Recognition

Today’s blog post will be very short because it’s already 2:08am and I’m trying to try this whole “get enough sleep” thing this semester. But it’s part of my Habitica list to try and blog at least twice a week, specifically on Wednesdays and Sundays so here I am. Hello.

The best part of my week was on Friday. One of the nurses who has somewhat unofficially become my mentor offered to write me a letter of recommendation. I was so stunned because I don’t remember formally asking him for one ever (and I tend to be very formal about it). I remember perhaps joking about it, and the nurse told me, “Oh you totally asked me like weeks ago!” I feel so touched that he would take something I probably said as a light (but sort of serious) joke, and then felt that I was a good enough volunteer to offer me a letter of recommendation.

Maybe this is just my opinion, but I think the best letter of recommendations are the ones you don’t necessarily have to “work hard” for. What I mean is that I didn’t have to try to kiss up or impress this person. I’m a naturally hard-working individual. And yes, I did want a letter of recommendation, but that wasn’t the reason why I work hard.

The same goes for the letters of recommendation I’ve received from my college professors. I never went into my Kinesiology professor’s office for the purpose of grabbing a letter. I genuinely love systemic Anatomy, and I just felt so moved to go into her office and announce it to her. And that was the very beginning of a great faculty relationship. Now I get to just drop by and talk to her about my life, and it feels natural. So when I asked her for a letter of recommendation, despite me still being nervous, I knew that if she said “yes,” it would be because she genuinely knew who I was–not someone I was faking to be.

I think these are the best letter of recommendations. The ones where your professors or mentors know you very well just because you’re you and they find that worthy of bragging about in their letters in order to purely help you achieve your goals.

Now because I’ve made a connection with this nurse, I have definitely one letter of recommendation ready for when I apply to medical school. Some people call me crazy, but working over one hundred hours in the ER was worth every moment, and getting this letter was just the icing on a very sweet cake.

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Second Semester Senior

The other night, I was talking to one of my friends, Lynn, about my post-graduation plans. She’s currently a sophomore, while I’m about to graduate in May. When I was a sophomore, I had a lot of anxiety about what my post-graduation life would look like. Would I get a job? Would I go directly into medical school? Would I go into teaching? Would I got abroad? I had so many different plans. In fact I had 6 pretty distinct plans before I came up with the plan I have now.

Plan 1: Get a job working for Aim High

It seemed like getting a job after college was the most natural transition, and it’s what most people who aren’t going to graduate school do. However, I realized I didn’t want to go into the workforce directly, even though I absolutely love Aim High and will continue to give back to the organization for the rest of my life.

Plan 2: Apply for a Fulbright Master’s in the UK

I realized that I didn’t want to go to school to learn how to teach (I would have pursued a Master’s in Education). Although I do wish to teach in the future in some capacity, now just was not the time.

Plan 3: Apply for a Fulbright ETA

I looked at all the countries I was eligible for (aka, those that don’t require a language fluency), and none of the countries got me excited.I felt that I shouldn’t apply for something unless it makes me super happy and excited. Otherwise, I just wouldn’t have a good and convincing strong application in general. And why would I waste time trying to convince myself that I was happy when I know I wasn’t?

 Plan 4: Apply for a Luce Scholarship

I applied to be nominated for this scholarship, and I was rejected.

Plan 5: Apply for the JET Program

When applications opened for this one, I felt the same way I did about Plan 3. Although this is a program in a country I am very excited about, English itself is not a subject I’m enthusiastic about. So once again, although I could probably make a strong argument for why I want to apply for the JET, it wasn’t ever going to be the thing that made me the happiest.

Plan 6: Do research for a year

I still think this is super exciting, but not as exciting as my current plan. And maybe my mind might change when I potentially do research over the summer. I just don’t have experience in research now, but I think I like the idea of research more than I might actually like it. But that’s based on my very limited research experience… so who knows.

