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A Week in the Life of a Hospital Physician Isaac Dayan This summer, I participated in the Ranney Pilot Summer Internship

Education Program at Monmouth Medical Center. There were nine students in this special program, who were all interested in a career in healthcare. The program aimed to give us a feel of what it is like to be involved in the healthcare profession by seeing many different fields within it. Over the course of the week, we received instruction from clinical staff on the units in their particular specialty and attended demonstrations related to several medical and clinical specialties. We started the first day in a conference room where we all introduced ourselves. Dr. Margaret Fisher, the chair of the children's hospital and an expert on the spread of diseases, was the first physician to speak to us. Together we named the sixteen pathogens against which we are commonly immunized. Dr. Fisher talked to us about the processes of how these diseases spread and how they can be prevented, and eventually eliminated, by vaccinations. We discussed the possible effects if the patient is not treated correctly. Dr. Richard DeGroote, a pediatrician, spoke to us about his field of medicine. He compared his work to that of Sherlock Holmes because he needs to use symptoms, physical signs, and test results (clues) to make a diagnosis. Dr. DeGroote spoke to us about the process of becoming a doctor, how he got to the point he is at now, that reading is important because medicine is constantly evolving and that communication with patients is a very important part of being a doctor. He then gave us a tour of the children's hospital inpatient floor where patients can be kept over night, newborn babies are kept, and where the pediatric intensive care unit and the patient examination rooms are. Afterwards, Dr. Heather Grossman took us to her office to view blood samples under the microscope. We were able to identify abnormal red blood cells, platelets, and white blood cells. Dr. Grossman specializes in pediatric hematology and oncology. She spoke to us about how she became a doctor and that the most important aspect of her job is helping as many people as she can. The last doctor we met that day was Dr. Kirby Rekedal, a neonatologist who discussed with us the philosophical aspects of his field. He treats tiny babies that were born premature with intensive care. We visited the newborn intensive care unit where these babies are taken care of. Before entering, everybody had to scrub his or her hands thoroughly for three minutes. On the second day, we met Dr. Sang Sim, a radiation oncologist who taught us about radiation and how it can be used to treat patients. He then gave us a tour explaining tomotherapy and the Gamma Knife. We had a discussion on procedures and protocols of this machinery, which is under high security since they contain radioactive particles. He showed us how the doctors in his field use three dimensional MRI and CAT scans on the computer to draw a program which locates the tumor in a part of the patient's body. This program is precisely followed by the Gamma Knife, which emits gamma rays at the tumor identified by the doctor in the program. The whole time, the patient is secured to the Gamma Knife with a metal frame so the rays only hit the cancerous tissue. This field of medicine is very interesting because it is highly technologically based, with the doctor working almost entirely from a computer. Next, Dr. Robert Graebe, the chair and program director of Obstetrics and Gynecology, spoke to us about his field and how it changed with technology over time. Today he performs minimally invasive surgery with

