2018
AN ARTS & LITERARY MAGAZINE GEISINGER COMMONWEALTH SCHOOL OF MEDICINE VOLUME 5 | 2018
about the cover art & artist The White Angel Feather | Finding a white angel feather is said to be a sign of faith and protection and that angels are near. Linda Horvat Bradley | Guest Artist Originally from Kansas City, Kansas, Linda currently lives in Waymart, Pa. She is a standing member of the London Visual Arts Guild located in London, Ohio. Her exhibits have been shown at the Gallery on High in London, Ohio, and her hobbies include horseback riding, calligraphy, pottery and southern-style cooking. Linda says, “I choose to discover nature! Mushroom-shaped hearts, twisted roots by the creek and the beauty of winter snow invite a walk in the woods…. My goal as a nature photographer is to encourage others to take time to be observant of details, textures and little things along the way.” Come discover the treasures of nature! A bounty of riches awaits! Black Diamonds is an arts and literary magazine of Geisinger Commonwealth School of Medicine. All content is the property of each respective author/artist. No part of this magazine may be reproduced without the permission of the author/artist of each submission.
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or thousands of people living in northeastern Pennsylvania (NEPA) during the 19th and 20th centuries, coal was precious. It was the black diamond they mined and the substance that supported their
lives. Formed in ancient times under the massive pressure of the sediment above it, coal became the foundation of an entire economy in NEPA. That economy has all but vanished from this part of the country, but today, NEPA is witnessing the formation of a new and valuable resource. Created under the pressure of a great need for future physicians, Geisinger Commonwealth School of Medicine now exists. New students are coming in to NEPA every year to begin the process of being transformed into physicians through the steady, constant pressures of medical school. And like the rich veins of coal that extended through the region, these future physicians are now stretched across counties in northeastern and central Pennsylvania. For many of these students and their teachers, the arts are an important part of life outside of medicine. Our hope is that this journal can serve as a showcase for their expression and be an inspiration to those who read it.
Zachary Wolfe, MD md Class of 2015
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Geisinger Commonwealth School of Medicine is committed to non-discrimination in all employment and educational opportunities.
table of contents From the Editor 06 Capturing True Beauty 08 Grateful at Geisinger Commonwealth 12 The Colors of Fall at the PA Grand Canyon 14 Fun 15 Learning Through Giving: Faithcare 16 Tiger Lily 19 a beautiful fall river view in sayre 20 Waterfall adventures 21 A Day in the Life MBS - Doylestown 22 Survivor 24 Light 1 // Light 2 25 Spotlight on Faculty: Carmine Cerra, MD 26 Treetoes 29 A Day in the Life MBS - Scranton 30 Sentinels 32 Front Row Seat for Fall // Collapsed 33 End of Season // Charity Starts At Home 34 Untitled 1 35 Taking Time to See 36
39 The Gift 40 Military Medicine 43 Memory 1 // Memory 2 44 A Day In The Life M1 46 My First Patient 47 Heartbeat // Becoming 48 A Day In The Life M2 49 ReadySetGo 50 Nay Aug Falls // Lakeside Perspective 51 Untitled 2 52 homecoming 53 Frozen Leaf 54 A Day in the Life M3 56 In motion 57 Mushrooms 58 a Day In The Life M4 60 Nature’s Yellow Brick Road // Moving Parts 61 Contrast 1 // Contrast 2 62 Untitled 3 63 Editorial Staff 05
from the editor COMMITTEE
OLApeju simoyan, md, mph, bds, faafp associate professor of family medicine & epidemiology “If you walk the footsteps of a stranger, you’ll learn things you never knew
Olapeju Simoyan, MD, MPH, BDS, FAAFP Editor in chief Vanessa Thiel Managing Editor Miriam Eagleson Layout Designer Heather M Davis, MFA Production Manager Debra C Tierney Staff Editorial Assistant Amelia Mackarey Student Editorial Assistant Kristina Lake Borham Student Editorial Assistant
you never knew”. These profound words from the song “Colors of the Wind” in the movie Pocahontas speak to the theme of this issue of Black Diamonds. Appreciating differences by celebrating diversity is one of the cornerstones of the Geisinger community and our CEO, David Feinberg, MD, encourages us to “let kindness be our beacon in a sea of change.” Indeed, walking in the footsteps of others not only increases our awareness about our fellow humans, but it can also help us to be more compassionate and empathetic. International health experiences provide opportunities for students and faculty to learn about other cultures while contributing to the health needs of underserved populations. Emily Amendola, a fourth-year medical
Art and science inform each other. From the earliest drawings of neurons by Santiago Ramón y Cajal to Rosalind Franklin’s X-ray diffraction images giving us the first glimpse of DNA, creative expression has been an important means of disseminating scientific knowledge. These pioneering endeavors deepen our knowledge and enhance our lives. We need your support to continue the pursuit of beauty and truth. Please consider a charitable gift to fund the annual publication of Black Diamonds.
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student, writes about stepping out of her comfort zone to participate in a medical mission trip to Nigeria and how this experience reinforced her passion for global health. Carmine Cerra, MD, one of our faculty members, shares how his experience attending medical school in Italy provided him with a cultural education he would not have received if he had attended an American medical school. Poetry can be a powerful vehicle for expression and Vanessa Thiel, a second-year medical student, in a very moving poem, reflects on her expe-
rience visiting “the country she could have called home,” for the first time, an experience that led to the desire to incorporate global health into her future career. We are especially honored that Rick Guidotti, an award-winning photographer, agreed to be interviewed for this issue and granted us permission to use his photographs featuring amazing people with various genetic conditions. Rick is truly using the gift of photography to help others see the beauty in human diversity. Photography as an art can also provide balance in our busy professional lives, an important factor in preventing burnout. This is demonstrated in the article about Mark Ayzenberg, MD, a member of our charter class who is also featured in this issue. Alluding to his interests outside of medicine which include music and photography, Mark suggests that he “may have too many hobbies,” but these outside interests help him to stay grounded. This is something that I, as a physician with similar interests, can personally relate to. Finally, in the spirit of Geisinger’s kindness project, Amelia Mackarey reflects on why she started the Grateful at Geisinger Commonwealth project, which is intended to, in her words, “highlight rays of sunshine” and “brighten each of our days.” We hope that through these essays, poems and pictures, your day will be brightened and you will be encouraged to expand your horizons, walk in the footsteps of others, and discover “things you never knew you never knew.”