Current Plan: 

I’m applying for a summer research program at Children’s Hospital of Philadelphia (CHOP). Regardless of my acceptance or rejection, I will get my EMT certification either in the summer or fall and then work as an EMT for a little bit before I apply for medical school in the Fall of 2018. I absolutely fell in love with interning in the emergency room, and it’s an environment I genuinely enjoy working in. It’s the place that makes me the happiest and I think being happy is way better than convincing myself I need to do a fellowship abroad in order to be a good candidate. Also, as an EMT I would get to gain skills I would not otherwise acquire. This is the plan I have now, and this is what makes me excited and ready to graduate.

I’ve always been the type of person who starts to transition from one part of my life to the next quite smoothly. For example, I have two classes this semester + comps + research. I’m spending more and more time working outside of school so that I don’t get too attached to a school schedule. I’m sure I will miss Oxy when I’m done, and I’m sure the second semester senior feelings will hit me soon. But for now, I’m very excited to go on a journey after graduation–one where I am not weighed down by academic obligations I’m not passionate about but one where I get to immerse myself in an environment that makes me feel joy every single day.

 

Oxy-CHLA Reflection

Now that my two week adventure at CHLA is over, I just wanted to reflect upon my experience at the hospital. Just to recap, my school has a partnership with the hospital that allows about 10 students to shadow through multiple units for two weeks in the Winter or Summer. I was able to visit the following units: Cardiothoracic ICU, Pediatric ICU, Medical Genetics, Hospital Medicine, Infectious Diseases, Surgery Clinic, Rehabilitation, and Surgery Operating Room.

Favorites and Highlights:

My favorite unit I visited was Hospital Medicine. I liked rounding with the attending and fellow because I was able to have a lot of interaction with the entire staff as well as the patients. The attending and fellow also took time to really teach me their physical examination skills. And although I will learn all of these skills in medical school anyway, it’s still nice to be exposed to it before entering school. I prefer hearing the process of something as simple as a physical exam–it makes my trip on rounds that much more informative.

The other unit I really liked was the Surgery Clinic, mainly because the surgeon I was with was very energetic. She was like a ray of sunshine. We got to see many patients in a short amount of time, and she just did such a phenomenal job of instilling confidence in her patients while being incredibly efficient with her time. I also got to see her when she visited the PICU earlier in the program, and got to hear how much she loves cardiothoracic surgery.

The unit I probably learned the most in was Medical Genetics. I thought it would be boring because instead of rounding on patients, they basically do consultation on patients who suspect there may be genetics at play in their disorders. And although we didn’t get to see a lot of patients, I got to learn a lot about specific patients as well as their specific potential disorders. I thought that was pretty cool because I would not have otherwise explored the topic of genetics.

Lastly, a major highlight throughout the program for me was just generally being able to understand or pick up on medical lingo. I have taken anatomy and physiology classes, and I was actually able to understand a fair amount of terminology just because I have a little bit of foundation. Also, because I volunteer at hospitals so often, I knew certain medical terms such as NPO, PRN, and all the different kinds of tubes, like NG tube and G tube. I thought that was absolutely cool and it really revealed how much I have learned over the last couple of months! I’m really glad to know and feel comfortable with the language of medicine, and that my vocabulary will continue to grow!

Lows and Expectations: 

There weren’t many lows, but rather there were many things that were just different from my expectations. I thought I was going to be super psyched about the ICU, but I actually wasn’t! Even for the CTICU, I just wasn’t as excited as I thought it would be. I think partially it’s because we were in those units at the beginning of the two-weeks, and I don’t think the staff exactly knew we were coming or what to do because we were there… so maybe our experience was just less-than-stellar due to lack of preparation. Either way, it just seemed too calm when I visited. I was also told the units were calmer than usual the days we visited. But it was just so quiet. Unlike adult hospitals, there aren’t even patients asking for things like water because most of the patients are babies. The ICU was also just very sad because many of the patients are unconscious and intubated, so you can’t interact with them in any way. I don’t really think the ICU is a place that would match my personality.

The unit that ended up being very different from what I expected was Rehabilitation. When I see “Rehabilitation” I usually think of just Physical Therapy. However, when I walked into the Rehab unit, I found out that this unit was probably the most intense unit and that the teams were huge, and encompassed by more than just physical therapy. There were occupational therapists, speech therapists, dieticians, nutritionists, medical specialists, clinical workers, social workers, spiritual workers, psychiatrists, etc. It was so interdisciplinary. I also sat in on family and team conferences and learned a lot about the patients on the floor. It was just very intense and sad, but so informative at the same time. I feel like in another world, I would have been interested in Rehab, but in this world I’m not.

