Dr. Fuller, General Surgeon

Avery Clark, 2009

Throughout the winter term internship at Porter Hospital I was able to observe a vast array of medical specialties. I learned what it means to be a part of the medical field, and the responsibilities that go along with that. I spent the majority of my time at the hospital shadowing doctors and surgeons as they went about their daily practices: seeing patients, performing procedures, analyzing test results, collaborating with other doctors, etc. This internship was incredibly valuable as it opened my eyes to time, dedication, and care it takes to become a good doctor.

My mentor for the month was Dr. Fuller, a general surgeon at Porter. Most of my days were spent observing his surgeries in the mornings, and meeting with patients in the office in the afternoon. The thing that struck me most about the surgical field was how essential it was to establish trust with the patient. They basically put their lives in the hands of the surgeon and must trust that he/she will take the best care of them possible. With Dr. Fuller I learned how important it is to form a relationship with the patient first, to explain and clarify exactly what they will be experiencing, and to try and allay the fears and anxiety the patient is feeling.

Watching the surgeries was an eye-opening experience for me. Honestly I was not sure how I would handle seeing an actual operation at first, but after getting over the initial queasiness I found it fascinating to actually view all the parts of the body and how they are interconnected. Dr. Fuller was so helpful in taking the time prior to each surgery to explain to me what he would be doing, and then continuing to talk to me about what I was seeing throughout the actual surgery. I learned just how precise and systematic you must be as a surgeon in order to ensure you perform each step correctly, as well as how important it is to have a strong team behind you. Over this period I was able to observe a broad range of procedures including laparoscopic gallbladder removals, colon resection, emergency spleen removal, thyroid lobectomy, and hernia repairs to name a few. No two surgeries were ever the same, and each one continued to teach me something new.

Although surgery is a fascinating field, my goal for this internship was to gain as many different experiences as possible, and to take advantage of the tact that we could participate in rotations in a wide range of specialties. Beyond figuring out if I do want to attend medical school, I also need to decide what field of medicine I would like to go into myself, and this was the perfect opportunity to explore these options further. Over the month I had experiences in the emergency room, orthopedics, ophthalmology, pathology, obstetrics and radiology. I noticed how much variation there is within a hospital and how each doctor’s day to day routine was completely different.  All of the doctors were incredibly open to sharing their experiences in becoming doctors with me. It became clear how passionate they were about their jobs and the responsibility of caring for other human beings. Not a single doctor I talked to said to me that they regretted their choices, to them, medicine was incredibly exciting and worthwhile.

Across all the fields, it became clear that in interacting with patients, a doctor must exhibit genuine interest and compassion for the patient’s well-being. No patient is ever completely comfortable going into a doctor’s office, and they want/need to believe that the doctor truly cares about them and their problems. In order for a patient to trust in a doctor enough to fully and openly disclose information about their health they need to have established a strong relationship with that person. This takes an incredible amount of time and patience on the doctor’s part, but I could see how worthwhile it is in the end when you actually help someone improve their life.  It is clear that this is the most rewarding part for the doctor’s I interacted with, the fact that, at the end of the day, they know that they made a significant difference in multiple people’s lives.

Overall I found this internship to be an incredibly rewarding experience. Prior to this j-term, my only real experience in the medical field was a volunteer position in the emergency room of Greenwich Hospital. Although it was interesting to observe the daily activities in this department, I was not really given the opportunity to interact with many of the doctors and nurses on staff. At Porter all of the doctors I interacted with, especially Dr. Fuller, were willing to answer any questions I had, and took significant time out of their month to provide me with an inside view of the workings of a hospital. The amount of exposure I was given was invaluable, and I now have a much better idea as to what it takes to be a medical professional. I greatly appreciate the generosity of the doctors at Porter Hospital, and would recommend that anyone possibly interested in a career in medicine take advantage of this excellent opportunity Middlebury offers us.

Dr. Carl Petri, General Surgeon

Natalie Dupre, 2010

As a Pre-med student at Middlebury College, I have been struggling with a life/career decision on whether or not to attend med-school. To help me with this life altering decision, I looked to the Porter Hospital Winter Internship. Over the month on January, I was fortunate enough to shadow Dr. Petri, a general surgeon at the hospital. I’m so appreciative for the time and effort he took out of his day to answer my questions and to tell me things about life and medicine. He, and the rest of the doctors and nurses, did a great job at teaching me fundamental and practical things dealing with medicine. While, of course, I did not help on any of the procedures besides turning on and off the lights, my responsibilities entailed: observing surgical procedures and office visits, asking questions, organizing times to meet with other doctors, not getting in the way of the nurses, being on time, dressing appropriately, and not touching anything in blue that indicated sterility. While the internship does require a lot of hours and waking up very early on some days, it was well worth it; not to mention, that outside of being in the hospital there was little stress or written work, making it perfect for a J-term experience.

