This week, being my third, has been extremely busy. On Monday I attended three meetings with Dr. El-Bayoumi. The first of which was a meeting that occurs every other week for the members of the Rodham Institute to go over current issues and planning for upcoming events. We went over the Motion Picture Association of America event and planned to meet with the individuals who attended to discuss donations. Then we spoke about the Institute’s grant steering committee and how there was a possible grant opportunity for diabetes intervention with the AAMC. The interventional study would identify diabetics using geocoding and then preform outreach programs with meal plans and healthy meal deliveries to help clients better control their disease and lower the hemoglobin A1C count (which is a way to measure the average person’s blood sugar levels over the course of 3 months in one drop of blood; so a single instance that provides insight into 3 months worth of blood sugar levels).
The outlined program is very similar to an existing program called Food and Friends which does meal plans and deliveries to DC and the surrounding area for patients with HIV and cancer and their families, who otherwise might not be able to afford healthy options. Food and Friends is currently doing pilot testing with diabetics, so the Rodham Institute is hoping to collaborate with them to expand the target group to diabetics and to implement meal plans with the help of a grant, and then measuring A1C outcomes in the future to assess the outline’s effectiveness on improving people’s control of diabetes.
We also spoke about the upcoming H.E.L.P event on the 11th, 12th and 13th of August and the possibility of involving Children’s Hospital residents as volunteers and mentors for the students as the work on their Social Impact research projects.
The second meeting we attended was discussing a collaboration and grants for Upward Bound and H.E.L.P. Upward Bound is an education program that helps underprivileged students improve their study habits and grades in working towards getting into college. The program helps them throughout high school, with the application process and everything leading up to college, and also with early college in making sure they have good study habits. The majority of African American students who drop out of college do so for reasons unrelated to finances. The two programs were looking to collaborate during the H.E.L.P. three-day summer program beginning on August 11, and incorporating more self-help/self-care education into the curriculum.
The third meeting we attended was with Med School students working to incorporate community service hours into the GW Medical school curriculum. It relates to the Rodham Institute in that the Institute is always working to educate and involve upcoming medical professionals in community service projects, especially those involving the community of DC. One aspect that was thoroughly discussed was the possibility of bringing in GW Med students as volunteers to the Barry Farms Health Festival/Expo on August 22, and all the aspects relating to health, education and improved quality of life that should be incorporated into the festival itself.
On Tuesday, I went into resident clinic with Dr. El-Bayoumi again, and she gave me the opportunity to speak with her patients as they waited for her to come in. Because is so busy, I spoke with her patients for 20-45 minutes each. As mundane as it sounds it was a really incredible and impactful experience. Many of her patients are senior citizens, and the first couple I spoke with was the son and daughter-in-law of one of Dr. El-Bayoumi’s recently deceased patients who had died on his 105th birthday in January.
I spoke first to the couple together about the project that I am doing with Dr. Jain, and then I spoke with the woman on her own while Dr. El-Bayoumi saw her husband. Both of them had come in for their annual physicals and were both of very good health for their ages. It was very interesting the speak with both of them and to hear about their experience in caring for the even-more-elderly father in his last 5 years of life. The woman shared her experience of caring for her mother through the early 2000s and how the experience highly contrasted with her late father-in-law’s independence. It was amazing to hear both of them recount their experiences and then speak to them about themselves and also myself. They were extremely kind and sweet people, and speaking with them led to my deeper understanding of the patient-doctor relationship in that it is not just a “patient-doctor” relationship but one full of compassion, understanding and even friendship.
I spoke with two more of Dr. El-Bayoumi’s elderly patients who were very interested in telling me about their ailments and their lives, and also in giving me valued advice in life. Finally I spoke to a gentleman who was a little bit younger but still middle-aged who was very lively and kind. For me, it was a really valuable experience in that I got to meet some incredible people and learn about them and just how to interact with patients in general.
Afterwards I worked with Dr. Jain for our project and went with him to a nearby pharmacy to give them a survey pertaining to our study. The pharmacist was very interested in our project and concerned about waste. Most shocking was that the pharmacy’s policy for disposing of expired medication was to actually dispose of medication that was 3 months away from becoming expired. So not only were they sending expired medications to outsourced contractors for disposal, but also sending medication that wasn’t even expired yet and wouldn’t be until September!
The following day I went to resident clinic again and shadowed one of the senior residents working under Dr. El-Bayoumi. In the afternoon Dr. El-Bayoumi set it up so I had the opportunity to shadow some of the cardiologists at the GW Hospital and examine echocardiograms, which are specialized forms of ultrasounds that specifically look at the heart, often called heart echoes. I spent three hours with them, which was really interesting, and was able to come to understand more about the heart and problems that can occur with it, which was very interesting and new. I also was able to see an echocardiogram being performed on a patient who had just undergone surgery to replace his aortic valve.
An image of a echocardiogram. Seen here is a view of all 4 chambers,the right atrium and ventricle and left atrium and ventricle, and the mitral and tricuspid valves and the septum.
Afterwards I attending another meeting regarding the planning for the Health festival at Barry Farms, at which a lot of progress was made. It was determined that they needed a logistics coordinator and that all the tests in which fluids are exchanged could not occur on the premises but would have to be done in a van, which surprised me.
The following day I was in resident clinic once again, working with some of the residents at the MFA, and then went to general rounds during which the presentation was on strokes and interventional therapies that have proven to make a difference in recovery after very severe strokes, affecting about five percent of the population, in comparing 5 different international studies.
In the afternoon I and the other new intern, Kunal, shadowed in radiology with the doctors who examine nuclear imaging scan, such as PET scans and others that use radioactive tracers that have affinities to certain areas of the body or certain organs. The doctors that work in nuclear medicine see all kinds of different scans on a large spectrum of areas of the body, and thus it is not monotonous. The last scan we were viewing was a PET scan and the doctors actually found a mass in a patient’s nose that was due to lymphoma, which was pretty amazing although sad.
Afterwards I, Kunal and a rising third year Med Student at GW, Aaron, visited Food and Friends where we took a tour of their facilities and discussed cooperation for the Health Festival at Barry Farms.
Overall it has been very busy, but I am being exposed to a huge range of medicine involving everything from health policy to nuclear medicine and residential clinic. It has been amazing and I am sad that I only have two weeks left; hopefully they won’t go by too fast. Sorry if this was a bit ridiculous in going through each day, but I have come to understand that every moment is important in itself although each experience it very different. Thanks again.
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