying for Step 1 – not that that excuses my impulse to run through a mental illness script). When that flush washed over my face, it was because I was shocked at myself: Why did I not – first and foremost – put myself in his shoes and try to feel the same pain and panic he was feeling?

I immediately apologized – again and again and again. Over the next few minutes, he asked me questions about appendicitis, how likely it was that his appendix would rupture, and more. At the end of the phone call, we had made plans to meet the next day, after his surgery, and my friend was calm. I, however, felt unsettled, and so guilty.

At our “Transition to Clerkships” retreat this past Friday, we sat in small groups and reflected on our individual hopes and fears for clinics. One of my fears was that I might become jaded or desensitized to patients’ conditions and not react with the empathy my classmates and I have cultivated and practiced so carefully. This incident with my friend brought that fear to the forefront of my mind.

I think that in many ways, it is a blessing for a physician to be somewhat desensitized to human suffering (after all, I can’t be fainting all over the place, can I?). But I also think there’s value in reflecting on how we can work to retain and prioritize that element of emotion that makes us human and that makes a doctor someone who is kind and trustworthy. As I move into clerkships this June, I sincerely hope I’m able to find that balance.

Hamsika Chandrasekar is a second-year student at Stanford’s medical school. She has an interest in medical education and pediatrics.

Photo by george ruiz

Medical Education, SMS Unplugged

Why does “just doing medical school” feel like it’s not enough?

Why does “just doing medical school” feel like it’s not enough?

stethoscope on book - 560

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

A friend from home came to visit me a while back. I hadn’t seen this friend in years, so we traipsed off campus, to a café I love, and nursed our lattes as we caught up on each other’s lives. She told me about her recent travels, highlights from her college years, her plans for the next several months and more. And then she turned to me and asked me what I was up to these days. I described what my typical day was like – workout, go to classes, study, repeat.

When I was done, she asked – “So… outside of med school, what else are you involved in at Stanford? Start-ups? Student organizations? Research?”

I felt a slight flush come over my cheeks and found myself saying, almost sheepishly, “I’m mostly just focusing on med school.” Just. Just med school. 

We continued our chat, but when I came home later, my thoughts wandered back to that “just” and why I felt so guilty about not having many outside commitments in medical school.

I knew part of it was the knowledge that I had never been a one-task kind of girl. In high school, there was debate, science Olympiad, Indian classical dance, and more. In college, there was Camp Kesem, a fusion dance team and research. I poured hours and hours into each and every one of these activities, but something in me shifted when I came to medical school.

That mental transition was and continues to be such a difficult one for me. I know Stanford is an incredible place – with start-ups blossoming every which way and the word “innovation” being uttered somewhere on campus every minute (probably not an exaggeration). Everyone around me seems so impressive – with multiple research publications, various awards to their name, travels abroad to assist with surgeries, and so on. Don’t get me wrong, I love this passion at Stanford, this drive to change the world – it’s why I came here, and why I hope to stay here as long as possible.

But it’s also easy to look at every other person and wonder how they’re doing it all, and more than that, wonder why graduating  not only with an MD (after all, everyone in the class gets one of those!) but also a string of additional achievements, feels like the baseline expectation for med students.

In just a few weeks, my classmates and I are going to be done with our pre-clerkship years and those of us who aren’t taking one or more research years (myself included) will directly transition to clerkships. I can’t wait to spend hours speaking with patients, working in a team to figure out diagnoses, and brainstorming treatment plans. I can’t wait to experience that excitement when I realize what aspect of medicine I want to practice for the rest of my life and feel that puzzle piece slide snugly into place inside me.

And I can’t wait for the moment when I can leave out the “just,” to see that same friend and happily say, “I’m mostly focusing on med school. And I wouldn’t change a thing.”

Hamsika Chandrasekar is a second-year student at Stanford’s medical school. She has an interest in medical education and pediatrics.

Photo by Dr.Farouk

SMS Unplugged

Six thousand words to describe my decidedly non-medical winter break

Six thousand words to describe my decidedly non-medical winter break

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

This past winter break was all about me NOT being a medical student. For three blissful weeks, I didn’t have a copy of First Aid for the USMLE Step 1 anywhere near me, I didn’t log on to Coursework (Stanford’s online course system), and I barely checked my email. This is a snapshot, worth 6,000 words, of what happened instead.

Top left: I met up with a friend from high school and we baked bread from scratch! I’m not much of a baker, so the fact that this bread ended up being edible is a huge accomplishment. My younger brother ate pretty much half the loaf all by himself, which could only be a good sign.