Capturing True through the Lens Beauty of a Camera Positive Exposure Elizabeth Zygmunt Director of Media & Public Relations
S
tanding outside an auditorium at
complications. That’s why all medical
a chromosome 18 support group
students study the condition. What
meeting, all Rick Guidotti could hear was
saddens Rick, however, is how the
the laughter. The children inside were
students first meet these children. They
being entertained by a clown making
don’t become acquainted at a time when
balloon animals — and he was evidently
the kid is just being a kid, delighted by
doing a very good job, judging by the
balloon animals. Instead the introduction
joyful shrieks.
occurs in the pages of a textbook, where the children are photographed against
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Children with chromosome 18
a wall, stripped of their humanity, with
anomalies may have developmental
a floating black “anonymity” bar pasted
issues and often suffer severe medical
across their eyes. “What the medical
Rick Guidotti, an awardwinning photographer, left the fashion industry to create the nonprofit Positive Exposure. Positive Exposure uses photography, film and narrative to transform public perceptions of people living with genetic, physical, intellectual and behavioral differences. The nonprofit’s educational and advocacy programs reach around the globe to promote a more inclusive, compassionate world where differences are
students don’t get is the giggle,” Rick said. It’s
Other people were always telling me who was
his mission to change that.
beautiful, but I see beauty everywhere.”
celebrated. Rick delivered
Rick is a former fashion photographer who has
Rick’s epiphany occurred when he spotted a
“The Spirit of Difference,” at
worked with people the world deems beautiful.
beautiful girl waiting for a bus in New York
Geisinger Commonwealth
One of the last supermodels he photographed,
City, a girl he realized would probably not be
School of Medicine’s fall
for example, was Cindy Crawford in the late
accustomed to being called beautiful. She had
2017 Keystone Symposium,
‘90s. As an artist, however, Rick said he felt
albinism, a congenital disorder characterized
Innovations in Autism
limited. “The aesthetic of beauty has always
by the absence of pigment in the skin, hair
driven me,” he said. “So working with those
and eyes. “I looked at medical photographs
Awareness and Diagnosis.
supermodels was fantastic, but frustrating.
taken to depict albinism and they were horrible,
the keynote speech, entitled
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dehumanizing. That’s when I decided to devote myself to helping others to see what I see — to see the beauty in human diversity,” he said. Rick’s first act was to contact the National Organization for Albinism and Hypopigmentation. His suggestion was simple. “I called them and said, ‘Let me take a million pictures to show the world.’” Rick’s first subject was Christine, a young woman with albinism, and the power of his photography to change the way she viewed herself has kept him motivated ever since. “She came in, shoulders hunched, no self-confidence,” he said. “But I treated her the way I treated any supermodel. I said, ‘Look at yourself, you’re fantastic!’” The resulting pictures will make anyone a believer. Christine stands — sometimes with hands on hips, sometimes with arms thrown wide — confidently flashing a dazzling smile Rick says “could light up New York City.” Since that session almost 20 years ago, Rick has photographed countless children and adults with genetic conditions, as well as other physical, behavioral and intellectual disabilities. Rick presents not Marfan syndrome, trisomy 18 or albinism, but a boy splashing in a pool, kids chumming around at summer camp, a mom kissing her beloved child. Although his photos are not exclusively for medical students, they are an important audience to Rick. “I want to be sure they remember that it’s not what you treat, but who you treat,” he said. “They should never forget the humanity in their profession. There’s lots of art and passion in medicine — let’s be sure to embed it early in these students.”
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GRATEFUL AT GEISINGER COMMONWEALTH AMELIA AMELIA MACKAREY MACKAREY MD MDclass classof of2020 2020 PHOTO PHOTOBY BYASSAD ASSAD HAYAT HAYAT Class MD class of of 2020
R
ight ight before before II take take an an exam, exam, I’m I’m aa mess. mess. My My
and and dreaming dreaming that that one one day day she’ll she’ll be be accepted accepted
hands hands shake shake and and my my skin skin is is clammy. clammy. My My
so so that that she she can can finally finally follow follow her her lifelong lifelong goal goal
stomach stomach is is in in knots knots and and my my mind mind is is racing. racing. As As
of of becoming becoming aa physician. physician. Who Who am am II to to take take for for
II drive drive to to school, school, II usually usually cry. cry. On On one one particular particular
granted granted an an experience experience that that this this other other girl girl so so
exam exam day, day, II am am in in the the middle middle of of this this anxious anxious
deeply deeply wants? wants? Who Who am am II to to cry cry away away the the dream dream
ritual. ritual. As As the the tears tears stream stream down down my my face, face, II
that that this this other other girl, girl, this this other other “me”, “me,” would do
suddenly suddenly understand understand that that I’m I’m the the lucky lucky one. one.
anything anything to to realize? realize?
Somewhere Somewhere out out there, there, there’s there’s aa girl girl and and she she is is
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just just like like me. me. She She has has brown brown hair hair and and brown brown eyes eyes
According According to to various various studies studies on on medical medical
and and two two younger younger sisters. sisters. She She went went to to college college in in
education, education, nearly nearly all all medical medical students students will will
Florida Florida and and her her family family is is home home in in Scranton. Scranton. She She
experience experience some some form form of of distress, distress, burnout burnout or or
desperately desperately wants wants to to be be accepted accepted to to medical medical
depression depression throughout throughout their their training. training. AA metameta-
school, school, she’s she’s volunteering, volunteering, shadowing shadowing and and doing doing
analysis analysis and and systematic systematic review review determining determining
research. research. She’s She’s also also networking networking and and studying studying
the the prevalence prevalence of of depression, depression, depressive depressive
and and taking taking the the MCAT. MCAT. She’s She’s attending attending medical medical
symptoms, symptoms and suicidal ideation among medical
school school interviews. interviews. She’s She’s hoping, hoping, praying, praying, wishing wishing
students students at at various various institutions institutions published published in in
these doing rays reallyofexciting, sunshine positive in our medical things. Grateful school lives at
or medical depressive students symptoms experienced and 11.1% someoftype students
and Geisinger to brighten Commonwealth each of ourisdays meant by focusing to highlight
experienced of depression suicidal or depressive ideation.symptoms Another study and
on these the rays goodofthings sunshine happening in our medical here at Geisinger school lives
found 11.1 percent that, although of students students experienced enter medical suicidal
Commonwealth and to brighten each School of of ourMedicine. days by focusing
school ideation. with Another similarstudy ratesfound of depression that, although as
on the good things happening here at Geisinger
compared students enter to themedical non-medical schoolstudent with similar population, rates
Commonwealth School Medicine. to focus Each month, everyone isof encouraged
there of depression is a rise inasdepression comparedscores to the non-medical and in
on the positive aspects of medical training by
persistence student population, over time there in the is a medical rise in depression student
submitting Each month, good everyone thingsisthey’ve encouraged experienced to focus in
population scores andcompared in persistence to the over non-medical time in thestudent
relation on the positive to GCSOM. aspects In order of medical to protect training privacy by
population. medical-student Otherpopulation studies also compared indicate that to the the
and submitting to encourage good things candorthey’ve in the submissions, experienced in
percentages non-medical for student medical population. student depression Other studies and
students, relation tofaculty, GCSOM. and Instaff ordercan to protect submit privacy entries
burn-out also indicate are higher that the than percentages those reported for medicalin the
anonymously. and to encourage Contributors candor inmention the submissions, people,
general, student non-medical depression and student burnout population. are higher There is
events, students, and faculty thingsand for staff whichcan they submit are grateful. entries
athan need those for programs reported in and theinitiatives general, non-medical which focus
Entries anonymously. range from Contributors silly (“I’m mention grateful for people, the
on student improving population. medical There student is a mental need forhealth programs and
