Ajay Koti (17 Posts)Columnist and in-Training Staff Member
Morsani College of Medicine at the University of South Florida
Ajay is a pediatric resident and a Class of 2017 graduate of the SELECT MD program at the University of South Florida. He is passionate about delivering primary care to underserved populations—specifically, low-income and homeless patients in urban centers. Ajay will be specializing in pediatrics, with a particular interest in child maltreatment.
M.D. or Bust
Numerous studies have documented that medical students lose empathy during clinical years, becoming jaded and pessimistic. This has been linked not only to diminished enjoyment of our work, but also to worse patient outcomes. My goal is to sustain the humanistic values that drive so many of us to medicine, so that, instead of being quelled by cynicism, our idealism can be refined by wisdom.
The white coats and patient gowns that confer the implicit power dynamic of the physician-patient relationship are not to be found here in the operating room. This place has neither the tolerance nor the patience for this subtle symbolism. Here, on the other side of the Rubicon, the rules are stark, the stakes laid bare. The patient lies naked on the table, arms extended on boards, Christ-like, as the surgeon holds the knife handle and plays God.
One after the other, day after day it seems, I find myself in a room where the resident is breaking the news of terminal cancer to my patients and I feel an overwhelming sadness belied by numbness. It has only been a week and a half on internal medicine and we have already diagnosed three unsuspecting patients with cancer.
Last Saturday evening I was on the admitting team in Orange County. We got a call about a hematology/oncology admission that we would later pass off to another team in the morning. We were told “fever with an ANC <500.” That admit, was Ronaldo, a young male with acute lymphocytic leukemia.
An indulgent gasp / grasps the molded corners / dry tongue to chipping paint / searching for a word to say
In the rest of the house, the noise of the party is deafening: the clink of glasses, the sizzle of burgers on the grill, the excited cries of relatives reunited after long absences. But in the bright light of the kitchen, Mark is talking to me without sound. He presses his right hand over his left then moves up its length, separating his thumb from the rest of his fingers as he goes replicating the open and shut motions of a jaw. “This is the sign for cancer,” he says.
I’ve come to realize having an automatic word filter is one of my greatest blessings. It becomes quite useful when, in the middle of rounds, a patient’s single, monosyllabic response inspires such a flurry of mismatched curse words that only a properly formed filter can save my dignity. What exactly did this patient say that stunned me so violently? My attending had asked him a straightforward, albeit grim, question. “Do you know you have cancer?” …
A leading expert on language and the mind, cognitive psychologist Steven Pinker suggests in his book “The Stuff of Thought” that “conceptual metaphors point to an obvious way in which people could learn to reason about new, abstract concepts,” as well as provide the imagery and substrate to help store and share knowledge. The metaphorization of illness allows us to describe it in easily-digestible forms which have relevance and relation to our everyday speech. The …
Standing at the foot of her hospital bed, it was clear to me — as it was to the attending physician — that my grandmother was suffering from a disease: an obvious structural disorder identified by scientific medicine as negatively impacting her health. Hilar mass, cavitation, hypercalcemia. Keratin pearls, intercellular bridges. Hemoptysis, dyspnea, edema. It was also apparent to this eight year-old, however, that she was burdened by an illness, or an impaired sense of well-being. …
How can doctors-in-training honor the voices of their patients, especially children’s voices? Trisha, a first-year medical student who aspires to become a pediatric oncologist, discusses her mission to give children with cancer the opportunity to be heard. She describes a project she developed inviting children to tell the stories of their illness, which she compiled into her book, “Chronicling Childhood Cancer: A Collection of Personal Stories by Children and Teens with Cancer,” that was published this month in honor of National Childhood Cancer Awareness Month.
How can doctors-in-training allow their personal experiences with the health care system shape their own practice? Kalla, a second-year medical student in New York, describes how witnessing her father benefit from the addition of meditation and acupuncture to his cancer treatment inspired her to incorporate an integrative approach to her own self-care and future practice.
The wonderfully cheery 66-year-old woman sitting in the conference room with her family listened to us explain her diagnosis – ovarian cancer – the first occurrence. We explained that ovarian cancer tends to appear suddenly with non-specific symptoms preceding it. Its prognosis can be quite good if treated aggressively with surgery and chemotherapy, but recurrence rates are very high. We told her to be positive because her 5-year survival looked quite good. “Oh, I’m a …
After arriving at the hospital, scrubbing in and warming up with a few anatomy questions with my attending, I was relaxed and ready to assist with the upcoming thyroidectomy. My patient, who will be referred to as “M,” was a 17-year-old girl who presented to the office with dizziness. After an extensive workup it was discovered that her symptoms were due to thyroid dysfunction. The surgery was meant to be a straightforward case, but the …
Anjani Amladi (2 Posts)Contributing Writer Emeritus
The Commonwealth Medical College
Anjani Amladi is a Class of 2015 medical student at The Commonwealth Medical College in Scranton, Pennsylvania. She was born and raised in the San Francisco Bay Area, and went to the University of California at Davis where she received her undergraduate degree in biological sciences. She balances the rigors of medical school with extensive writing, and finds inspiration in her daily interactions with others. She takes pride in being a dedicated sister, daughter, student, friend and "dog mom." She has a passion for people and writes in honor of those who have enriched her life.