Top middle: New Year’s Eve was spent playing a cutthroat game of Pictionary. Sadly, my team lost. But on the plus side, the game helped me stay up past my 10 PM bedtime to ring in the New Year!

Top right: Under my mom’s guidance, I managed to FINALLY learn how to make my own lattes – not that that has prevented me from spending $3 a day on coffee from the med café…

Bottom left: This picture, taken in front of Universal Studios in LA, will very likely be my only red carpet moment for a while.

Bottom middle: I got to spend an entire day with these two adorable twins. They’re entranced by a show called Peppa Pig. If you haven’t seen this show, I highly recommend you check it out on YouTube!

Bottom right: During my time in the LA area, I went with friends to not only Universal but also Downtown Disney, where we stopped by the LEGO store and created this masterpiece – and left it there for the next person to find and wonder who the heck I am.

Thus passed my winter break. And now, back to the grind – just 9 weeks till my classmates and I are done with our pre-clerkship years!

(Side note: I was struggling for a blog idea, when I remembered this entry, written by a fellow MIT alum – Elizabeth C. – back when we were both blogging for MIT admissions. All credit for this entry idea goes to her!)

Hamsika Chandrasekar is a second-year student at Stanford’s medical school. She has an interest in medical education and pediatrics.

Photos by Hamsika Chandrasekar

Emergency Medicine, Medical Education, Patient Care, SMS Unplugged

Role reversal: How I went from med student to ED patient in under two minutes

Role reversal: How I went from med student to ED patient in under two minutes

SMS (“Stanford Medical School”) Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

emergency sign - smallAs part of the second-year clinical skills course, each member of my class is required to complete two 8-hour Emergency Department (ED) shifts. I had my first ED shift last week, and when I walked in, I introduced myself as a second-year medical student who needed to practice IV placements, EKGs, and any other procedures that happened to come my way. Three hours later, when I walked out of the ED, staff knew me not as a medical student, but as a recently discharged patient, grasping paperwork with my official diagnosis: “syncope and collapse.”

It was 30 minutes into my ED shift, while I was watching a pelvic exam (ironic, given my post a couple weeks ago), when I began to feel a little dizzy. I’ve fainted twice before – once in high school after getting my blood drawn, and once when watching a C-section at a clinic in India – so I recognized the signs: feeling a little hot, starting to see black dots, slightly swaying. I tried to fight off the sensation by breathing slowly, but I could tell it wasn’t working. At the earliest possible opportunity, I turned to the attending in the room, saying, “Is it okay if I leave? I’m feeling lightheaded.”

I barely waited to hear her response before I bolted out of the room and found the closest stool to sit on. Bad call. The stool had no back to it, and next thing I knew, I was on the ground. When I opened my eyes, there were at least five  nurses around me, one whom matter-of-factly said, “Honey, you just became a patient.” Another nurse quietly slipped my hospital badge off my jacket, returning two minutes later with a medical bracelet that she fastened around my wrist.

My memory of those early moments is a little shaky, but I do remember saying over and over again, “I’m so sorry, I’m so sorry.” I felt awful that I had come to the ED to learn from the patients, physicians, and staff – without being a burden – but had ended up being another patient for whom they had to provide care. The nurses and attendings immediately normalized the situation, telling me repeatedly that this is a common occurrence in the ED and that many of them had had this happen to them as well. Their assurances made me feel so much better.

The efficiency of the events that followed totally impressed me. The nurse helping me to the bed did the fastest history on me I’ve ever heard, all while hooking me up to a BP cuff and a pulse oximeter. Did I have allergies? (Nope.) Did I  have diabetes? (Nope.) When was the last time I ate? (That morning). Any other medical conditions that I’m being treated for? (Nope.) Any family history of cardiac conditions? (Nope.)

The attending who was with me when I initially felt lightheaded came in at that point and asked, “Has this happened to you before?” and when I told her about the C-section, joked, “ObGyn probably isn’t your favorite thing, huh?” She then laid out the plan for what would happen next: an EKG, a glucose stick, and a blood test, to check for cardiac abnormalities, low blood sugar, and anemia, respectively. Within 30 minutes, all three of these had been done, and I even got a bonus ultrasound thrown in by someone who was practicing recognizing cardiac pathology (not that I had any). Noticing my scrubs and med student badge, this person took the time to show me each ultrasound image, pointing out the various heart chambers, valves, and the location where my IVC entered my right atrium.