cool events temperature and thingsand for pleasant which they smell are grateful. of the first
emotional and initiatives well-being. that focus It was on with improving these medical national
floor Entries bathroom”) range from to silly sincere (“I’m(“I’m grateful grateful for the for our cool
statistics student mental and personal health and experiences emotional in well-being. mind that I
Dean temperature of Students and pleasant for her truly smell beautiful of the first-floor heart
founded It was with Grateful these at national Geisinger statistics Commonwealth. and personal
and bathroom”) for giving to110% sincere to (“I’m her students; grateful for I wouldn’t our dean
experiences in mind that I founded Grateful at
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Grateful Geisinger atCommonwealth. Geisinger Commonwealth is a
entries giving 110 praising percent oneto another her students; for theirI wouldn’t academic
monthly newsletter which features messages
contributions be where I am(“I’m without grateful her”). forStudents the awesome submit
from Grateful students, at Geisinger faculty,Commonwealth and staff praising is avarious
lecture entries outline praisingand oneanki another deck for from their myacademic classmate;
aspects monthlyof newsletter our GCSOM thatcommunity. features messages Although
itcontributions really helped(“I’m me on grateful our exam”) for thetoawesome their personal
some from students, days can faculty be really and difficult, staff praising there arevarious so
support lecture outline (“I’m grateful and Anki to my deck roommate from my classmate; for
many aspects wonderful of our GCSOM people community. at our schoolAlthough who are
being it really in helped the trenches me onof our medical exam”)school to theirwith personal
doing some really days can exciting, be really positive difficult, things. there Grateful are soat
me; support she makes (“I’m grateful every day to my better”.) roommate People forare being
grateful GRATITUDE
students (JAMA) inexperienced 2016 foundsome that 27.2 typepercent of depression of
THANK YOU I’m
Geisinger many wonderful Commonwealth people at is our meant school to who highlight are
’m grateful for our Dean of Students
JAMA Journal inof 2016 the American found thatMedical 27.2% of Association medical
I’m grateful to my professor
I’m grateful for the awesome lecture outline and anki
in the trenches of medical school with me; she makes every day better”). People are also thankful for their professors going above and beyond in order to provide the best medical education to each and every student (“I’m grateful to my professor for holding extra study sessions, for creating helpful study guides and for going over test-taking strategies with me”). Members of the GCSOM community are also grateful for the excellent staff at the medical school, emphasizing the positive contributions of the security team, the cafeteria staff, the facilities staff and the exam proctors. Looking back over this year, I have to say that I’m grateful to be a student at Geisinger Commonwealth School of Medicine. I’m grateful to be supported by such a compassionate, empathetic and loving school community of students, faculty and staff. I’m grateful to be able to study and learn in such a beautiful building with its amazing facilities. I’m grateful to be taught and mentored by so many incredible clinicians. And I’m really grateful to see so many heartfelt submissions and genuinely uplifting messages in the newsletter each month. They have truly brightened my days and I hope that they do the same for many others in our GCSOM family.
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The Colors of Fall at the PA Grand Canyon christian bohan md class of 2019
Dances through mazes, ghosts to outrun, chances to face them, but often outgunned, doubt is no stranger, can strike you aghast, this game is not easy, nor simple, nor fast. And if all the nuggets you quickly collect, evade all the dangers The Game could project, you conquer the level, only to learn the next one is harder, with less time to burn! But that’s both the challenge and beauty in one — beating each level’s not how The Game’s won, if that’s your sole goal, your joy will succumb, ‘cause playing itself is where the fun’s from. No matter how many, the nuggets will fade, and all of us someday depart the arcade, so keep kind and curious, and savor each day and never forget why you started to play! What really matters, when all’s said and done, Who did you help — who shared in the fun?
FUN DAN SYLVESTRE md class of 2021
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Learning through giving My FaithCare Nigeria experience
EMILY AMENDOLA md class of 2018
I
n October 2017, seven FaithCare team members from the U.S. embarked on a two-week journey
to Kafanchan, Kaduna State, Nigeria, on a medical mission trip. During this trip, I hoped to step out of my comfort zone and broaden my medical education. I wanted to meet new people and seek a different perspective on healthcare and what that term means in other parts of the world. However, what I gained was much more than I could have ever imagined and was a truly eyeopening experience. Many people living in Nigeria and millions around the world do not have access to healthcare. They often wait too long, until they can no longer tolerate their suffering, and in doing
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so, things that may have easily been treated
obstetricians and gynecologists, as well as
become much more complicated and serious.
spiritual counselors, as we saw and treated
During this trip, men, women and children
3,500 patients and performed 151 surgeries.
walked hundreds of miles to be seen by our
Our U.S. team paired with a local Nigerian
team. I cannot imagine putting my family on
team as we helped establish a health clinic
a dusty path in Africa and walking hundreds
in the area. I was overwhelmed, as the days
of miles just hoping for a miracle for my loved
were long and there was a never-ending
one. On this trip, I was part of that miracle, a
stream of patients. This experience allowed
hat I never anticipated I would wear.
me to see firsthand just how underserved some populations are. The pathology that we
During this mission trip, I worked alongside
saw would not be seen in the United States.
a team of healthcare professionals including
I learned about how healthcare is provided
pharmacists, dentists, nurses, paramedics,
in Nigeria and the need for better access. I
surgical technicians, general surgeons,
was able to step out of my comfort zone and
FaithCare is a nonprofit (501c-3) organization composed of individuals interested in the healthcare field and in serving needy people with care, consideration and love. Although we spring from Christian roots, we welcome persons of all faiths as we seek to deliver care with compassion, a quality universal to all major religions. The goal of FaithCare is to integrate faith into the practice of medicine by providing excellent healthcare, locally through wellness centers, and internationally through medical missions. FaithCare has had missionary outreaches to Nigeria, Siberia, Haiti and the Dominican Republic. The international projects include medical consultations, surgical care, ophthalmologic care, dental care and spiritual counseling. FaithCare is currently embarking on a capital campaign to establish hospitals in Nigeria and Haiti. ”Imagine the joy of being used to significantly impact someone’s life... meeting a need that otherwise may not be met.” – Peter F. Schnatz, DO, FACOG, FACP Founder and CEO, FaithCare Learn more at faithcare.net.
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I believe that this is zone immerse and myself immerse in a myself culture in so a culture so different from mine that it challenged me to meovercome to overcome language language barriers barriers and cultural differences and culturalin differences order to provide in order appropriate to care. provide appropriate care. I was fortunate enough to have had the opportunity to serve a vastly underserved population in Nigeria, but the elements of this trip provided me with much more than I could have ever hoped. I knew that I would be serving many individuals who would not otherwise have received care. Looking back, I now realize the enormity of this experience. Through the years, I have been able to give back to my local community, the people and places that have helped shape the person I am today. I have been inspired to work harder, remain dedicated, dedicated and and achieve achieve my my goals. goals. This This trip, trip, however, allowed me to enter and serve a
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the essence of Global
a community community farfar different different from from my my own. own. The
Health, the idea that
The people people of Kaduna of Kaduna StateState entrusted entrusted me with me
we can take resources
have — their – their own health. own health. With With the combined the combined
and knowledge that we
were able to treat these patients who may
are fortunate enough
experienced the culture of Nigeria through
to have and spread our
some of my own culture and experiences
efforts to make the
essence of Global global health, Health,the theidea ideathat thatwe we
global population a
are fortunate enough to have and spread
healthier and better
a healthier and better community. This trip
community.
