Picture with Mentor

Activity Log Sheet #4

Journal Entry #5

Amita Raj

Abney

6^th Period

Journal Entry #5: Monday, September 27 2010

                Today I met my mentor at the hospital again. She showed me another patient and took time to thoroughly explain his file (lab reports, diagnoses, etc.) to me. We mainly discussed the implications of dialysis and kidney transplants, and the complications, advantages and disadvantages that accompany each treatment. She also described the side effects of the medicines that are given to the patients, and how further illnesses can be developed from these.

                Other than the usual patient-visits, my mentor was also enthusiastic about taking a picture with me. She found out which one of her patients in the hospital was undergoing dialysis at that moment and we donned protective gowns and posed in front of the dialysis machine.

Journal Entry #4

Amita Raj

Abney

6^th Period

Journal Entry #4: Thursday, September 23 2010

                Today I met my mentor at the hospital. She showed me two of her ‘more interesting’ cases. One patient had temporarily had the blood supply cut off from her leg because of a clotting issue. Because of elevated kidney failure and the hindered blood circulation, ‘Great toe’ on one of the patient’s feet started dying. It was not getting oxygen from the blood and eventually turned a greenish-black hue. To prevent this dead limb from getting infected, the patient had to be scheduled for amputation.

                Another patient I saw was admitted in the ICU. He was in a worse condition compared to any other patients I had seen. All the toes on his left foot had been amputated, and the right leg was amputated from just below the knee. This is a more aggravated condition compared to the woman I had previously seen. The man was clearly in constant pain and was not in his right mind, even with all the medications that were given to mitigate his condition.

                These two cases were eye-opening because I had not previously seen the disastrous effects of kidney disease, and they really showed me what can happen if people do not take care of themselves.

                I was incredibly impressed that the doctor still wanted to work with me on Thursday because her clinic hours had finished early, and if she was not as committed as she is, she would have been able to go home. I appreciate all the time she has given me and the fact that she goes out of her way to teach me everything she can.

Interview #1

Amita Raj

Abney

6^th Period

September 22^nd, 2010

Interview #1: Dr. Sujatha Venkatesh (Mentor)

Type of Interview: In person

Name: Dr. Sujatha Venkatesh

Occupation: Physician

Job Title: Nephrologist

Place of Business: Central Texas Kidney Associates

Mailing Address: 408 W. 45th Street Austin, TX 78751

Phone Number: 512-576-7478 (Dr.’s Cell Phone)

E-mail Address: sujathanitzsche@hotmail.com

Q.     What universities did you attend and what activities were you involved in?  What was your major?

A.      I went to undergraduate school at UCLA. I did my medical school at Tulane University in New Orleans. My major was Biochemistry. I did not have a minor. As far as extra-curricular activities at the time, I played piano. I took private piano lessons but I did not minor in Music. I pretty much concentrated on my major. I had an atypical college experience because I was in an accelerated college program so I was pretty young when I went to college. I did not do traditional high school.

Q.     So did you start college at seventeen?

A.       Actually, I was thirteen. I did not go to high school. I went to junior high and went to the accelerated college program from age thirteen to age seventeen, at which point I got my Bachelor’s Degree.

Q.     In this accelerated program, were there other younger kids studying with you in college classes?

A.      There were about ten or twelve kids total. We took regular college classes. It was not like there was any different college curriculum. We were with the mainstream college students. Initially people could tell that we were a little younger, but by the time I was fifteen or so I looked like a regular college student. That was my unusual experience. I always knew that I wanted to be a doctor because my parents enjoyed what they did a lot and I have had a lot of exposure to the field.

Q.     What kinds of majors did other people who were on the medical track take?

A.      Typically, it was the science-related field. For example, Chemistry majors, Biology majors, Kinesiology, Psychology. Some people chose to do more humanities related fields because they knew that they would be doing science for the rest of their lives so that was a different experience. I think it is a wonderful thing to do because that is the one time you have the opportunity to do something different for a while. I did know people who were English or Philosophy majors who subsequently went to medical school.

Q.     Do you think the college major choice affects their position now?

A.      It certainly can. I think a lot of the people who did the more unconventional majors may have ended up more in fields like psychiatry or public health related fields rather than the purely clinical fields that the rest of us do.

Q.     After you graduated from medical school, what was your first job?

A.      I was 22 when I started my first job, and that was my residency program. I did a residency in internal medicine that took three years. Your first year is the most brutal year called your Internship where you are on-call a lot. There are many sleepless nights and these are some of the most hard-working people in the hospital. We work independently and with a team. The team in the hospital consists of medical students, an Intern (1^st year resident) and a more senior resident. The senior resident has the more supervising position of the interns and medical students. Then there is the attending physician who is the head of the team, someone like me. These physicians usually work in academic facilities like Brackenridge Hospital. That is where students from UTMB medical school do rotations.