Overall Reflections:

This experience was absolutely wonderful and it was totally work coming back to school early. It helped me clarify what I liked, what I didn’t, and also how to think about choosing a specialty (even though I literally have like 6 years until I have to commit, so I’m keeping an open mind). For example, I realized it was important to think about the environment and the team you work with, as well as thinking about how much patient interaction you want. This experience also showed me what exactly physicians do, and how different members of the team interact with each other. Even though I’m often at hospitals volunteering, I really only interact with nursing staff, and not the physician staff. I’ve gained a greater appreciation for the direct and allied health staff at large because it takes a huge team to help a patient thrive.

Lastly, I’m just really proud of myself for getting through these two weeks–waking up early every single day before the sun rose, looking business casual every single day, and taking notes. I even committed myself to writing a blog post every single day I was there, trying to reflect upon my experiences each day. I’m really proud of myself for having been present for every moment I was there.

I’m grateful I finally has this opportunity. It really helped me realize how much I enjoyed being in a hospital setting and just seeing patients get better–and there are many ways to facilitate that! Being at CHLA has made me really excited to apply for medical school in a couple of years. Now I’m really confident that I know what I want and what I am working towards in my life.

Oxy-CHLA Shadowing Day 8: Surgery Operating Room

Today concludes my shadowing program at Children’s Hospital Los Angeles! I got to end my two-week adventure with a trip to the operating room! Despite having volunteered in two other hospitals, I’ve never had the chance to actually visit the OR or witness any surgeries, so today was super exciting!

What I learned about the unit:

I didn’t realize how short some surgeries are! I literally saw two surgeries that took a total of 30 seconds to complete (lingual frenulectomies). Honestly, the pre-operative procedures took way longer than most of the surgeries I saw. Apparently, today was a pretty slow day, so I didn’t see anything amazing or rare. I got to see two frenulectomies, an emergency exploratory laparotomy, an umbilical hernia repair, a rectal examination with excision of granuloma, and a bone marrow aspirate and breast mass biopsy. All of them took no more than 45 minutes. It was very cool to see how relaxed the unit was. Everything ran every smoothly and almost everyone I saw was really calm. It was a really wonderful concerted process.

What I learned about the job:

You have to be super calm for this job in order to keep things running smoothly, but there’s definitely room for a lot of socializing and joking around. A lot of the surgeons were having conversations about their lives while performing on a patient. It was very cool. I also gained a huge appreciation for the mechanical work that surgery is. You cut (or use a bovie… which is sort of like burning?), find what’s wrong, fix it, and then sew sutures to close (or use a silo bag). You have to be very explorative and be able to distinguish healthy from unhealthy tissue, and then you get to be creative on how to fix it. For example, will you close the skin vertically or horizontally? The answer is usually how the skin best comes together. You also have to flexible because when you get emergency patients, where the procedure will be exploratory, you never know what you’re going to find when you open up the patient. Additionally, if you’re doing a biopsy, you may have to wait to hear back from pathology before closing completely. Surgery not only requires being focused, but also being relaxed and flexible–the latter two I never really put thought into before.

What I learned about myself:

I like the idea of surgery because I like working with my hands. For those who don’t know, I went to a technical arts high school where I took classes in woodworking, metal fabrications, and electronics. I also like to sew at home. I have a very technical background in terms of how I like to do things. I like to build, and if things fall apart, I come up with creative ways to fix them. I think that’s what I really appreciate about surgery–it’s mechanically altering, but improving people. It’s wonderful to think about the fact you can just cut out dead parts of the bowel, and sew the healthy parts together and have a full recovery. Or when you take out a tumor and ultimately prevent the recurrence of cancer. I think I would like doing surgery because I love working with my hands. I think the lack of patient interaction I would get would make me sad though (that’s why I like emergency; you get to do procedures while also interacting with patients really often). I’m excited to go through a surgery rotation in the future because I can’t wait to be the person with the bovie or the scalpel.

