Huntington Hospital Preceptorship

Kisha Thayapran | December 29, 2017

Over the summer of 2017 I had the chance to shadow in a 6-week preceptorship at the Huntington Memorial Hospital in Pasadena. Lead by Dr. William Caton III, head of neurosurgery, the program was designed to introduce pre-medical students to a variety of different medical fields through shadowing. Though I had already decided on a career in medicine, my knowledge coming into the program was a bit superficially informed (and possibly still fueled by a naïve sense of wonder). My hope was that by attending this program, I would be able to understand what a career in this field is truly like, both the ups and downs, and solidify my goals for the future before I begin applying to medical school. During my time at Huntington I rotated with critical care, anesthesiology, general surgery, neurosurgery, pediatrics, cardiology, neuroradiology, and pathology. This diverse range of fields gave me a holistic view of the daily happenings in a hospital, not just from a physicians’ point of view but patients’ and the myriad of personnel. In all, my time at Huntington not only succeeded in helping me understand the field of medicine better, but also had an extremely positive effect on me as a student and person.

In critical care, I rounded with the attending physician and residents, listening to them discuss each patient thoroughly and observing as they visited each one. I became informed on a large variety of ailments requiring patients to stay in critical care, and the importance of the unit as a whole. I was able get a sense of how everyone in the unit functions as a team to continuously monitor each patient, and how various members respond to emergencies such as sudden heart attacks and strokes. I also witnessed how sometimes structure and protocol breaks down, when a patient who coded blue for heart attack passed away just minutes later. Though very saddening, it was a sobering experience.

Meeting with anesthesiologists, I watched as they put patients to sleep and monitored them throughout the entire range of surgeries that occur, and learned about the complex physiology involved in sedating a patient. From hernia repairs to ectopic pregnancies, appendectomies to open heart surgeries, I was able to see a huge variety of cases from the viewpoint of the anesthesiologist. Through this experience I have gained a newfound appreciation for anesthesiology, a seemingly quiet but intellectual specialty that I did not know much about before this rotation. This was also the first time I had been in the OR or witnessed surgery, and it was fascinating to watch the entire course of each case, from room and patient preparation to the last sutures.

The neurosurgery rotation was one of the most intense and exciting weeks during my experience at Huntington. I observed many different types of surgery, including spinal fusions, laminectomies, craniotomies, tumor removals, and shunts. During rounds, I was able to see patients that I had seen the previous day in surgery as they recovered. Through this rotation I learned about the intensity and risk involved in neurosurgery, its highly specialized nature, and how rewarding it can be. Watching operations on the system that generates thought itself was surreal, and the seemingly obvious yet startling realization that neurosurgeons are capable of healing such a profoundly important system was even more so.

With general surgery, I observed further more types of surgery. Rounding with trauma surgeons and residents, I saw patients who were victims of accidents, assaults, and other unfortunate circumstances. From gunshot wounds to motorcycle accidents, the range of trauma cases was startling. Besides other general surgeries of the abdomen and plastic surgeries, some of the most memorable cases were the robotic surgeries performed with the Da Vinci Surgical System. It was fascinating to watch entire cases such as hernia repairs or ovarian cystectomies be performed through just a few small incisions on the surface of the abdomen, through which cameras and instruments with incredible precision could be manipulated, with consoles completely removed from the surgical field. It was an exciting reminder of how far the field of medicine has progressed, and how it will continue to progress in the years to come.

In the pediatric unit and critical care, I was again able to see a range of interesting cases: from a 5-month old with an uncorrected ventricular septal defect in critical condition, to a sheepish teenager whose poor judgement had landed her in intensive care, to a boy who has spent nearly his entire 18 years of life in the hospital due to an accident when he was a baby. Through my observations and discussions with the pediatricians I learned about the differences between child and adult medicine, and how pediatricians interact with both children and their parents. As a young person just barely out of the pediatric age range, it was an interesting experience to see patients just younger than me, and how they, their parents, and doctors existed in the hospital setting.

Pathology was an interesting and different specialty that I did not know much about previously. I had the chance to tour the various sections of the laboratory, and learned about how pathologists diagnose ailments from very acute observations at the microscopic level. The aspect of this rotation that I enjoyed most was watching various tissues and organs, in different states of health and disease, being prepared for slides: being dyed, sliced, observed and manipulated in every way to begin the process of diagnosis. Of the cases I observed, the most interesting (and a little overwhelming) was the dissection of a right leg that had been amputated just above the knee due to severe gangrene. This was one of the most memorable days of the entire program.

With cardiology, I watched cases performed by both interventional cardiologists and electrophysiologists in the catheterization lab, a unique place in a hospital designed for the exclusive treatment of heart conditions. I watched angiograms, stenting, ablations, and pacemaker procedures, and had the chance to discuss cases with several physicians and technicians. Cardiology is one of the specialties that I am most interested in, and it was a very rewarding experience to see cardiologists at work. Since my father is a cardiologist, it was also interesting to see what he would do day-to-day, and be able to discuss the various procedures I saw with him.

Finally, in neuroradiology, I observed doctors read CT scans, MRIs, perfusion studies, and other advanced imaging that allowed them to diagnose the various maladies of the brain. As an unexperienced undergraduate, it was fascinating to watch them pick apart each image and locate features that would seem unremarkable to the untrained eye and isolate them as abnormalities. I was also able to observe MRIs and CT scans being done, and watch interventional radiologists do lumbar taps and angiograms. The level of advanced imaging and procedures being performed every day in radiology was another reminder of how far medicine has advanced, and how the field will continue to grow.

In all, my six weeks at Huntington were an all-encompassing and profoundly positive experience. From the scientific and structured aspects, to the emotional and surreal ones, I have been able to glimpse the gamut of events that occur every day in hospital. I have witnessed a huge variety of patients and cases, and met the entire range of doctors, from the first year interns to surgeons with decades of experience. From the physicians I have met I have found a wide range of attitudes and experiences with medicine, but the common thread I found among them was an unwavering compassion for their patients. These experiences have not only revitalized my childhood dreams of becoming a doctor, but have given me a more mature, realistic, and informed view of what physicians actually do. Though I am in my final year at Caltech, I feel even more motivated to work hard, so I may be given the privilege to someday work in such an important, exciting, and rewarding field. I am extremely grateful to Dr. Caton, Huntington Memorial, and James Berk at the Caltech Career Development Center for this incredible opportunity. I hope that my experiences can inspire fellow and future pre-meds at Caltech to partake in this program.