Interviews, Inoculations, and Intoxication

As most of you know, I am getting very close to my departure date (September 30th) for my mission trip to Kenya. A lot has been going on in the last month so I wanted to update everyone on what’s been up as I prepare to go away.

I am still living in Boston, but I had to move from my apartment into a sublet for the month of September. I was very frustrated initially when my landlord told me she would not extend my lease for the last month I would be in Boston, but it ended up being a blessing in disguise. First, the move helped me streamline my belongings down to the essentials for the upcoming trip. Secondly, the sublet I found is a beautiful apartment that is fully furnished and is like living in a 5 star hotel for a month. But the best part about the move was just the confirmation that God takes care of all my needs. At the last minute, several challenges came up that literally brought me to my knees. I’m thankful for those stressors, because they reminded me how much of my life is beyond my control, and even with the best planning, things can go awry. But God sometimes uses a calamity to demonstrate his love, and to help us see some things we might not have otherwise seen. This was an invaluable lesson on the eve of a trip around the globe to be thankful and trust in Him even when things seem like they are spinning out of control.

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My other painful experience last week was more humorous. I went to the MGH travel clinic to meet with one of my favorite MGH Infectious Disease doctors, Dr. Felsenstein. She proceeded to scare me half to death about all of the terrible diseases in the world. By the end of the consultation, I was ready to go live in a bubble. If that was not bad enough, then came the shots…SIX of them…three in each shoulder. The next day, I could hardly lift my arms (which happened to also be the day of the afore mentioned move out of my apartment…good timing, huh?) They say doctors make the worst patients, but I think I was quite brave. (And I did not even get a lollipop out of the deal!) In hindsight, being a pin cushion was not so bad, and I’m very glad that I have been given the appropriate information and medication to live in a tropical environment.

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I have been doing more than just hanging out and going to doctors appointments. I have been picking up some moonlighting shifts at MGH on the cardiac surgery and burn services over the last month as well. Every time one of my friends sees me, they say… “I thought you were in Africa, what are you doing in the unit holding pressure on a groin?” The shifts have been somewhat educational, but usually a bit boring, since I am working primarily on nights and weekends when not much is happening. However, my last call was quite exciting: I was covering the burn unit, when I go a page from OR #37. The trauma team was in the middle of a procedure, and they had a trauma victim who had arrested at an outside hospital coming in by medflight in half an hour that needed to go straight to the OR. They did not have to say anything else, because I was in OR #31 with my boots, goggles, and adrenaline pumping within 5 minutes. We ended up doing an exploratory laparotomy and median sternotomy (i.e. a very big incision), which was a very valuable experience. I have opened the chest a few times in trauma patients, but never with a saw, so I was glad I got to put those cardiac surgery skills to some good use. The sight of the beating heart is still amazing to me after all these years. Unfortunately, we were a bit late with our heroic efforts, and although we were able to get him to the ICU, he succumbed to his injuries shortly thereafter. While it is always upsetting to lose a patient, I count these experiences as good ones, because I may have learned the skills needed to save the next guy who gets to us sooner.

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In addition to moonlighting, I have been on the interview trail for my trauma fellowship ( to begin when I return from Kenya next summer). My interviews have taken me to some pretty cool places, and I have met some really amazing people as well. One of the first individuals I met is a surgeon named Joe Ayers from New York who had just finished his residency, and is spending the next nine months in Uganda before starting his trauma fellowship. We obviously hit it off, since we have nearly identical post-graduate plans. It was very encouraging to meet Joe, because I have had more than a fair share of strange looks and comments from people when I told them what I would be doing after residency. It confirmed to me that volunteering in Africa is a perfect way to use what I have learned, and to continue to learn and grow as a person and as a surgeon.
My top two places of the ones I have visited so far are Miami and Los Angeles. Jackson Memorial Hospital in Miami is a one of a kind county hospital that sees nearly all the Level 1 trauma in South Florida. It is an incredibly busy place and has the largest fellowship in the country. This was my first time in Miami, and I have to admit, I really enjoyed the informal Miami lifestyle. The current fellows all live on South Beach and they took us out on the town the night of the interview. Things don’t start on South Beach until after midnight, and by 4am they were still going strong. I had to go back to my hotel to pack my bags to catch my flight home. Note to self: If I do my fellowship in Miami, DO NOT live on South Beach.
My interview at LA County Hospital was equally compelling. I had déjà vu when I walked up the steps to the hospital, but it’s because the hospital façade has been used on so many movies and television shows, that it seemed familiar even though I had never been there. The best thing about LA is that my twin brother lives there, and I got to visit with him while I was in town interviewing. We had a good time as always. He is a DJ, and he was teaching me how to mix, cut, and scratch. I even got to “spin” a little at a get together he and his roommates were having at their house. It was great trip, but it has made my decision very difficult, and I still have more interviews to go, including my interview here at MGH.

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In addition, to interviewing for trauma fellowship, I also interviewed for the Durant Fellowship in Refugee Medicine. The fellowship is named after the late Dr. Thomas Durant, a very special Boston physician who spent his career traveling around the world to some of the most unstable places on the planet to take care of people in their time of need. His story is truly an inspiring one, and the fellowship that bears his name supports MGH employees who want to go abroad as health care providers in refugee camps or other resource depleted environments (like rural Kenya). While I do pray that I am awarded the fellowship, I must say that just the process of interviewing was extremely encouraging and uplifting, especially talking to two of Dr. Durant’s sons, Sean and Stephen.

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Finally, for the last month or so, I have been studying for my board examinations. I took the written exam on August 14…AND I PASSED!!! I have not gotten the official score report, but the American Board of Surgery website says I passed and they are allowing me to sit for my oral examination on September 23rd in Philadelphia, so I will be continuing a pretty rigorous study regimen for the next 3 weeks.
I do want to relate one interesting aside about the written exam. As many of you know I don’t drink…I never have really. When I as a teenager and a college student (when most people drink), I was too scared to touch a drop of alcohol out of fear I would immediately have my life come apart at the seams. (There is a long back story to that.) Anyway, as I have gotten older, my stance on alcohol has softened, but even though in my head, I know one drink is not going to kill me (in fact it may be beneficial), in my heart I have still been harboring those fears. Well after my written board exam, I faced my fears and celebrated the way most of my friends would have after a big test. Of course, I was still a nerd about the whole thing. I approached it like a science experiment, assessing my sobriety every 15 minutes and making mental notes about the effects of each subsequent glass, but one bottle of wine later, the only effect I was feeling was spinning, and not the good kind like on the dance floor…I’m talking about the bad kind of spinning…in your head. I didn’t really get sick or have a hangover the next day, so I count myself fortunate, but I think my days of drinking came and went in one night. Now at least, it’s an informed choice I have made to not drink (instead of a phobia), but I do have my one story (that everyone should have) about the time I got “totally wasted”.

So as I said, it’s been an interesting summer. I have the rest of the month to make final preparations for my trip to Kenya. I will be continuing to moonlight in the hospital, travel for interviews, and study for my oral boards, but come September 30, I will be on a 747 for some real adventure. I can’t wait to tell you all about it.

Yours in anticipation,
chad


"The best way to find yourself is to lose yourself in the service of others."
~Mahatma Gandhi

PS: I have to give credit for this quote to from the email signature of Toni, another very committed missionary I met this last month.