By 2 PM, my tests were all back, everything was normal, and I was able to laugh about the entire situation: Somehow, I had come into the ED hoping to practice blood draws and EKGs but came out having them done to me instead. Just another day in the life of a med student.

Hamsika Chandrasekar is a second-year student at Stanford’s medical school. She has an interest in medical education and pediatrics.

Photo by zoomar

 

Medical Education, SMS Unplugged, Women's Health

Learning the pelvic exam with Project Prepare

Learning the pelvic exam with Project Prepare

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

This past Friday, half my class crowded into a small room in the basement of the Li Ka Shing Center. When we walked in, we saw our names written on the board, under one of the following headings: “Male Pelvic Exam,” “Female Pelvic Exam,” and “Female Breast Exam.”

It felt like a safe space to make mistakes, ask questions, and fumble a little bit – without feeling like I was in over my head

For many of us, this was our first session of Project Prepare – a 3-session, 8-hour course designed to teach medical students how to provide supportive care for patients in the area of sexual health. (The history of the program is included in this article.) The teachers in Project Prepare take the dual role of patient and educator, using their own bodies to help students learn how to perform pelvic and breast exams.

This was my first day of the course, and I was scheduled to do the female pelvic exam session with a patient-educator whom I’ll call Stacie. I had heard from other classmates who had already done this session that it was “intense” and that it took some time to emotionally recover afterwards. I’d heard from others that it was “incredible;” one classmate even said it made her to want to be a Project Prepare patient-educator herself. The many mixed messages rolled together in my mind and distilled into a single overwhelming sense of anxiety.

But Stacie made everything so easy. She didn’t beat around the bush about how awkward or uncomfortable the experience could be. The first thing she asked us was, “What have you heard about Project Prepare?” and when I said I’d heard it was “intense,” she responded, “Why do you think that is?” In doing so, she set the tone for the rest of the afternoon: gentle, filled with open-ended questions and non-judgmental responses.

Over the next three hours, Stacie guided a fellow classmate and me through the exam techniques and word choice that accompany the 5-part female pelvic exam. She pointed out nuances that would never have otherwise crossed my mind, like how saying “that’s perfect” and “great” are fine in other parts of a medical interview or exam but painfully awkward and even inappropriate in the context of a pelvic exam.

After the session, I looked up Project Prepare, curious as to how many medical schools invite the team to their campuses. I was surprised to see that only Stanford, Touro University College of Osteopathic Medicine (both in CA and NV), Kaiser, and UCSF are on Project Prepare’s list of clientele. Though I still have two sessions left, it is so clear to me that Project Prepare is a unique, effective way of teaching students the pelvic and breast exams. As a medical student, the idea of doing these delicate exams for the first time on a real patient (one who is not simultaneously a trained educator) is terrifying. I had this experience last year, at Stanford’s Arbor Free Clinic, where I performed my first pap smear, with the guidance of an attending physician. I recall how scared I felt that I might hurt my patient and somehow “mess up.” In contrast, my experience with Project Prepare felt like a safe space to make mistakes, ask questions, and fumble a little bit – without feeling like I was in over my head.

This week, I have two more sessions with the Project Prepare teaching team, and this time, my feelings leading up to the sessions are colored with excitement rather than anxiety. To the Project Prepare patient-educators: Thank you so much for sharing your time, your knowledge, and most of all, your bodies, with us, as we take this journey from classroom to clinic. Our medical school experience feels more complete because of you.

Hamsika Chandrasekar is a second-year student at Stanford’s medical school. She has an interest in medical education and pediatrics.

Previously: Reality Check: When it stopped feeling like just another day in medical school

Medical Education, SMS Unplugged

Escaping the medical school bubble

Escaping the medical school bubble

Hamsika at Castle Rock

SMS (“Stanford Medical School”) Unplugged is a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

A few months ago, I read the following quote: “Don’t live the same year 75 times and call it a life.” For some reason, this quote got to me. This year is my 18th consecutive year as a student, and there are too many days that seem the same, where I’m caught in the tasks and obligations of school and extracurriculars and forget to take time out of the day just for myself.

Fortunately, I’m surrounded by classmates who are very much aware of the bubble but also skilled at disconnecting from the med school busyness. A couple weeks ago, I took a leaf out of their book, woke up at 5:30 AM, and joined four of my fellow classmates for a hiking trip at Castle Rock State Park.

