Chase, Midway-Final

It has been an amazing experience so far at Thomas Jefferson Hospital. So far, I have gotten to witness cool procedures in the operating room, colonoscopies, and office hours. Observing Dr. Isenberg has been such a cool opportunity as he makes difficult procedures look so seamless. My first day I observed Dr. Isenberg perform 10 colonoscopies back to back as he spotted hidden polyps in the colon with such ease. At first it was hard for me to follow, but as he explained certain landmarks, he looks for in the colon I started to be able to kind of keep track of where he was. For example, he explained to me that the transverse colon has more of a triangular shape compared to the ascending and descending colon. I also got to observe a couple of other doctors perform endoscopies, which was also very exciting as I got to see the inside of the esophagus and stomach all the way down to the pyloric sphincter. 

In the operating room I have gotten to witness routine quick procedures like hemorrhoidectomies and also a longer surgery called an abdominoperineal resection, more commonly called an APR. The APR is often a last resort for patients who have rectal cancer or Crohn’s disease. It involves the complete resection of the patient’s anus and rectum and ultimately results in a colostomy. It was especially cool watching the surgeons interact during the surgery and decide which planes to dissect on the patient. Also, watching different type of surgeons collaborate during a single surgeon has been really amazing. Within a single surgeon I got to witness Dr. Isenberg, a colorectal surgeon, a plastic surgeon, and a urologist all discuss the best course of treatment for a single patient. In my remaining few weeks I hope to be able to witness more surgeries and try to learn as much about the hospital environment as possible. 

I would to thank Dr. Isenberg, Thomas Jefferson University Hospital, and the Brandeis Pre-health department especially Erika Tai for arranging this opportunity. Overall it was an amazing and eye-opening experience. My favorite and the most interesting part of the experience was definitely the opportunity to experience clinic with Dr. Isenberg just because of the number of different patients and cases I got to witness. Even though some of the cases I saw were extremely sad, watching Dr. Isenberg listen to the symptoms of the patients and then examine the affected area followed by a seemingly instant diagnosis of the problem was truly astounding. I also had the opportunity to hear a lot of personal stories from the Medical students and residents about their experiences in medical school and residency that were very informative and helped me decide my future in pursuing medicine. Although clinic was the most interesting part of my experience, watching surgeries and being in the operating room was definitely the coolest part of the experience. It was amazing watching the scrub nurses, anesthesiologist, and surgeons work in unison to accomplish a common goal. 

Finally, I would like to thank Dr. Isenberg again and also wish good luck to the fourth-year medical students who I shadowed with as they apply to their residency programs. This site was truly amazing experience and I will be returning to Thomas Jefferson University hospital over winter break to shadow Dr. Isenberg again. 

Monica – Final Thoughts

Sadly, my shadowing has come to an end. These past weeks have been amazing- I have gained tons of knowledge, experience, and insight into the medical field and made life-long memories along the way. Observing Dr. Isenberg and his colleagues was a dream and I’m very grateful I received the opportunity to do so.

I watched him interact with his patients in the clinical environment, right before surgery, and his follow-up consultation with the patient about a few days or a week later. I was able to learn, in this particular profession, how he builds the doctor-patient relationship in its entirety throughout the different stages from their initial visitation, to surgery, to their follow-up visits. It shows the continuity in his practice and how he can get to know his patients, not just their case.

During the second half of the shadowing program, I finally was able to mostly distinguish the different parts of the colon on the screen when watching a colonoscopy. I even had an opportunity to try doing one on my own! Through a simulation screen, of course. I was elated to give it a go after weeks of watching, and I managed to reach the cecum, but I found out that it’s not nearly as easy as Dr. Isenberg makes it to be.  It was shockingly intense and saddening to watch a surgery on some patients that were around my age. I couldn’t imagine being in their situation, especially when some were suffering from  excruciating pain. On the flip side I also observed him helping elderly patients who were suffering from multiple issues. It made me realize that anyone can be exposed to unwanted ailments no matter the age, gender, or race, so being able to help people in their time of need is very rewarding.

I very much enjoyed the environment at Thomas Jefferson. Due to it being a university hospital, I was able to spend a good amount of time with Dr. Isenberg’s team, which consisted of a fellow, residents, and medical students. Everyone there was really amicable and explained cases to me and answered my questions. One of the medical students taught me how to tie square knots, and I was able to practice suturing. The fellow doctors in Dr. Isenberg’s department were also very friendly and I shadowed them as well, in clinic and in the OR. Before any surgery, the doctors always say “safety is a team effort so speak up” or something similar, which is nice because everyone in the room plays a role and needs to be working together to produce the desired outcome. It was good to learn that teamwork is very valuable in this profession as well.

Some new types of cases I observed were creating an ileostomy, reversing a colostomy, removing multiple metastasized tumors, and a perianeal proctectomy. It was still surreal seeing organs outside of the body, especially if they were damaged. Some of the surgeries were performed laparoscopically, some open which was my favorite, and some robotically which was also very cool since I was able to sit on the robot and see the 3-dimensional view from the eyes of the robot. I was fortunate to witness a rare situation where they needed to brainstorm the diagnosis in the operating room for various reasons and make decisions on the spot. I also observed that they were stressed at times, which I actually appreciated because it showed how much they cared about their patients and wanted to give them the best possible treatment.

I couldn’t have asked for a better shadowing experience! I would like to thank the Brandeis pre-health department for matching me with this program, and my sincere thanks to the colorectal team at Thomas Jefferson, especially Dr. Isenberg, for allowing me to shadow him and providing such a valuable life experience. I could only hope that one day I can be as good of a surgeon as he is. I’m excited for what the future holds!