Q.     How long have you worked in your clinic?

A.      I have been doing this for ten years. Prior to that, I was in another private practice group in Denver.

Q.     What inspired you to become a Neophrologist out of all the other medical fields that you were exposed to?

A.      That happened later, not med school, it happened in residency. In residency, you do rotations, one-month blocks that you spend in different fields in internal medicine. Some of the sub-specialties you get assigned to and some you can pick as electives. I chose Nephrology as an elective because it did interest me even in med school. I really enjoyed that rotation and thought it was challenging and something I would like to do. I decided I would do it in the following year. I applied to multiple Nephrology programs all over the country and picked the top four. One of them was in Denver, and I really wanted to live in Denver at the time so that is where I went.

Q.     I know some doctors who live and work in very small towns as opposed to the city. How do doctors chose where they want to work?

A.      Some people who like the small-town environment, and in that environment, you tend to be busier and more autonomous. There are not a lot of other doctors around and you tend to do your own thing. Some sub-specialists in rural areas tend to do primary care medicine where they are the primary doctor for the patient. As opposed to the bigger cities where there are enough specialists so, everyone has their own primary care doctor. That is why I like the bigger city environment because I can focus on my field and do it really well.

Q.     While you were studying to become a doctor, did anyone motivate you to take the path you chose?

A.      Both my parents motivated me to go to med school. They were not pushy about it but were very supportive when I chose that. I spent a lot of time with both my parents; my mom did primarily medical research and my dad primarily did patient care and private practice. I could tell, judging by my own personality, that I would do better in the patient care realm. As far as Nephrology goes in particular, my parents were not a big part of that decision but it was definitely because of the people I interacted with in the hospital where I trained. There were other nephrologists who were absolutely phenomenal doctors and they did inspire me to go into that field.

Q.     How would you compare your dreams when you were younger to how successful you are now? Is anything different from what you thought you wanted to be at that time?

A.      Yes. When I was a lot younger, I had aspirations to do a lot of things. I kind of knew I was going to do something scientific. There were times when I thought it was neat to be an astronaut or even a researcher, as far as a hard-core scientist in the lab discovering something brand-new and exciting. As I got older and started to get to know myself better I knew I really needed to be in a people-oriented field and I wanted be happy being in a lab doing experiments all day.

Q.     What characteristics do you think would make a person successful in your field?

A.      I think the basis of it all is studying your field well and knowing you field, academically. I think there is a lot more that goes into being a good doctor. One of the main things is your people skills and your social interactions with people—not just patients but also other physicians and patients’ family members. Mainly, you should focus on academics and knowing your data. But it is just as important to have a good reputation with your patients, their families and the physicians. Sometimes patients can get difficult to handle. Sometimes they are accusatory and ask questions like “Why am I not getting better?” As a doctor, you need to develop patience and be pleasant even if the patient-doctor interaction level becomes stressful. Good relationships with your patients develop gradually, and eventually they tell you that they would not want to see any other doctor except for you.

Q.     Has your character developed since you first started?

A.      I think so; I certainly am more patient now than I was starting training. Part of it is because I get more sleep now. I have learned not to take things personally. Over the years, you will have negative interactions with people and you have to learn not to let it bar you towards medicine or the field in general.

Q.      How important is networking related to your field?

A.       It is very important. It is important all through medical school and residency. You need to get to know your attending physicians and other residents you work with because you never know when you might want to get a job somewhere and if that person knows somebody there. The best reference you can get is just word-of-mouth from somebody who knows you much better than any CV (Curriculum Vitae) might have. I can send my CV out to multiple groups I want to join but if somebody in that group knows somebody who has worked with me before and says “Hey, she’s really good,” that will carry much more weight than all of the honors you might have on your CV. It is important in my job too. Pretty much every physician I meet in the hospital I make sure I am friendly and nice to them and that they think I am nice to my patients. There is a little bit of a business aspect to medicine as well, at least in private practice. I have to keep my referral base happy. In fact, in a few weeks, my colleague and I are hosting a dinner for several hospital physicians who refer patients to us regularly just to show them that we appreciate them. There is some marketing involved to.

Q.     Is that how you got your current-job? Through word-of-mouth?

A.       Partially, my husband found a job in Austin and I really wanted to live in Austin so I decided we should move there. I sent out my CV to multiple groups. Nobody was actively looking for someone but the group I ended up joining looked at my CV and one of the senior partners in the group knew one of the doctors I worked with during my residency and called them up. They told me that they were not looking for someone but my CV looked really good and they had talked to people about me so they wanted to interview me. I got a full-time job from them.

Q.     Can you tell me more about what kind of extra-curricular activities you put on your CV?

A.      During medical school, there was this Asian-American Association. I was president of that. I do not think I did that much except we had some fun parties. But it was good; we brought some awareness to our ethnicities and it was a diverse multicultural group. Things like that, which you might not think are that important, kind of look good on your CV—like leadership experience. It shows that you have also experienced things outside the medical field which help you develop your character. Other things I did during the summers between the years of college were volunteering at a Multiple Sclerosis Clinic, some lab research at a Muscular Dystrophy Basic Science research lab. All of these things you put on your resume, it shows that you have tried some different things and shows some diversity.

Q.     What do you most look forward to every day?

A.      I most look forward to going to the hospital and seeing really sick people. And also, interacting with my peers. I feel like I am working with a really good knowledgeable group of people and a really fun group of people. My hospital work is really what I live for, it’s really what I enjoy. I see a lot of sick patients with different medical problems and they really challenge me. They really make me enjoy what I am doing.

