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In This Issue:
Each summer, a distinguished and diverse group of residents participate in BWH training programs. This year, in a two-part series, BWH Bulletin spotlights a group of Internal Medicine Department residents with unique experiences, backgrounds and talents.
Ryan Schwarz, MD, MBA
When did you decide to become a physician?
Growing up and throughout college, I lived and worked in a number of impoverished communities both domestically and abroad. These experiences, a healthy dose of inspiration and encouragement in humanism from my parents, and a fascination for the sciences eventually led me to choose medicine as a tool to address social inequity.
What has been your biggest career accomplishment so far?
For the two years prior to internship, I was director of the non-profit organization Nyaya Health, which works with the Nepali Ministry of Health to develop health care capacity in one of the poorest and most marginalized regions of Nepal. Our work has grown significantly over the last few years, and I was privileged to work with a truly incredible team, while also working with inspiring partners such as Partners In Health. During residency, I'll continue my work with Nyaya as an advisor to the current directors.
How would you describe your first few months of training?
Being an intern at BWH is a deeply humbling experience, and I'm honored to join this year's class. The housestaff and faculty are a continual inspiration to strive for the best for each of our patients.
What unique skills do you bring to BWH?
I'm reminded daily how much I have to learn, both to provide the care my patients deserve and also to catch up to my colleagues! However, in addition to being a floundering intern, in a parallel life I'm trained as a manager and hope that my insights in this realm will help my colleagues and me more effectively address some of the systemic issues we face at BWH, and those that our patients face in accessing care.
Where do you see yourself in five years?
I aim for my career to straddle the clinical and operations realms in the field of global health delivery. In the immediate years following residency, I hope to work abroad. If my residency will offer me an understanding of how health care functions at two of the finest hospitals in the world, then I hope for the following years to afford me a deeper understanding of the systemic and operational barriers that prevent us from providing similar care in resource-poor settings.
Ibiayi Dagogo-Jack, MD
What initially drew you to a career in medicine?
Both of my parents were physicians, and I always knew that I wanted to practice medicine. However, it wasn’t until my third year of medical school that I truly understood why. It was the day that the bravest patient I’ve ever known—an ovarian cancer victim—died. That humbling moment helped me realize that I had a long way to go. It taught me that being a good physician is more about changing the force of disease—the impact of illness on a patient’s life and wellbeing—than changing the course of disease.
Tell us how your first year of residency is going.
I’ve always made it my policy to surround myself with people I can learn from. So far, I have been amazed by how much my opinion matters and how seriously I am taken. The BWH culture of collegiality allows for the exchange and intersection of ideas ranging from politics to education, economics and literature. I am continuously impressed with my colleagues and their multi-dimensional interests.
As someone who invests a lot of time in writing, I’ve come to realize that I think differently from many people. For example, I’m more interested in patient stories and histories than I am about intersecting data points. I suppose it has something to do with my upbringing. I was raised in a traditional Nigerian family where advice was often given in the form of anecdotes and parables. Since medical school, I’ve used this unique vantage point combined with the poignant exchange I have with patients on a day-to-day basis as inspiration for a collection of essays that I’ve been writing on the subjective experience of illness.
What accomplishment are you the most proud of?
In the summer after my second year in medical school, I wrote an essay on the med student experience of choosing a career that has since been published. I received an email from a medical student in Israel thanking me for writing the essay. It was great to feel so connected on a global scale.
Some of the most skilled physicians in the world have trained at BWH. What is it like to train here alongside such talented staff?
I am humbled. Part of me feels that I’ve yet to earn the privilege. Sometimes I don’t even put my stethoscope earpiece in the right way.
Carlos Joaquin Gonzalez Quesada, MD
What are you most enjoying about your training at the Brigham?
The people I work with. My fellow residents are not only outstanding physicians, but also amazing and genuinely nice human beings. When you happily wake up every day to go to work, you know you are training in the right place.
Our attendings and mentors are renowned leaders in Medicine and also some of the nicest teachers I have ever come to meet. When I came to BWH for my interview, I was amazed at how most of the medical chiefs showed up during lunch time to share some of their thoughts and encourage us to train here. Every day, I am fortunate to have conversations with outstanding clinicians, researchers and educators. They are so easily approachable that no one feels intimidated by them; everyone is welcome to ask and discuss, and of course, to disagree.
What experiences led you to a career in medicine?
Initially, I was attracted by how medicine uses scientific principles to solve real problems, and how it provides solutions that one could actually see and experience. As I became more involved with medicine I additionally discovered how rewarding it was to become part of the most important events in people’s lives. I feel really fortunate to be where I am today; I am still discovering reasons why I went into medicine.
I empathize with our patients in a special way. At 26, I was diagnosed with a rare form of brain cancer and have since undergone surgery and recovered. But that experience has provided me with a better humanistic way of health care. As residents, we have the opportunity to become closer to our patients. Prescribing drugs and treatments is just half of the equation; the rest depends on how warmly and humanly we can address our patients’ needs.
In 2005, I gathered a group of more than 200 physicians (medical residents and attendings of the academic centers in Mexico). Together we created the first edition of a General Medicine treatise; we named it Guía EXARMED (Guide to the NAtional MEDical Residency EXamination). The first edition (a 1,300-page book) was released in 2007 and it became a medical best-seller. A second edition, consisting of 1,800 pages, was released in 2009. We are very excited because by mid-October of this year, the third edition will be released. I have had the fortune to serve as the editor-in-chief. Now, our book is distributed in several countries in Latin America.
Tim Menza, MD, PhD
What kind of experiences led you to want to a career in medicine?
I saw becoming a doctor as a way to give back. In college, I spent some time studying queer activism and world-making. I realized how much I have benefitted from the work of other LGBT folks and how I have been able to live a safer, healthier life because of that work. We know that discrimination and prejudice is not only unhealthy, but also deadly. I wanted to provide a safe, affirming space for LGBT youth and adults for their health care. Additionally, the HIV epidemic is still a part of the lives of many LGBT people, and I want to develop prevention strategies to keep those without HIV negative and to help those living with HIV thrive.
What career accomplishments are you the most proud of?
Completing a productive MD/PhD program is my biggest accomplishment. However, I also had some great opportunities during my PhD work that made the experience even more rewarding. Towards the end of my graduate degree program and through my HIV testing and counseling work with Public Health—Seattle & King County, I was asked to serve as a consultant in the development of the Centers for Disease Control and Prevention’s new guidelines for HIV testing in non-clinical settings. I participated in creating a CDC-funded HIV prevention plan for men who have sex with men in Washington state and worked closely with Public Health—Seattle & King County to develop instruments to assess substance use through the life course of HIV-positive people. It is a great feeling to be recognized for your work and to be asked to share your skills.
It is wonderful to learn from attendings who are recognized experts in their fields of practice and research. The morning reports and the noon conferences are brilliant. Moreover, each of the residents here has something extra, something special about him or her, whether it be a PhD in anthropology, running an NGO doing global health, or advising a national ministry of health. Needless to say, I have learned a great deal from my fellow interns and residents just through our working together.
I strive to develop and nurture strong therapeutic relationships with my patients and make them feel well taken care of regardless of the gravity or acuity of their illness. I don’t think that is a unique skill necessarily, but it is something I think I am good at and something I try to bring to work daily.
Over the history of the hospital, some of the most skilled physicians in medicine have trained here. What is it like to train here alongside them?
I am really lucky to be here and quite humbled. Given the legacy that those who have trained here have built, I have no doubt that I will also be a well-trained doctor by the time I complete my residency at BWH.