Thursday Top Ten: Twenty-four.

This evening we celebrated the completion of internship for our Transitional Year interns. For those unfamiliar, a Transitional Year is essentially a twelve month clinical experience following medical school graduation that provides a general medicine foundation for young doctors entering fields like Radiology, Neurology, Anesthesiology, Ophthalmology and Dermatology. For the last five years, I have served as the residency program director for this program of twenty-four diverse and dynamic individuals, and my oh my. . . lucky me.

Here's the thing--internship is such a pivotal time. . .and the thing is. . .I realize that. I really, really do. Despite all that you learn as a medical student, being an intern is kind of like being shot out of cannon high into the air. The learning trajectory is ridiculous; the personal growth indescribable. My internship remains one of the most memorable experiences of my entire life. In fact, most physicians would tell you that about their rookie-doctor year.

I get the chance to play a key part in that period for twenty-four fresh, new doctors--every single year. On that first day of July, we finally take off their medical student training wheels, strap on their helmets and walk behind them carefully as they pedal onto a sometimes bumpy sidewalk. We resist the temptation ride for them and grab the end of the bike only when necessary. And because the stakes are high--and human--we know what "necessary" is and on those days we do grab the end or even step in to ride tandem with them. If they fall and they will because they're learning--and human--our job is to provide them a soft place to land while providing our patients with a safe place to be.

So this, in addition to all of the other cool things I get to do with medical students and patients and colleagues, is yet another reason why if I didn't have my job, I'd sure wish I did.

This week's top ten? No question. I bring you the top ten moments and reminders from this evening that underscored why I love being the Transitional Year Program Director for The Twenty-Four.

***

#10 ~ Evolutions.

Knowing someone as a medical student and now seeing them step out into being a resident is a pretty magical thing. This is Katie S. (pictured here with her sweet fiancee.) I still remember meeting her when she was a medical student fretting over an epiphany she'd had about choosing a residency. I told her that she'd earned the right academically to do whatever she wanted to do and that it was okay to change her mind (since that's what she was about to do.) In other words, I suggested that she follow her heart.

She did.


#9 ~ Boys to men.

I love seeing this picture and recalling their first day of internship. I imagine them with graying beards, sitting in the same seats some thirty years from now.

#8 ~ Priorities.

This is Ryan B. and Sara G. They both had the joyous experience of brand new parenthood during internship. Ryan had a sweet baby girl and Sara a juicy and adorable baby boy.

Internship is hard. Having a baby during internship is. . . .damn. I have no idea because I didn't experience that. But here's what I do know -- children are a joy and family is a priority. Always.

Tonight at dinner, Ryan said to me, "I remembered what you told me about that time you missed your sister's graduation. I remembered that story and knew to keep my priorities straight. Family is always first."

Who knew when I said that mantra or told that story that someone was listening? Someone was.

#7 ~ Collaboration.

This is Deb B., my associate program director (pictured here with her amazing husband, E.J.) She is--in a word--unbelievable. She is smart. She is organized. She is kind. She is understanding. And best of all? She's just a cool person to work with.

Our styles are so complimentary. I get my bright ideas and jazz hands suggesting some new change and Deb is the one who concretely lays the nitty-gritty of it into an excel spread sheet--quickly letting me know if it's a good idea, a great idea, or a "there's no way we can do that" idea. We are almost always on the same page about things, and she is so easy to work with.

And. Don't let that relaxed look fool you. She is crazy accomplished. This woman? Oh, she was only promoted to FULL PROFESSOR this year. Hello? Full-frickin' professor which, in case you didn't know or aren't in the academic sector, is kind of a big deal. She's so humble that the way she told me she got promoted was like . . .I don't know. . . the way you tell someone to turn off the light or hand you a Diet Coke from the fridge. That's my favorite thing about Deb. She is one uber-smart Radiologist who is so "over it" when it comes to "oooh-aaaaahh, look at me"-ing.

I deeply admire this woman and feel fortunate to work with her so closely. Deb = Rad.


#6 ~ Smiling faces.

This is Jessica C. Her smile is one that always reflexively makes me smile, too. I bet her patients in Anesthesiology will appreciate that smile so much. I sure did.

Imagine getting to see twenty-four of these all over the hospital every single day.

#5 ~ Getting to know you. . .getting to know all about you. . . .

