September 28, 2010

• The Thought Experiment-continued

  Despite my earlier post and your natural assumptions, I have continued to work a little to refine my personal statement everyday. It’s still a train of thought but at last a cohesive idea is beginning to take shape. Your thoughts and comments, directions on where to go, what is not going to work, etc as always, are appreciated.

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  GI is a specialty of contrasts. Where some of the greatest technological advances are being made every year in fields like capsule endoscopy, virtual colonoscopy, endoscopic ultrasound…for the technophile, it is pure heaven. At the same time, travel abroad, to rural villages and you find the physical diagnosis skills are still just as important, with the GI physical exam revealing just as much information as ever. The digital rectal exam is still the best way to detect prostate cancer. Jaundice, asterixis and hemangiomas will tell you about a cirrhotic patient long before you can reach a ct machine. Ascites doesnt require anything more than a glance and a touch to diagnose and another simple low tech procedure to treat, although even that has been given the higer tech accompanient of ultrasound. The joining of the old and the new seen in GI is perhaps the best field for the physican of my generation…learning to balance the classical diagnostic skills of the time honored tradition and those who came before while making use of the knowledge from those far ahead.

  The majority of the health problems outside the united states are often gastrointestinal or infectious in origin, and quite frequently both. The knolwedge of how to diagnose and treat gi bleeds, hepatitis, and a host of other intestinal anomalies,gives me an incredible set of tools with which to travel. And ultimately, I would like to do so. I am a hands on kind of guy, I want to travel to rural areas with doctors without borders, combine my love of being abroad, with my love of medicine.

  I spent a month in china learning acupuncture and traditional chinese medicine and the number of herbs they use is astonishing and an excellent area for further research. Already spices like turmeric and ginger are making strides in treating conditions like inflammatory bowel disease, nash, and being used as promotility agents. This only further helps to tie in another of my hobbies with GI, cooking. I could become a better chef and researcher at the same time.

  Liver patients also pose an interest to me…they are among the most complex patients any doctor has to deal with and the constant fine tuning of those with chronic conditions, up to and including transplant hepatology is just as exciting. finding the right recipe to keep each person thriving, with no two patients the same.

  So why do I want to do GI? A long tradition as a specialty, mixing old techniques with new technology, the opportunity to perform procedures and intervene directly with the patient from pegs to colonoscopies all the way up to transplant. A chance to deal with acute issues like bleeds or pancreatitis to chronic follow up patients like ibd or cirrhotics. Skills that can help me in the old and new worlds, and ones that already tie into my hobbies of traveling and cooking. Advances in research being made into long overlooked traditional remedies alongside new pharmaceuticals that offer promise where before there was only maintenance. What first appears to be a field of contrasts for a man of contrasts, ends up coming full circle to being a unified specialty for a man with a single goal

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  yes yes, i know i need more things about my personal statement and less a glowing paean to the gods of GI, but before I can write anything to make this personal, I had to figure out all over again why i wanted to do this, and hopefull I am getting closer to that.

  • 10:35 pm
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