Oxy-CHLA Shadowing Day 7: Rehabilitation (Inpatient) and Medical Genetics p. 2

Today, I got to round in the rehabilitation unit and also visit medical genetics again. Again, I will split my reflections into two parts.

Rehabilitation (outpatient)

What I learned bout the unit:

I didn’t know that the rehab unit encompassed more than physical therapy. When we walked into a team conference, there were at least 20 people present, from the attending MD, to physical therapists, occupational therapists, speech therapists, social workers, spiritual coordinators, dieticians, psychiatrists etc. The attending explained to us that Rehabilitation is one of the few medical sub-specialties that is very interdisciplinary and requires a very large team. Rehab aims to treat the patient holistically, which is why often times school coordinators get involved as well as spiritual leaders and psychologists. Also family is usually very involved in the process as well. It was just so different from what I imagined! I got to sit in on a speech group therapy session, where the patients did a deductive reasoning worksheet and then played the game Skip-Bo (which I love by the way) and got to see what really happens. I also got to see a little bit of the physical therapy session, which was also amazing because the room is set up like a small jungle gym of sorts. I also sat in on two family meetings, where they talked about the plan of care for the children, as well as went over the progress that had been made. Some patients had ongoing chronic issues while others were in traumatic accidents where there was both physical and brain injury. Although not as active, it was still incredibly engaging and I’m glad I got to see that side of medicine.

What I learned about the job:

The attending told us that today was a particularly busy day and was a sort of less-than-ideal day to be visiting. The attending was truly the head of everything, and the resident took the day off that day. He was one who invited us to the meetings and had us go with the speech therapist. He also made sure that other MDs who were specialized (for example, rhematology) were informed of the care plan because he got paged several times during conferences. Otherwise, I didn’t get to learn too much. I thought Rehab was very cool though, and I feel like I would enjoy being a care partner of sorts in this unit.

What I learned about myself:

I don’t know if I have a fit here because I wasn’t super interested in doing any of the work they do as a job. I feel like it would be awesome to volunteer here or work here temporarily, but for me, it isn’t the career of choice. I will be able to learn some of the things that happen in PT during my biomechanics class, so that’s pretty awesome that my learning material is relevant. I also now know that CHLA has such an amazing comprehensive rehabilitation unit. If my future kids ever needed the best care, I know CHLA is the place to go.

Medical Genetics p. 2

Today I got to visit this unit again, but this time with a different doctor. I learned all about neurofibromatosis type I (NF1). We saw a 1 year-old with cafe au lait spots (also called macules) whose mom ended up consenting to getting genetic testing just in case. Then soon after, we saw middle school-aged twins that were actually diagnosed NF1, which was very interesting because we got to see how the disease progressed. Both of the children were very active in school and didn’t seem to let their disorder negatively affect their lives. Even though we really only go to learn about one genetic disorder, and only saw three patients, it was still a really nice day. It was nice to have a more relaxing day prior to my day in the OR tomorrow!

What I learned about the unit, the job, and myself:

I’m going to skip this because I already wrote about this in part 1. I visited this unit last week!

 

Oxy-CHLA Shadowing Day 6: Infectious Diseases and Surgery Clinic

Gah this post is a day late because I had to move out of my room yesterday and into a new room. Sorry about that! But now here I am. Yesterday, I got to visit two units: Infectious Diseases (ID) and the Surgery Clinic. I’ll go into each unit separately.

Infectious Diseases (ID)

What I learned about the unit:

This isn’t so much a unit as it is a team of individuals who basically go answer questions from team physicians to check in with patients who may or may not have an infectious disease. Infectious diseases often complicate cases, and can be deadly in those with immunocompromised systems. This department is all about looking at the history of patients (fevers? what time? what grade?) and other possible indicators of infectious disease (hives, rashes, etc) and then doing cultures tests and determining which antibiotics to use in order to treat the infectious disease while also taking care of the chief complaint (whether it was a surgery, a chronic disease, or a debilitating disease like cancer).

