by Jeff Gonzalez, MD Resident, Department of Medicine, Hospital of the University of Pennsylvania
Early in medical school, I suspected I would chose a field in medicine based on a long-standing fascination with the complexity and varied nature of disease processes. With an open eye, I embarked on a rigorous year of clinical clerkships. However, while rotating through medicine, my initial interests were solidified. I found the ability to connect with patients and the development of strong emotional ties all encompassing. When taking care of patients I was focusing not on one, but multiple body systems.
The marriage in medicine between pathophysiology and man is best exemplified by MP. I had begun my month in hematology when I was first consulted on his case. Recently transferred from an OSH for management of “the worst case” of ERCP induced pancreatitis anyone had seen, his diminished platelet count of 30,000, PT of 16, and numerous schistocytes led me to believe it was disseminated intravascular coagulation(DIC). As his underlying pancreatitis was controlled his DIC resolved. The following week, now as part of the infectious disease team, I was seeing him again, this time for continual spiking fevers to 103 degrees despite negative cultures and a trial of antibiotics. Since cultures of his pancreatic cysts had been negative, we went ahead and stopped all antibiotics, and waited, believing this to be a drug fever.
The days passed and MP remained in the hospital, with out much change. I moved on the the liver service, which had been his primary team, and eventually left him still fighting for his life – and me wondering if there was anything different that we could have done. Although fractured at time, I found the relationship which I developed with him and his family to be the most rewarding experience I have had as a medical student.
During medical school I have used the opportunities afforded me to broaden my networking and educational experiences in pursuit of a more well rounded medical education. During the summer after my first year I spent a month in one of the university hospitals in Madrid, Spain, gaining insight into the differences and similarities inherent in our health care systems. I found that medicine abroad is much more holistic and spiritual when compared to our system. My goal when I returned was to share these findings with my classmates. I began acting on this interest by revitalizing the William Pepper Medical Society under the guidance of the Department Chairman, Dr. Peter Traber.
My responsibilities include recruiting medicine faculty to lecture students interested in internal medicine on topics that are not covered by the traditional medical curriculum, such as medical futility and alternative medicine. For many students in their pre-clinical years, this forum serves as an introduction to the field of medicine, and hence is of enormous import in medical education at the University of Pennsylvania. Another of the intriguing challenges that I have faced at Penn includes living with nine other medical students at Nu Sigma Nu, a medical school co-op. Being able to work as a team with many diverse personalities had been a formidable task, but, one that has shown me that many times you need to step back, let go of your ego and think of the broader picture. Only then can you proceed. For the next three years, I hope to join a program that will impart a solid foundation in the science and technical practice of medicine while maintaining a personal connection with the patients I see.
Eventually I aspire to a career in academic medicine, which will allow me to increase my effectiveness as an educator and researcher. Academia allows for a continuous exchange of ideas as well as interaction among colleagues enabling me to contribute and keep up to date with new advances in medicine. The training and rigors of an academic institution will also strengthen my interests in combining clinical research with that o patient care. By partaking in such activities I will also be acting as an educator passing my insights to rising residents and medical students.
As someone who has always been very goal-oriented, I am looking forward to beginning my residency. My life to date has prepared me to deal with many obstacles and also has shown me the determination, resilience, strength, and caring that are a part of my character. As I look toward my future in medicine, I believe these characteristics will enable me to succeed and be a valuable asset to the profession. My experiences have been very rewarding because I have identified with patients and admired their courage in the face of an uncertain prognosis. I anticipate that working in internal medicine will be equally rewarding and look forward with enthusiasm.