Hello! My name is Louis Gonzales and I am one of the two 2018 Pinterns representing Montezuma-Cortez High School from Cortez, Colorado. For my internship I am shadowing Donald Brunk, MD at the Unity Care NW Health Clinic in Bellingham, WA.
Week one has been exciting, to say the least. I arrived in Bellingham Sunday afternoon and didn’t begin work until Tuesday after Memorial Day, so I had some time to get settled in with my host family. I was lucky to have had friends here that I would be able to
stay with, so there wasn’t much conflict in getting to know each other, and they showed me around town and where I would be working.
Tuesday morning we walked to the clinic (their home is only a 10 minute walk away) and I was given a tour of the facilities and introduced to Dr. Brunk and his staff. They explained to me that Unity Care NW is a Federally Qualified Health Center, which are health centers equipped with staff to handle everything, including behavioral health, dental, medical treatment and pharmaceuticals. These health centers are granted government funding so that they may be able to treat everyone, regardless of ability to pay. This can lead to some interesting patient situations.
Starting off, the day was a little slow. I followed and observed Dr. Brunk with all of his patients, who were there mostly for follow up appointments and check-ups. But I quickly learned how interesting shadowing would be when a patient came in to get a precancerous lesion removed. For context, before Dr. Brunk moved to Bellingham, he worked with the Indian Health Services agency for most of his career. When he settled in Washington, the sudden shift to lighter pigmentation in most of his patients led him to study deeper into dermatoscopy, and become the resident “skin doctor.” Now any patients that have concerns with their skin are referred to him. This patient had already had an actinic keratosis (that is, a skin abnormality with increased risk of turning into cancer) removed from one of their arms. Now the other arm was due for another removal, and I was allowed to watch the entire procedure.
In description, I’m sorry to say, there isn’t much to tell. They numbed the area that would be cut, removed the legion down to the top layer of fatty tissue, then sewed them back up. However, as an experience it was beyond exciting to be able to observe the procedure, and I am proud to say I never once felt in danger of fainting. It was an amazing way to start the internship and got me fired up for the week ahead.
In synopsis of the other exciting events for the rest of the week, a patient came in for a follow up appointment after being discharged from the hospital for pneumonia. As the appointment went on, their oxygen saturation level dropped to 82 percent! and they had to be taken back to the hospital. I saw the patient the next day when I walked to the library, and they seemed well recovered. I met another patient who had survived two terminal cancers, and was a world traveler. They claimed to have seen the ghost of a Hawaiian princess, and recommended that I visit India.
And finally, there is an ongoing mystery about a patient with acholic stools. Stool gains a brown color when the liver releases bile into it. Acholic stools, or pale/clay-colored stools, are typically caused by a liver dysfunction, but upon examination of the liver through a myriad of different tests, it seems to be functioning fine. The case is still being worked on to find the cause, I will follow up if we discover it while I’m here.
When we’re not with patients, Dr. Brunk is educating me on everything that goes on throughout the day. When an interesting topic comes up during a patient examination, I write it down and build a list to cover in our down time. So far he’s given me overviews on drugs, like SSRIs and beta blockers, some medical history, conditions like diabetes and hypertension, as well as some philosophy and psychology, among other informatio
n. In fact all of the knowledge in this blog is directly due to his teaching, except for anything that I may have misunderstood. But mainly what I’ve learned, without getting too sappy, is that being a doctor is not about healing your patients. It is about the art of truly caring for strangers. One quote from Dr. Brunk that I really enjoy is “I can’t stop everyone’s suffering. But I can suffer with them.”
When I’m not working, I’m with my host family Todd and Rosalind Schumann, hiking, playing cards, watching Westworld, and learning a little guitar. Todd plays (pretty well, 
despite claiming that he doesn’t) and offered to teach me, so now I’ve learned a few chords to start! Today I’m learning a little about baking and helping Rosalind with a cake, she is an excellent cook. The area around Bellingham is absolutely beautiful. Coming from Cortez, which is more desert than green, to this climate is awesome. There’s so much plant life here it almost looks prehistoric on the hiking trails. Saturday we went to the farmers market to buy fresh pasta for dinner, and it was good people watching too. Everything here is like nothing I’ve ever experienced back home.
I am so immeasurably grateful for this experience and can’t wait for what’s ahead. Until next week, goodbye from Bellingham!
My host family, Todd and Rosalind Schumann
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