Monica – Midway Point

I can’t believe it’s already halfway through! I’ve seen so many incredible procedures and interactions, met and had conversations with various people, and have gained so much knowledge these past few weeks. The first day I began shadowing was probably the most nervous I’d ever felt entering a new environment, mainly due to the fact that there were so many thoughts running through my head. Immediately Dr. Isenberg got to work, and I had only just started to grasp how jam-packed his workdays are. He is very friendly and made me feel comfortable being there, especially since I initially felt like I was constantly in the way. Although seeing a colonoscopy has since become normal for me, the first time I saw him perform one I was awed at how easy he made it look, and was captured by seeing the inside of a colon through a camera. Though I have to admit it was weird to see it at first, weird was quickly replaced by fascinated. I’ve seen him remove polyps inside the colon to preemptively get rid of any causes for cancer, and I am constantly amazed at how he can distinguish the different parts of the colon on the screen, since they all look the same to me!

I also witnessed him interacting with lots of patients. I like how he is able to communicate effectively and succinctly while still maintaining an amiable and caring persona. He goes into each appointment with a game plan already in mind, and asks more questions from the patient to confirm his thinking. It’s interesting to me to see how quickly he is able to draw conclusions by hearing about a patient’s worries or by checking them, because it shows how knowledgeable he is in his field. Many of the patients he sees have similar cases, but some have had different issues and some more serious conditions, namely cancer. I was shocked the first time when I heard Dr. Isenberg talking to his patients about the threat of cancer and ways to immediately start fighting it, because cancer can completely change a person’s life. However, after observing such cases for some time, it is no longer shocking and now I understand the seriousness of the situation and how a cancer can be life threatening. It was also amazing to see how the doctors set their emotions apart while treating their patients, knowing fully well that at times the results may not be very favorable and in some cases even fatal.

Another situation I observed was when doctors did not have all the answers to help solve the patient’s issue. When patients complained about having certain ailments to Dr. Isenberg, all he could tell them was to wait since nothing else would fix their problem immediately. I could understand the frustration from the patient’s side, but it was also interesting to see if from the doctor’s perspective: waiting was the best option because giving medicine or immediately operating wouldn’t help at all. Though patients come to doctors expecting for a quick fix, I learned that sometimes it’s not the case, and I also witnessed how some took the news well, while others not so much.

The coolest part of these past few weeks was definitely surgery. I’ve been able to see different surgeries ranging from cases such as fistulotomy and hemorrhoidectomy to more invasive ones like a laparoscopic removal of the colon and perineal proctectomy. I get to stand in the ER and watch everything- the patient getting put under, sterilizing the patient with betadine, the incisions and the actual surgery, suturing the cuts, and dressing up. The environment is a bit more relaxed than I thought it would be since they play music in the background! The doctors are still completely focused, of course. When Dr. Isenberg removed the colon from one patient, I couldn’t believe how big it was when he kept pulling and pulling it out from the incision he made! Then, the colon was just put in a pile on the table for a few minutes, and I was just staring at that patient’s colon. It was surreal, seeing a major organ outside of the body just lying there. Seeing surgeries and the work/effort that goes into it is giving me a new appreciation and perspective for the development of the medical world and the amount of procedures surgeons are able to accomplish.

Finally, being in the heart of Philadelphia where the all the actions are has been such a blast. It’s the perfect location for me to be in the hospital all day, and then walk around the city in the evening and explore everything that it offered, such as museums, restaurants, and outdoor activities. The hospital is located in the heart of the city, so there are a lot of patients that check-in with a wide variety of ailments so I get to see a varied types of cases. I’m very much looking forward to the next few weeks to see what else is in store!

Monica – Pre Departure

This summer I have been given the opportunity to shadow at the Thomas Jefferson University Hospital in Philadelphia, Pennsylvania through the Brandeis program! I am looking forward to shadowing Dr. Gerald Isenberg, professor of surgery and program director for the Colorectal Surgery Residency.  I intend to shadow him as he meets, interacts with, and examines patients. I am truly excited about the opportunity to be able to witness him and his colleagues performing surgery in the OR.

Since young I have always wanted to become a doctor. In high school I attended a summer camp for students interested in pursuing a career in medicine, and also volunteered in a university hospital recovery room where I assisted nurses by attending to patients’ needs.  I witnessed firsthand how stressful the environment can be and how those nurses handled the patients with care. These experiences reaffirmed my goal to work in the medical field and help others.

This being my first shadowing experience, I hope to learn as much as I can from a doctor’s perspective by observing what goes on behind the scenes during pre-and post surgery activities in a hospital environment, and the teamwork that it takes to fully treat patients. I have watched a few medical shows on TV, but I’m guessing that in reality, hospitals may not be as dramatic at all times!

I would really like to learn how Dr. Isenberg communicates with his patients about their condition- the approach he takes to relate to the patients, the types of questions he asks them, the medical terminology he uses to articulate his thoughts, the steps to diagnosis, and the decision-making that goes into providing treatment options. I look forward to hearing about his experiences over the years, and how he got to where he is today. It would be nice to also witness doctors collaborating with other specialists to understand how they come to conclusive diagnoses. In addition, I’m excited to meet and network with others who work there, such as fellow doctors, nurses, and interns, so I can gather as much information as I can about what it takes to be a doctor and work in a hospital environment.

The knowledge I gain this summer will hopefully transfer to the research I am involved in on campus during the school year. Furthermore, this summer will provide experiences that I’ll carry with me for a lifetime. I can’t wait to start!