Global global health Healthand andisissomething somethingthat thatIIwill will
with one of one theofmost the most important important things things they they have efforts of the Nigerian and US U.S.teams, teams,we we not have otherwise had access to care. I my interactions with people and shared with them as well. I believe that this is the can take resources and knowledge that we our efforts to make the global population has reinforced the passion that I hold for carry with me into the future.
tiger lily Linda Bradley guest artist MD? 19
a beautiful fall river view in sayre christian bohan md class of 2019
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Waterfall adventures at buttermilk falls state park christian bohan md class of 2019 21
a day in the life
Sheream James Reed MBS-Doylestown class of 2018
[4 a.m.] I awake to the un-delightful intro
yesterday. I also can’t stop thinking about
of a song that resembles the barking of an
this cardiovascular lecture and how — if
alarm clock. There is no way I can sleep
I get out of bed — gravity will decrease
through this sound, which is why it has
my cerebral oxygen flow, ending with my
been my alarm tone for the past seven
passing out on the floor. It is right then and
years. I love “Frayed” by The Naked and
there that I realize — I’m a nerd.
Famous anytime other than 4 a.m. [4:30 a.m.] Still kind of weak from my blood
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[4:15 a.m.] Check emails and social
donation, but I survived my 10-minute
media, but still frozen in bed. OK, enough
shower. On to replenishing my red blood
procrastination, it’s time to get the day
cells with a B-12-rich breakfast and six
started. Oh shoot! The thought of me
cups of water. I wonder: If I drink too much
fainting crosses my mind because I
water, will I get through my neuroscience
gave blood at the student blood drive
exam without a restroom break?
[5 a.m.] Two-hour commute to Stryker
won’t be able to work these cool
[6:30 p.m.] Sit in alphabetically arranged
Orthopaedics in Mahwah, N.J. As I see
labs anymore.
seating assignments for the exam and log
the road covered with leaves and jack-o-
into Examplify. Here we go!
lanterns lined along the streets, I suddenly
[10 a.m.] Two-hour commute to the
have the urge to recite the sodium-
Pennsylvania Biotechnology Center
[7:30 p.m.] That went well. Over-studying
potassium pump mnemonic, “Pump-K-in.”
of Bucks County where Geisinger
proved useful. But now I don’t have any
The nerd in me strikes again.
Commonwealth’s Master of Biomedical
brain cells left for the post-exam lecture.
Sciences - Doylestown (MBS-D).
Phew, thank goodness for Tegrity recorded
[7 a.m.] This will not be an ordinary day in
lectures because I mentally checked out.
the training lab. The orthopaedic surgeon
[Noon] Detour. Restore glycogen at the
arrived without his assistant, so I will have
Doylestown Chipotle.
to help him during the procedure. Even
[9 p.m.] One-hour commute to home in Philadelphia. Eating and reviewing class
though the procedure was beyond the
[12:30 p.m.] Enter the study room of the
notes, while watching my beloved Sixers
scope of my job duties as a tissue steward,
school and not surprisingly see a dedicated
pulverize the Atlanta Hawks. The Sixers
I feel excited to hold the cadaver knee as he
MBS-D student sitting in the exact place I
are back!
makes the first incision. Next, the surgeon
left him the day before. He is focused on
asks me to use the mallet to hammer a
overcoming the academic hurdles of the
[11p.m.] I feel like a zombie. Positioning
baseplate between the femur and tibia.
program so that he attains his future career
heavy cadavers for surgery trainings
in medicine. His work ethic is contagious,
and endless study sessions is quite
so I dive head-first into study mode.
exhausting. Before I notice, I doze off into
[7:45 a.m.] Wow! I really just performed my first and probably last triathlon
nothingnezzzzzz.
knee replacement. I cherish this
[5:30 p.m.] Histology class begins. The
moment because I recently accepted
neuroscience exam is within the next hour
a scientific process operator position in the
and it’s hard to focus with my fate on the
Vaccine Department of Merck & Co., so I
neuroscience exam looming.
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Survivor Esther Good MD class of 2020
You can run for a long time, Weak as you are, Lungs burning for air And muscles burning for rest When your fear reminds you That you are made of flesh, But you can’t outrun the fire. You always pass the fools who, Tired to their last bone, Turn around to face the flames Thinking the Phoenix Is more than a fairytale. When you finally fall,
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The fire is waiting; Hot tongues lick your skin Like an ice cream cone. If the fire dies before you do Your bandaged wounds Will grow into angry scars, Red, twisted, and painful. Don’t mourn your lost beauty. Those scars make you stronger Than mythical feathers ever could.
Light Malina Lim mD CLASS OF 2020
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s p o t l i g h t o n fa c u lt y 26
Carmine Cerra, MD Pathologist and Medical Educator by Kristina Borham and Vanessa Thiel MD class of 2020
D
r. Cerra, the pathologist for the
Q: What inspired you to go into medicine?
Systems I and II courses at GCSOM,
is a specialist in the gross and cellular
A: Well, my mother was a nurse so I was
manifestations of disease that are essential
exposed to healthcare at a young age. My
in making diagnoses and treating patients
cousin had been a lab technician at the old
across all fields. He trained at the University
Mercy Hospital in Scranton and got me a
of Bologna in Italy, and prior to joining
summer job there, where I learned about
the faculty at GCSOM, was a practicing
laboratory medicine and pathology — I saw
pathologist at Pocono Medical Center
firsthand what being a pathologist was
in East Stroudsburg for more than 30
all about. I’ve also always liked science;
years, serving as chair of the Department
pathology is a lot of science, and it’s a
of Pathology and director of Laboratory
great halfway between clinical and basic
Medicine. GCSOM students love the
sciences.
photographs of Italy that he shares at the close of his podcasts and are immensely appreciative of his teaching efforts that
Q: When did you decide you wanted to be a pathologist?
certainly qualify as “above and beyond.” Dr. Cerra’s passion for education shines
A: From the first day of medical school,
through in all he does and we are excited
I was working towards becoming a
to share his story!
pathologist because I had had enough
“It was a great experience living in Italy” Q: What was your favorite part of going to school there?
exposure to the specialty. The world
oral exams and believe it or not, the easiest
of pathology includes both anatomic
one was pharmacology because it had
pathology (autopsy) and surgical pathology
multiple-choice and written components. It
(tissue diagnosis). Another component
really was different than what we do here
A: Education at the University of Bologna
is laboratory medicine, which is used to
because you had to think on your feet when
was not just a medical education — it
interpret the results of laboratory testing.
answering the questions.
was also a cultural education. In addition
It really is a field of diagnostic work. The
to my medical lectures, I used to attend
residency is a four-year program and the
In the summers, I worked as a waiter in
lectures on the history of the town and the
board exam includes two parts: anatomical
the restaurants to make some money for
university. I love opera and had season
and clinical.
travel. The great thing about the University of
tickets to the local opera house. I still
Bologna is that it is the oldest university in the
enjoy going to the opera today. History
Western world. The concept of a university
and the arts were a big part of the culture
was born in that town by gathering all the
— they were everywhere. On weekends we
different college disciplines together under
frequently went to other cities to explore
A: Many of my professors at The University
one umbrella — mathematics, engineering,
museums and historic sites. We visited
of Scranton encouraged me to go to Italy,
law. When I was there, there were about 60 to
most of Europe and parts of the Middle
especially having been put on the waitlist
70,000 students across the disciplines. I still
East. It was a great experience living in Italy,
in American schools. I spoke some Italian
speak Italian fluently, and when there are big
as I had never been anywhere outside of
before I went, but everything was in Italian
world events, I like to watch the Italian news
northeastern Pennsylvania (NEPA) prior to
at the University of Bologna. Exams were
to get another perspective.
the age of 21.
