Things are beginning to come together.
Before I started medical school, I had a pretty strong interest in a specialty called physical medicine and rehabilitation (PM&R). However, as any physician can tell you, everything can change when you’re in your third and fourth year working in the hospitals and experiencing all of the great medical specialties. One of them may just jump out and grab you, and who knows what specialty you’ll end up going into? At this stage of the game, however, I am really excited about PM&R and it seems like maybe the universe wants me to be a PM&R doctor too because, as I said, things are coming together.
One month ago I was just plodding along as a first year medical student, nothing of note to report. Now, I am sitting here as the new president of the PM&R club at LMU-DCOM, the co-chair for the national student council executive committee for the national osteopathic PM&R organization (AOCPMR), and fresh off a week-long shadow experience with a PM&R doctor at Vanderbilt’s new PM&R department. Some things are just meant to be!
Well, it all started with my wife, really. She had mentioned that one of the physicians at the rehab hospital at Vanderbilt where she works was really cool and that she had spoken with them about me being a medical student interested in PM&R. One evening, my wife suggested I contact that doctor and see if I could shadow them for a day. I sent the doctor at Vanderbilt an email and asked if I could spend a day with them to see what life as a physiatrist (physiatrist = PM&R doctor) is like. When they responded, they said that I could shadow for a day or spend the whole week with them if I wanted. That was an unexpected surprise and one that I was really excited for!
Those of you who have shadowed know how awesome it is to be with a physician all day and see what they do, all the ins and outs of practicing medicine. As much as you learn in a day, a few days with a doctor is so much more valuable and meaningful because you get comfortable in the setting and start to really learn after the first day (and you also get to see if that specialty is diverse and interesting or repetitive and boring). Well, as much as I can learn in a few days, all week was even more fascinating and educational. It almost felt like a short clinical rotation since I got to spend the entire week coming into work each day.
One thing I did not expect was how much more I got to experience as a medical student, as opposed to being an undergrad shadowing. It was like I had joined the club. There was no hesitance, skepticism, or simplifying of the complex medical cases. I sat in on every meeting, saw every patient, and was in on every procedure. We were (almost!) like colleagues. It was such a welcome feeling, one that has given me new excitement and appreciation for being in medical school. One day I will get to be the doctor I got to pretend to be during this week.
This amazing experience was eye-opening for many reasons. I learned firsthand how much of doctoring this day and age is non-medical. Working with family members, social workers, and hospital administrators, trying to coordinate care for a patient before any actual care can be given, was monumental. Not to mention that hours of documentation had to be done every evening after seeing patients (which luckily I didn’t have to stick around for!). There are more lawyers, HR, insurance, and other administrative interactions every day than there are medical interactions. It was a bit disheartening, but not too much, in the end.
What was really sad was some of the horrific injuries we were seeing every day (inpatient rehabilitation) as a result of people (often teenagers) driving drunk or high. Unfortunately, such is life. However, the one disorder I witnessed that I don’t think I will ever forget is one we saw twice during the week while doing BoTox injections for muscle spacticity. The BoTox (botulinum toxin) interferes with the acetylcholine neurotransmitter in the neuromuscular junction and relaxes the muscles that are tonically contracted. We saw two patients who were severely mentally handicapped. They could not walk or talk or feed themselves; they were very close to a vegitative state. The thing I learned about two of these patients was that they were both born perfectly healthy. They had no genetic disease, no infections or accidents that caused their mental disability. They were both the victims of shaken baby syndrome. They had the potential to lead healthy lives but sustained severe head trauma at such a young age (both around 4 months old) that their brains stopped developing. Now for the rest of their lives they need around the clock care for every aspect of their lives. That experience will be with me forever.
Learn more about shaken baby syndrome here: http://dontshake.org/
I also had a ton of other really great experiences (less sad ones) and met some really great patients and doctors. I really enjoyed visiting Vanderbilt, and its new PM&R department is shaping up to be a really awesome place! Maybe one day I will be back at Vanderbilt in a new role (residency?? … too soon, too soon). It has been a very PM&R-filled month so far, and we will see where it goes from here. Like I said, I may end up a trauma surgeon, who knows, but I know that for now I’m excited to be a part of the PM&R community.
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