Maybe I'm Becoming a bit Premed...

When I applied for college as a Biology major and well into my first year at UW, whenever I told someone I was a bio major, they'd always respond with the same question: "Are you premed???" and I'd always respond: "No, I want to go into the research side of the medical field." However, something started to change last year. Something began to niggle at the back of my mind, saying maybe, just maybe, I did want to be a doctor... Now, I'm still not sure, but I know for certain that I need to explore the doctor side of the medical field as well as the research side (which I'm currently doing, check out my first experiential learning) in order to decide where I want to go in my career. So, over winter break, I shadowed some Pediatric Infectious Disease doctors at Seattle Children's Hospital for two days. This experience was incredibly influential and educational for me.

I spent the first part of my first day in a mini conference with most of the larger Infectious Diseases team at SCH. In the conference, they discussed the advantages and disadvantages to a drug they had started using more heavily to treat infections, as well as some more complicated patient cases. I was struck by the strong collaborative aspect of these discussions, and just overall (I'm not entirely sure if this is an ID thing or just a doctor thing...I'll get back to you). Every single thing they mentioned was up for discussion, and they went back and forth, bringing up new sides to an issue and evaluating pros and cons. I learned how many things must be taken into account when looking at each unique ID case: which pre-existing conditions does a patient have (ex. are they already a cancer patient?)? Which antibiotics have they already been on? How can we ensure they're on antibiotics for the least amount of time? Does this patient live far away from the hospital, and thus inpatient treatment is challenging? How expensive are these drugs? What is the patient's family's perspective on treatment? Do they not want surgery? Each patient case is unique and has a million different things to consider, making each situation a complex puzzle to solve. I found this part of the job very fascinating, and certainly challenging, because for most cases, there isn't a perfect solution.

Next, I spent a lot of my time observing the conversations and case briefings between the smaller team of practitioners I was shadowing. Each person, whether they were a doctor, Fellow, Nurse Practitioner, or Physician's Assistant, would go over each of their cases for the Attending and the rest of the team. They'd review the patient's history, medication, what they've observed when visiting the patient, and what they're thinking for treatment options. Then, the team would discuss their ideas and they'd come up with a plan, whether that be for medicine, whether or not they'd visit the patient that day, or anything else. Once again, I really enjoyed the collaborative and intellectual aspect of the job exhibited here.

Then, we visited the patients. I knew that being in a hospital, especially a children's hospital would be challenging, but as I walked through the halls and looked into the patient rooms, I was still struck by the tragedy and profound sadness of the reality of sick children. As we visited kids, some of who were incredibly sick or battling multiple different ailments at the same time, it was very devastating to see how downtrodden or subdued these children were. While it was extremely sad, I think it was definitely important for me to see, to be aware of the reality of this job, specifically in pediatrics. I do also think that my perspective was slightly skewed, because the ID doctors act as consults, so they only visit patients who were sick enough that their primary doctors wanted to call in disease specialists. Additionally, we didn't visit the patients who were doing well. So, I definitely saw some of the sickest kids, which I'm trying to remember as I reflect on the emotional aspect of the job.

When visiting patients, I got to observe bedside manner, specifically that of ID doctors, who are consults and not primary doctors for patients. This was pretty unique and interesting to watch, and it definitely showed me a personal downside in the ID specialty. Because the ID doctors are only consulted when a patient has an extra complicated or difficult case relating to disease, they get a lot less time with patients. Although some patients stay for a long time or return often, they generally don't get to build as strong or long relationships with patients and their families as primaries do. This was one aspect of the job that I didn't enjoy as much, because I think that building relationships with patients and families would be something that would be very important to me as a doctor. However, it was interesting to see how the doctors I was shadowing were able to effectively communicate with patients and their families even though they weren't as familiar with them. Additionally, there was an added layer of complexity because the hospital is pediatric, so when interacting with patients, you're also interacting with incredibly stressed-out parents. It was cool to see the way the doctors balanced communicating with the kids and the parents, and how they tweaked their bedside manner and tone in each situation.

Overall, this experience was incredibly valuable. It was really cool to just be in the hospital environment and get a feel for what it's like. It was very interesting to talk to real doctors about what being an ID doctor is like and how they split their time up (which includes a wide range of things, often including research!). I'm super grateful to the doctors I shadowed for their willingness to answer my questions and show me all the different parts of the job. It was also really amazing (educationally) to observe the interactions with patients and see how that aspect of the job works. It definitely showed me that I'm interested in the patient interaction side of things. Because of this, and the slightly depressing nature of ID that I observed (for reasons I discussed above), I don't think being an ID doctor is for me, as of now. However, I'm still super interested in doing more shadowing of doctors in different specialties. One specialty I'm especially interested in right now is OBGYN, because I'm interested in women's health, and I really like the idea of doing medical work in the vein of bringing new life into the world, as opposed to treating people who are really ill. I look forward to more shadowing opportunities in the future.