After a month of observing physicians in the hospital, I cannot give justice to how much I learned not only about medicine, but also about life and work within a hospital. While it’s not as dramatic as Grey’s Anatomy, I did encounter a fair share of ethical and moral issues, intriguing surgeries, and unfortunate and depressing problems that both patients and doctors have to deal with. While this is over generalized, I observed that certain types of doctors have stereotypical quirks about their personalities. For example, the main focus of primary care physicians has less to do with practicing medicine but rather, most of their time is spent on talking about life and building a relationship with the patient. Primary care doctors want to know about the patient’s life and they want to make sure that he or she is living a fine and healthy lifestyle. They are the popular doctors who are good with babies, kids, teens, and adults. They like to spend time outside of the office doing things with their family, taking classes, and learning about life and people. Surgeons on the other hand like to avoid excessive conversation with the patient and are more focused on the medical aspect. They know exactly what they are doing and they are very good at it. It may seem like they don’t have a life outside of the office and OR, but it’s not that they don’t have a life outside of surgery but rather they do the things that they know they like. There are even subspecialty personalities like the orthopedic surgeons who are like the rock star surgeons. They work with crazy tools and drills and they listen to AC/DC while they repair the mechanics of the body. Some doctors don’t even see patients. The pathologists and radiologists are these doctors who get to choose how much patient contact they want. It’s not necessary for them to talk to the patient. Instead, they work in their lab or office and look under a microscope or analyze images to help come up with an appropriate diagnosis.

After comparing these different fields of medicine, I’m no longer torn about whether or not I want to go to med school. Now, I’m torn as to what field of medicine I prefer. I like the fact that a surgeon is not set on a daily and weekly routine that primary care doctors are confined to. In many cases, surgeons help to restore the life of the patient. This is what I like about surgery. You get to do things and really fix things, whereas a doctor who works in an office all of the time does more counseling, which may or may not help the patient. There are more risks associated with being a surgeon than a primary care physician, but knowing what you do really makes a difference in someone’s life may be worth the risks of being a surgeon. However, I really like the relationships that a primary care physician builds with his or her patients that are sometimes compromised with being a surgeon. Either way, all of these doctors do a great and thorough job of taking care of their patients and that is what makes me want to be a doctor.

From this internship, I was also introduced to the troubles of a rural hospital that range from small town issues to government intervention within the hospital. Being from a larger city than Middlebury, I am used to hearing about violence issues, etc. But I was shocked to encounter situations of domestic violence in rural Vermont where there is little to no awareness of such topics. It also shocked me that the government-which has so much involvement in medicine and hospitals-has not addressed these community issues. This made me realize that there is a fundamental problem with how the government gets involved with medicine. Maybe the money that is spent on patients to have surgery is only taking care of the symptoms but not the underlying problem. Maybe more money should be invested into making sure that sexual predators aren’t roaming the streets, or that people have easy and non-bureaucratic access to family counseling so that less money has to be devoted to covering up the problem with surgery. Until preventative care gets better, these band-aid issues are going to keep rising.

On the whole, I would definitely not pass up this awesome opportunity for any possible med-school student. Shadowing a doctor is an opportunity that not many get to have and it’s great for those who are toying with the idea of med-school. I am so grateful for this internship program, because it really elucidated my decision process and taught me a lot about life. I found out through this experience, that as a woman, I can be a hard-working doctor and still live a balanced life. I also learned a lot of anatomy and physiology that I never really appreciated until I actually saw it in the OR. Even though I only learned a small fraction of what med-school must learn, I am definitely better off after doing this internship and I completely recommend this to anyone who wants to go to med-school.

