STUDENT INTERNSHIP & EXTERNSHIP REFLECTIONS
(continued from page 21)
to pursue medicine, but those reasons and motivations felt unified
and shared in that moment. This picture (on page 21) captures what
I felt was a true collaboration of minds across oceans, a mutual
respect we shared for our teacher Dr. Anguyo - his knowledge and
expertise, and the desire we all had to learn more about medicine,
the better to help those around us.
Nicholas Chen is a second-year medical student at the University of Louisville
School of Medicine.
PEDIATRIC EXTERNSHIP REFLECTION
A
AUTHOR Brandon Chen
t first, the emergency department
(ED) was a confusing mess. Some-
one was on the phone here, some-
one needed a question answered
there, everywhere I saw parents
looking for rooms, physicians dis-
cussing patients and babies crying.
Some alarm beeped incessantly. I was so dis-
oriented on my first morning that I introduced myself to a dental
student, thinking she was an attending. By afternoon, I had begun
to make sense of things. The nurses sat on one side, the doctors
on another. The residents wore scrubs, the fellows sometimes, and
the attendings almost never. I could read the big board with all the
patients, their chief complaints, a number indicating priority and
colors indicating hospital status. In the following week, more things
began to become clear. There were doctors who liked chatting with
the nurses and auxiliary staff, others who preferred just to see pa-
tients and go back to write the note. If the physicians stood up and
walked to the printer, they were just discharging a patient. If they
walked toward the back, they were eating or using the restroom.
Now if they grabbed a stethoscope, well that meant business and
I should tag along.
It was tedious at times, introducing myself to a new set of resi-
dents every few days, or a new attending every four hours. And it
was hard to differentiate the hierarchy, since to me, everyone was
just an actual doctor. Occasionally I would meet a new physician,
thinking they would be staying in the ED, but when they abruptly
disappeared, I learned they were doing consults. These few missteps
were the main negatives: everything else was gravy.
I loved being able to see such a wide variety of cases every day.
While some of my classmates in other departments saw the same
variations of a handful of patients, I was fortunate enough to see
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LOUISVILLE MEDICINE
and interact with patients with psychiatric, orthopedic, neurologic,
gastrointestinal, lung, genitourinary problems and traumas. It made
the experience that much more fulfilling; I could learn all different
things but remain interested in each due to the unique nature of
the case. But beyond the “hard medicine” that I learned, I came to
appreciate the interpersonal skills of many of the physicians in the
ED. I witnessed truly enlightening tutorials on how to treat younger
patients and also on how to properly involve the parents.
Dr. G was speaking to an “SIP” (sensitive issue psychiatric)
patient who refused to talk. She broke down in simple terms why
she was there, what her role was, and that she just wanted to make
sure the patient was doing okay from a medical standpoint. Treating
him as a friend instead of a patient worked great.
Dr. X was trying to perform a physical exam on a fussy five-
year-old who was in a lot of pain. The patient wasn’t cooperating at
first so she asked if she could first perform the steps on the patient’s
stuffed unicorn, after which the patient became compliant.
Dr. Y would assess cap refill by telling the kids, “Your toe will
become red if you have super powers.”
Dr. Z asked the patient’s mom how she would feel if her child
was discharged immediately, to gauge her response and to involve
her in the process of shared decision-making.
There were so many more subtle actions, speech patterns and
tricks that only years of experience and a passion for working with
children can teach.
I am also thankful for the kindness displayed by the residents
and fellows towards me. Many of them went above and beyond in
explaining medical jargon, disease states, mechanisms of action
and anatomy. Furthermore, they helped me to suture, do the FAST
exams, do forearm reductions and more. They also fed me cheese
sticks and almonds during my first night shift, when I forgot to