What I learned about the job:

In this unit, we rounded with a nurse practitioner as well as a physician (I believe she was an attending). We got to go and visit almost every single patient on the list. Many of the patients were awake and could react to us, and many of them were older school-aged children. We mainly followed the NP, who was super happy and seemed to really love her job. She was very open to answering all of our questions, which was great. She even said hi to patients who she didn’t even have updates for, but just because she wanted to see them. Rounding took about 2.5 hours.

What I learned about myself:

I can’t wait to take microbial symbiosis because it seems like the material in that class would be super relevant. I wasn’t super excited about infectious diseases, though I was very curious about the process of choosing the medications. I probably wouldn’t want to go into this field, but it was very fascinating to understand.

Surgery Clinic

What I learned about the unit:

So this is a consult clinic. Basically a lot of patients who may need surgery come in and talk to the surgeon about whether or not they actually do or should, or what alternative options are. No actual surgeries take place here (or maybe super minor ones do, but I didn’t see any). There are also patients who previously had surgery who were just getting a check-up. One minor procedure I did see was the nurse changing the G-tube. There were patients of all ages, from 3 months to 18 years old, with all different kinds of issues: skin lesions (with bone exposed), anterior displaced anus, pectus excavatum, labial fusion, inguinal hernia, pilonidal cyst, ganglion cyst, etc. So many things! We got to see a lot of patients in a very short period of time, and it was a lot of fun.

What I learned about the job:

I didn’t know that as a surgeon how many hours you actually spend in the clinic, but it makes a lot of sense. I also didn’t know that as a pediatric surgeon, you only perform surgery on patients who are completely asleep (at least the attending I followed said that). I received local anesthesia on a surgery I had, but it’s because I went to an adult surgeon. I also learned how to make the job fun, such as providing toys to all the small tiny humans who step into the exam room. The surgeon was absolutely phenomenal in the way she interacted with patients and their families, making them feel super comfortable but also providing many options. To be a surgeon, you aren’t actually in the OR all day like I thought you would be, but I wouldn’t mind being in the surgery clinic either because you just get almost exclusively patient interaction… and it seems less paperwork than the other units. It seemed like a lot of fun and I think I would enjoy being a surgeon. Maybe.

What I learned about myself:

I really liked this job. One of the questions I was forced to answer was “Why do I want to go into medicine [as opposed to other jobs such as nurse practitioner, physician assistant, nurse, etc]?” And it’s really because I love problem-solving and I love continuously learning about new syndromes, disorders, problems… but also really enjoy finding new solutions. This is in addition to how much I love learning about the human body and how happy it makes me, and how long it has been a part of me. I feel like it’s really hard to come up with a reason for why I want to go into medicine that isn’t really what I just said… I feel like other people have that same reasoning (it’s not a “bad” reasoning. It just isn’t “unique”) It’s hard to tell if my answer was good enough for the attending, and I’m worried that it wasn’t. However, this pushes me to think more about my reasons for going into medicine, and I think will really help me in the application process.

Oxy-CHLA Shadowing Day 5: Hospital Medicine

Today was an absolutely wonderful day at the hospital, certainly my favorite day thus far. I not only learned a lot, but had a lot of interaction with the attending, fellow, resident, medical student, and the patients! I didn’t know what Hospital Medicine at first, but it appears to just be the general pediatrics floors, or the non-ICU floors. Also the hospitalists work exclusively inside the hospital (as opposed to outpatient work). It was a really wonderful and interactive experience.

What I learned about the unit:

The general pediatrics floors are great! Most of the patients are on the upswing in terms of their recovery, and many of them are awake and active, unlike the ICU floors. The wings were specialized I think, but it wasn’t made super clear to me. Many of the patients had acute problems, like back pain, while others were therefor cystic fibrosis treatments or chronic lung disease. This unit was a lot of fun to go around, and the entire team (Team 2) was super friendly.

