My name is Kendall Zaleski, Class of 2022, and I was an intern for the Beth Israel Deaconess Medical Center at their West Campus location in Boston, MA. While I have not officially declared a major yet at Skidmore, but I am planning on double majoring in Health and Human Physiological Sciences and Chemistry with a concentration in Bio-Chem. In addition, this past spring at Skidmore, I received my EMT-B certification and joined the SCEMS agency. As one may see, I am very interested in medicine, which is why I looked for an internship where I could experience the different areas of healthcare and what a career in a hospital setting would look like. Despite knowing what I love, I am an indecisive person and have had a lot of trouble figuring out what kind of path I would like to explore in the future and have been struggling with my interests in becoming a physical therapist, doctor, physician’s assistant, or nurse practitioner. Last summer I was lucky enough to assist in a physical therapy facility near me (and loved it!), so this summer I looked for opportunities to delve into my other careers of interest.
I looked into internships and volunteer opportunities at many different hospitals in the Boston area, Rhode Island, and Cape Cod and while many of the programs at these facilities would allow me to gain valuable shadowing experiences, most didn’t think that they would be able to accommodate the 250 hour requirement. I finally was able to coordinate a schedule with the volunteer manager at Beth Israel, where I would spend half of my time working in the hospital’s Structural Heart Clinic with a team of nurses and the other half shadowing physicians, watching procedures, and observing in numerous ICUs, CCUs, and ERs.
The Structural Heart Clinic is a small division of the Cardiology department that focuses on the structural aspects of our body’s most important muscle, mainly the four valves that control the flow of blood through the heart. The team of nurses that I worked with would coordinate with interventional cardiologists and cardiac surgeons for two transcathetar procedures, the “MitraClip” and “TAVR”. The MitraClip procedure is to replace the Mitral valve, while the TAVR (transcatheter aortic valve replacement) fixes an aortic valve. The TAVR and MitraClip procedures are performed through the femoral vessels in the groin where a catheter is threaded up through the heart’s aorta. By doing the procedure in this way, it significantly diminishes the risks and time of both the procedure and the recovery. I was fascinated watching these procedures and seeing how far technology and medicine has come in just the past ten or so years. The patients were able to avoid open heart surgery and were up and walking about around four hours post procedure and were discharged from the hospital one to two days later with better working valves. My time in the Structural Heart Clinic wasn’t just watching these procedures, but it also involved a lot of patient communication, which is one of the reasons I am driven towards healthcare. Every Thursday, our team would host a clinic where we would meet with potential patients to determine their qualifications for the procedures and follow up with former patients. Since the TAVR and MitraClip procedures are relatively new, my job at the clinic would be to collect information for the database to determine if there were specific factors that affected the outcome of the procedure and perform frailty tests. My other responsibilities with the Structural Heart team included: uploading CT scans of the patients chest and abdomen to specific valve company websites for custom measuring, informing patients’ primary care physicians of any incidental findings in the CT scans, uploading dental clearance and KCCQ forms into patients’ records and the medical database, collecting patient discharge information for a new research study, and creating pamphlets and informational documents for the patients to learn about their procedure, what they should expect, the different appointments and approvals they will need, and post-procedure instructions.
On the days that I was shadowing physicians (mainly cardiologists and cardiac nurses), I was able to observe many different experiences. During my first week (which was the last week before the discussions ended for the summer), I was able to sit in on the Cardiology Grand Rounds where a cardiovascular surgeon presented a plan to diminish the risk of death due to pulmonary embolisms. I was also able to watch a few fellows display their experiences of high risk patients and their research on how the hospital could have been more effective in those specific situations during their M&M (morbidity and mortality) discussion. When I shadowed the physicians, I was able to observe and was taught how to read an echocardiogram (ultrasound of the heart) and TEE (trans-esophageal echocardiogram) scans and Cardiac MRIs. I was also able to demonstrate my knowledge from my EMT certification when I was shown many different EKG readings from patients with a variety of different issues and diseases. When I shadowed in the Cardiology ICU, I was able to view both continuous and short-term dialysis and the different machines and techniques used for the different patients. On one of my shadowing days in the CICU, I was able to observe a patient arrive in the hospital’s care and be attached to a VA ECMO (Veno-Arterial Extracorporeal membrane oxygenation) machine. This was an amazing device that is attached to a patient under sedation whose heart and lungs are not working properly. This machine is more of a long-term bypass device where the device takes over the function of these organs (it pumps and oxygenates the blood while eliminating all waste materials). On my most recent shadowing experience in the CVICU (Cardiovascular ICU), I was able to observe a patient returning from a CABGx4 (coronary artery bypass grafting with four bypasses) surgery and I was able to participate in his post-procedure care. The nurse that was overseeing the patient allowed me to take the patients’ vitals, check pupillary action, use a doppler to confirm pedis pulses (in the feet), and after four hours in recovery I was allowed to extubate the patient from the breathing tube.
While a lot of my time was spent with sick, elderly patients that had a variety of different cardiovascular illnesses, the experiences that I gained from shadowing were valuable and very rewarding. Being able to follow a patient from their worst to recovery was an incredible experience and seeing first hand how advanced medical technology has come was fulfilling and has given me a lot of hope and excitement to see how much more we will know and can help patients in the next few years. I want to thank Skidmore and its donors for awarding me the SGA’s Responsible Citizenship award, which was able to grant me this rewarding experience. I am extremely grateful to have been able to observe and absorb all of the information and medical experience that I did, along with creating many new connections with a variety of people in the field.