1Spring 2006

VCUSchool ofMedicine

Spring 2006 Volume 3

2Spring 2006

Skull and Bones is a non-profit journal produced by students atthe VCU School of Medicine. All rights are reserved. Nothingmay be reproduced without written consent from the author.The opinions presented in this journal are not necessarilyendorsed by the Skull and Bones publication staff. Credits forgraphics available at mcvskullandbones@vcu.eduCover: Kevin Lee, Class of 2009

editor’s

Skull and BonesProduction Staff

Kristin Ondeckoondeckokm@vcu.eduMSG vice presidentof publications andsenior editor

Van Tatav@vcu.edueditor-in-chief andlayout

Kevin Leeleekj2@vcu.eduphotographer andpublicity

Matthew Morganmorganma@vcu.eduassociate editor

Heather Katebinikatebinihm@vcu.edudesign

Mireille Truongplittvr@vcu.edudesign

AAAAA

letters the 2005-2006 academic year is coming to a close, students in

the School of Medicine are busier than ever. For some, this marks the end of theirfirst stride into the quest of becoming a physician. For others, these are the lastpaces on the path, ending with many bittersweet memories of the past four years inmedical school.

The Class of 2006 has a mere few weeks remaining of their tenure as medicalstudents before they prepare to venture out into the real world of residency. Onecan only imagine their excitement for graduation day when they can trade in thosesleepless nights of studying before exams, anxiety attacks at bubbling in hundredsof exam sheets, and chants of "P = M.D." for the fruit of their labors — the famed"Doctor of Medicine." Oh yeah... with that M.D. comes an intern pager which willoffer a continuing source of sleepless nights of a different kind.

As for the Class of 2007, they are beginning to see the light at the end ofthe tunnel. In the coming months they will make one of the biggest decisions oftheir medical careers; whether surgery or medicine, pediatrics or geriatrics, manythird year medical students are starting to fill with angst at the thought of fillingout yet another round of applications. They will begin sitting for the second stepof the USMLE, applying for away rotations, choosing fourth year electives, orselecting just one particular career path for the rest of their lives.

With the end of the school year looming just around the corner, the Classof 2008 seems to be thinking, dreaming, walking, sleeping, and talking Step 1 of theUSMLE... yes, that single test that culminates two years (or 150 pounds+ of syllabi,depending on how you look at it) worth of medical education into a seven-hourexam.

For the Class of 2009, they have successfully undertaken a bold challenge. The first year of medical school often is an exhausting, eye-opening experience,but it's also an experience filled with new friendships, new study habits, and a newbreadth of knowledge and skills never before realized. Students have spent theirevery waking hour memorizing the Krebs Cycle, the nuclei of the cranial nerves,and the inspiring physiology of the human body... all the while moving toward theirdream of becoming a physician. Now, ending the first year, they look forward to ayear studying how to fix these systems when they go wrong.

In this issue, we hope to capture some of this spirit. Our first articleis about the history of the VCU School of Medicine, followed by the heart of thewhite coat and some of our extracurricular pursuits. We are sure you will enjoythis issue as much as we enjoyed producing it.

Sincerely,Skull and Bones Editors

3Spring 2006

Skull and BonesSkull and BonesSkull and BonesSkull and BonesSkull and BonesMay 2006features C

O N

T E N T S

MCV/VCU SCHOOLOF MEDICINE CIVILWAR YEARSFarzin Yaghmaie44444 1919191919

VIEWS FROM THE NATIONALCATHEDRAL NO.6Kevin Lee

RADIANT PULSEDan Park

M&M: BENIGN NEGLECTAshley Mortenson2020202020

1010101010RichLIFE SURVEYMatt Morgan

MEDICAL STUDENTSIN THE COMMUNITY

25252525251111111111

HOMBRE andVITREOUS HUMORDarshita PatelUppinder Mattu

GENTOO PENGUINMcKinley Haas 1616161616

BUSY BEEJay Ronquillo

1212121212

MUSING OF POSTMATCH-DAYDrew Davis

1414141414SPRING SNOWMANJay Ronquillo2626262626INTERVIEW WITHDR. PEELMatt Morgan2727272727

SPORTING THE SHORT COATMeagan Littlepage 1717171717

WELL, YOU MUSTHAVE BEEN ABEAUTIFUL BABY

88888

2828282828TRANSITIONSKevin Lee

77777

MATCH DAYPICTURESKevin Lee

2323232323

AUCTIONSam KhandkerMireille Truong

3131313131

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MCV/VCU SCHOOL OF MEDICINE-HISTORICAL HIGHLIGHTS & TIMELINE-

Part 2: The Civil War Yearsby Farzin Yaghmaie, Class of 2007

The history of the Medical College of Virginia, now officially recognized as the VCU School ofMedicine, dates back over 167 years. The following historical highlights & timeline will serve asa good introduction to the founding principles, the trials and tribulations endured, and the greatpeople that have made this institution what it is today. Comprised of four parts, in this issue ofSkull & Bones, we present, Part 2: The Civil War Years.

MCV had been in existence for less than two decades whenin the 1850s, political tension between the north and southbegan to mount. At that time, a number of southern studentstraveled north for their medical education and prominentsouthern physicians were serving key faculty positions inNorthern medical schools. These southerners foundthemselves cast into the great controversy of their time andas political tension intensified, regional pride and loyaltyfurthered the divide between them and their northerncounterparts.

The lines are drawn:In October of 1859, the situation came to a head, when JohnBrown, intent on starting a slave rebellion in Virginia, raidedthe small town of Harpers Ferry. Although the uprising wassuppressed and he was captured, tried, and hanged, the raidon Harpers Ferry polarized the ever-growing divide betweenthe north and south. Some Northern abolitionists supportedJohn Brown’s actions. This alarmed southerners and resultedin a massive migration of southern professionals back to thesouth. The medical community was not spared the drama.

A massive secession of as many as 300 southern studentsleft their northern medical schools and returned to the southto complete the remainder of their education. They wereled by Dr. Hunter Holmes McGuire, who personally paid thefares of the students from Philadelphia to Richmond. At thetime, Dr. McGuire was a faculty member in Philadelphia,then the nations Mecca of medical education. Prior toorganizing the massive secession, he telegraphed MCV, whichresponded that no fees would be demanded of the studentsand all expenses would be paid.

On their arrival, there was a great reception, during whichGovernor Henry A. Wise made a stirring speech and the cityrefunded the railroad fare of all the students. The RichmondTimes Dispatch commemorated the event. In an article

published on December 22, 1859, they declared that thefaculty of MCV, by granting the returning students admission,acted in “a spirit becoming of Virginian gentlemen.”

Dr. McGuire went on to join the confederate army and servedas one of the most prominent confederate surgeons in thewar. He traveled from battlefield to battlefield alongsideLieutenant General Thomas “Stonewall” Jackson, whoregarded him as a friend. Dr. McGuire is perhaps bestremembered for attempting to save Stonewall’s life after hewas mortally wounded at the battle of Chancellorsville inMay 1863. However, many would agree that his mostimportant contribution to the war was setting the precedentof releasing captured federal surgeons, a humanitarian actthat generals on both sides practiced. After the war, he settledin Richmond and served as Chair of Surgery at MCV. Hiscareer culminated in his election as president of the AmericanMedical Association.

Dr. Hunter Holmes McGuire (1835-1900) ofVirginia, his statue sits prominently on thegrounds of the Virginia State Capital and theMcGuire Veterans Administration MedicalCenter is named in his honor.

5Spring 2006

MCV ultimately granted admission to 144 of the returningstudents, while the rest continued south to complete theireducation. Their arrival, along with Dr. McGuire, infusedMCV with patriotism and energy, propelling the younginstitution into a new era of purpose and civil duty.