What I learned about the job:

As soon as we walked in, a medical student greeted us and went over her two patients. We got to see her rehearse to the resident, who gave her feedback. Then we got to round on about 8 patients with the attending, fellow, resident, medical student, and clinical care coordinator. We got to go into almost every single room. At first, it was mainly the resident talking about the patient as well doing their physical exam. However near the end of rounds, the attending and fellow invited us to stay with a patient and explained what they look for during a physical exam: fontanelles, listening to lungs, myoclonic movements. Both the fellow and the attending took time to thoroughly explain what they were doing as well as answer any questions we had, no matter how simple it seemed. They even knew our names personally, which made a huge difference in my experience there. It was nice to know that even as a fellow and attending, there was still time to teach–a huge part of me. The attending also took some time to go over some XRays. I would say the best part is that the attending asked us to state what we observed about patients: are they relaxed? how’s their color (pale, flushed, etc)? how’s their muscle tone? when they wake up, does their state change? what do you observe on this XRay? The attending did such a phenomenal job at both explaining and teaching that I didn’t even feel tired despite functioning on 2 hours of sleep.

Some complicated things I learned about being a physician, especially in pediatrics, is that there are times when there will be non-accidental trauma patients. That is another word for child abuse. I learned some things about how to look for suspicious injuries (such as posterior rib fractures, which are much harder to attain than anterior rib fractures, or retinal hemorrhaging). Furthermore, it’s hard to give care on a pediatrics patient when basically all procedures require consent, but obviously pediatrics patients cannot give consent. So in NAT patients, there are legal components to care as well as the medical, and physicians cannot get involved in the legal. Just gotta wait for that to be sorted out.

Another frustrating thing is knowing that a patient needs imaging or a test in order to help accurately diagnose them, but sometimes parents freak out and won’t consent. It can be super frustrating, and I saw the team basically go “what the heck” when they found out a patient went up for an MRI, and at the last second the parent refused consent because they were told the patient was a “high risk” patient due to a condition they had–despite imaging being done on other patients with the same condition all the time. I knew the patient’s case, so even I felt really frustrated because I knew the MRI would likely reveal a lot (or perhaps nothing at all) and aid in the care of the patient.

I feel like today provided a lot of insight on the breadth of responsibilities and duties as a physician to their patients and to their team. I’m really glad I had the preceptor I did!

What I learned about myself:

If I wasn’t super sure about pediatrics before, I can say I definitely like pediatrics now. I really loved being on this floor. How does this compare to adults? I don’t really know yet. But I definitely like the general pediatrics floors more than the ICU floor. I really liked being able to interact with more patients, especially those who were actually awake and could react to me. It’s also nice not seeing patients filled with tubes at every orifice (not that the ICU bothered me, but it was very sad to me). Although I didn’t get to go, the toy playroom was present in every single wing, which I thought was awesome. The floors just seemed super fun compared to the other units I’ve been in. If I had to choose pediatrics, I would definitely choose general pediatrics over ICU (but I haven’t been to the Emergency Department yet! So who knows for sure).

Oxy-CHLA Shadowing Day 4: Lectures

Instead of shadowing physicians in a unit today, we were scheduled to have lectures. CHLA seems to have regular speakers (unclear if weekly or monthly) called “Grand Rounds.” Today we got to hear from Johanna Olsen-Kennedy and her work with transyouth, which was amazing. I feel like I learned a lot about how taking care of transyouth is a very comprehensive and all-encompassing regimen. But the outcomes are largely positive, and lead to thriving trans children and adolescents, which makes me very happy to hear.

After that lecture, we had a Q&A with one chief resident, followed by a Q&A with two 3rd year medical school students from USC. Some of the major takeaways (and I’m just thinking off the top of my head, indicating the ideas that stuck out the most):

  • To be a physician, you can’t just think of it as “just a job.” Some people like to think of it as a vocation, or that medicine is their calling.
  • Cynicism is a sign of burnout.
  • Do you like wearing a white coat? Because if you do, pediatrics is not for you. (I thought this one was funny, but so true).
  •  Med school applications are 99% your work ethic, passion, and commitment. You don’t need clinical work, and you don’t even need to have done your pre-med classes during undergrad. You just need to know it’s what you want, and work really hard at it.
  • Think about how much you want to interact with your patients, and how much you just want to sit around and think.

