Natalie Cassello ‘21 Joins Atlantis’ Clinical Shadowing Fellowship in Ecuador

Natalie Cassello ’21 pictured second from left outside the operating room.

With hopes of attending medical school in four short years, I decided it would be best to start gaining experience early. I applied to the Atlantis Clinical Shadowing Fellowship, known as “a competitive physician shadowing program,” in order to learn and better prepare myself for my future. Within a week of submitting the online application, an interview was scheduled and I was accepted. Prior to arrival, I was informed that I would gain at least 60 hours in the hospital, learn about the process of med-school applications, meet a group of fellow aspiring doctors, practice a second language, and observe physicians in various specialties, all while immersed in a unique culture. Based in Cuenca, Ecuador, I had the unique opportunity to explore a new country. Each of these tasks was completed in just three short weeks.

Natalie Cassello ’21 preparing for surgery.

In the initial week of my fellowship, I had already seen and learn so much, both inside and outside of the hospital. During my first day of shadowing, I observed the removal of hernias on a man and osteomas (bone growths) on a woman’s skull, a repair of a deviated septum, a colonoscopy, and veins being crocheted together to treat thrombosis on a leg. Later that day I reflected on all that I had seen and everyone who I met. Most of the nurses and doctors expressed enthusiasm about us learning by answering questions before we would ask and continuously encouraged us to watch the surgeries. Although every day in the life of the clinic was completely different, each was busy as I rotated between departments, including surgery, radiology, nutrition, pediatrics, neonatal, intensive care, physiotherapy, emergency and clinical medicine. Later in the week, I observed identical twin brothers conduct a cesarean section and visited the NICU, otherwise known as “the beach of the hospital” because it is kept warm to help the babies maintain their body temperature. My time here deepened my desire to continue on the path of becoming a neonatal doctor.

The cross-cultural medicine provided me with new perspectives. One of the most memorable topics was how the doctors showed their patients they cared about each one as an individual person. A little boy was anesthetized in his mother arms, as they injected him with ‘coconut juice,’ an 85-year-old man who had a hematoma in the Broca area of his brain was remembered from six years ago when he had a brain tumor, and the geriatrics doctor kissed his patient on the forehead when leaving her room. The overly-friendly Cuencana culture was apparent and forced me to become more aware of my interactions with others. It was also extremely valuable to learn in both settings of a private and public hospital, as there are slight differences due to the free healthcare in Ecuador.

When we were not observing a physician, we were lucky to have lectures and converse with the doctors. My site coordinator, Dr. Anto Flores, taught us about patient care. We went over the basics of the four vitals, including how to take blood pressure, followed by the questions asked in a patient interview and the seven qualities of pain, how to conduct a general physical exam, and the steps to scrubbing into a sterile surgical environment. The neurosurgeon gave us two classes, allowing us to ask questions about the brain, clarifying the differences, causes, and treatments of tumors, concussions, strokes, seizures, and aneurysms. Just a few days prior, we observed a successful surgery to relieve a ruptured aneurysm and were able to follow the case through to radiology, where his CT scans showed less bleed, showing just how complete the experience became.

Natalie Cassello ’21 pictured on left at Laguna Quilotoa.

Even while in the operating room, doctors listened to the radio and discussed their opinions on the World Cup, which was all the gossip in Cuenca this summer. I was happy to experience this important part of the culture, as well as watch a handful of the matches. In addition to learning about football, I went on a city tour and learned about the true diversity of “the Athens of Ecuador,” visited the natural hot springs, saw the Catedral de la Inmaculada Concepción, ate delicious traditional foods, joined a gym, visited the ruins of Ingapirca during the Inti Raymi festival, and travelled twelve hours north to the towns of Banos, to go to the End of the World Swing and bungee jump off a bridge, and then to Quilotoa, to hike and kayak in a lagoon in the center of a volcano, while soaking in the beauty of the highlands. The following weekend we took a trip to Cajas National Park and drove six hours to Playas, where I attempted to surf and nearly stepped on a snake. My many adventures surely exceeded my expectations of the short time period in the Latin country.

Atlantis was truly a holistic medical and cultural experience, which aligned perfectly with my hopes of studying anthropology and practicing medicine abroad post-graduate school. This program offered opportunities to constantly challenge myself to step outside of my “bubbles” that I create for myself, as the founder of my high school, THINK Global School, Joann McPike spoke about in her graduation speech. These bubbles make us comfortable, but by traveling while defying our instincts to be ethnocentric and rather take a culturally relative perspective, we are able to gain a deeper education from the new places we are in. Atlantis further peaked my interests in travel and healthcare and reconfirmed my dream of becoming a doctor. It simultaneously reinforced the reasons why I decided this path for myself in the first place, to provide opportunities to improve the quality of life for those all around the world, while continuing to learn through first-hand travel experiences.

If I learned anything from my experience and site coordinator, Anto, it would be that there is more to being a doctor than devoting your time to science classes. In order to be a good doctor, you must begin by being a good person, one major part of that is the ability to understand your patients’ culture. After my time with Atlantis, I already want to return to Ecuador to reconnect with my new friends, as well as further explore the four ecological regions of the highlands, beaches, rainforest, and, of course, the Galapagos Islands. I also feel much more prepared to further pursue my career and hope to live up to Atlantis’ hopes of innovating the healthcare system once I officially enter the medical field.

Words cannot describe how grateful I am to have received the support of Skidmore’s Career Development Center through the award of the Summer Opportunity Fund, my friends and family through GoFundMe, and of course, the Atlantis program. As I did not have to worry about finances on this trip, I allowed myself to give my undivided attention to observing and soaking in new information. I strongly recommend that all students search for and participate in an internship experience that interests them, as well as take advantages of the services provided by Skidmore.


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