Institution of the Confederacy:That very next spring, on March 1st 1860, the board of visitorshanded over the deed to all MCV property to theCommonwealth of Virginia, which then officially declaredMCV a state institution. Lured by the need for betterfinancing and a new hospital, MCV sealed its fate as an entityultimately reliant on the state. The new hospital, called theCollege Infirmary, was built directly across from the EgyptianBuilding, using state funds at the cost of $22,336.57. It wasa 3-story brick building with 75 beds, central heat andgaslights.

That following year, on April 17, 1861, Virginia withdrewfrom the United States and became the eighth state of theConfederate States of America. By that June, the rest of thesouth turned to Virginians for leadership in military affairs.

Richmond was declared the capital of the Confederate States,and President Jefferson Davis came to live there. He and hisfamily lived in the house just north of the Egyptian Buildingon Clay Street. The home, now known as the white house ofthe confederacy still stands as a prominent landmark on MCVcampus.

Call to Duty:MCV was soon swept into the frenzy of the Civil War as theVirginia General Assembly enacted legislation organizingthe states military forces. The entire MCV faculty of eightprofessors held posts in service to the Confederacy while atthe same time running the medical school. Of the most notablewas MCV chemistry professor Dr. James B. McCaw whowas named to organize Chimbarazo Hospital, one of thelargest military hospitals ever operated.

Dr. McCaw held the position of surgeon-in-charge andcommandant up until the moment he surrendered the facilityto Union medical officers upon their successful occupationof Richmond. Sick and wounded soldiers reportedly shot atthe approaching Yankee army from their hospital beds. Whenthe inevitable moment of defeat finally arrived, Dr. McCawpolitely greeted the Union medical officers with frosted mintjuleps, an act of southern civility thought to have favorablyinfluenced the subsequent handling of the hospital bynortherners.

Also of note was MCV professor of surgery and surgicalanatomy, Dr. Charles Bell Gibson. He was named Virginia’sSurgeon General and under his guidance, the college founditself playing an important role educating much-neededConfederate surgeons.

In addition to the MCV faculty’s embrace of duties beyondthose bound by the Hippocratic Oath, the bravery andprofessionalism of the medical students attending MCVduring the Civil War years cannot be overstated. Rather thandelaying their education to avoid the inevitable wave ofdestruction brought by war, the students of MCV hastenedtheir education to better serve their fellow southerners. Someof the students at MCV were actually soldiers assigned ashospital stewards stationed around Richmond during thewar. They took advantage of their proximity to the collegeto attend lectures and complete work for their medical city’s

The College Infirmary waslocated on the present site ofthe Medical SciencesBuilding on the MedicalCollege of Virginia campusof Virginia CommonwealthUniversity. Used forConfederate woundedfrom 1861 through 1864.

Photograph of JeffersonDavis’s home in 1865.Now known as the WhiteHouse of the Confederacy,the house still stands as aprominent landmark onMCV campus. TheMuseum of the Confederacystands just to it’s east andmaintains the world’s largestand most comprehensivecollection of military,political and domesticartifacts associated with theperiod of the Confederacy,1861-1865.

Chimborazo HospitalLocated just east ofChurch Hill on 40 acres, itwas comprised of almost250 buildings erected tohouse the more than76,000 sick and woundedsoldiers treated thereduring the four years ofCivil War.

6Spring 2006

degrees. Because of their bravery, MCV has the distinction ofbeing the only medical school in the South still in existencethat graduated a class during each of the war years.

The civilian students at MCV also contributed considerablyto the care of wounded confederate soldiers being treated atthe college infirmary. Amongst the graduates of 1862 was Dr.Simon Baruch, who was quoted, to his amazement, as beingsent out during the war to do major surgery without ever havinglanced a boil! After graduating, Dr. Baruch served three yearsat the front and was actually captured on two occasions. Duringthe war, his essay “Bayonet Wounds” received much attentionand after the war, he went on to pioneer the diagnosis andsurgical treatment of appendicitis, a condition that up to thenhad only been treated medically. In 1939, Dr. Baruch’s memorywas honored when the Egyptian Building was restored in hisname.

The Cost of War:As the war progressed, operating the college hospital wasexceptionally challenging. Although MCV petitioned early onfor the right to purchase government subsidized supplies andfood stuffs, the price of much needed chloroform, morphine,and Epsom salts skyrocketed as the North’s successful navalblockade kept medical supplies out of Virginian hands.

In 1863, in response to this severe escalation in prices, thecollege hospital increased its rates to $20 per week for whitepatients and $12 per week for black patients. The cost includeda private room, board, medical attendance, medicines, nursing,and washings. This worked for a short time, but as the warprogressed and confederacy’s fortunes waned, MCV, like allother state funded facilities, experienced a financial crisis.

The faculty and students struggled to maintain patient care byany means necessary. They moved all the patients to theEgyptian building laboratories and leased the college hospitalrooms to boarders, providing more funds to purchase supplies.Finally, in March of 1865, as a last resort, MCV auctioned offthe hospital ambulance horse in exchange for worthlessconfederate money in order to purchase the most criticallyneeded supplies at ultra inflated prices.

That very next month on April 2, 1865, General Lee notifiedPresident Davis that Richmond had to be abandoned becausethe Confederate lines at Petersburg had been broken. Theevacuation was initiated and confederate authorities orderedthat the warehouses of Shockoe Bottom be burned rather thanleft to fall in the hands of Yankee soldiers. By noon, the flames,spread by a southwardly blowing wind, transformed that portionof Richmond between 7th and 15th streets, from Main Street tothe River, into a desert wasteland. Over nine-tenths of the

commercial district burned and as the citizens ofRichmond fled, saloons were destroyed and liquor waspoured into the streets to keep the spoils of war fromUnion soldiers.

Federal troops soon entered Richmond, and occupiedMCV buildings. As the Union army consolidated itscontrol of the city, and while Jefferson Davis andmembers of the Confederate government fled, thephysicians of MCV held their ground. They committedtheir personal finances to funding the day-to-dayoperations of the college, shortening the length of thecurriculum and continuing educating future physicianswhile healing sick patients.

On April 5th 1865, one day after the capture of Richmond,President Lincoln arrived by boat. He surveyed thedestruction and visited Jefferson Davis’s home. Less thanten days later, on the evening of April 14th 1965, he wasassassinated by John Wilkes Booth.

In the years that followed, MCV, like the rest of theembattled city of Richmond, struggled like no time inits history. Although regular state funding eventuallycame trickling in, by 1871, enrollment at MCV droppedto 20 per class and only 10 students graduated that year.While the state’s finances slowly recovered from thedepths of bankruptcy, and Richmond’s basic infrastructurewas brought back on line, MCV did its best to surviveover the next several years; it slowly recovered just intime to meet the challenges of a new century.

Next issue we present part 3: The New Century.

7Spring 2006

Radiant Pulseby Dan Park, Class of 2009

8Spring 2006

Well, You Must Have Been a Beautiful

Linda S. Costanzo, Ph.D.

Richard Costanzo, Ph.D.

Richard Costanzo, Ph.D.

Stephen A. Gudas, Ph.D.

Robert Diegelm

ann, Ph.D.

Deborah Lebman, Ph.D.

Richard Krieg, Ph.D.

Jiepei Zhu, MD, Ph.D.

A special thank you to the professors who helped us with this project.