Castle Rock is about a 45-minute drive from Stanford and filled with beautiful redwoods, moss-covered trees, and stunning views. Much of the group had to be back on campus at 1 PM for meetings and such (can’t escape the bubble forever!) so we chose to do a ~6-mile hike, giving us time to pause along the way whenever we felt like it.

There were moments when all of us were quiet, relishing the moist, woody smell of the forest and appreciating the absolute silence that surrounded us. Of course, most of the time, we were chatting it up. Despite the fact that all of us are together almost every day, taking the same classes and working together on group presentations that accompany our coursework, it felt like we hadn’t really talked in ages! During our three-hour hike, we bonded over so many different topics – where we wanted to live when we graduated from medical school, things we’ve struggled with this past year, our families, and so much more.

This isn’t the first time I’ve had a chance to escape into the wilderness with classmates. Last year, med school kicked off with a pre-orientation camping/backpacking trip called SWEAT (Stanford Wilderness Experience Active (Orientation) Trip). SWEAT was a 4-day, 3-night adventure, and, like this hike, was an incredible bonding experience – one that even included a few bear sightings.

The point of this entry is to 1) make it seem like I have a life outside of med school (Kidding! Kind of…), and 2) emphasize how important it is to take the time to do things you love and enjoy. One of the things I struggled the most with – both when I went to college and when I came to med school – was figuring out how I could incorporate the things I’ve always loved doing – dance, drawing, reading, etc. – into a life filled with classes, deadlines, and meetings. While the classes will soon come to an end, the deadlines and meetings and obligations certainly won’t. And that’s when I’ll make a conscious effort to traipse off to a dance class, a bookstore, or a hiking spot like Castle Rock.

Hamsika Chandrasekar is a second-year student at Stanford’s medical school. She has an interest in medical education and pediatrics.

Photo courtesy of Hamsika Chandrasekar

Medical Education, Medical Schools, SMS Unplugged

Buzzwords in medical school

Buzzwords in medical school

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

Learning in medical school often feels like learning a completely new language. There are numerous acronyms (OPQRST, CAGE, etc.) and molecules (IL-1, TGF-beta, etc.) and more. But most striking to me are two particularly ubiquitous buzzwords: “high-yield” and “protected time.”

I feel like I heard both these terms – and particularly the former – thrown around every single week of this past school year. “High-yield” has been used to refer to, as you might guess, the material that yields the highest amount of gain – i.e. for us students, it’s the material that’s going to show up on our tests. This term pervades not only conversations among classmates but also study materials. First Aid – one of the main Step 1 book resources – takes pains to highlight “high-yield” concepts, and Pathoma – another Step 1 resource – goes even further, identifying ideas that are not just “high-yield” but also “highEST-yield.”

This idea of focusing on “high-yield’ concepts bothered me at first and continues to bother me a little bit today, largely because my classmates and I often determine for ourselves what is “high-yield” and what is “low-yield,” dedicating our study time to the former and ignoring the latter. The worst part is that we may be ignoring information that may be “low-yield” in the context of exams but actually “high-yield” in the context of patient care. The flip side of this is that we only have a certain number of hours in the day; perhaps it makes sense for us to be judicious about what we focus our attention on?

Another phrase that has been widespread in medical school is the term “protected time.” I started hearing this during the very first week of medical school, when we had part of our afternoon off for “protected study time.” Later in the year, I attended a panel featuring five pediatricians. The question of work-life balance came up, and one of the doctors mentioned that she carved out “protected time” to be with her 2-year-old daughter every evening between 5 and 7 PM. This statement was met with general appreciation but also minor panic. There are so many aspects of our life that deserve “protected time” – family, friends, time for creativity, and more – and yet, again, there are only 24 hours in a day. Where does “protected time” start and end? And what does it include? And is it really reasonable to expect “protected time” when there are so many patient -care demands for physicians to navigate?

As I’m about to enter my second year of medical school, some of my questions remain unanswered. How can my classmates and I make sure to learn medicine well enough and thoroughly enough that we can both meet and exceed expectations in patient care? Is identifying “high-yield” material an ineffective, shortsighted approach? And how do we identify what falls under “protected time”? Here’s hoping I figure out this tentative balance during this upcoming year!

Hamsika Chandrasekar just finished her first year at Stanford’s medical school. She has an interest in medical education and pediatrics.

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From August 11-25, Scope will be on a limited publishing schedule. During that time, you may also notice a delay in comment moderation. We’ll return to our regular schedule on August 25.)

