If there is one thing that I learned from this internship, it is to love your job! Dr. Chung embodied that adage in and out of the examination rooms. Over this summer, Dr. Chung, a pediatrician at Pediatric Associates of Brockton, stressed the importance of genuinely caring for your patients, understanding human vital systems, and diving deeper into medical curiosities. I was able to shadow Dr. Chung at two of his three office locations in Brockton and Canton and see patients ranging in age from two weeks to 22 years. Whether it was a well or sick visit, every patient interaction was rewarding.
Before each visit, Dr. Chung and I would look at the growth chart, which detailed the height, weight, and BMI (Body Mass Index) of the individual and review any patient complaints about their health. Although this may seem routine, it is a crucial step in identifying any underlying health issues or changes so the visit is as productive as possible. If the height curve of a teenage patient was flattening, Dr. Chung could attribute the growth change as a precursor to puberty. Or if there was a significant dip in body weight without any attempts of weight loss, celiac disease or diabetes could be plausible pre-diagnoses. These possible diagnoses would guide Dr. Chung’s questions during the visit, requests for specific blood tests, and physical exams. As the internship progressed, Dr. Chung would start asking for my opinion on the charts and patient complaints; I even correctly pre-diagnosed swimmer’s ear. Through this, I learned how to pre-diagnose in a well-timed manner while taking in the patient’s medical history and connecting it to fundamental vital systems.
During the actual visit, Dr. Chung would always start by asking non-medical questions and recalling information from their previous visits. I found this particularly beneficial because by doing so, Dr. Chung “humanized” his medical persona to both the patient and the family, which deepened their relationship. Over the first couple of visits, Dr. Chung taught me how to use an otoscope to look into patients' ears, an ophthalmoscope to look for reflections from the retina, and a stethoscope to listen for irregular heart rhythms and breathing sounds. I was fortunate enough to hear a couple of heart murmurs in infants, wheezing, and several patients with Long QT (a heart condition with a prolonged QT interval). After the first couple of weeks, Dr. Chung started allowing me to lead the physical examination. I would conclude if there were any abnormalities such as swollen lymph nodes in the neck or chest, fluid or inflammation in the ear canals (which are common symptoms of swimmer’s ear), or any blood in the nostrils.
After memorizing Dr. Chung’s sleep, nutrition, and reading speeches, I was able to perform history-taking without Dr. Chung. This included addressing notable weight changes, diet, and performance in school. At first, I was nervous to interact with the patients, but the experience allowed me to adapt my communication skills to the patient’s age, interests, and mood.
Just as Dr. Chung noticed a familial pattern with his strep patients, he is noticing another pattern with patients with periodic fever. Periodic fever usually arises in a patient after they have had strep. The anti-strep antibodies’ production and destruction cause an immune reaction, which in some cases is a fever. To get rid of this fever, the body creates new antibodies to clear the anti-strep antibodies, which were causing the fever. Although these new antibodies will help clear the fever at the moment, the new antibodies will cause the development of another fever in about a month thus creating a cycle (or sine graph) of periodic fevers. Standard treatment is a single dose of steroids at the beginning of fever symptoms. On the other hand, Dr. Chung hypothesized that if you treat the patient with steroids at the time when anti-strep antibodies are expected to be at peak production (the top of a sine graph), but before they cause symptoms, that one might be able to prevent the fever from appearing at all. This would cut the cycle short and stop the cycle. So far, Dr. Chung has been able to treat one patient with successful results, but the next expected fever is due just after Labor Day, so we will see.
When I was not in the examination room, Dr. Chung introduced me to his colleagues, brought me to an AstraZeneca Pharmaceutical drug pitch, and explained any sort of medical data he could get his hands on. I am also very grateful for two of Dr. Chung’s colleagues, Dr. Nader, a pediatrician, and Ms. Berish, a nurse practitioner, who both helped contribute to my amazing experience. Dr. Nader taught me how to make a splint for an upper hand fracture and a boxer’s fracture, while Ms. Berish showed me how the ID NOW Strep machine worked and explained its data.
One of my favorite parts of the internship was giving back to the local community through a new program called Gear for Greatness. Dr. Chung’s offices are located in some of the poorer communities in Massachusetts, and as a result, children do not have equal access to sports equipment. Dr. Chung stresses the importance of physical activity, which is just another reason why this project is so critical. My vision for Gear for Greatness is to create a system that involves Rivers students coordinating and executing the collection of used sports equipment and then donating it to Middle and High Schools in Randolph and Brockton. Over the summer, Dr. Chung and I worked to establish connections and plan to roll this project out at Rivers in the fall. My hope is that through this program, more kids will have access to whichever sports they wish to play.
My experience with Dr. Chung and his entire medical staff was extremely beneficial to my view on medicine. Dr. Chung provided an in-depth view of the day-to-day life in primary care, which is something I will definitely use in my future medical career! I would like to thank Mr. Schlenker, Dr. Chung, and all the patients who graciously allowed me to shadow.
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