The Mistake on the Lake was the best decision I ever made: why melatonin isn’t the answer, how many case of cardiac sarcoid can you see and other rarities I saw across the lake

What up everyone. I know it has been a few weeks since I last posted but things just got so busy with my rotation and coming back home.

But I am back now and I’m back with a post filled with everything and everyone I experienced while at the Cleveland Clinic.

And let me tell you – doing an away rotation was such a positive experience. I already mentioned it in my Insta story a few days ago but I just have to reiterate how rewarding this experience was. Definitely once-in-a-lifetime and something I would encourage all residents to experience if possible.

Ok the deetz that everyone is waiting for.

So while I was at Cleveland, I spent 4 weeks on the pulm consult service. We had a different attending every week and the team was made up of one fellow every 2 weeks and along with me, there was a new intern weekly +/- a senior resident. The service ran just like you would expect – see consults as they come and round generally late mornings/afternoons once most of the new patients were added to the list.

Week 1 highlights:

  • got to work with the head of Bronchology (and did a thoracentesis on my very first day!)
  • saw at least 5 different types of pleural effusions/day (CCF has their very own pleural service – which is awesome!)
  • was asked to help write a chapter on bronchology techniques which I was stoked about

Week 2 highlights:

  • worked with an attending who specializes in ILD
  • his name is Dr. Southern and he is from Alabama – can life be any more perfect??
  • saw 9 different cases of cardiac sarcoid – ok I knew cardiac sarcoid existed but I never in a million years expected to actually see it

Week 3 highlights:

  • worked with one of the leading researchers and authors in sleep medicine (plus she is an associate editor at CHEST and a bunch of other journals – and the fact that she is a female physician who is also a mom is just badass)
  • learned that inpatient PSGs are a thing & actually got somewhat decent at interpreting them
  • apparently there is a separate sleep fellowship at CCF and the fellows are part of the DREAM TEAM. No joke.
  • that drug melatonin that we tend to give to our patients thinking it’ll help them sleep? Don’t bother. Apparently studies have actually shown little to no benefit and it actually just creates more polypharmacy

Week 4 highlights:

  • worked with another attending specializing in ILD
  • he wasn’t Southern but he had the best NY accent I’ve heard in awhile
  • learned how to manage true primary PH
  • saw firsthand what an actual flare of vasculitis looks like (GPA, MPA)
  • diagnosed someone with chronic eosinophilic PNA
  • became better at reading imaging – I think…

Not only did I learn how to manage some really cool medical cases, I met some amazing people. All the interns I worked with were so welcoming and willing to learn. Plus the co-seniors I were with were plain awesome, as were the fellows. It also didn’t hurt that there was an Au Bon Pain on campus ๐Ÿ˜›

Even though I had a 3 mile walk back and forth from the garage to the hospital, I loved every second of it. It was great to be at another institution and see how medicine was practiced. While some things never change (think frustrated patients, delays in discharge and bad hospital food), I loved how CCF fostered an environment of collaboration and discussion. I have always appreciated that at my home institution and it was great to see such a well-known place also promote these values.

Tomorrow I start my admitting rotation at my home institution. And while I can’t wait to get back to my roots, I will cherish the one month I had at CCF. Here’s to looking at you, Cleveland – hopefully I get to find my way back to you soon!

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Ermagerd I’m in Cleveland!!!!

Hi guys! Sorry for the loong leave of absence – obviously I have been having a busy week (see title). I know this post is wayyy overdue and mucho apologies for that, I’ll try to be a little more regular from now on.

 

Now onto the good stuff. So a few months ago I applied for a pulmonary rotation at the Cleveland Clinic and who would have thought – I got it. Why is this such a huge deal? Because it’s the Cleveland Clinic.

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Yes that was me when I found out I got in hehe.

The Cleveland Clinic is a premier medical and research institution in the US. It is at the forefront of innovation in pretty much every medical field manageable. You get to work alongside inventors and discoverers of treatments that are used in day-to-day medicine. For example, my attending for the past week is the head of Interventional Pulmonology at CCF and has co-authored numerous textbooks and created new techniques involving bronchoscopy in order to better diagnose/treat pulmonary disease. Can I just say- this whole week has been me fangirling- and I still have 3 more weeks left!!

Before I forget, let me mention one other thing. The Cleveland Clinic is HUGE. It is HUMONGOUS, MASSIVE, ENORMOUS. Ya get my point? I looked at the Health app on my iphone the other day and every single day this week I hit 10,000 steps without realizing it. There are even skyways connecting all the buildings because each place literally takes up a whole block and lets’ face it – you’d be drenched before you would make it inside.

It’s not only large but I like to call it a mini-airport. You have the skyways, the mood lighting, there’s a Starbucks and an Au Bon Pain on the main floor and to top it all off, there is a hotel that is connected to the main building on campus (Yes I did try to get a room there but it was too expensive for a poor medical resident like me :p).

So I got placed on pulmonary consults which is what I wanted – a chance to learn some innovative medicine and also meet some of the heads in the subspecialty. ย The way the pulm consult rotation works is that you have a second-year fellow and a mix of residents and interns you work with. As a visiting resident, you get to see patients and write notes (CCF has Epic as well thankkkkkkkk god!)

Now let me tell you. I love the hospital that I’m doing my residency at – I truly do. But when you do pulm, I hate to say it, the majority of consults are for COPD exacerbation. Having been at CCF for one week now, I haven’t seen a single COPD exacerbation – instead I got to see 4 cases of cardiac sarcoidosis, 1 case of Churg-Strauss disease and I got to do a thoracentesis on my very first day. Guys, how awesome is that???? Completely nerding out here ๐Ÿ˜€

Plus if you want to get involved in some research, CCF is the place to do it. Dr. Mehta is on faculty at CCF and he essentially is the leader in pulmonary disease research. Plus you get faculty and fellows from all over the world. In fact, the attending I worked with last week (the head of IP) asked me to help him write a chapter on bronch techniques – guys do you know what this means? Yeah yeah for those of you who have thousands of papers published I know it’s not a big deal but for someone like me who’s still getting her feet wet, this was huge. My name is going to go into print next to a giant in the field I love. What more could you ask for??

I can’t believe I still have 3 more weeks to go – I genuinely wake up each morning excited to get to work and start seeing consults. Why can I do that? Because the people I work with are great and I’m in an environment that fosters learning. Yes it was extremely intimidating at first but once you spend even just an hour there, you realize these are residents just like you – people who are here to learn while doing what they love.

Ok – enough procrastinating from finishing up my fellowship application (deadline is fast approaching eek!). Check out my instagram (@dr_priyaj) for some pics I happened to grab of the campus and we’ll chat again – there’s no end to the interesting cases I’ve been seeing here!

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