Friday, June 21, 2013

Week 1 - Marie

I have been matched with Dr. Jonathan Weinsaft, a cardiologist at WCMC, for the immersion term. Dr. Weinsaft's work focuses on cardiac imaging; in particular, he focuses on cardiac magnetic resonance imaging (MRI). My background and research interests are very disparate, so I have been spending a lot of time reading: MRI: From Picture to Proton and Cardiovascular MR Imaging have been quite useful. My immersion term research project will likely focus on MRI detection of thrombus.

I spent a portion of my first day of the immersion term shadowing Dr. Weinsaft as he saw patients in the clinic. The most illuminating part of this experience was seeing first-hand how patients are "non-ideal"-- this particular patient had elected to stop taking medicine prescribed for a blot clot and her beta-blocker because she felt they were affecting her mental status. Dr. Weinsaft had the challenge of acknowledging and respecting her concerns while informing her of the importance of taking her medicine. This experience reminded me of two things: (1) patient compliance is key to successful treatment and (2) patient mental health is as important as patient physical health.

I also spent a few mornings in the cardiac care unit (CCU / cardiac ICU)-- the highest level of care for cardiac patients. Around 8:30 in the morning rounds begin. Rounds consist of the attending physician, fellows, residents, PAs, and nurses discussing each patient's case and any recent changes. There are 20 beds in the CCU, so rounds take 4-5 hours. What's most interesting to me about the CCU is that while the heart is the *most* concerning aspect of each patient's condition, most of them have multiple other health concerns-- diabetes, infections, cancer, etc. This reminds me that medicine is usually not practiced on healthy patients. I also found interesting how many patients do not speak English-- in the CCU, I've seen patients whose primary languages are Croatian, Serbian, Russian, Spanish, and German. The hospital has special policies to ensure these patients are properly informed in their native language.

From my current perspective, a career in medicine is rather enticing--everywhere I turn I see people being *useful* in real-time. The timescale of a ICU is almost inevitably short-term, and the outcomes observable in a matter of minutes, hours, or days. Coming from a research perspective of months, years, or decades, it's exciting to see such quick results!

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