I’ve been back in sleepy Houma, Louisiana for over a week now; looking back through my photos and journal entries from last month makes the adventure seem like a dream. However, I know that the lessons I’ve learned are real and will be carried with me from here onward.
I remember the first patient I tried examining on my own in the internal medicine ward. I was nervous and my Vietnamese was tentative, but I carefully went through all the appropriate steps which I had learned just moments before (look through the patient’s file, observe visual signs, feel the neck and quadrants of the belly area, ask about medical history and lifestyle). Becoming familiar with procedure for new patients and developing my examination skills were top learning priorities for me as I was entering the internship, so I took every chance I could to don the white coat and take a look at patients. In the neurology department, I saw many stroke victims and thus by the end of that week I’d begun to notice the signs and read x-ray charts for stroke of the brain (you can see one below!). Some of my favorite investigations fell under this diagnosis, only because they involved extensive and clever examination. My mentors watched and guided me each day, often with amusement. Although I was sad to leave a department at the end of the week, just when the staff and I were becoming friends, I left my internship having friends all over the hospital. During the last week, I never went to lunch without running into a familiar face. Contrast that with my first lunch at UMC – my mentor was busy so I walked the side streets alone, paranoid that my clothes would label me as a naive foreigner, and still clumsy with Vietnam đồng denominations (which certainly outed me as a naive foreigner).
An x-ray chart for a stroke patient. Names and personal information have been blacked out.
In every department I would find physicians eager to discuss health care politics with me. I spent many lunches, free time in the office, and walks between patient rooms exchanging information with physicians, professors, and students. We talked about the medical school system, method of payment for doctors, health factors, and patient attitudes in both the U.S and Vietnam. Nearly every patient came in with preconceptions about what their diagnosis should be, or was found to have self-prescribed medication after their last visit. The pharmacies in Vietnam require no physician signature on prescriptions, so patients are able to buy any drug at any time. This, of course, leads to complications in diagnosis and treatment. I learned that effective communication was more than half the job.
I suspect this summer is one I will continually come back to, as I make connections between what I have seen and what I will learn in the classroom. I have yet to see much of the terminology and mechanisms I was exposed to during my internship in school, but I know I will eventually come across them. Having hands-on, visceral experiences to link to readings will solidify the knowledge in my mind. For this reason I hope to continue to build more real-world experiences in the medical field by perhaps working as a scribe or volunteering at different hospitals. One day, I would love to travel again with a program to help administer health care. Foremost, I am excited to learn more about everything I have encountered this summer.
For anyone interested in shadowing at UMC or in the industry at all, I highly recommend developing personal connections and reaching out to administrators and physicians directly. Not only is it cheaper than going through a sanctioned program, but it also allows for more control over what you will be learning and accomplishing, and is likely to strengthen and extend your professional network. In such a competitive environment, standing out and maintaining strong networks gives you a special advantage. The more important advice, though, is just to go beyond your borders and do something you love in a new place you might come to love.