Q.     Do you want to expand or develop your career?

A.      I think later on in my career, when my kids are out of the house, I think I might be interested in doing more teaching. For example, having a med student shadow me for a month. I think I would expand the academic aspects of my job.

Q.     What do you look for in a resume?

A.      I look for where they have trained, I look at their honors and I look at their references and usually call somebody I might know at a place that they have trained. Knowing someone who has worked with this person, who can vouch for them, is very important. You can tell the ones that stand out. In each field, there are certain training programs that are considered the better ones in the country. And if you are in that field you know which ones those are and that’s what you look for in a resume. It does not mean if they were not in the top programs we are not going to pick them, but if they were part of those programs those are the people we are going to look at more closely. If I have five CVs of people who want to join my group, the ones that will be weeded out are the ones who are less well trained.

Q.     What is your opinion about employment opportunities in medicine?

A.      I think that there are enough jobs in medicine that doctors will find a job somewhere in this country. That is one good thing about medicine, as times go on there is going to be a general shortage of doctors. Less people are going in to the field, and there are some changes going on in the healthcare system, but I will not get into that. That is for a whole other interview. But there will always be jobs for doctors. That is one promising thing, if you are in a field related to the stock market or something there will not always be jobs for that. But as a doctor there are always stable, secure jobs. I think it is really important to keep an open mind and work really hard to be successful.

To get the opportunity to interview with my mentor, I had to tell her in advance that I needed some time out of her week. She was more than happy to be asked questions, and suggested we meet at Barnes & Noble for the interview. Although I only had 45 minutes to interview with her, there was a lot of information that she provided me with and allowed me to ask her further questions about what she was saying. The doctor was very candid about what she was telling me, and also asked me questions related to what I had asked her. This allowed us to develop a more personal connection now that each of us knows a lot about the other’s background. After learning that I am proficient in math, she asked if I could tutor her children next month because it is difficult for her to do that on a full schedule! I was glad I had this opportunity to talk to the doctor in depth about her education and her success.

Activity Log Sheet #3

Journal Entry #3

Amita Raj

Abney

6^th Period

Journal Entry #3: Tuesday, September 21 2010

                Today I went to the El Milagro Dialysis Clinic that my mentor’s private practice is associated with. There were many more patients connected to the dialysis machines that I had initially assumed. These patients usually have to be at that Clinic for 3 to 5 hours, depending on how severe their cases are. The patients were provided with elements of comfort like a reclining chair with a pop-out leg rest and each had their own television and blanket.

                I was shown how the machines worked, and how the blood was taken from the patients. Some had to use ‘catheters’ put into their chest (these are usually temporary) and others had ‘fistulas’ in their arms (these are usually permanent). A fistula is an abnormal passageway that the doctor makes in the patient’s arm using blood vessels. This is used to facilitate dialysis. The machines’ job is to keep the temperature of the blood at body temperature and remove all the toxins that have accumulated throughout the day. The machine does in around 4 hours what our bodies do in 24 hours. Many patients I talked to told me that they could not have jobs because of their kidney disease. Because their kidneys are not functioning properly, fatigue and fluid buildup are often chronic and renders them incapable of performing normal duties. Others who have been having successful dialysis treatments are able to work and do not have to rely on family members.

                What surprised me most was the amount of care that the patients have to put into their diets. They are not allowed to consume more than 3 liters of fluid in 2 days and have to limit the kinds of food they eat because they have to monitor potassium and phosphorous levels.

                I had not previously acknowledged the sheer number of people who have such drastic kidney problems. Most of them are caused by not monitoring their diets or consuming excessive amounts of tobacco which bind to the haemoglobin in the blood. My experience with my mentor continues to be extremely fascinating, and I am learning a lot about Nephrology during every visit.

Journal Entry #2

Amita Raj

Abney

6^th Period

Journal Entry #2: Thursday, September 16 2010

                Today I visited my mentor while she was working in the Emergency Room at St. David’s South Austin Hospital. We mainly focused on one patient who had severe kidney problems. These problems were caused by excessive smoking (using the more heavy kind of cigarettes) as well as using nicotine patches and nicotine gum. Such high levels of these toxic substances in the body will lead to kidney failure. The patient had told the doctor that she did not want to undergo any severe dialysis treatment, but changed her mind after she was told that she would not live much longer on the medications that the hospital was currently giving her.

                The Emergency Room was a fascinating experience. Although many patients kept coming in on gurneys, the doctors remained optimistic and went about helping as much as they could. These doctors were also very friendly and welcoming of my presence, talking to me about the patient and how she could have avoided the problems she has right now.

                In addition to the patient care aspect of the shadowing on Thursday, the doctor also showed me how she used the databases on the computer to check lab results and the various levels of substances that were present in the patient’s blood work.

                After doing the Annotated Bibliography about kidney cancer and the subsequent surgery n different circumstances, I was able to reciprocate what I had learned in the news article to some of what my mentor was saying. She was impressed that I knew that information and I think she feels more confident that I will understand her medical jargon.