UMass Magazine Online

Spring 2006

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Prerequisite

Medical Practice
Some UMass Amherst students can't get enough of the emergency room

–Faye S. Wolfe




	Fidela Blank, who supervises UMass Amherst premeds at Baystate Medical Center’s emergency department, shows current volunteer Adam Curtis ’07 how to use a calibration syringe. They’re standing at one of the “racetracks” in the main room of the emergency department.

IT'S A TYPICAL WEEKDAY MORNING at Baystate Medical Center’s www.baystatehealth.com Emergency Department (ED). No gunshot wounds, no car-crash victims—yet. Just the usual stuff: a retiree with chest pains, a 72-year-old woman who’s short of breath, a guy who fell off a ladder at a construction site. In the suite used for psych cases, an agitated woman in a semicircle of nurses, doctors, cops, and security guards refuses an injection.

During her research internship in Baystate’s ED the winter of 2005, UMass Amherst student Shannon Demas ’08 saw such scenes every day: “I love ER; this was like living it.”

Demas also learned how real life differs from TV dramas: “It wasn’t as though there was a huge tragedy every day, and often it’s the pernicious diseases—the flu or heart trouble—not catastrophes, that are the major problems.”

Student volunteers like Demas, who are planning to go on to medical school, are regularly plunged into the thick of things at local hospitals, witnessing up close how doctors and nurses heal, how patients cope, how wounds get staunched—and less glamorous tasks, such as how blankets get warmed. UMass Amherst doesn’t have a premed program per se but offers the complement of undergraduate science and math courses generally required for admission to medical school. Biology professors Brian and Kathleen O’Connor, acting as unofficial advisers to students interested in medicine, steer them toward volunteer work like Baystate’s Research Internship Program and the ED volunteer program at Cooley Dickinson Hospital (CDH) in Northampton www.cooley-dickinson.org/ for several reasons—including the fact that most medical schools expect applicants to have it. (Students who work hard in these programs are also likely to get letters of recommendation for med school.)

Fidela “Del” Blank ’91G, research coordinator for Baystate’s department of emergency medicine, manages the interns. “They’re bright, motivated, and don’t need a lot of supervision; they catch on right away. Eventually they learn how to read charts, extrapolate data from studies. They’re exposed to medical procedures…[and] they see all kinds of people—people in distress. It’s partly about learning how to deal with people, how to comfort people, how to introduce oneself, explain things, get feedback. The shy ones come out of their shell when they have to help someone. They learn a lot about communicating with people in pain.”

Last summer, Rachel Willis ’06 learned all those things, fast. “You find out in the first couple of weeks: Can you hack it or not? Somebody screaming, prisoners being escorted in by guards. One of the most important lessons I learned from watching the staff is not to be afraid. You have to be the stable one.”

Willis worked on a study investigating factors that affect the accuracy of EKGs and another related to pulmonary emboli. “Some mornings I’d get there early, and I couldn’t wait in the car,” she recalls. “I loved the atmosphere, everything going on at once…no way you could be bored.”

“We’ve always had young volunteers—candy-stripers,” says Dr. Raymond Conway, director of emergency services at Cooley Dickinson, who initiated and runs its emergency department volunteer program, “but not in the ED. You need a certain kind of maturity for that.” The college students in the volunteer program, many of them from UMass Amherst, are screened carefully and trained. Conway also tells them, “Eat before you come.” Those with empty stomachs are more likely to keel over watching someone being stitched up.
Putting blankets in the blanket warmer, filing records, bringing a patient to another part of the hospital—these are the kind of useful, if mundane, tasks the students do. With patients’ permission, they also observe doctors examining patients and performing procedures. “UMass students get to see appendicitis, broken arms, rashes, heart attacks…” says Conway, “and to interact with just about every department.”

Both of his parents are doctors, so medicine is hardly exotic to Ali Irshad ’06. Still, his stint in the CDH emergency department a year ago gave him a new perspective.

“Part of what I liked was seeing how a hospital environment works,” says Irshad. “It might just be cuts and bruises, cleaning up after the doctor, but I appreciated what I was getting. It’s not just the medical experience you’re exposed to, but the protocols and procedures, the schema, of an American suburban hospital. Even in those times when it was very slow, and I did a lot of standing around, I was learning.”

At Baystate, Demas also learned to read the subtext of what was before her eyes. “The ED can be seen as chaotic,” she notes, “but after a while, you can see the underlying organization in what’s going on, the teamwork, the constant exchange of information among the members of the team about the patient.”

“It’s a win–win situation,” says Del Blank of the ED programs. “I’ve heard from students later that they didn’t realize how much they knew till they got into medical school.”

Irshad put what he knew to the test the summer after his CDH stint. On a trek through Nepal he volunteered in a clinic in a Tibetan refugee camp, as well as one in Gilgit, in the Northern Areas of Pakistan. “The [Gilgit] clinic saw a lot of victims of civil strife, people with bullets in their chests, severed limbs as the result of a bomb going off.” Looking at his photographs of the primitive conditions—in one picture, a cat sits under an examining table—his friends can hardly believe what they’re seeing.

Arriving at UMass Amherst having taken 14 advanced-placement courses in high school, Irshad will graduate in February, after two and a half years of college. This fall, he is working in biology professor Rolf Karlstrom’s lab; ultimately he may specialize in neurology or neurosurgery.

After Laurent Benedetti ’03 volunteered at CDH, he took an EMT course on campus, worked—like Irshad—in clinics in Nepal, and has just completed his first year at UMass Medical School. Of his CDH summer, the former English major says, “I was able to observe a medical environment that had a little bit of everything. The unpredictability appealed to me.”

Benedetti is considering specializing in disaster-relief medicine. “Emergency medicine has stuck with me. There’s not the relationship-building that you experience as an internist or a family practitioner, but you’re helping someone when they really need help.”

Of course, not all the UMass Amherst volunteers end up going into medicine. For some, the trial run convinces them to pursue a different career—a valuable realization in itself. But both Blank and Conway hear from many who are now doctors, dentists, nurses, or physician’s assistants. Says Blank, “I even get invited to their weddings.”

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