9Spring 2006

YYYYYourourourourour ClassmatClassmatClassmatClassmatClassmateseseseses

Gaurav Bhatia, Class of 2008

Charlotte

Gregory, C

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2009

Jessica Randolph, Class of 2009

Kevin Lee

, Class of

2009

Van Ta, Class of 2009

Jay Ronq

uillo, C

lass o

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Peter Nguyen, Class of 2008

Dapo Olarinde, Class of 2009

Meghana Gowda, Class of 2006

Catherine Schuller, Class of 2009

10Spring 2006

RichLIFELIFELIFELIFELIFE

Q Which coffeeshop/coffeebar do you enjoymost?

QStarbucksCafe GuttenbergOther

Favorite bar/club fordancing?

Tobacco Company

Q Favorite place forwatching sports?

Stool PigeonsBuffalo Wild WingsMulligans

Q What’s your favorite the-atre/cinema-indpendenttheatre?

Byrd TheatreWesthamptom Cinema

Best cheap dateQPicinic at Maymont park 63.2%Science MuseumThe LaundromatMoonlight night at Hollywood cemetery

Which would be your firstthought for a day outsidein Richmond?Q

Strolling around Maymont ParkScraping around Belle IslePerusing CarytownCycling andRunning

Here’s what49% Class of 2009,31% Class of 2008,14% Classof 2007,and 6% Classof 2006had to say:

by Matt Morgan, Class of 2009

11Spring 2006

Match DayPhotos by Kevin Lee, Class of 2009

12Spring 2006

Busy Beeby Jay Ronquillo, Class of 2009

13Spring 2006

I think I wanted to stay in Richmond. I lookedat a lot of places though.

What factored into your decision?I mostly look at programs that were regionallybased. I looked at North Carolina, Virginia,DC.

Going into match day, did you have a prettygood idea of where you were going to match?Yes

What do you remember about match day?I went to breakfast with three of my bestfriends and their husbands. My husband was

the only one who didn’t go, because we prettymuch knew where I was going. But the tensionwas unbelievable. We were sitting there at TheBaker’s Crust and you could just sense thateveryone was uneasy about what was going tohappen that day. My friends were anxious,but so were the husband’s. I mean their liveswere changing too. My other 3 friends didn’tknow where they were going to end up going.

Did you bring anyone to match day with you?No. I knew that barring some catastrophe, Iwas sure where I would be.

What was it like when you got your envelope?It was still exciting. Everyone puts money intoa raffle and the last person who gets calledwins the money. So I was hoping I would getcalled last. But there was also tons ofanticipation for my friends and watching asthey opened their envelopes. All my friendsmatched somewhere else though. One wentinto OB, one went into Internal Medicine, and2 into Pediatrics. Oh and 1 went into the Navy.

Did you cry?Nope.

Any particular memories about any of yourfriends or classmates from Match Day?There were some people who I forgot werein our class. Oh and my friend Caroline endedup on the front page of the Richmond Times-Dispatch, because she matched at theUniversity of Chicago for OB.

How did you celebrate?We all went out to dinner. Actually, it’s kindof neat, because out of the group of us thatwent to breakfast and then went to dinner,we’ve all been able to stay in touch. We havean email group now that goes around to thefour people from that day. It helps us all tostay up to date in each other’s lives. It’s been

four years, andwe still all stay intouch once amonth.

Who was thefirst person youcalled?My mom. Icalled her up andsaid, “Yeah, I gotthe letter.”

Having completed your residency, are youhappy that you matched where you did?Yes. The one thing I would say is thatresidency is not just about the job orprestige. Your personal life is very importantto your residency. If I hadn’t made the choiceto stay here and make my marriage a priority,I wouldn’t have been happy and my residencywould have felt miserable. So, make sureyour personal life will not suffer.

Any advice for the M1’s, 2’s, & 3’s?Try not to worry too much about where youend up. There’s enough to think about nowand things will fall into place. Plus, it doesn’treally stop. Life doesn’t work that way. Youdon’t get to a certain place and everything isdone or everything stops. It’s not the lastmove, it’s not the final move. So, just focuson what’s in front of you and let things unfoldthe way they’re going to unfold.

VIEWInter

Match Day Alumni Interview: Dr. Liv Schneider

Name: Liv Schneider, MD

Current position:Chief Resident, Pediatrics,VCU Health Systems

Where are you from originally?Los Angeles, CA

Where did you go for undergrad?Stanford University

I know that you wentto MCV for medicalschool, what made

you choose MCV?I loved the early

exposure to patients andthe FCM program. I likethe idea of getting used

to the clinical setting asa first year student.

What made you go into medicine?Well, I was originally a political sciencemajor. But ultimately, I felt that I neededto have an individual effect on people’slives.

Did you always know what kind ofmedicine you wanted to do?Yup.

When did you start getting a sense ofwhat specialty you wanted to go intoand where you wanted to do yourresidency?When I met my husband. He was in lawschool at the University of Richmond, so

14Spring 2006

I find it amazing that a person’s life can literally be turnedupside down and inside out all in a split second. Think aboutit: one second Mr. Jones is doing fine in the ICU, then thevery next second—flatline. One second the baby is insidemommy, and then the very next second—outside mommy.One second I’m holding an envelope that will dictate myfuture, and then I open the envelope in the very nextsecond—new job, new city, new life. BAM! Just like that.

Match Day 2006 was an interesting experience for manyreasons, many of which I still do not fully comprehend. Eversince interviews ended in January, I have been waiting andpraying and waiting and praying and WAITING ANDPRAYING that I would end up at a good surgery residencyin a good city and be ready to embark upon the next phaseof what has alreadybeen a very good life.And while I’m notdeeply religious, theBig Guy Upstairsdefinitely was lookingout for me when itcame time to open myenvelope—I discovered I was going to Emory University inawesome Atlanta, my first choice no less! I truly could notbelieve it—everything I had worked for in my life; all thepremed classes and interviews and filling out form after formafter form after form after form after form; all the tests I hadtaken, questions I had answered, doubts I had overcome,and hoops through which I jumped; and all the advantagesand privileges I had been given in my life and tried not totake for granted, had culminated in one instant into completeand utter success. I don’t mind telling you, at that verymoment, I wanted to take my envelope and its contents andgo find every person who ever teased me in elementary,middle, or high school to say “What’s upNOWWWWWWW?!?!?!?!?!”

But—there’s always a ‘but,’ isn’t there?—the feelings ofexhilaration and jubilation that I thought would bepersistently present from Match Day right up until Day 1 onthe job have slowly begun to fade. They’re still there, to besure, but not as….’powerful,’ I guess, as they were when theenvelope was first opened. The reason for the slow declinein euphoria is hard for me to explain—not just because it’sdifficult to put into words, but also because I wonder….does

anyone else feel like I do? Is anyone else—particularly fellowM4’s—going to read this article and think, “Those areEXACTLY the thoughts I’m having!” Or am I the lone freakwho is being too contemplative and uptight about this wholeresidency thing?

Honestly… I think not. Somehow, I think I might have afew comrades who empathize with me.

I think the thing that got me after Match Day was thefact that, all of a sudden, everything was for real. It wasn’t agame anymore of trying to bubble in my best answer on thescantron sheet, turning in the test, then going out to tie oneon at the local bar. It wasn’t a game anymore of enjoying theluxury of being a fourth year medical student, doing ‘official

rotations’ that allowed me to‘officially sleep in’ on a daily basis.Literally, I had a job in a splitsecond—and not just any job, butthe job of a doctor, a surgeon,someone who will be responsible forother people’s lives in so many ways!Through some random and

mysterious process, my grades, board scores, and personalityhad gotten me hired at a prestigious medical center to beginworking as a certified medical doctor.

WHAT?!?!?!