I know I wrote way more takeaways, but these are what came to mind. So these are the ideas that resonated with me the most. The first one especially resonates with me because after having spent 72.75 hours in the ER in a month (my hours finally got calculated y’all), I have definitely told my friends, “The ER is my calling. I know I love it.” I’ve been in the PICU, CTICU, and in Medical Genetics and none of those things gave me as much excitement and passion as thinking about the ER. So I was super happy to have heard someone describe their job the way I would.

After the Q&A, we had another lecture from the Cystic Fibrosis (CF) team. The team basically went over the pathophysiology and biochemistry of CF, as well as how it is treated: respiratory, diet and nutrition, and psychosocial. I thought it was so cool to learn about CF in-depth. I never knew that it affected more areas of the body so heavily than just the lungs, and now I know why and how it is treated. I also didn’t know that in my lifetime, the life expectancy of CF patients has doubled from 18-25 to about 40! That’s really exciting news to me. I wish we had more of these lectures. Like honestly, if I had a lecture like this every single day, I would be very happy.

I’m not splitting up my learning into three parts this time because it doesn’t really make sense to. However, I have a ton of both academic and personal notes with me! I learned a lot today about transyouth and CF programs, and I also thought a lot about myself! And that’s the whole point of this shadowing program. It was a great day.

Oxy-CHLA Shadowing Day 3: PICU

Today I was in the Pediatrics Intensive Care Unit (PICU). Similar to when I was in the CTICU on Tuesday, this is an intensive care unit for incredibly sick kids. Different from the CTICU is that there are many older patients, several school aged children and even some teenagers, though there are infants and toddlers as well. Similar to my day on Tuesday, we rounded with the doctors and then we were allowed to split up and shadow some nurses. It was a pretty good day.

What I learned about the unit:

Sort of like what I said earlier, the patients in the PICU are very sick and are typically school-aged children. I saw patients with diagnoses from pneumonia, to trisomy 21, to paralysis in one extremity. The PICU gets all types of patients, instead of the specialized cardiothoracic patients in CTICU. Otherwise, the PICU functions very similarly to the CTICU. There was a lot more action going on, either because of just the day, or maybe it’s because more procedures can be done at bed-side with bigger kids. I got to see a 12-lead EKG (which I’m familiar with, but still), and an echocardiogram performed. I also learned about G tubes versus J tubes, and got to see a portable arterial blood gas tool. I also learned a good amount about ventilators today! Now I feel more comfortable reading respiration waves.

What I learned about the job:

Today I rounded with a fellow, two residents, a nurse practioner, and a pharmacist. Unlike CTICU, the attending was not with us on rounds. We didn’t end up going into any of the rooms (which made me sad because I really like seeing patients). However, I saw the fellow enter the rooms later. I ended up rounding with the main PICU attending, who was absolutely amazing. I would love to be a doctor just like her. She was very kind, funny, and even when she personally disagreed with the patient’s parent’s opinions, she hid it very well. There was definitely more doctor-patient interaction in this unit than in the CTICU, which is what I like to see.

Additionally, I got to see a little tiny baby admitted into the unit, and one of the residents did a physical exam on him, and also explained to me what to check for (such as fontanelles). I so very much appreciate any time the doctors invite into the room and then explain things. It makes the day so worth it.

What I learned about myself:

Hmmm… don’t know how much ICU suits me. I do love kids, but being at CHLA hasn’t bee like “WOW THIS IS WHAT I WANT TO DO FOR THE REST OF MY LIFE!” For example, the ER makes me feel that way. CTICU/PICU haven’t made me feel that same level of passion. I was telling one of the nurses, who figured out I was Filipino, that if I was never exposed to such hostile levels of Filipino stereotype (“All Filipinos become nurses.”), I probably would have opted to do nursing instead because of the amount of patient interaction. But whenever I think about being a nurse instead of going to med school, a piece of me dies inside because I want to study all the anatomy and physiology and pathology in-depth because that’s what I love. Also every time I think about switching to nursing, I literally cringe because it’s like falling into a stereotype I have fought so hard to go against and I could just see my family being like, “Ha! I told you so!” and no no no we cannot have that.

That’s all I’ve got for today’s post on my shadowing adventures at CHLA. Check back tomorrow!