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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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