Dr. Linn Larson, MD

Susan Read, 2009

As one of the Porter winter term interns, my job was mostly to follow my mentor physician to get a sense for what a career as a physician might entail.  The majority of the time, I simply sat in on patient visits and observed how the physician interviewed and interacted with the patient.  Later on in the month, I was allowed to interview patients on my own, following a generalized problem list created by the office.  I was also taught basic examination techniques, such as how to listen to a patient’s heart and lungs and look in their ears.  After seeing a patient on my own, I would discuss my findings with my mentor and tell her what I believed the patient’s diagnosis to be.  With any patient visit, we would go over the patient’s diagnoses and the plan of action for treatment, including any complications that might arise from other medical conditions or family problems.  When I shadowed physicians from other specialties, I had similar discussions about treatment plans but less patient interaction, as I had less freedom while in other physicians’ offices.

Throughout the internship, I was encouraged to ask questions and pick physicians’ brains both about particular cases and about the process of medical school and residency.  I’m sure there were hundreds of questions I had that were left unanswered, but it was difficult to organize my thoughts enough in the fast-paced environment to pinpoint what exactly it was that I needed to know.  I felt as though much of what I wanted to know could be learned through observation, and that many of the specific questions I could think of pertained to the drugs being prescribed – information that I could look up on my own without needing to take the time to ask the physician.  However, I believe that I could have been less tentative in several areas of the internship, questioning included.  I was perhaps more reluctant than I should have been to see patients on my own – the office that I was in made it particularly easy with their pre-made forms for various categories of illness, which would go over the common symptoms.  I did have the limiting factor of only being able to interview a limited number of cases, though – being in family practice meant that a great deal of the cases we saw were routine physicals, where my limited skills would not have been of much use.

This internship showed me that medicine, while certainly not an easy career path, does not require any sort of superhuman skills in order to have a successful career.  The physicians that I spoke to were certainly all of the mind that medical school was difficult, though not unreasonably so.  Residency, on the other hand, sounded like an exhausting process – the advice that my mentor passed on to me was, “If you see a bed, lie in it; if you see a chair, sit in it; if you see food, eat it.”  Despite the hardships everyone had faced during the course of their education, they never spoke of reconsidering their career path or of anyone dropping out of the program because it was too much.  I got the sense that everyone had discovered their passion while in the clinical rotation years of medical school, and that was what kept them motivated throughout all of the exhausting years.  Sacrifices were necessary to maintain a semblance of a normal life, in some cases – my mentor, for example, had started out doing obstetrics earlier in her career, but had been forced to give it up in order to spend more time with her family.  While she occasionally lamented the fact that it was not something she could do for her whole career, she recognized the importance of a good family life and took pleasure in that instead.  From this, I became more aware that my career may not go exactly as I envision it now.  I must be prepared to allow my interests and priorities to shift, but not to allow myself to be talked out of what I believe is best for me.

Being primarily in family practice emphasized to me the importance of the doctor-patient relationship in primary care, and the appeal of this relationship to me.  I enjoyed watching my mentor’s interactions with patients that she had been seeing for years and the sense of trust that had built between them over time.  In that situation, the physician becomes not only a healthcare provider, but also an educator, counselor, and friend.  It is this type of interaction that makes medicine my career of choice and draws me to primary care.  By getting to know patients so well, the difference that the physician can make in one’s life is much more obvious.

Shadowing in different specialties, including physical therapy, showed me that the fast pace of medicine, while exhausting, also functions to keep me motivated and on my toes.  No two cases are ever alike, meaning that there will always be something new and interesting to see, even if the patient is only in for a routine physical.  In that sense, medicine will never boring, thanks to the wide variety of issues that could present themselves.  Finally, I discovered that I enjoy the excitement of the operating room, so that I would like to pursue a field that allows both time in the office to interact with patients and surgical privileges, such as orthopedics or OB/GYN.  A month-long internship is obviously not enough to allow me to make a decision about what exactly I want to do for the rest of my life, but I think I can safely say that medicine is the right path for me, and I will eagerly await the opportunity to fully explore all of my options for what specialty I am truly best suited for.

In addition, the follow list of students also participated in a Winter Term Internship with Porter Hospital:

Sophie Clarke, 2011; Sean Denny, 2009; Lisa Gretebec, 2010; Ben Grimmnitz, 2008.5; Matt Labunka, 2010.5; William McConaughy, 2011; Mean O’Keefe, 2010; Ashley Panichelli; Roger Perreaullt, 2009; Richard Saunders, 2009.5; Anne Sullivan, 2010; Laurel Wickberg, 2009

Contact the Career Services Office for more information about internships with Porter Hospital.