Q: Why did you choose to go Italy for medical school? What was it like?
27
“ L earning me d i c i n e i s a l l about e x The school in Bologna was quite diverse, with students from Europe, North America
Q: What brought you back to the NEPA area?
and the Middle East. I am very grateful to
would be something special. I wanted to be a part of it. I was part of the volunteer faculty for four years and eventually
have gone there. Many of my friends were
A: Truthfully, it was hard to come back
applied to work here full time, and it is now
enrolled in school in the States and didn’t
after having such an amazing time at the
my fourth season here! The transition to
have time for the type of cultural activities
University of Bologna. It was difficult to find
teaching was easy for me.
that I engaged in. It was natural for me to
a placement in Italy for training, and I ended
be involved in something else beyond my
up coming back to train in New Haven,
medical education.
Conn., and then I moved to the Poconos to
Q: What advice would you give to us preclerkship medical students?
work with a longtime friend, practicing there
Q: Do you still keep in touch with your classmates? A: Many of my classmates were from the New York City and northern New Jersey
for 35 years.
shouldn’t be doing it! The responsibilities [of
Q: When did you start at the school and what drew you to Geisinger Commonwealth School of Medicine?
area with a long family history of attending
28
A: Make it enjoyable. If it isn’t enjoyable, you our career] are huge - you don’t want to hurt someone but, inevitably, we will all make mistakes and we will have to live with them. We have to learn something from each experience,
the university. We have occasional dinner
A: I knew the reputation of some of the
because it will not go perfectly all the time.
reunions in New York City.
founding doctors — and that the school
Learning medicine is all about experience.
pe rie nc e . ” Q: What is your favorite part of teaching? A: Well, the students are everything! It’s all about the idea that this is not really a job, it’s a way to give back and to share my experience with young future doctors.
Q: What are your hobbies? A: Besides opera, I like to play golf! I used to play four days a week, but now I play about once a month. I also like to cook, especially based on my restaurant experiences in Italy. I like to cook northern Italian food the most. You can read more about the history of the University of Bologna at unibo.it/en/university/who-we-are/our-history/thenumbers-of-history.
Treetoes Linda Bradley Guest artist 29
“Wake up from your dream about studying for your upcoming quiz or exam or both. Check your clock and realize that you have
a day in the life
CAMERON RUTLEDGE mbs-SCRANTON class of 2018
two hours before class. Take a breath and realize that two hours is enough time for showering, breakfast, studying and your daily “I can do this!” pep talk. Then actually shower, eat breakfast, study, give yourself a pep talk and get to Geisinger Commonwealth before lecture begins. Sit through class, taking notes diligently and thinking about how you definitely have to watch Tegrity (online recordings of daily lectures) later because you’re not quite sure what a transposon or a prion — or a gene for that matter — is.
30
From the comical but true “Day in the Life” essay, you can see that this Master of Biomedical Sciences program is very rigorous but manageable. Students are working to do and be their best, while constantly being aware that they are here to succeed. Our days do involve early Eat lunch in the GCSOM lounge with your fellow classmates over conversation about your impending quiz or exam while laughing about some students in the lunch line who complained about only getting 6 hours of sleep when you’re running on 3 hours of sleep and the caffeine kick from your
mornings and late nights, all in preparation for our future careers. However, the all-nighters alluded to in the satirical piece here are preventable with proper time management and avoiding procrastination. This program is demanding because we’re surrounded by professors, administration and
10-minute break during your last class.
peers who see our full potential and push us to do our best.
Attend your second class and again take notes as you laugh
the best for one another.
to yourself on how watching Tegrity in the evenings over dinner has completely replaced your Netflix binge watching.
GCSOM is a family of individuals, and like any family, we want
While we work diligently in the classroom, we do keep in mind that we did not make it this far alone. We take daily breaks
Sit in with your professors and teaching assistants during
from studying with check-ins to our families and friends.
office hours, during which time you ask them to re-explain
We also keep in mind that physical, emotional and spiritual
everything stated in lecture in layman’s terms.
fitness are just as important as our mental well-being, so many of us work out daily, participate in yoga classes and/
Continue to study late into the night until you realize it’s no
or attend our diverse places of worship. When time permits,
longer nighttime, but instead the next day and you should
we also engage in community service, sporting events and
probably get some rest because you’re waking up in three hours to start your routine all over again!”
friendly conversation. We try to get the most out of our “free time” because we’re back to studying and preparing for the near future soon after.
31
SENTINELS ALAYNA CRAIG-LUCAS md class of 2021 32
Collapsed Andres Rodriguez md class of 2021
Front Row Seat for Fall Andres Rodriguez md class of 2021
33
Charity Starts at Home Iris Johnston library assistant Mastocytes secreting cytokines aren’t in it for the #humblebrag. They never say, “My Uncle was a Merkel cell, so I’ll protect you, Fingertips.”
No one pays the basophil or lectures it on civic duty to spur it to squirt histamine. It waves no Marrow Flag, sings no patriotic tune.
End of Season Dan Sylvestre md class of 2021 34
Why should we?
Untitled 1 Assad Hayat md class of 2020 35
Elizabeth Zygmunt Director of Media & Public Relations
W
hen Mark Ayzenberg, MD, a member of Geisinger Commonwealth’s charter Class of 2013, first began his orthopaedic surgery residency at Einstein Medical Center in Philadelphia, he feared the 80-plus-hour weeks spent in the hospital might be a threat to his passion for medicine. “When all you do is work, you stop looking around. You don’t really see your surroundings,” he said. He knew capitulating to drudgery would lead to burnout, so having interests outside of medicine was vital – and he vowed to be sure to indulge them.
36
With a camera borrowed from his dad, Mark began visiting favorite spots in his native Philadelphia and photographing them using a multiple-exposure technique he thought truly captured the essence of the place. “I would go to a site and just sit there for a while, enjoying it,” he said. Because his time off was scarce, it sometimes required great self-discipline to go, but eventually it became his habit to explore different sites — some well-known, some off the beaten path — and capture them on camera.
