I remember the first day I entered the halls of Cleveland Clinic’s J building — home of its Heart and Vascular Institute. With its double-height lobby, walls of windows and art installations that offer color to an otherwise large white space, I felt like I was walking into a grand airport or museum. Inside the J building, cardiologists, cardiothoracic surgeons and other members of the team work closely together to earn that No. 1 U.S. News & World Report ranking each and every year. There’s no question that the standard here is high.
I have to admit that I was a little intimidated when I did my cardiology inpatient month as an intern. I knew the expectations from the staff and patients would be steep and that I would work my tail off. That I definitely did. But I conquered that month and was happy with my quiet intern duties: doing paperwork and collecting data.
Now I’m on cardiology service again and caring for patients with complex valve disorders, acute coronary syndromes, and heart failure issues. Often, they present for interventions or re-do CABG surgeries. But instead of seeking comfort performing behind-the-scenes duties, I’ve been inspired with a new confidence.
A particular moment of inspiration came to me the other day that I wanted to share. I was paged on the general cardiology pager to the bedside of an elderly woman who was having chest pain. I was joined by an Interventional Cardiology fellow, who, although with a short stature, displayed tremendous command and poise He questioned me and a first-year cardiology fellow about the patient and shared his thought process.
The patient had severe aortic stenosis, and controlling her chest pain with only nitroglycerin would have been a tough and dangerous task. Through the fellow’s eloquent speech and clear thought process, I felt inspired to confidently approach the patient’s problem.
The fellow then explained the plan to the family, and I could see it in the patient’s and family members’ eyes that they were confident in his abilities. We then transferred the patient to the Coronary Intensive Care Unit for an aortic balloon pump and nitroglycerin drip. It was not only his command of speech with the patient and her family but also the way he taught me and the fellow. I could understand completely what we were doing and the calm and collected nature of his voice at the bedside taught me more than what I could learn in a book.
As a second-year, my job entails formulating cohesive plans for patients and helping to carry out those plans. I’m excited for the challenge. Because I can’t yet be 100% sure of my abilities, I have fellows and staff to help guide my clinical decision making. I also look to emulate the best of them, to follow their examples of providing superior patient evaluation and management. This learning, more than anything else, continues to inspire me to practice medicine — and to do it well.