a robot, called the Da Vinci robot, which mimics his hand movement. This way, surgery is less invasive because a large incision is not necessary. We were very fortune to have the opportunity to operate a real Da Vinci robot on a practice simulator. Afterwards, Dr. Stephen Chagares spoke to us about the life of a general surgeon. Dr. Chagares is a general surgeon that specializes in laparoscopic and breast surgery. For me, it was interesting to hear about types of surgeries on other parts of the body since I saw orthopedic surgery last summer. He talked about what it is like to have a private practice and about the business aspect of being a doctor. We also learned a bit about being a resident. He told us that medicine is special because you can shape your practice to your life style because there is a large range of options for fields and specialties. The next day, Dr. Absatz, an orthopedic surgeon who specializes in joint replacements, spoke to us about his field. He told us that what he deals with has a lot to do with physics principles because of the mechanical movements and measurements involved. Also, with Dr. Absatz we saw another side of medicine, the academics. He no longer performs surgeries but is part of the academic program at the hospital, giving lectures and teaching medical students. There are so many things one can do with a medical degree that go beyond treating patients directly. Afterwards, Rob Czarnecki, the Director of Support Services, brought us to the surgery equipment room. We saw the various machinery, tables, and tools that are used in different types of surgery. This showed me that engineering is even more involved in medicine than I expected. One of Mr. Czarnecki's jobs is to make sure the nurses and their assistants are assigned to a particular doctor and that all the proper equipment is there. The behind-the-scenes work in surgery is as important as the procedure itself. After that, Dr. Greg Greco gave us a lecture on his profession as a plastic surgeon. Then, we were able to sit in as he gave a lecture to his medical students as part of their academics. Experiencing what an actual class for medical students in the hospital is really like made me feel like I was in medical school already! Finally, Dr. Louis Zinterhofer, the chair of pathology and laboratory services had a discussion with us about technology. He took us to the different sections of the lab. The first one we went to tested blood and urine samples and body tissue removed during surgery for diseases. There, we viewed a blood sample under a microscope. There were so many machines that did a lot of the work, such as mixing and staining the samples. The next part of the lab we visited looked at cells even closer. The person working there was a cytogenesist. She showed us how she looks closely into the cell under a microscope and can see the chromosomes inside the nucleus. Then, she makes a karyotype by matching the chromosomes on a computer so she can see if there are any abnormalities. For example, she can test if newborn babies have Down's Syndrome or for a certain trait of breast cancer that mutates a chromosome. After explaining this to us, she let us look at chromosomes under the microscope. I couldn't believe that I was able to see them so clearly! They looked exactly as they did in my biology textbook, but here I was seeing them for real with my own eyes! Since I was totally amazed by seeing something so small, one can imagine my excitement when I saw actual genes at the next section of the lab. In that section, they stained the chromosomes and a computer program zoomed in on specific genes that were identified with the trait they were looking for. Since they were stained, the doctors could count the ratio between the different "colors" to gather the information they needed. When I looked in the microscope, I saw genes that appeared as

colored circles. At this lab I saw some of the most amazing things I have ever seen. When we left, one of the pathologists gave us a lecture on obesity and multiple sclerosis. Next, we met with Dr. Peter Park, the section chief of interventional radiology. We saw the rooms where patients are given MRIs and CAT scans and where the doctors look at these images. We also learned about the different rays or waves that are used for the imaging techniques; some use radiation while others use sound waves. A radiologist can see the inside of any part of the body and make a diagnosis. An interventional radiologist goes even further and treats the patient. They cure tumors and blood clots, for example, by making small incisions and either trapping the tumor so it dies or clearing up the blood clot. We watched one procedure being done where the doctor inserted a tube down a patient's jugular vein to clear a blood clot. The doctor did not have to open the body because he was already able to see the inside via the various imagining techniques (MRI, CAT scan, etc.) and used a small camera on the end of the catheter (tube) that displayed where he was going on a screen outside the body. Dr. Park then showed us various technologies used in these procedures, such as long tubes, catheters, and stents, and explained how they are used. Interventional radiology seems like a great alternative to oncologic surgery because in most cases they can contain a tumor and cut off its nutrients supply until it dies without opening the body. We ended our experience in the classroom discussing several medical and clinical specialties given by medical directors, clinical staff, and residents. Throughout the week, I received insight on becoming a doctor and was given a glimpse of what life would be like when I become one. I would recommend this program to anybody who is considering a healthcare profession or even to somebody that is interested in learning new things or experiencing a unique environment. For somebody that already wants to become a doctor like me, the program is excellent in that it gives a glimpse of the wide array of fields within the profession. I would like to thank Mrs. Laura Siemientkowski for organizing this program and for being by our side the entire time. I would also like to thank Mrs. Shifra Hanon and the Pathfinders Program at Yeshivah of Flatbush Joel Braverman High School for helping me enter the program.