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 😛

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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