The resulting photographs are startling rich and vivid. Familiar, iconic views of the city — boathouse row, the art museum — take on a surreal, magical quality. Mark’s photos of Antelope Canyon in Arizona make the swirling rock seem alive and full of motion. Photos of waves churning on a Hawaiian beach seem to be images from a lovely, distant planet. In his own way, Mark adheres to the creative aesthetic of artist Georgia O’Keeffe, who painted flowers up close and in colorful detail and who explained her process simply by saying, “It takes time to see.” In describing his inspiration, Mark emphasizes the same fascination with “primary forms.” “So many people don’t take the time to really appreciate their surroundings,” he said. “I started taking pictures as a way to sit and enjoy the little things. I would force myself to go out and explore nature and architecture, things that people don’t have the time to really see. I try to capture the scene as I see it in my pictures.” People did begin to see the familiar in new ways through Mark’s photos. An entire business, springing from his first commercial sale, resulted from photographs he shot during the day while he was
working months of nights. His first commercial sale was to Metro Club condominiums, where he mounted almost 50 photos when he wasn’t in surgery at night. To his surprise and delight, his photography began to sell locally, as well as abroad through his website. Hotels like the Sheraton and universities like his alma mater, Penn, bought them. Galleries have invited him to exhibit his work and it’s been used on greeting cards. He even found an unexpectedly direct connection between his photography and medicine. “Next year I’ll begin a sports
37
As a student at Geisinger Commonwealth,
medicine fellowship in Los Angeles,” he said. “When I was interviewing for it, I was asked by the interviewer if I thought my photography related to arthroscopic surgery and the ability to visualize problems inside a joint — something I never really considered before that conversation.” Best of all, however, Mark’s determination to ward off burnout with artistic expression has worked. “Appreciating my surroundings and having hobbies has kept me grounded,” he said. “In fact, I may have too many hobbies for my own good! But I’m not jaded at all.”
38
music was Mark’s creative outlet. He plays guitar, piano, drums and ukulele. He and fellow charter class members John Kotula, Mike Gabriel, Charlie Karcutskie and the late John Madsen formed a band that played together throughout their four years. “It’s the thing I miss most about medical school,” Mark said. The band was unnamed until, in their last year together, the musicians decided to participate in Scranton’s annual Battle of the Bands. Pressed to decide what to call themselves, the group seized on the fact that the school had a new dean. They called themselves Stevie J. and The Shine Men. Laughing at the memory, Mark said, “Dr. Steven J. Scheinman was a good sport. He didn’t mind at all. He even came to see us play.” In the photo above, Mark is in the dark blue T-shirt, in foreground, playing guitar.
THE GIFT by Sarah Schreiber MD CLASS OF 2020
I am the knowledge that fills our minds. The gentle compassion that made us kind. For every soul we hope to save, I am the experience that makes us brave. I am the deft movement of scalpeled hands. Rebuilding hearts in far off lands. Do not stand on my grave and quiver. I am not there. I did not wither. I am the first step on a life-long road. A gift beyond value to no one owed. I am the passion that fuels our focus. The beautiful reality that forever woke us To the true significance of what we do. I am the humble duty bestowed on few. I am the elder’s final embrace. I am the smile on a newborn’s face. Do not stand on my grave and quiver. I am not there. I did not wither.
39
MILITARY MEDICINE 40
Kristina Borham MD class of 2020
A
t Geisinger Commonwealth School of Medicine, an average of approximately
5 percent of each class is committed to serving in the military following their medical education. The majority of these students are recipients of the Health Professions Scholarship Program with the Army, Navy or Air Force. Students are, for the most part, just like their civilian counterparts in that they study hard, take board exams and achieve all graduation requirements to obtain their MD (or DO at osteopathic schools). But what makes them different?
Here are a few examples: •
These students are direct commissioned officers that serve
A MYSTERY TO MANY
one 45-day active duty tour each year for their scholarship that can include: officer training school, aerospace medicine training, clinical rotations at
military base hospitals and sometimes a “campus tour” meant for academic enrichment •
•
Students apply to the military Match, in addition to the civilian
Madalyn Plessinger MD Class of 2019
Match, through the Joint Services Medical Education Board and
Anybody who knows
receive their residency placements in December — three months
me knows that I am the
earlier than their civilian counterparts!
farthest thing from a
Students do not accrue medical school financial debt and receive a monthly stipend.
•
Students will serve active duty commitments as physicians following their residency training.
•
Some students may serve as flight surgeons, general medical officers or medical directors.
•
Students are considered dual professionals: officers first, physicians (or students) second.
“military person.” I hate confrontation, I’m not athletic and until very recently, I was NOT a morning person. So, when people find out I’m in the Air Force, they generally ask why I joined. The answer is complex. First of all, I have always looked highly upon military members and truly believe that military service is one of the ultimate forms of sacrifice. I am thankful for all who served before me and honored to stand beside my fellow airmen today. Although it is honorable, the decision to join is difficult. I became a commissioned officer in my senior year of college before I began medical school. While this time may be considered exciting, I found it daunting and isolating. I was about to
So why do students choose a career path that involves military
graduate college and leave the protection of my ivy-covered
service in addition to their medical service? Here’s what our students
walls and private school education, I was interviewing at
have to say:
medical schools while secretly just praying one would accept
41
me (and yet also terrified one actually would) and, to top it all off, my
The first time I contacted the Air Force, I was 17 years old. I was
parents were in the midst of a divorce. In this time when my world was
curious about the different career options and the lifestyle — although
spinning and my future was hazy, I was searching for support, stability
I had been set on pursuing a career in medicine since my early teens.
and security. I wanted a vision of what my life would be and a plan to
I continued on to pursue a degree in cell and molecular biology at
get there — I was a recruiter’s dream. Enter USAF recruiter (no worries
West Chester University, and I still felt drawn towards service despite
— he was cool).
my strong desire to become a physician. I wasn’t ready to sacrifice the freedom of beginning my medical education as soon as possible
While I may have entered the Air Force out of desperation, the reasons
and truthfully, I was too young to make the best decision for myself.
I want to stay in the Air Force are substantially different. I found
Over the years, however, I watched such incredible people around me
what I was looking for. I am part of a gigantic family full of love and
serve in some capacity: my father in the Army, my high school best
camaraderie, I have financial security, my future is stable, I have had
friend at the Naval Academy, my high school peer mentor at the Air
once-in-a-lifetime experiences and I have made the greatest friends.
Force Academy, my supervising volunteer lead, a Marine who served
Although I still hate confrontation and push-ups make me nauseous,
in Vietnam, and countless friends who served on the enlisted side
I have never been more at peace with and thankful for this decision. I
and those who joined the Reserve Officers’ Training Corps (ROTC)
get to practice medicine beside the most amazing people while serving
in all the services. All of these people had qualities that I admired
my country, and that’s pretty cool.
— courage, altruism and ultimately, recognition of and devotion to something greater than themselves. When I first read about the Health Professions Scholarship Program (HPSP) as a sophomore in college, I called an Air Force recruiter and we had an hour-long conversation about the program, during which he answered every question I had, fully and honestly. I felt that this was the perfect way for me to serve and as soon as I began my applications to medical school, I also began my application for the Air Force HPSP. I worked with an inspiring and supportive recruiter on my application and have since had such a positive experience with the Air Force at Officer Training School. I am
Kristina Borham MD Class of 2020 42
incredibly thankful for this marriage of an opportunity between my two desires to serve: my country and my future patients.
Jon Livezey MD Class of 2021 I never planned to join the military. I knew from high school that I wanted a career in medicine, but the armed forces had never even crossed my mind. Reflecting now, this is rather surprising because my grandfather joined the Army and went to law school on the G.I. Bill. At family dinners, golf outings and
MEMORY MALINA LIM MD CLASS OF 2020
holidays, he would tell stories of his Army days to me. You could watch his face light up as he reminisced about basic training and his time in San Francisco and all across the country. He always ended his stories by stating that it was the best decision that he ever made. It made him better in his law career, and he was grateful for the opportunity. I learned about the option of joining the military while pursuing my medical degree on the Health Professions Scholarship Program during my junior year in college. I made a call to the Army recruiting office, met with a few recruiters, discussed the option thoroughly with my family and friends and made the decision. The choice felt natural, and I grabbed the opportunity in front of me. I am very excited to be an officer in the United States Army, and I hope that it will teach me to be a better doctor.
