September 22, 2010

• The Thought Experiment-day 1

  Alright so with the clock ticking down until it comes time to apply for my fellowship, and the need for a personal statement drawing ever nearer, here is how this is going to work. I am going to do a free-write to brainstorm, and post every revision up on xanga, no matter how inane until I achieve something actually resembling a statement. I will start with why I want to do GI and build from those few basic facts until I have some kind of narrative. if I can do this every day for a month, my own personal fellowship nanowrimo, the goal is to have something come out of it that is not only a good personal statement, but helps motivate and remind me why i wanted to do gi in the first place

  So the main reason I like GI? procedures. endoscopy, colonoscopy, ercp. the ability to actually get into the patient and do something. similar to surgery but without the hell residency that surgeons have to go through and i wasnt willing to do to begin with. Sometimes simple problems really do have simple solutions. alcoholic with a gi bleed? scope em, check for varices, find and band them. but what about the more complex problems? gi offers me an entire system full of problems keeping variety in the mix. i am not restricted to only heart, or only lungs, or only blood. things could be wrong with the gallbladder, the pancreas, the small intestine, the colon. there is ibd like crohns and uc, there is cirrhosis, there are tumors and h pylori and the bread and butter abdominal pain not otherwise specified. that is just on consult. subspecializing gives you a chance to see things that are more rare, more intellectually stimulating because by the time a case gets referred to a subspecialist, it means other doctors cant figure it out. you are given good exposure to both the exotic and mundane. while gi is great, you can focus in on even one solitary organ, the liver. it detoxes, it regrows, it is the source of ridiculous amounts of pathology. with liver alone (hey! liver alone!) i could see hepatitis, cirrhosis, liver cysts and maybe even get involved in transplant workups. there are actual physical findings that present themselves. no listening with a stethoscope to maybe hear a murmur…simply look at the patient! are they jaundiced? are there hemangioma, caput medusa, asterixis? the signs are all there pointing the way for you to tell you exactly how sick your patient is. i can see myself getting involved in transplant hepatology. i have the same reaction to so called liver bombs that cardiologists have to the chance to cath someone. the respect/expertise that accompanies being a specialist doesnt hurt either. so how to tie these reasons in? talk about my passion for food and relay out to some patient story? work in my love of travel and time spent studing medicine in china? expound upon my desire to join a doctors without borders setup, where so many 3rd world countries are afflicted by primarily gi and or infectious disease problems, places where you cant always rely on the fancy technology? do i talk about comedy and my time as a stand up. do i bring in anything from my first personal statement about being a detective and how it got into medicine?

  enough for tonight. at least i have made a start. now over the next few days the goal is to start collecting this thought cloud this word diarrhea into sentences and reasoning. and to continue finding programs in both gastroenterology and hepatology that emphasize clincial practice. I will never be a good researcher, so I need to find some way to present myself that puts that in a postivie light. liver might be the way to go. Alright, until tomorrow.

  all comments and criticism, constructive or otherwise welcome.

  • 6:00 pm
  • Leave a comment