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AN ARTS & LITERARY MAGAZINE GEISINGER COMMONWEALTH SCHOOL OF MEDICINE VOLUME 4 | 2017

about the cover art & artist Kimberly Watanabe is a student in the master of biomedical science program at Geisinger Commonwealth School of Medicine. Originally from Newport Beach, California, she graduated from the University of Wisconsin – Madison with a bachelor’s degree in biology and certificate in studio art in 2016. Since a young age, she has been inspired by the ability of art to not only evoke emotion and thought, but to affect others in healing and comforting ways. The Black Diamonds 2017 cover painting is an abstract using acrylic and paper mache on poster board to depict multiple hands among two central arms reaching in to hold coal in their palms.

Black Diamonds is an arts and literary magazine of Geisinger Commonwealth School of Medicine. All content is the property of each respective author/artist. No part of this magazine may be reproduced without the permission of the author/artist of each submission.


F

or thousands of people living in northeastern Pennsylvania (NEPA) during the 19th and 20th centuries, coal was precious. It was the black diamond they mined and the substance that supported their

lives. Formed in ancient times under the massive pressure of the sediment above it, coal became the foundation of an entire economy in NEPA. That economy has all but vanished from this part of the country but today, NEPA is witnessing the formation of a new and valuable resource. Created under the pressure of a great need for future physicians, Geisinger Commonwealth School of Medicine now exists. New students are coming in to NEPA every year to begin the process of being transformed into physicians through the steady, constant pressures of medical school. And like the rich veins of coal that extended through the region, these future physicians are now stretched across 17 counties in northeastern and north central Pennsylvania. For many of these students and their teachers, the arts are an important part of life outside of medicine. Our hope is that this journal can serve as a showcase for their expression and be an inspiration to those who read it.

Zachary Wolfe, MD md Class of 2015

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ta b l e of c on t e n ts The importance of story for the physician 08 Meet the Layout Designer 12 The tracks we follow 14 When summer yawns and autumn stirs15 Diwali 16 a day in the life: mbs18 first friday 20 Heartbreak // teacher // edward 22 pura vida // innocence // la 23 Italy 24 Health benefits of fasting 26 a day in the life: mbs-D 28 Like jets fly 30 Community roots 31 Icarus 32 tony 34 trying 36 Omw 37 a day in the life: M1 38 Cooking with ken 40 flying over the alps 42 04

43 Building healthy communities 45 contents of a cockroach // did you go 46 reflection 47 it takes a community 48 a day in the life: m2 50 always take flight 51 eggs benedict 52 Weeding 53 study views 54 A day in the life: m3 56 rescuing a kitten 57 community building through quilting 58 med related 59 serenity 60 work-life balance for medical students 62 a time for reflection 64 a day in the life: m4 66 a patient thank you 68 a scranton oasis 69 a quandry trail 70 long way home

Geisinger Commonwealth School of Medicine is committed to non-discrimination in all employment and educational opportunities.


t ho u g h ts on our n e w i d e n t i t y OLApeju simoyan, md, mph, bds, faafp associate professor of family medicine& epidemiology

steven j scheinman, md president & dean

A

W

little over a century ago, a widow named Abigail Geisinger was one of the few people in Danville who owned a car. The luxury of a car and driver, together with her generosity and kindness of heart, resulted in frequent requests for her car to be used as an ambulance to transfer patients to the nearest hospital, which was in Bloomsburg, almost 10 miles away. Abigail eventually decided that Danville needed its own hospital. By this time, the value of the modest estate left by her husband had increased significantly and few people were aware of the extent of her wealth. She decided to finance the building of a hospital for her town and its surroundings, with one request, that it should be “the best ever built.”1 Since the first patient was admitted on September 12, 1915, the hospital has grown to become the Geisinger Health System, one of the nation’s largest health service organizations, with 12 hospital campuses and approximately 30,000 employees across northeastern and central Pennsylvania and southern New Jersey. In a separate series of developments, a group of professionals began to meet in 2004 to explore the

possibility of establishing a medical school in order to address the impending physician shortage in northeastern Pennsylvania. Four years later, The Commonwealth Medical College was established, with the first students enrolling the following year (2009). On January 1, 2017, The Commonwealth Medical College became a part of the Geisinger family and was renamed Geisinger Commonwealth School of Medicine. It should come as no surprise that two institutions, each born out of a response to a community need, have now become one. It is hard to imagine that Abigail could have anticipated the growth and expansion that her hospital has experienced over the last century, not to mention that it would one day have its own medical school. As we look to our past, we anticipate the future with hope and the expectation that this new relationship will impact our community and society at large in ways that our founders could not have imagined. And yes, we do “think Abigail would be pleased.”

hile the integration will bring with it many advantages – enhanced research and residency opportunities and other scientific and technological perks – one often-overlooked benefit is how the integration will help ground physicians and scientists of the future in a patient-centered environment where medical care powered by respect for each individual patient’s dignity is guaranteed. In 2015, Geisinger Health System President and CEO David T. Feinberg, MD, MBA, unveiled the health system’s latest and perhaps boldest innovation, “Proven Experience,” a program that offers refunds to patients whose expectations weren’t met based on kindness and compassion. There couldn’t be a more perfect fit for our medical college, which was founded to offer a “patient-centered, inter-professional” curriculum. Those words are in our mission statement and they align perfectly with Geisinger’s philosophy. As the medical college evolves into its new identity as the Geisinger Commonwealth School of Medicine, it is embracing an even greater emphasis on the humanistic aspects – the art, if you will – of medicine.