When the year starts, a lot of the interns are strangers to me and each other. I love watching them become friends and also personally getting to know them better. This is a picture of Tom L. and Neil S. Neil was on my ward team once this year and almost every day, he taught me something new and made me laugh out loud. It was one of my favorite memories of this year. They're both going to be Radiologists, like Super-Deb.

This picture is of Pavan K. and Dan W. Pavan went to Morehouse School of Medicine and Dan is an Emory SOM alumnus. Interestingly, despite the fact that both of these institutions are in Atlanta--and even in Grady, the students at each of the schools don't interface or know each other as well as one would think. As a Meharry Medical College graduate, I know this dynamic well; our much smaller, historically black med school was in Nashville just a few miles away from the academic powerhouse Vanderbilt.

Like Morehouse students, we were proud of our institution and loved every moment of our experience. But also like Morehouse students, we would often find our school hidden in the shadow of Vanderbilt's reputation and prestige which created this odd separation between us. We knew the gems held inside of our walls, but at times, few others did or were even willing to try. For some folks, it was outright disdain, but for a lot of people it was just . . . .this weird indifference. . .almost like we were invisible. Something about that always hurt more.

No. It wasn't everyone at Vanderbilt just like it isn't everyone at Emory. But it's more prevalent than it should be. Yeah. It's hard to explain unless you've experienced it.

Anyways, Pavan from Morehouse and Dan from Emory became fast friends while working in the Grady intern trenches together and became like brothers. It's kind of like finding out you lived around the corner from someone who becomes super important to you years later. And you know? Something about that friendship and what it represents warms my heart. It just does.

(Dan actually wasn't one of my twenty-four, but I adopted him this year so he was welcomed to our dinner table.)

#4 ~ Thoughtful gestures.

This is Pavan K. (again) and Marae S. They were elected by their classmates to serve as class representatives and helped to keep my finger on the pulse of what was going on with the class. Pavan has a personality that can only be described as magnetic. Marae has this way of immediately making you feel important just by the way she looks at you and listens to you when you talk.

They presented us with the kindest cards and gifts--which we totally didn't expect. When I got home, opened the card and read all of the words from them, it made me cry. The best thing about these two class representatives is this: They truly represented all that was good about this year's twenty-four.


#3 ~ Hands on deck.

This is Tanya C. She's our residency program coordinator for our residency program and an absolute godsend. For the first few years that I was in this position, I didn't have consistent administrative support. Through the efforts of some wonderful people like Melanie L. and a few others, Tanya joined our team in late 2008. I had no idea what I'd been missing until I got her.

She rocks.


#2 ~ Being Trusted.

This is Dairon G. (pictured here with Deb B.) I adored working with him, partly because he's smart and fun but more because he's thoughtful and honest. Dairon came to Deb and I with some career direction questions and found himself asking hard questions. I feel so honored that he trusted us with those concerns. Everything worked out better than he ever could have imagined, and we were fortunate to have been there to listen.

This sweet girl is Allyson S. She is one of the strongest people I have ever met in my life, and the kind of person that makes a parent so proud they could explode. This year, she trusted me so much that the moment I tried to hand her the certificate of completion I was immediately brought to tears. Just like the ones I'm blinking away as I type this.

Whew.


#1 ~ I'm O.K., You're O.K.

I don't always drag the B.H.E. (best husband evaaaah) with me to all my work functions. Our rule is that he simply asks me, "Is this one you want me to attend?" and he simply follows suit with whatever I answer. I realize that I have quite a few commitments and that, no, we aren't in political office or anything. Harry's time is valuable, too, and I try hard to respect that.

Yesterday, I answered "Yes" when he asked me that question. I wanted my interns to see my soft place to land and the rock that I cling to when my waters get troubled. Because even when you are an attending physician and a program director and even a full professor like Deb, your waters still get troubled sometimes and your bike without training wheels still gets wobbly.

So as I read those kind words scribbled by each of the twenty-four into that card, I thought about how easy it is to go to work and parent your kids and live your life when you're okay with you. And though I have my wobbly days, I pretty much am okay with me on most days. On the days when I question who I am, it's Harry who grabs the back of my bike, tightens the chinstrap on my helmet, and tells me to "Go get 'em." And that makes me ride even harder.

Yeah. It was a great day and a great year with our interns. And just think. . . . on Tuesday, I get to do it all over again with twenty-four more.

***
Oh happy day.