How did this happen? Shouldn’t I have seen this comingwhen I applied to medical school? Didn’t I know this was theultimate outcome of the past four years? Why is this resultsuch a realization to me now? When I’ve asked myself thesequestions over the past few weeks, I’ve realized how stupidthey sound. Of course I knew I was training to become adoctor—someone who would faithfully and altruistically dothe very best for his patients on a daily basis and who wouldnever forget just how lucky he was to be doing what he wasdoing. There are plenty of applicants, thousands I’m sure,who apply every year to enter medical school but are nevergiven the opportunity. There are probably 10 times thatnumber who for whatever reason are not even given thechance to apply in the first place. And here I sit, wonderingwhether or not I am ready or even willing to handle all theresponsibility inherent in the words, “Dr. Davis, M.D.” Afew of the more pressing concerns on my mind have been:

MUSINGSMUSINGSMUSINGSMUSINGSMUSINGS OF AOF AOF AOF AOF A POST-MATCH-DAYPOST-MATCH-DAYPOST-MATCH-DAYPOST-MATCH-DAYPOST-MATCH-DAY

by Drew Davis, Class of 2006

Did I pick the right city?“Hotlanta”—hoo doggies!

15Spring 2006

Did I pick the right program? Emory is trulyphenomenal—I knew it when I applied, I reaffirmed it whenI went there to interview, and everyone has told me so sinceMatch Day. But was the grass greener somewhere else onmy rank list, and I just didn’t know it?

Did I pick the right city? “Hotlanta”—hoo doggies! Biggerthan Richmond, which is what I was going for. But will Ihave fun there? Is there a good social scene for me? Will Ihave friends there like I do here?

And what about my social life? Will I even have one? AmI kidding myself by even using those words? I am going tobe a surgery resident—the very position negates anything inlife that might be ‘fun,’ or ‘extracurricular,’ or ‘social.’ It alsonegates things like ‘sleep,’ or ‘hygiene,’ or ‘being nice topeople.’

And let’s not forget—will I actually be a good resident? Imean, sure, I know stuff and can do stuff. But there’s somuch that I don’t know, and can’t do, and am I going to fallflat on my face because of that? They say the learning curveis steep—is it really just one big, long vertical line? Will I beable to keep up, maintain energy, think on my feet, do whatis expected of me, and not disappoint anybody?

But perhaps the most pressing—and incredulous—question I have is: Is this it? On more than one occasionsince Match Day, I have caught myself thinking about thequality of my life over the next few years. Being the high-flying, free-thinking, wanderlust spirit that I am, I envisionedmy years between 27 and 34 to be full of swinging parties,clandestine midnight encounters, and general good-natureddebauchery sprinkled with a touch of responsibility inherentin whatever job I had to sustain my entertainment-richlifestyle. Basically, I wanted to work hard, but play harder.But now all I see coming my way over the next 7 years is bagsunder my eyes, a balding patch on my scalp, shabby clothingthat hasn’t been washed in weeks, an apartment that lookslike a cyclone hit it, and long days and even longer nights ofsick patients and nagging nurses and grumpy attendings andforms and paperwork and standing on my feet for endlesshours and no sleep and forgetting that life ever had anything‘fun’ in it. And I wonder: is this all I have to look forward to?Have I made the right choice? Were there otheropportunities that I missed along the way for which I shouldhave been on the lookout? Was I destined to be somethingelse, but somehow missed the chance to find out what? AmI really ready to embark on this journey known as adulthoodand give up my selfish, carefree ways?

Question…..after question…..after question. To be sure,some are introspective and calculating, others are petty anddecidedly not altruistic. But nevertheless, they have all been

racing through my mind at various points over the last fewweeks. I suppose the truth of the matter is that I’m excited tobe in the position that I am, but scared about where I’m going,and sentimental about what I’m leaving behind. It’s a bigchange I’ve got coming my way, and I will be the first to admitthat I’m not sure how to handle it. I think the only thing I cando is just dive right in, face all the challenges head-on, and holdon for the ride. Is Emory the right program, and Atlanta theright city? Yes—I picked them based on my gut feelings, andthey obviously picked me, so I’m going to just ride the waveand see what they have in store for me. Am I going to be agood resident? Yes—sure, I won’t know everything, but beinga good resident is more than just book knowledge. It’s usingyour common sense, knowing how to talk to patients, andstepping up to the plate to get the work done….things I know Ican do. And will I have fun, and actually make friends, and geta chance to be social?

C’mon….who do you think you’re talking to?

And finally, when I ponderwhether I have made theright choices in life andwhat the quality of my lifewill be like in the future,I realize that nobodyknows the answers tosuch questions. If Imissed ‘greener grass’along my travels, doesthat really matter? I thinkthe lawn I ended up on,metaphorically speaking, isgrowing quite nicely! And nothing iswritten in stone about my future—it’s what I make of it, and ifI choose to be positive or negative, then my life will followsuit. If I think about stress and fatigue and work overload,then chances are I’m in for a bitter time. Instead, I think abouthelping a med student with fumbly fingers learn to tie surgicalknots, or enjoy being part of a once-in-a-lifetime operation, orwork hard enough to successfully obtain a fellowship of mychoosing, then I get excited about all the things that are stillto come my way. The fact is, my life is mine to live, and no oneelse’s. No matter who I make promises to from here on out—friends, family, and even God—I promise to myself to trulyappreciate every experience and emotion I encounter and learnfrom them what I need to make me a better person along myjourney. Good times or bad, easiness or struggle, we all have itin us to make the best out of life and be the best we can be. Sobring it on….residency, relationships, life in general. Come whatmay, I’m going to be alright, because I have the strength anddetermination to make it; in my rare moments of clarity whenI remember that fact, in a split second all the doubts andquestions and fears that I have vanish into thin air.

16Spring 2006

by McKinley Haas, MD Gentoo Penguin, Antarctic Peninsula

17Spring 2006

Upon initial reflection, it seems like only yesterdaywe were sweating our heinies off in our freshly-donnedwhite coats, surrounded by parents snapping away infrantic attempts to capture every moment of ourceremonial entry into this noble profession. On secondthought, however, I am filled with visions of the hoursspent in FCM, the intense days of frantic cramming indeference to inevitable procrastination, the endless stream

of exams and hoops jumpedthrough, the time spent with new friends in a new city.All of it brings me back to my senses and makes me realizejust how far we’ve come on our long journey.

I write this as a third-year medical student,member of that small breed of crazy masochists that

haunts the white hospital hallsat ungodly hours of the night.

As I’ve slowly clawed myway up the totem pole, afew nuggets of wisdomhave made it through thefilter. I’ve come to realizethat the world ofmedicine, especiallyacademic medicine, is oneof great complexity. Theacademic teachinghospital swarms withactivity; physicians,

nurses, ancillary staff,patients, visitors, and

countless others bustle about on

a daily basis to completethe plethora of tasksnecessary to keep thehealthcare machinerunning smoothly andsafely. It is difficult forthe naïve medicalstudent to find his

or her placeamidst such chaos; it is subsequentlyvery easy to lose sight of the role ofthe budding physician. As medical

students, we play a very unique role in the healthcare mazeand I wanted to take a moment to recognize andcongratulate you on the hard work you’ve done and theprogress you’ve made on the quest to fulfill your potential.

The short white coat is a symbol. It tells the worldthat we are student-physicians, that we have a lot oflearning and a little experience under our belts and a longroad ahead. It declares our exponential potential; that atthis point in time we still can, in our parents’ words, beanything we want to be. We still possess the freedom todecide what we want to do, who we want to serve, andwhere we want to live. Every day we take steps towardour future selves and make decisions that couldsignificantly affect our tomorrow. Our choices are vastand exciting, our horizons of possibility virtually endless.