43
In memory of Ramsey Coles* Deconstructing the human body with
I pause,
our hands,
I watch.
While we construct it in our minds.
I start,
How it’s formed,
I stop.
And how to take it apart. My first patient. Is this how we learn? The room is buzzing,
This is how I begin to shape
Hands and tools and instruction,
The way that I treat my patients,
Words and terms and questions
This is how I begin to be The physician that I am called to be.
His hands,
my first patient Kristina Borham MD CLASS OF 2020
46
His hair,
He asks me to be gentle,
His face.
He asks me to give thought, While I dissemble,
Quickly and digging and pulling,
What was once full of blood,
Rushing hands begin;
Full of life and full of heart.
The parts of the body Meet my fingertips,
Whoa’s and wow’s and oh’s
Memorizing the path of the vessels,
Yeses and what’s and no’s
The organs that once worked So curiously together
His family,
To make this body move.
His surgeries,
Heartbeat Miriam Eagleson MD Class of 2021 His life, Is this how we love? I stop, I start. Slowly and thinking and planning, Gentle hands begin. The contours of his body, Meet my fingertips. Learning the feel of his delicate vessels, His complex organs that once worked So beautifully together To give this man life.
*Ramsey was a beloved classmate whom the Class of 2020 will never forget, nor his sense of humor and good heart. We miss you — every day.
Becoming Miriam Eagleson MD Class of 2021 47
I think a medical student’s routine can be pretty monotonous. After all, we’re bound by class schedules and study routines. A typical day for me involves waking up at 6 a.m., going to school to study, attending class and studying afterwards. I try to hit the gym and take breaks when necessary, of course. This, I think, is the general routine for most. It’s exhausting, and sometimes frustrating how monotonous it can get. It’s like I’m living in the movie Groundhog Day, in cruise control, just waiting to get to my destination. There are,
a day in the life Vanessa THIEL md class of 2020
however, moments that make every day special. There are moments which make this all worthwhile. Moments •
when I get to school and see the friendly faces of classmates
•
when I’m in the cafeteria, eating breakfast with my closest friends before study or class time
•
when we eat lunch and bond over quesadillas and ridiculous stories
48
•
when my roommates and I eat dinner together, a much-needed break from the busy day
•
when I call my dad and hear the comforting sound of home
•
when my roommates hop into my bed, and have lengthy late-night conversations about school, life and puppies
•
when my roommates and I hesitate to say goodnight because there are only so many nights left together, all in one campus
Ah, yes. In the end it is these “moments” that make everything worthwhile. This endless routine can take its toll and there must be some source of light in one’s life. For me, that light is the people around me — the friends that I have come to know and love. All together, these moments and these people give me the strength to
Readysetgo Linda Bradley Guest Artist
keep moving forward. A day in my life would be nothing without them.
49
Nay Aug Falls Andres Rodriguez MD Class of 2021
Lakeside Perspective Andres Rodriguez MD Class of 2021 50
Untitled 2 Vanessa Velez MD Class of 2019 51
homecoming Vanessa Thiel MD CLASS OF 2020
Guatemala
“Fasten your seat belt”
La Aurora Airport
Blinks red as we land
Unbelievable, a dream Awe
Heart beat quickens
A strawberry onesie
I look out the window —
A far away land
Getting to know the country I
darkness
One way ticket — Never
could have called home Unpaved roads
Feet falter, heavy
My first time in the country I
Rundown homes
Stumbling, Unbalanced
could have called home
Violence, corruption
Unsteady
A world I’ve never known Vibrant clothes match a
52
I look out the window - darkness
Why me? Why not her?
My hands are trembling, Feet falter, heavy Stumbling, Unbalanced Unsteady
Why me? Why not him?
thought I’d be back My hands are trembling,
“Fasten your seat belt”
Blinks red as we land Thousands of questions Heart beat quickens
A stroke of luck?
My first time in the country I could have called home
A blessing?
I’ve heard this tale
Many times before, Questions, unanswered It echoes in my mind
An infant, a flight - La Aurora Airport
Confused
A strawberry onesie A far away land One way ticket - Never thought I’d be back
A week in the country I could
My first time in the country I could have called home
have called home
Vibrant clothes match a vibrant land Beautiful language Inspiring landscape I look at the people - Resemblance
My first time in the country I
vibrant land
The marketplace run
could have called home
Beautiful language
By mothers and children
A week of reflection
Inspiring landscape
A sharp realization
Unveils a newfound respect
I’ve heard this tale
I look at the people —
Guilt
For the life I was given
Many times before,
Resemblance
It echoes in my mind
Mountains, Volcanoes
Getting to know the country I
A mother, a choice
An infant, a flight —
A breathless gasp
could have called home
A sacrifice
A week of service
This culminating moment Gratitude A week in the country I could have called home A week of thanks A week of prayers Cultivate a dream, a desire A compulsion to serve the country I could have called home Another departure An overnight flight Hope A dream to return to the country I could have called home
Editor’s note: After being adopted from Guatemala as an infant, Vanessa attended a service trip to her birth-country. The trip had a strong impact
Frozen Leaf Linda Bradley guest artist
on her decision to pursue medicine and she hopes to continue serving the people of Guatemala throughout her career.
53
a day in the life JENA PATEL md class of 2019
[6 a.m.] Alarm goes off — hit snooze.
[7:45 a.m.] Time to talk to the family of the little boy who is getting his tonsils
[6:09 a.m.] Alarm goes off again — ugh,
out. The nurse anesthetist is amazing at
OK! I will attempt to get up. But first I
keeping the parents calm and reassured.
search through my podcasts to see if
She explains all of the medications
there is anything I want to listen to today
that he will be given and how long the
for some morning inspiration. Hmm, looks
procedure will take — usually 30 minutes.
like Oprah recently interviewed Shonda
She is so great at communicating all of
Rhimes about her book, A Year of Yes.
the information without overwhelming
This sounds perfect!
them — taking some mental notes for the future! All right, let’s roll the patient back to
[7 a.m.] Wow, nothing like a little morning
the OR.
Oprah to get you going! Teeth brushed. Clothes on. Coffee made. Lunch packed.
[10:30 a.m.] Tonsillectomy is done and
Going to head over to the OR and change
the patient is recovering well in post-op.
into scrubs – I can’t believe that I basically
We have some time before our next case,
get to wear pajamas at work! OK, time
so I am going to the intensive care unit to
to review some facial nerve and neck
check on a patient we operated on a few
anatomy before the first patient is ready.
days ago. As a medical student, talking to patients, answering their questions and
54
[7:30 a.m.] Meet my preceptor in the
asking them how they are doing is the
pre-op area and review the day’s cases.
area in which I feel I can really make an
Looks like I will be watching a few
impact. Patients usually have questions
tonsillectomies before we dive into a case
about their diagnosis and how the surgery
involving a parotid gland cancer.
went. “What kind of cancer was in the
mass? What is a squamous cell carcinoma?”
