Interviews
My first interview in New York was with the man who cut open John Lennon's chest after he was shot.
- Thoracotomy: to cut open (otomy) the chest (thorax). A last ditch emergency procedure to salvage the heart in the setting of penetrating chest trauma, the thoracotomy is performed by making a deep incision between the 4th and 5th ribs on the left anterior chest, spreading the ribs, opening the pericardial sac, inserting the hand into the chest cavity, and attempting to directly close any hole in the heart while, if necessary, performing cardiac massage to manually pump the heart if it has already stopped beating. This procedure was unfortunately unsuccessful in John Lennon, as it is with 95% of the people who undergo it.
While shaking the hand of my esteemed interviewer, I did not know that that same hand had, 26 years before, held the heart of the man who's face looked down on my childhood bed from numerous posters and album covers. How desperate that bloody clutch must have been.
I performed a thoracotomy once. On a sheep. A sheep that was anesthetized and finally "sacrificed" so that I could learn a potentially life-saving procedure that I may never have to perform. In the animal lab at the University of Minnesota I found myself staring into the open chest cavity of a living, breathing creature. I could tell that it was breathing because I could see the lungs right there, soft mottled pale pink pillows inflating and deflating to the rhythm set by the ventilator. And I knew that the ventilator tube was in place, because I had intubated the sheep myself, several times, after placing various IV's, a central line, an arterial line, and an interosseous line. Poor sheep.
It was about to get much worse for that nice sheep, because I was about to open the delicate sac around its heart and attempt to repair the hole in the heart muscle that my instructor was about to cut with a scalpel. What followed was one of the most poignantly comedic moments of my medical school career. Staple gun in hand, I closed the hole in the fibrillating heart. And then, because the sheep's pressure was dropping, and she kept slipping back into V Fib, I got to inject epinephrine directly into the heart itself, a la Pulp Fiction, if you will. The heart responded so vigorously to this literal rush of adrenaline that the staples I had placed started to give and blood started to leak out of the heart. I stopped it with my finger, and then, in classic form, leaned in to see what the problem was. "I'll just take a closer look." When I released my finger, blood exploded out of the heart and shot over 10 feet across the room, completely bathing myself and my colleague, in addition to the back wall, in warm sheep blood.
Standing there, blood splattered across my face shield and dripping down my arms, my first thought was "this is AWESOME." My second thought was, "this is awful. My patient is bleeding to death, so I should probably try to close that hole." I frantically jabbed staples haphazardly into the wildly beating heart, blood continuing to spurt and splatter between my fingers. As the heart started to tire, I wrapped my hands around it and squeezed, trying to prolong the life that was destined from birth to be unsaveable. Thank you, nice sheep. I aknowledge the callousness of sacrificing animals for the sake of medical education. It made me sad, but I will never forget what I learned that day.
My dad later asked if I thought they would use the sheep to make dog food. I said that I didn't think so.
. . .
Interviewing is weird. You have 20 minutes to express to an attending physician, perhaps the program director, why you would make an excellent addition to their residency program, while all the while giving them a sense of your personality and interests and intellectual prowess. You walk in and shake hands. You sit down. Sometimes, the program director will be playing Dvorak's New World Symphony on his computer, and you can talk about classical music and jazz for most of the interview. And sometimes it is more formal, and you get asked a question before you sit down. If you are me, your question is "Ask me a question." And if you don't know that the man who is sitting across from you held the heart of John Lennon in his hands as he died, you might respond with something like, "How long have you been at St. Luke's-Roosevelt?"
I don't know what I would ask someone even if I knew that.
Crazy.
Fiona,
You always have the wildest stories :) I just saw the "U.S. vs. John Lennon" movie. Tears welled up from my eyes several times. How did you find out that physician who interviewed you was the one who attempted the heart massage on John?
I saw a thoracotomy for the first time several weeks ago. It was the 2nd time that a resident near the end of training told me that it was the first time they had seen a particular procedure performed. The surgical resident told me that the first thoracotomy they had witenessed occurred one week earlier and that this was their second experience. The other procedure that was witnessed by several EM residents near the end of their third year was a retrograde intubation that was successfully performed by an anesthesiologist.
For questions you might try reading about the program and faculty at links here.
http://www.saem.org/rescat/contents.html
Though I am sure you already know about this or have gone to the web sites for your interviews.
Good Luck! I know you will match at one of your top picks. You have a lot of charisma and personality.
You are one degree away from John Lennon's heart!!
Fiona,
Hello. My name is Monica. I am a Physics student. Just finished my master's degree. I am doing research in astrophysics but I have always had the competing interest of studying Medicine. I find myself at a point in my life where I feel that Physics takes me away from the world, isolates me, in a way. I spend all my days in front of a computer trying to fix a code and reducing data. Although I find astrophysics fascinating as a subject, and Physics is wonderful, I feel isolated, and I still feel that I would like to be trained to help people, to work at a hospital and be with people. I would like to feel that I can make some difference, however small, in this world. That I am not just learning for myself only. I know all this probably sounds weird but I came across your website, and thought that perhaps you may be able to give me a word or two of advice on medical school. What made you decide to become a doctor? Why a doctor in medicine among all the other professions you could have chosen? Do you still feel the same excitement as when you entered med school? HOw long did it take you to study for the MCAT?
If you can provide me with any advice, I would be very grateful.
Lots of success in your search for residency programs.
Monica
Good luck! You should give them the address of your blog in your interviews - I'm sure they could get a much better impression of who you are from them, and they'd love the saga of the interview shoes and brown pantsuit.
After some careful deliberation, I did include my blog on my residency application. To date, only one interviewer (a resident, not a faculty member) has commented on it. But his review was favorable, so I guess I should keep it up. I was initially worried that it would be risky to advertise my blog - since it is not exactly the most professional record of my educational achievements. But then I thought, screw it. So welcome, future interviewers.
And in answer to Monica's question... To me it wasn't a difficult decision to study medicine - it is the only thing I have ever wanted to do (after I ruled out living on a horse farm with my sister as a potential profession). I love it, and can't imagine doing anything else. It is incredibly rewarding, and incredibly challenging. That said, it is a very long road, especially if you have to go back and complete pre-med prerequisites. So I would recommend that you be sure - get involved in the medical community, volunteer at a clinic, see if it feels right. You don't want to risk becoming over $100,000 in debt if you are unsure of medicine as a career (and you have very little chance of being accepted if you have no medical volunteer experience anyway). That is my advice. But once you decide, it goes by pretty quick. I took a summer to study for the MCATs, on and off - I took a Kaplan course and it served me well. Good luck.
Out of curiosity, how did you later find out that your interviewer had opened John Lennon's chest?
Oh, one of the residents off-handedly mentioned it. "You know, he was the one who did John Lennon's thoracotomy and then pronounced him dead on national tv. Every year a bunch of reporters come around and interview him." Something like that. I think my jaw literally dropped.
Fiona, great blog. F
Please remember that the medical community and the scientific community are VERY POLITICAL. WBR LeoP