We go by a number of names in the hospital. Mytitles have varied as widely as “nurse,” student,” “the medstudent,” “stud,” and “you,” to “scut slut” (my personalfavorite), to just emphatic pointing and snapping in mygeneral direction. I’ve done countless H&Ps, cleaned bloodoff my booties, carried a kidney from a daughter to hermother in the next OR, and delivered a baby. I’ve obtained

Sporting the ShortShortShortShortShort Coat

by Meagan M. Littlepage, Class of 2007

“I’ve done countless H&Ps, cleanedblood off my booties, carried a kidneyfrom a daughter to her mother in thenext OR, and delivered a baby.”

18Spring 2006

vital signs at five in the morning, assessed a suicidal girl my own age, made presentations in front of attending physicians,and sewn up a tubal ligation. In what other career would I be able to experience all this? Every day I am blessed toengage in some of the most potent of human interactions and I find it daunting and flattering to be able to do so.

If I could share some of the lessons I’ve learned from this process, I would tell you to make the most of theexperience. Engage and interact as much as possible. Learn everything you can, every day. Don’t get bogged downwith the realization of how LITTLE you know; rather, use each opportunity available to make correlations with whatyou DO know, which is more than you think. Verse yourself in the hospital as well as human anatomy. Just knowingwhere to go is a battle in itself and a working knowledge of the hospital will save you time and frustration and help youguide lost patients when they flag you down. Take your role seriously—you DO matter. A misfiled note or lab resultcould prove drastic for a patient, and your compassion and thorough exams are an appreciated and integral part of thetherapeutic relationship necessary for true healing to occur.

On the other hand, don’t make the mistake of taking yourself TOO seriously. We’re all human and thereforemake mistakes. Attendings are people too, and often serve as humorous and knowledgeable mentors. Learn as muchas you can from them. Work hard for your interns and residents. It may not appear as though it matters to your grade,but they really appreciate it and you may end up working with them again sometime in the future. It never hurts tobuild a reputation of hard work and competency. Also, treat the nurses and ancillary staff as your friends. Often theyhave years of experience in their field and can teach you a lot if you show respect, friendliness, and a desire to learn.

Finally, make the most of the entire experience. Utilize your free time wisely. Fill the spare moments you havewith activities that make you happy and recharge your battery for the next round of exams, the next night of call,whatever. Exercise your mind and your body. Involve yourself in organizations and evoke change in the world aroundyou. Until those little white coattails grow up and an “M.D.” majestically appears behind your name, take full advantageof the unique role you play in the world of healthcare. Work hard, with heart and compassion, absorb as much knowledgeas possible, and sport those short coats with pride, my friends!

19Spring 2006

by Kevin Lee, Class of 2009Views from the National Cathedral No. 6

20Spring 2006

Tue Mar 14 2006 11:32 amOn Thursday, the ninth of March, my best friend in medicalschool asked me to feed his saltwater fish while he was awayin Italy.

“Of course,” I said. “But I don’t know anything about fish.”He said, “That’s okay. It’s very simple. I’ll write outdirections.”“Well, make it idiotproof, because I don’t know what to dowith fish. You’re not going to be mad at me if they die, areyou? What should I do if one of them dies?”“It’s okay if one of them dies. Flush them down the toilet.Look, nothing’s going to happen.”

We hung up.

I called back a while later. “Can I get a contact number or anumber of someone who to call in case there’s an emergency?”“No, I’m gonna be in Italy and my phone’s not going to work.It’ll be fine.”“Okay, but remember, I’m not going to feed them untilMonday night.”

Mon Mar 13 11:30 pm we came home from Greensboro soTim could get to work and so I could feed Andy’s fish. Wewere tired. The written directions said “put 2 capfuls ofcalcium, one gallon of fresh water, and defrost 4 shrimp cubesand give them to the fish. They are in the freezer door.” I goto the freezer door. There are a lot of tinfoil wrapped things.

Odd looking, but recalling Tim’s experience in Okinawa withfish hot dogs, I dutifully unwrapped 4 of them and defrostedthem in a bit of tank water. I broke them up into chunks anddropped it into the tank. The fish were ecstatic at first, butquickly became disinterested in the food. I went back to thefreezer and found “Fish Shrimp Cubes.” S*@%. I think I putthe wrong thing in. I defrosted one of those and put it in,and the fish were happy. I went outside to the car whereTim was waiting and told him that I thought there might bea problem. I showed him the tinfoil wrapped food thing,which he thought might be a banana. We went back in and Iscrubbed up OR style and started removing all of the chunksof stuff that I originally put in. I used a slotted plastic spoonas I couldn’t find a net. We fed the fish 3 more cubes of shrimp.The water was clear and I hoped that 50 gal of water woulddilute the effects of one banana. When we got home I wrotemy friend in vet school, whose interest is in all things aquatic,about what happened and she thought that “bananas werenot toxic to fish.”

Tues Mar 14 5:00 pm I decide to go to Andy’s just to checkeven though feeding time isn’t until Thursday. The tank lookslike a snowstorm with zero visibility. Perhaps an anemonewas waving in the toxic sludge. I saw some fish upside downand the rest were on the bottom or wedged against the glassin between the coral. Panicked, I started calling people, noneof whom knew what to do. One guy said, “Call Andy,” and Itold him that this was ABOUT Andy’s fish. Sally, theveterinary student, said to drain some water and then to go

M&M: Benign Neglectby Ashley Mortenson, Class of 2008

21Spring 2006

buy 20 gallons of distilled water and start thinking aboutpartial water change. Makes sense drain the toxic crap andreplace with normal water. Seeing no pump but something

that looked like a siphon, I drained out about 10 gallons, withthe water still above the pump. I went to the store andbought 24 gallons of water and a 6 pack of beer, aiming tocome back and have Sally talk me through mixing up newwater. Lugging all that water up 2 flights of stairs was quitea workout.

I brought my laptop to try and find instructions on how tomix up the water and change it out. It’s more complicatedthan adding salt to water. There’s specific gravity, pH,temperature, etc. I found a specific gravity meter and foundthat the current tank specific gravity was 1.019. But I couldfind no specific directions on how to mix up the stuff. Therewere no instructions on the bucket other than that the 75kg was for 225 L of water. I called Jonathan, who has ownedsalt water tanks in the past.

“Darlin’,” he drawled, “you can’t mix up the water. It takestime. You have to buy premade salt water from a pet store.”Ever resourceful, he finds a pet store close by and convincesthem to stay open past their 8:00 pm closing time. He givesme directions and I gather as many large containers that Ican find and run down the stairs, driving like a bat out ofhell to get to the store, arriving at 7:55. The pet store sold me28 gallons of saltwater at the proper temp and reassured methat this happened to them once, and they were able to savethe coral and some of the fish. Fish can look dead but still bealive. However, they warned me to take out all of theobviously dead stuff.

Wondering how to shut off the system without disruptingthe timers, I debate unplugging vs. trying to look for a powerswitch for the fourth time. It’s something to think aboutwhile hauling 28 gallons of water upstairs. Tim comes over.The pumps, while covered with water, have been runningwith a lower volume of water for about 3 hours now. I find apower switch and shut off the pumps, lights, etc. We removemore water, amounting to ~45% total of the water, exposingthe tops of the hard corals for a few minutes. I pull outfloaters, flushing them down the toilet as they were

“obviously dead.” I pulled off the gunk on the intake ventson the pumps. The new saline is 1.020-1.021, within normallimits of “healthy tank water,” or at least according to the

highlighted area on the saline measurer.We start adding back water, turning onthe system once the water is above thepumps. We have added about 20gallons of water to the tank. We watchthe remaining fishes for 2 min each forgill movement. Nothing. I pull out theremaining carcasses- blenny, blue fish,clown fish, angel fish. The anemone nolonger waves in the current.

