A Glimpse into the Heart of a Physician

Editor’s Note: This is a series of real-life essays written by physicians for entry into medical school and into residency. We hope that by sharing these, those who are not physicians will have the opportunity to see the why and know a piece of our hearts. We also hope that those who are physicians will be inspired and touched and helped to remember why we do what we do- the meaning behind our work. Copying these will constitute plagiary.

Putting the Pieces Together

From my childhood hobbies to practicing as a physician assistant to rotating in internal medicine in medical school, it has been apparent that internal medicine is the right career choice for me. Growing up, my father was often busy with work, but the time we did spend together was spent doing puzzles. My brother and I were not allowed to look at the picture on the box and, as we got older, the puzzles became more challenging: thousands of pieces, mirror images, and the same picture on both sides of the puzzle! There was something about the challenge, the teamwork, the thrill when a piece was put in its place, and the excitement when the picture came into view.

Internal medicine is much like a series of puzzles; patients present with symptoms, which may or may not fit a pattern and, in time, the picture is made clear.

I have always been drawn to the more challenging cases, the ones that require problem-solving, research, and working with team members to narrow down a differential diagnosis.

Just as I approach each puzzle, I approach each patient’s case with renewed fervor, working hard to figure out a diagnosis and helping to develop a treatment plan. I recall one particular patient who presented for medical management following a cholecystectomy. The previously healthy middle-aged man now had severe dilated cardiomyopathy requiring an automatic implantable cardioverter-defibrillator. Six months earlier, he had been diagnosed with idiopathic disease but, on further questioning, I was able to elicit other symptoms that prompted me to look further into his records at the other hospitals he had visited. In doing so, I was able to present a more complete picture to the team, which eventually led to a diagnosis of systemic lupus erythematosus.

It was gratifying to work through the history, laboratory data, and imaging studies to diagnose a patient with a manageable illness and give him the opportunity to get appropriate treatment and get back to his usual life.

Since I became a physician assistant, I have consistently been involved in research. Research enables me to answer questions that we encounter every day in the field and provides yet another piece to the larger puzzle. In fact, the level of research a physician can perform is part of what inspired me to transition from physician assistant to physician. I also enjoy having the opportunity to present my research and discuss ideas with people who will push me to keep asking questions. For example, when I presented a poster on my empathy research at the Southern Group of Educational Affairs conference, I was encouraged by faculty and other students to look into other methods to improve empathy in medical students and was able to use those comments to further my research.

One of the greatest joys of doing puzzles is teaching my younger cousins how to puzzle and sharing the joy of discovery. My work as a peer tutor has confirmed my love for teaching. I worked with one particular first-year student who was struggling with the first module and, after receiving a C on the midterm, requested assistance. It was fulfilling to learn how to approach problems differently so that I could teach him in a way that he would understand, and when he received an A on the final, the pride I felt was incredible. My election as Chief Tutor exemplifies my strong leadership skills, ability to work with my peers, and ability to organize a large group of individuals. It also prepared me to help develop the student track scientific courses at the American College of Physician’s Internal Medicine annual conferences. I look forward to continuing to develop my skills as a teacher and incorporating it into my career.

Internal medicine is more than just the challenging cases that push my intellect and provide interesting research and teaching opportunities.

The very last thing my brother and I did with our father was complete a puzzle. He was in home hospice and, in his last day, my brother and I rushed to finish this final puzzle- a collage of family photos.

After hours of work and with the help of others who had come to say goodbye, we reached the final piece. We gave it to my father and helped him push it into place.

Sometimes completing the puzzle means giving a poor prognosis. Internal medicine lends itself to developing a relationship with a patient and his or her family. It is truly a privilege to be allowed into people’s lives so readily and I look forward to working with patients and their families, to complete the puzzles together and, hopefully, to see them overcome disease more often than not.

However, when they cannot be overcome, I want to be the trusted and caring physician who has the privilege to guide them through the difficult times.

Academic internal medicine provides me with all the pieces for a rewarding career: intellectual challenges, depth of knowledge, research and teaching opportunities, and patient interactions. I simply cannot imagine anything else I would rather do than wake up each day and be part of such an amazing profession.