6/27/2011- Cardiology - Jessica

I can't believe we are in our final rotation already! It's the first day of our 4th week of rotation and we only have less than a week left in Taiwan! We start the day with Dr. Feng (馮文楷醫師) in the ultrasound room. Like Dr. Lin, the thoracic surgeon we met last week, we met with Dr. Feng before in the public health screen two weeks ago. Coincidentally, both Nicole and I were in the same station with him too. Since we are not familiar with ultrasound, we were a little disorientated in the beginning by the images. But after Dr. Feng's explanation, we quickly managed to be able to identify the key anatomy structures. This morning we saw many valvular and other cardiac diseases that we saw only on the textbooks before. For example, we saw an example of aortic stenosis and a patient with ventricular septal defect (of which we were able to hear the murmur very clearly as predicted by the textbook). We also saw a patient with suspected previous MI that caused hypokinesis of the anterior septal wall. One interesting thing we observed was the interaction between different departments, especially thoracic and the cardiology department, since many respiratory failure symptoms are either cardiogenic itself already or can be induced by heart failure.

The highlight of the day was the afternoon case presentation of colon cancer. The presentation was originally scheduled last week, but due to schedule conflict, was postponed to today. We have prepared ourselves all week long and the anticipation has made me more nervous as the time of the presentation approaches. The fact that I am responsible for the pathology section and Dr. Hsieh from the Pathology department was the only attending physician that day too did not help at all with my anxiety! But luckily the presentation went well for everybody and I didn't make any gigantic mistakes that I somehow have convinced myself would happen by all the anxiety and anticipation accumulated throughout the week. Despite the fact that it was nerve-wracking for me, the presentation was actually a very good learning experience for me, since it gave us the chance to see how different subdisciplines work together in cases like this as well as giving us the chance to practice our presentation skills that will be extremely valuable in the future.