Water is all over the floor. One of the major tubes comingout of the tank is dry. I hadn’t noticed that before, but Idon’t know what it does. The intake valve is submerged andit’s still dry so I hope it’s supposed to bedry. It feeds into some otherreservoir, which looks low. Igingerly add some water to thatand things start overflowing.The roomate’s personal bathtowel is sure coming in handy.

The tank is clearing, you can see therocks. The anemone still lies limply on the ground. I’m $40out so things better start improving. Reeking of dead fishand manky salt water, we finish off the beer and decide to gohome.

Wed Mar 15- I’ll find out today if the coral is still alive. If itstarts sloughing off, I know I’m in deep s*@#. At this point Iam hoping that the tank hasn’t exploded.

Wed Mar 15 2:00 pmI go back, returning with a camera, my mop bucket (it hasmeasurements on it) and high hopes. As I walk up the stairsI was greeted with the stench of salty decay. I look at thetank. It’s cloudy. I can see in about 4 inches. The anemone islimper than yesterday. I call the store. They advise me to doanother water change. I take pictures of the tank and of thelifeless anemone because it’s the only thing I can see. I bringalong a sample of the tinfoil wrapped toxin. The fish tankguy is impressed with the pictures and advises me that ifthis doesn’t do it, then nothing will. He is puzzled with thefrozen object and decides that it might be a banana. We bothwonder why anyone would keep quartered bananas in thefreezer.

I buy roughly 21 gallons of saltwater--bringing the total costto $60. To put it in perspective, my last major calamityinvolving someone else’s property cost over $17,000, so thisisn’t too bad. I then return to Andy’s. Dragging water upstairs

What should I do if one of them dies?”“It’s okay if one of them dies. Flush themdown the toilet.

22Spring 2006

is easier than it was yesterday. I open the house, turn on thefan, remove the reeking towels, find a replacement “blotter”towel, grab a new roll of paper towels and his roommate’strashcan. I turn off the pumps, set up an efficient drainingsystem (read: less water on floor, on self, in mouth) and beginsiphoning. One trashcan is roughly 4.5 gallons. I take out 4.5trashcans plus 5 more gallons. The water is very low. Thistime I notice where the water’s going and move the diningroom carpet out of the way. I remember to take out thebathroom mat and put it on the roommate’s floor, since I’mspilling rancid water onto her plush red carpet on the wayto the bathroom. I start refilling the tank, hoping that Sally’smandate to “add it slowly” translates to “pouring it in tryingto avoid the invertebrates.” At this point, the 3 gallon mopbucket is heavy, and I am not tall enough to control thebucket well, so most of the 25 gallons I had on hand made itinto the tank. Making sure I didn’t overfill the tank, I turnon the pumps. The sweet hum of working machinery overjoysme. The water is mostly clear. A small anemone opens itspale green face. Looks great! It’s just missing the fish.

The house has been completely open for several hours nowand it still stinks. I can’t identify the source. Is it comingfrom me? Does the room just need a good cleaning? I takeout the living room rug. I mop the floor, clean the table, chairs,tank, and tank base. The specific gravity is still within normallimits and I write up a comprehensive report. That night atthe bar I run into one of Andy’s longtime friends, who tellsme that Andy is very attached to his fish, but that the tankhas crashed several times. Mike White has the current prizefor “Biggest Crash,” where the thermometer went on the fritzand fried the fish.

Thurs Mar 16 1.00 pm- the water continues to clear. pH isabove 7.4 (the pH meter only went to 7.4), specific gravity isright where it needs to be, and the house doesn’t smell thatbad. Patient is in stable but critical condition.

Thurs Mar 16 8.00 pm- I go to drop off the last few gallons ofwater that are rolling around in my trunk. The lights and TVare on. The roommate is home. I go upstairs and she’swatching TV with her boyfriend, like nothing has happened.I kind of introduce myself and told her that her floors areclean. She reassures me that everything’s cool, they’ve lit aton of candles and cooked a garlicky meal so it smells okay. Iask her what the things in the freezer are. “Bananas,” shereplied. I look at her as if she’s from another planet. “Why?”“They’re great frozen, for desserts. Haven’t you ever had one?”

Assessment: I gave the tank a massive transfusion and hopethe system clears the rest of the debris. We had some volumeoverload but I think we solved that. We lost the fish. Whenthings went awry despite my best intentions, I had good,but not local resources to assess the damage and tell me how

to control it. I did not have, even though I repeatedly asked,the owner’s info to contact him and have him help me solvethe problem as he saw fit (informed consent).I see this as a small lesson of what will happen at least oncein a physician’s career. I will be put into unfamiliar situationswhere I’ll have no available mentors, little/no book info, andjust my gut to work with. Andy is my best friend and I don’tknow how to tell him about his fish. He is an easygoing personand I don’t anticipate losing the friendship over this.

However, one day I will kill or hurt someone through wellmeaning mistakes, or “benign neglect,” good intentionscoupled with ignorance that has calamitous results. I wonderif it’s possible to make good decisions while fatigued. Howwill I tell the family that we screwed up? That I did all Icould to try to rectify the solution? I doubt “I’m sorry” willbe enough and won’t stop them from suing me.

In this case the most obvious answer is that I gave themsomething that wasn’t supposed to go into the tank and thatit overwhelmed the tank’s filters, sending the tank intosepsis. Maybe the fish died from something else. Maybe myhand or the plastic spoon wasn’t clean enough. But thisidiopathic calamity seems iatrogenic.

So who is responsible? Should I flat out have said no? Itseemed easy enough. Should Andy have found someone elsewhen I indicated that I wasn’t comfortable with theresponsibility? Should he have had me over and showed methe stuff before he left? Hindsight tells us that all of thisshould have taken place. However, hindsight isn’t going tohelp me much when he comes home on Friday. I supposethat will be a lesson in “breaking bad news.”

23Spring 2006

Medical Students outin the Community

The Geriatrics Student Interest Group (GSIG)April 2006

Medical students and residents at the Imperial Plaza retirement community gottogether to learn ballroom dancing taught by Rietta—a second year medicalstudent who taught ballroom dancing professionally in DC for 10 years. Membersof the Imperial Plaza want to know when GSIG will return! Photo: Left to Right:Chris, Lee Goodglick, and Rietta Coetzer (Class of 2008).

MCV School of Medicine Class of 2009October 2005

While in communication with some evacuees, Lesli Brown and Rishi Soodorganized a drive to fill seven large boxes with clothes and shoes for childrenand adults. The boxes were shipped to Baton Rouge, LA and given to manyappreciative families who had relocated to that area immediately after the flood.Picture: The seven large boxes shipped to Baton Rouge.

March 11-18, 2006

A group of health care students and professionals went to El Salvador to providebasic services for its medically underserved population. Traveling to different villagesand communities around San Salvador, they set up clinics serving nearly 200individuals. The group also worked at an orphanage, meeting the needs of thechildren. Thank you to everyone who donated supplies and money--”we are trulygrateful.”

24Spring 2006

Mattaponi Healing Eagle Clinic

VCU SOM students volunteer to assist Dr. Narinder S. Arora M.D. in his desire to helpVirginian Indians with limited healthcare on the Mattaponi Reservation. Free checkups, examinations, medications, screenings, and when necessary, referrals are givento any American Indian who comes. Students help by taking histories, vital signs,helping organizing medication stores, and documenting the doctor’s instructions tothe patients. The people are very grateful and friendly, making it a joy to volunteerhere.

Women in Medicine Student OrganizationFebruary 3, 2006

On “National Wear Red Day” medical students, professors, administrators, and healthcare workers from VCU SOM and MCV Hospitals wore red, joining with people acrossAmerica showing awareness of heart disease as the leading cause of death in Americanwomen. “The Heart Truth: A Campaign about Heart Disease and Women” wassponsored by the US Department of Health and Human Services, the NIH, and theNational Heart, Lung and Blood Institute.