Pediatrics, SMS Unplugged

Behind the glass window: Experiences in an infant follow-up clinic

Behind the glass window: Experiences in an infant follow-up clinic

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

behind window - smallAs I mentioned in my last entry, I’m in Boston this summer. I’m one of several interns who are part of the Newborn Summer Student Research Program, coordinated by the Harvard Program in Neonatology, in partnership with a number of Boston hospitals. Aside from connecting us with excellent research mentors, this program ensures that participants get some clinical exposure as well. Over the past 5 weeks, I’ve had a chance to shadow physicians in the Boston Children’s Hospital neonatal intensive care unit (NICU), the Brigham and Women’s Hospital delivery room, the BWH nursery, and most recently, the BCH Infant Follow-Up Program (IFUP).

It’s this last shadowing experience – in the infant follow-up clinic – that I want to touch on in this entry. When I first heard about this clinic, I thought it was for babies who were being seen soon after birth, just to make sure everything was okay. As soon as I walked into the clinic, I realized that IFUP was not for newborn babies but rather for kids of all ages, who were being followed up on for various developmental issues that had arisen during their previous time spent in the NICU.

During my brief time in the clinic, I met patients ranging from 22 months to 10 or more years of age. I use the word “met” loosely here, for in fact, I did not meet a single patient in person during my time at the clinic. I stood with some fellow interns and some physicians behind a one-way mirror, quietly observing as various tests were run on these children. At first, I found myself fascinated by the physician administering the various tests (ex. the Stanford Binet, the Beery VMI), for I had never seen them given in a clinical setting.

Soon, however, my attention slipped from the physicians to the children being tested. I felt such a complex mixture of emotions: sadness, for many of these kids had never experienced a week devoid of doctor’s appointments; amazement, at how far these children had progressed developmentally given where they started; and humility, for it was pure luck that prevented me from sharing the same developmental struggles that these little patients did.

As these thoughts swam around in my mind, my attention slipped once more, from the children in the room to their parents. I felt drawn into the emotions that flitted across these parents’ faces – pride when their kids correctly answered the physician’s questions, a pang of pain when a question was answered incorrectly, a sense of helplessness when the physician mentioned that the child would need yet more therapy. In response to the latter, one mother said, “I’ll do whatever it takes.” Such a simple statement, something I’ve heard several times before in movies and TV shows, but hearing it here, in a clinical setting, while standing unseen behind a glass wall, my heart broke. I wanted to reach past the divider and give these parents and these little kids huge hugs, to tell them it would be okay.

I can’t quite say why this clinical experience touched me so much. Perhaps it’s because the glass wall between me and the patients, physicians, and family members was less like a barrier and more like a window, offering me a view into the lives of not only patients but also the family members who love them so much and the physicians that strive to do everything in their power to help them heal.

Hamsika Chandrasekar just finished her first year at Stanford’s medical school. She has an interest in medical education and pediatrics.

Photo by A

Medical Education, SMS Unplugged

Fewer than six degrees of separation: the small world of higher education

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category

six degreesSeven months ago, almost on an impulse, I decided I wanted to spend summer 2014 doing research back in Boston (home to my undergrad institution), instead of at Stanford. To this end, I started looking into possible research mentors, and after browsing through the Boston Children’s Hospital website, I found one person whose research interests aligned with my own, sent this person an e-mail and went back to studying for finals. Less than an hour later, I received a response. Two days later, we spoke on the phone. By the end of the week, I was all set for a summer in Boston.

What struck me the most about this entire exchange was not the speed with which it was conducted but the happenstance that accompanied it: I found out during the phone meeting that my now-mentor had actually attended Stanford medical school as well! What, I wondered, were the odds that the single person I chose to e-mail had graduated from the same institution that I now attended?

I thought about this coincidence more in the months that followed, and the more I thought about it, the less it felt like pure luck. Indeed, the past year has shown me just how small the world of higher education can be. Nearly 50 percent of my 102-person med school class comes from four institutions: Harvard, Yale, MIT and Stanford. One of my closest friends in medical school not only went to college with both the girls I’m living with this summer but also lived with one of my current roommates during a summer in undergrad. One of the other med students with whom I’m working with this summer gave med-school advice to the girlfriend of one of my undergrad buddies and – get this – both this coworker and I, unknowingly, performed at the same dance competition last year.