[4 p.m.] DONE and now on to closing the
all about going slow and steady, and taking it
As a student, I love taking the time to answer
incision. My preceptor is teaching me how to do
one week at a time.
these questions, helping patients to feel more
subcutaneous stiches today. “The needle should
comfortable and cared for.
go into the muscle, but be careful not to pierce
[5:30 p.m.] My best friend is calling — can’t
the skin. And keep your elbows tucked in when
wait to update her on my day! It is so important
[11:30 a.m.] OK, I am back in the OR and
you stitch — table manners!” Ten subcutaneous
to make time for your relationships outside of
it’s time to review the next patient’s CT
stitches later — hopefully I will get faster at this.
medical school — friends and family definitely
scans to visualize the extent of this parotid
Practice makes perfect!
keep me grounded.
allergies and operative risks one last time
[5 p.m.] How is it already 5 p.m.?! It feels like
[7 p.m.] Off to yoga. My back is feeling a little
before we scrub in.
I just got here and now it’s time to go home.
achy from standing all day, so this is going to
First things first — collapse on my bed for
feel great! Everyone deserves a little “me time”
[2:30 p.m.] Three hours into this surgery and
a 10-minute phone break. Checking emails,
and self-care at some point in their day. Finding
the mass is out. We can see the facial nerve
Instagram, texts — wow I missed a lot.
balance in medical school can be a challenge,
mass and go over the patient’s history,
branching — the last time I saw this was in
but even taking a few minutes out of my day to
first year anatomy lab! It is always so exciting
[5:15 p.m.] Dinnertime and time to attempt
to see the things we have spent so much time
some reading for family medicine clinic
studying come to life in the clinical space.
tomorrow. It is crazy how much we do not know
[9:30 p.m.] Showered, relaxed, grateful for an
“Through what hole does the facial nerve exit
about medicine yet, but reading about the things
amazing day and ready to pass out. Cannot wait
the skull base?” (Good thing I reviewed my
we see in clinic definitely helps reinforce a lot
to see what is in store for tomorrow!
facial nerve anatomy!) “It exits through the
of the concepts we studied during our first two
stylomastoid foramen.” Phew. Some of the
years. Review questions and reading for Friday’s
lymph nodes looked a little suspicious on CT,
continuing educational development session
so it looks like my preceptor is going to do a
must also be done. Every week I feel a little
neck dissection too. More anatomy!
more confident with the material. Third year is
reflect or meditate does wonders for my mind.
55
In Motion 56
Mushrooms Linda Bradley guest artist
57
a day in the life RACHEL POLINSKI md class of 2018
The beauty of being a fourth-year medical
podcast on one of the chief complaints or
student is that no two days are the same, and
research treatment options on UpToDate
no day is the same for any student. After finding
to discuss with an attending. When you
our passions in third year, we have embarked on
can put a face to a diagnosis, it makes it
the next step in chasing our dreams — “away”
easier to recall information for that next
rotations and interviews. Though there are still
“abdominal pain” complaint. We’re embark-
mandatory rotations to be completed, many of
ing on a profession where we must strive
us are using our time to do rotations that help
to continually refine our skills, because our
prepare us for the next big step — intern year.
knowledge base directly impacts the lives of
Here’s what I’ve learned:
our patients.
1. Study something new after each shift.
58
2. Work extra hard on away rotations.
I started this habit during third year and
Away rotations are a way to see if a pro-
found it was so much easier to remember
gram is a good fit for you. If you’re going
pathologies when I could recall a patient
into Emergency Medicine like me, however,
interaction. Some days, you’ll be so “on” that
they have the added stress of being “audi-
you’ll blow yourself away; other days, you’ll
tion” rotations where you’ll obtain a Stan-
struggle making the differential diagnosis
dard Letter of Evaluation. Make sure you
for the patient with a simple chief com-
work hard on shifts and read up and review
plaint. Take at least one interaction from a
the topics with which you may have strug-
shift and learn something from it — be it the
gled. Be sure you show that you’re an awe-
correct dosage of medication or the atypi-
some person to work with — follow up with
cal presentations. Go home and watch a
patients and ask if there’s anything you can
do to help. Most importantly, let the staff at
time in medicine than being a fourth-year
during my residency. (Again, being labeled
these away rotations get to know the real
medical student.” You have the opportunity
as “student” allows you so much more
YOU. On the interview trail, you’ll learn that
to still be a “student,” but the autonomy to
freedom to learn!). I scheduled rotations in
there’s nothing worse than a program trying
finally spread your wings and pursue your
radiology, infectious diseases and nephrol-
to sell you on false pretenses. The same
interests. So go ahead and binge on the
ogy — subjects that I enjoyed and wanted
goes for you — don’t be anything other than
entire second season of Stranger Things in
to explore, knowing that they wouldn’t be
your true self on away rotations.
one sitting — you’ve worked hard to get to
my final career choice. I would also suggest
this point and another opportunity like this
doing rotations in specialties that you’ll
isn’t close on the horizon!
NEVER get to do again — for me, that’s a
3. It’s OK to occasionally do nothing. After so many years of feeling guilty for taking a nap or spending time doing something other than studying, the constant
rotation in Salt Lake City, Utah in forensic 4. Do rotations in specialties that interest you, but aren’t your chosen specialty.
need to DO something is engrained into
The end of third year is a daunting time —
our heads. We’ve all felt it — that nagging
it’s time to pick one specialty that you’re
voice in our heads that says “you should be
going to spend the next three to five years
studying” instead of sitting watching a TV
training in, all based on the limited expo-
show. But what’s unique about fourth year
sure you had in third year. If you’re anything
is that you CAN and SHOULD take the time
like me, you’ll find bits of each specialty
to do the things you love — you’ve earned it.
that pique your interest (hello, career in
The past three years have been a roller-
emergency medicine!). While planning my
coaster, and the next three to five years will
fourth year, I wanted to pursue rotations in
be too. As many residents and attendings
subjects I found interesting, but to which
told me on rotations, “There’s no better
I might have limited one-on-one exposure
pathology (fulfilling my CSI dream!). You’ve decided on a specialty, but it doesn’t mean you have to spend your entire fourth year pursuing just that.
Fourth year is an incredible time in your medical school career. Cherish this awesome time and the incredible opportunities presented to you — the year goes a lot faster than you think, and it will be done before you know it!
59
“moving parts” Stephen Long MD CLASS OF 2020
The sickle moon partly occluded Lights the way just enough to see That I’m waiting for nothing in particular And nothing in particular waits for me.
From first glance, I am granted access; I am a valued cog in the machine. A means to an end at least, but maybe A keeper of secrets—seen and unseen.
As flawed and blemished as I am, This faith in me and my unsound heart
Nature’s Yellow Brick Road Andres Rodriguez MD Class of 2021 60
Is the subtle but necessary reminder, That maybe I’m more than a moving part.
Contrast MALINA LIM MD CLASS OF 2020
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Untitled 3 Assad Hayat MD class of 2020 62
COMMITTEE
Olapeju Simoyan, MD, MPH, BDS, FAAFP Editor in chief Vanessa Thiel Managing Editor Miriam Eagleson Layout Designer Heather M Davis, MFA Production Manager Debra C Tierney Staff Editorial Assistant Amelia Mackarey Student Editorial Assistant Kristina Lake Borham Student Editorial Assistant