MCV Class of 2008March 24, 2006

The second year medical students co-sponsored a blood drive with the VirginiaBlood Services on March 24, 2006. Over 40 people donated blood, and the volunteerstaff was unable to accept all donors due to the volume of walk-in donors. Althoughmany were not able to donate, the goal of collecting blood in hopes of saving liveswas accomplished.

Food Bank

That the Under Served Become the Equally Served:Volunteer events have been coordinated over the past year by the 1st and 2nd yearclasses in an attempt to give back to the underserved. While this is still a work inprogress, medical students hope to gradually make strides in raising awareness ofthe struggles that many individuals face on a daily basis.

25Spring 2006

HombrHombrHombrHombrHombre e e e e neneneneneeds yeds yeds yeds yeds your our our our our HelpHelpHelpHelpHelp

Catherine Schuller, Class of 2009. Rainor shine, HOMBRE is baking up a stormto raise money.

Dear MCV Alumni, Faculty, and Staff,

Hombre needs your help. Each year a group of medical students travel to Honduras to provide healthcareto underserved Hondurans. We will be serving patients and, in addition, we hope to become moreconscious about creating social change in our own communities.

We still need to raise $5000 to help reach our goal for this upcoming trip. Please help us. All the moneywe raise goes towards purchasing medications and surgical equipment for patients.

We are eager to accept a variety of types of donations including but not limited to joint-fundraisers, financial donations and whatever other services or products which you maycreatively identify as helpful to HOMBRE and the people of Honduras. A list of medicationswe need is available on our website: www.hombremed.org.

HOMBRE3720 Grove AvenueRichmond VA 23221

Thank you for your consideration,The 2006 HOMBRE Team

Hombre, Inc. (Honduras Outreach Medical Brigada Relief Effort) is a 501 © 3 nonprofit organization thatwas formed by first year students at the Medical College of Virginia Campus at Virginia CommonwealthUniversity in 2000.

by Darshita Patel and Uppinder Mattu, Class of 2009

Upcoming: Vitreous Humor, an IMPROV Comedy Group of MCV faculty andstudents, is having a show on May 2nd and all proceeds goes towards HOMBRE.Please come out and join us for some fun (more info on the following page).Thank you Vitreous Humor!

Vitreous Humor

LIVE IMPROV COMEDY Tuesday May 2, 2006 7:30 PM 18 and over $5

All proceeds will go towards HOMBRE (Honduras Outreach Medical Brigada Relief Effort)

ComedySportz Improv Theatre (corner of Glenside and Staples Mill, behind the Shoney’s) RESERVATIONS 266-9377

26Spring 2006

by Jay Ronquillo, Class of 2009Spring Snowman

27Spring 2006

Dr. Carolyn Peel is VCU SOMgraduate and a specialist inFamily Medicine. She is alsoa course director for the"Foundations of ClinicalMedicine" classes currentlyheld at the medical school.

How did you pick the field of familypractice?

I chose family medicine because I aminterested in a preventive and somewhatholistic approach to patient care. I amall about relationships. I am not a personwho gets excited about technology, ingeneral. I am also not a person who loves“drama” (or trauma, for that matter).When I went through my clerkships, Iwas able to easily narrow down myinterest to pediatrics and familymedicine. I chose family medicinebecause I liked the large variety ofpatients and illnesses. I still love to seethe kids!

What is the best thing about familypractice?

The relationships you make with thepatients and their families.

What is the worst thing about familypractice?

I think the thing I enjoy least aboutpracticing medicine right now is notisolated to family medicine. There is afairly large hassle factor associatedwith practicing medicine in our currenthealthcare system. By hassles, I amreferring to the never ending forms,pre-authorizations, and formularies.

Who were your role models in highschool/college/medical school?

My father is a retired dentist. I can’tsay that he came home effusivelypraising his job (his hassles were thebusiness aspects of running an office).There was a woman in our church whowas attending USC Medical School aswell. She was a non-traditional secondcareer with two children—veryinspiring. She took me to her M-2lectures one day when I had a schoolholiday. I comprehended nothing, butwas very impressed that the studentsdid.

There are many role models in medicalschool. The most memorable one forme was Dr. Robert Newman, a family

doctor who formerly practiced inKilmarnock, VA. I did my communitypractice rotation with him. He was avery impressive individual and had a lotto do with my eventual choice to pursuefamily medicine.

What do you remember most from yourfirst two years of med school? Yourclinical clerkships?

The first two years of medical school area blur of Sanger second floor. However,I was the student who almost passedout on my first day of anatomy lab. Verymemorable. Also, I made some greatfriends during those two years and wehad some fun times.

We were so unprepared for clerkshipsthen, that that was a dramatic paradigmshift. I had never seen people so sick—that was a little tough. And, I was theperson who almost passed out in myfirst surgery.

What was the best/worst moment ofmed school for you?

I cannot isolate one—that was a longtime ago. Best moments would havebeen in the second half of the third year

by Matt Morgan, Class of 2009

“Choose a field you LOVE”

Dr. Carolyn PeelInterview with

28Spring 2006

and the fourth year when I actuallystarted feeling like I might knowsomething. Anatomy was my all timeworst experience in medial school.

In your opinion, which actor/actresswould play an ideal doctor?

Meryl Streep

If you lived in the 16th c. would you stillbe a doctor?

Absolutely not—blood letting andleeches are not for me.

What did you tell yourself inmed school that you would never doand then ended up doing?

Worry about productivity

What do you hope medical research isable to accomplish in 5 years? 50 years?

I am really more interested in figuringout ways to help populations livehealthier lives. So much disease iscompletely related to lifestyle. I’d like

research to accomplish discovery ofways to motivate patients to livehealthy lives. Having said that, I justlost a 39 year old friend to breast cancerand hope researchers can continue tomake progress with curing cancer andHIV.

What is your perspective on the healthcare system in Canada? in the U.S?

From where I sit, the US health caresystem is sick. The excessive focus onillness after it happens and heroics tosave a few at the expense of qualitypreventive care for many is all wrong. Ithink Canada actually does a better job

with that.

What is you biggest patient petpeeve?

Patients who return whining (literally)about something I have already maderecommendations for that they did notfollow through with (like taking aprescribed antibiotic).

What is your opinion on alternativemedicines?

They have their place. If they makepatients feel better, more power tothem. There are actually some wellconstructed studies that support someof them—I will recommend those topatients. It would be good if the FDAcould somehow mandate standards in

the industry so that the products aresafe and reliable.

What qualities do you look for in yourdentist?

I mentioned before that my dad is aretired dentist. I am certain that thisflavors how I answer this question. Iwant a dentist who is personable (whodoesn’t?), not too aggressive withtreatment and more focused on qualityteeth sparing work than on cosmeticdentistry. Fortunately, I have had veryfew dental issues.

What advice do you have for futuredoctors?

Choose a field you LOVE. You need tospend the rest of your life doing it. Ifyour chosen specialty is notintellectually and spiritually (in thenon-religious sense) fulfilling, it will behard to enjoy your work life.

29Spring 2006

Ethan just had his 7th birthday. I can’t even believe that he’s going to be in the 2nd

grade. Ethan was the first Oncology patient I ever had a strong relationship with. When

I met him, he was 4. He had had a seizure while he was at pre-school. When they brought

him to the emergency room, they discovered he had a brain tumor, about 1.5 cm away

from his brain stem. What was fortunate for him though was that the tumor was encased

in a cyst, so it made for a clean resection. And by the time I met him, he was already into

his 3rd month of treatment.