Moments like these make me feel that the “six degrees of separation” theory would more appropriately be called the “two (or fewer) degrees of separation” theory in the world of higher education. And what I’m wondering is whether or not this is a good thing.

Don’t get me wrong – I love playing the Name Game when I meet someone new (“Hi, I’m Hamsika! Where are you from? Yale? Oh, wait – do you know person X, person Y, or person Z? You know all three! No way!”). But there’s something to be said for diversity, not only in terms of race and culture (the two that seem to receive the most media buzz) but in terms of educational background, as well.

I summarized my thoughts on this “small world of higher education” phenomenon to a Harvard Med friend (incidentally, I met this friend at Stanford Med’s Admit Weekend) a few nights ago, and his response was – “Well, it kind of makes sense. If you go to a school like Harvard for undergrad, you’re probably going to end up at a similarly high-ranked institution for grad school. And,” he added as almost an afterthought, “your parents are probably decently well-off, as well.”

Could it be that we’re creating a self-perpetuating cycle in which the world of higher education becomes smaller and smaller and those who miss the “train,” per se, particularly at the “station” of undergrad education, are “derailed”?

I can’t say I know the right answer, but I’d love to hear your thoughts, as the topic of education – as you might notice from the two-liner at the end of each of my entries – is of particular interest to me. Feel free to add a comment below!

Hamsika Chandrasekar just finished her first year at Stanford’s medical school. She has an interest in medical education and pediatrics. 

Photo by Beth Kanter

Medical Education, SMS Unplugged

From NICU to nursing home

From NICU to nursing home

SMS (“Stanford Medical School”) Unplugged was recently launched as a forum for students to chronicle their experiences in medical school. The student-penned entries appear on Scope once a week; the entire blog series can be found in the SMS Unplugged category.

NICUThis quarter of medical school has by far been my favorite, because almost everything we do has an explicit clinical correlation. Each week we work in small groups of 10 or so students to go over patient cases, practice respiratory and cardiovascular (our two organ blocks this quarter) physical exam skills, and interface with real patients in the hospital. These experiences have been both exciting and humbling, and two in particular – one in the NICU and one at a local nursing home – stand out the most in my mind.

I visited the NICU for the first time two weeks ago, to shadow the physicians and residents as they conducted morning rounds. I saw the tiniest babies I’ve ever seen in my life, buried by wires and hooked up to incredibly sophisticated technology, like ECMO and a Berlin Heart. I’ve visited the NICU two more times since then, swept away by the fast-paced nature of the ICU setting, amazed by the large number of specialists working together to coordinate each baby’s care, and – more than anything else – touched by the gentle kindness of parents. There is one parent in particular to whom my heart went out, because each time I visited, I saw this father sitting next to his child’s crib, tenderly holding the baby’s hand and reading the baby stories out of books. This image is etched in my mind, and I hope it always remains so because this parent, with his simple gestures of affection, gives me insight into just how heartbreaking it is for a parent to bring new life into this world, only to have that new life marred by the possibility of death.

Equally humbling are the experiences of patients at the opposite side of the spectrum – i.e. not neonatology but geriatrics. The same week as my first NICU visit, I joined classmates on a visit to a local nursing home, as part of our POM (Practice in Medicine) clinical skills curriculum. The very first thing our facilitator asked us to do was comment on our feelings about geriatrics and on aging. I brought up the fact that aging – and in particular, care of aging individuals – is handled differently from one culture to another. For instance, in many Indian families, including mine, grandparents live with their daughters/sons and grandchildren, and there is no doubt in my mind that I want my parents, when they grow older, to come and live with me. This group discussion was followed by patient visits, and once again, I was touched the things I saw. One particularly sweet woman meandered over to me and – ever so gently – placed a hand my shoulder, telling me quietly that she would be leaving the nursing home soon because she and her husband both felt stronger. I can’t explain why this moment felt so poignant to me. Perhaps it was because this patient – who didn’t know me at all – saw my white coat and implicitly, as she placed her hand on my shoulder, placed her trust and friendship in me as well.

I know that these patient experiences are the firsts of many I’ll be a part of during my years in medical school and beyond but it’s these firsts that I want to remember because they capture my wonder for medical advancements, passion for family- (not just patient-) centered care, and gratitude for being able to be a part of the medical community. I hope to share many more such firsts with all of you, as my journey continues these next three years.

Hamsika Chandrasekar is a first-year medical student at Stanford’s medical school, with an interest in medical education and pediatrics.

Photo by bradleyolin

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