Ethan and I hit it off right away. I had to wake him from his nap to take his vitals.

He was kind of cranky, so I tried to keep him relaxed. When I saw his firefighter gear, I

asked him if he liked firefighters and firetrucks. He stopped mid-whine and got real quiet. I told him that I was a volunteer firefighter and

he looked at me as if he were trying to figure out if I were being honest with him or not. As soon as I was done, he jumped out of bed and

started going through the drill of putting on his gear, and asking me if I preferred pumpers or trucks (pumpers of course). At the

precocious age of 4, he was a walking encyclopedia of firefighter knowledge. He knew all of the names of all of the tools on the truck. He

knew what everything was used for. He knew

what went into each compartment. And the best

part was that he would talk about these things

sounding like a childhood version of Elmer Fudd.

I used to push him and his ever-present

IV pole down the hallways in a little toy car, while he would make all of the siren sounds as we turned the corner. When he was neutropenic

and couldn’t leave the room, we would play hide and seek. He once hid in the bathroom and I pretended to not know where he was. So,

I yelled out loud, “Ethan, are you out in the hallway?” And he yelled back, “I CAN’T. I’M NEUTWOPENIC.” If you’ve never heard a 4

year old say the word “neutropenic,” I can’t begin to capture how priceless it is. My favorite was when he used to hide in the closet… with

his IV pole standing outside the closet door. Or when he would wrap himself in the curtain… with the IV pole standing outside this

mysterious bundle of cloth. He never really figured out that the IV pole was seriously cramping his hide and seek technique.

I spent quite a bit of time with Ethan outside of the hospital as well. I used to go to his house to “baby-sit.” We played fire

engines with his 9 million toy fire trucks. I would read with him while he waited to get his neupogen shots. And in one truly remarkable

moment, we played MedEvac, where we picked up a patient that turned out to have a “lumpy” in his brain. He then said, we were going

to have to take the lumpy out, and he said that the two of us were going to pretend to be the 2 pediatric neurosurgeons that did his

operation. And as we were pretend operating, he looked up and said, “We caught the lumpy just in time.”

The first year I worked at the hospital, everyone who saw me asked me about Ethan, no matter what I was doing. The two of us

were like peanut butter and jelly. You just didn’t think of one of us without thinking of the other. For his birthday, I got a print of Mickey

Mouse shaking hands with a firefighter. A friend of mine’s parents worked at Disney World and got one of the Mickey Mouse’s to

autograph a brief personalized note to Ethan. For my birthday, he showed up at the hospital with a big birthday cake that had a fire truck

on top… and it was very clearly home-made.

by Kevin Lee, Class of 2009

Transitions

“He never really figured out that the IV pole was seriously cramping his hide and seek technique.”

30Spring 2006

When he was done with his treatment, we spent that summer going to movies and

getting ice cream. He used to drop a penny into the wishing wells at Reston Town Center

and wish out loud, “I wish my lumpy would stay away.” And we also celebrated at the

second annual “Lumpy-palooza,” a fundraiser that his family started to raise money for the

Pediatric Brain Tumor Foundation. The summer after that, he came to Richmond for another

fundraiser called the Ride for Kids, where he was one of the guests of honor and got to ride

in the sidecar of one of the lead motorcycles. But that was the last time I saw him. You see

an amazing thing happens to patients after they stay off treatment for a while. They start

discovering their own lives.

After 2 years of being surrounded by nurses, doctors, hospital staff, and other kids

with cancer, Ethan’s life began to start resembling the life of any other 6 year old. He had

school, T-ball, gymnastics, swimming, biking, and a million little girls who wanted him to

be their husband. I got accepted to medical school and started preparing myself to enter an

intensive 4 year journey. His world was so jam-packed with activity now and he was

spending so much time with kids his own age and my life was getting so much busier by the week, that we kind of hit a natural transition…

and slowly drifted apart.

I’m less than a month away from the end of my first year of medical school. On the one hand, I feel like the year completely flew

by. On the other hand, it feels like it’s been years since that first day of orientation. My first year did not go at all the way I expected it to.

And yet, in a strange sense, it went better than I could have ever hoped. I feel pretty much like the same person that I was in August. Yet,

when I do a bit of self-reflection, I know that I’ve changed… in very dramatic ways.

I think about what my life was like last summer. I was working quite a bit. I spent a lot of time with my friends from the

hospital. I was very involved in the lives of the families I have or had taken care of. But I’m not as involved anymore. I don’t know exactly

how it happened. When I first started school, I guess I felt like my old life kept dragging me back just by virtue of so many of my former

patients passing away. In 2005, I lost Edwin, Geraldine, Branden, Dianne, Mark, Ryan, Michelle, and James. It felt like everytime I started

to explore my new life as a medical student, I was getting another phone call taking me back to where I came from. But throughout this

emotional tug of war, I found friends here, both new and old, that helped pull me through and helped me to move forward even as I felt

myself tumbling backwards. And as I become more engrossed in the community that I was a part of, I found myself contacting my old

community less and less. And whenever I had a chance to go back home, I found myself too tired to reach out to those I knew, and ended

up cocooning myself from the outside world so that I could recharge. And as the weeks became

months, and the months began to feel like eons, I soon discovered that I hardly ever spoke or even

emailed the people I spent so much time with just 9 months ago.

I wondered. Did I change? Did I burn out from dealing with so much grief? Did I lose

interest in what I used to do or the people I spent time with? Yes. No. Maybe so. The thing is,

our lives are in constant motion. Old fades into new. What was new becomes old. The things we

were sure of become uncertain. That which we cherished becomes a memory. And that’s what has

happened to me. I’ve drifted away from the person I was in the beginning of the year. And though

the person I am now bears a strong resemblance to the person I once was, it is still noticeably

different. I’m still a sap. I still like being sarcastic. I’m still goofy. I still love working with kids. I

still love all of the kids I ever worked with. But I no longer feel like, Kevin Lee, the Tech who works

in Peds Onc. Now, I feel more like, Kevin Lee… an actual, future doctor in training? I guess I’m

31Spring 2006

moving on. Not because there was something wrong with the

who and what of my past. But simply because… it’s time.

There’s more for me to learn. There’s more for me to

grow. There’s more for me to explore. All of this is impossible

to do without movement of some kind. Obviously, those things

that have passed will stay with me forever. There are days when

I see old photos of Ethan and I miss him and his goofy voice. I

miss looking at the closet and seeing his IV pole just outside of

the door, giving away his “hiding place.” I miss him sneaking

out of his room to come find me on the floor just to see what I

was doing. I miss him climbing onto my lap so that I could

read him another firefighter book. But mostly, I’m just thankful that our paths crossed. I’m thankful that he’s healthy. And I’m thankful

that he’s doing all of those things that a 7 year old should be doing.

I cherish those memories… and I even cherish some of the bad. I am so grateful for having had the experiences I did earlier this

year. By having to deal with so much grief and by having so much emotional pain right from the get go, I learned so much. I saw how

debilitating enormous grief could be. I saw how emotional pain could completely take over your life. But, I also saw how amazing some

of the people in our class are. I saw how incredibly compassionate and caring my friends could be. And I saw how resilient I truly was.

The other day, I was feeling a bit stressed from the volume of information I still had left to study, when one of my friends sent me a simple

text message, “This is nothing for you compared to last semester.” And just like that, every last bit of stress just lifted away.

This is who I am now. It’s been a 9 month journey of a million miles. And as I take a moment to catch my breath and allow myself

to soak in all that has happened, out of the corner of my eye, I can’t help but wonder what next year will bring. The end of this chapter is

simply a transition into the beginning of a new one. And I can’t wait to see what happens.

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33Spring 2006