1 - Foss HL. The Story of the George F. Geisinger Memorial Hospital, 1961.

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from the editor COMMITTEE

OLApeju simoyan, md, mph, bds, faafp associate professor of family medicine & epidemiology

“F

or the things that can’t be counted, you will need story.” Those were the

Olapeju Simoyan, MD, MPH, BDS, FAAFP - Editor in chief Melissa L Sanko, MS - Managing Editor Christopher Sullivan, MPH - Layout Designer Heather M Davis, MFA - Production Manager Alysha Nicholls, mshe - Staff Editorial Assistant Debra C Tierney - Staff Editorial Assistant Amelia Mackarey - Student Editorial Assistant Kristina Lake Borham - Student Editorial Assistant Kimberly Watanabe - Student Editorial Assistant

closing words of Abraham Verghese, renowned physician-author, in a TED

talk during which he addressed the importance of “story” in healthcare. While *

numbers and statistics play an important role in the delivery of healthcare, the quantitative information they provide has its limitations. The importance of story to practicing physicians is further explored by Harmar Brereton, MD, a radiation oncologist, in a special feature article in this issue of Black Diamonds. Using examples from literature and his own experience, Dr. Brereton reminds us that listening to our patients’ stories is essential for effective patient care, and can shed light on situations that we may have otherwise missed. Our patients are people with life stories and experiences beyond the medical conditions for which they seek treatment. A biopsychosocial approach to patient care considers the social, cultural and environmental factors that influence our patients’ health and wellbeing. This is

Art and science inform each other. From the earliest

further explored by Margrit Shoemaker, MD, in her essay “It takes a community,” in

drawings of neurons by Santiago Ramón y Cajal to Rosalind

which she writes about the importance of community engagement and how this

Franklin’s X-ray diffraction images giving us the first glimpse

has been incorporated into the curriculum for our medical students.

of DNA, creative expression has been an important means of disseminating scientific knowledge. These pioneering endeavors deepen our knowledge and enhance our lives. We need your support to continue the pursuit of beauty and

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Our editorial team decided on the theme of “balance” for this issue, recognizing the challenge many of us face in achieving the right balance between the numerous

truth. Please consider a charitable gift to fund the annual

facets of our lives. While the essays that focus on medical students contain lessons

publication of Black Diamonds.

that are relevant for all of us, we have included an article on a surgeon who found


a way to reignite his passion for music. We also address the importance of mental and physical wellbeing and the mind – body – spirit connections. Spirituality and various religious practices are also explored in essays on the health benefits of fasting and the Indian festival of lights, known as Diwali. Back by popular demand, the “Day in the Life” series showcases “typical” days in the lives of our students, and this year we have included essays from students in the masters’ degree programs, too! Whether you are attracted by the poetry, prose, artwork or photography – or you are just curious about this relatively new medical school in Pennsylvania that now has a new name, we welcome you to enjoy this issue of Black Diamonds. It is both humbling and encouraging to be at the cutting edge of medical education and health care in our region, even as we acknowledge that although we may not always cure, we can help our patients and communities heal, a process that begins with listening to their stories. Since story telling is a two way street, we offer yet another issue of Black Diamonds as “our own story” - a gift to our community - and trust that the essays, poetry and artwork contained therein will be a source of inspiration for all our readers. *Verghese, Abraham. The Great Lie that Tells the Truth. TEDx Stanford. http://shc.stanford.edu/file/34876 (accessed February 6, 2017).

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the importance of story for the physician harmar d brereton, md clinical professor of medicine

S

tory is history! It is a means through which

essential to my understanding of that person.

we see others and ourselves. Story involves

both listening and telling and we will consider

Consider this narrative: “This week my husband

four aspects of story that are important for the

left me when he found out I had breast cancer; I

practicing physician: passive listening, active

have two children and no job.”

listening, storytelling and story as metaphor. Finally, we will consider the importance of great

This woman’s personal life becomes the priority

patient progressed in a totally unexpected, but

literature, specifically epic and tragedy, and how

rather than the cancer for which she was

essential manner.

these art forms inform our listening and telling

referred! This fact may have been lost with a

of story.

question such as, “So when did you find out you

It is important for a physician to ask, “What does

PERSONAL STORY

had cancer?” Although I am not able to solve her

this patient need from me?” rather than “What can

personal problem, I now have an opportunity to

I do to this new patient?” These are questions

If the duty of a physician is to relieve suffering,

help her in a completely unexpected way.

that will elicit different responses. Being open to patient need may take the physician out of

then listening to someone tell their story is the

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beginning of that service. As I begin taking my

Does she have a safe place to stay?

Who is

a familiar and comfortable role while offering

patient’s history, I may ask them to tell me their

watching the children? Does she have the

an opportunity for greater service.

story, and then wait. Once the story starts, I may

necessary resources, including family support and

listening to open-ended questions can be critical

hear something completely unexpected, but

social services? The first consultation with this

for our patients!

Passive


Another patient, also with breast cancer, came

she died, she gave me a copy of her narrative

continue in their efforts. Story can put suffering

to see me, accompanied by her husband.

and told me that the process of writing had

into a context that can be sustaining and

Right after I introduced myself, her husband

given her some peace and a sense of closure with

even inspiring.

approached me, stating with a hint of menace in

regard

his voice that his wife was the most important

her husband.

to

the

abusive

relationship

with Story as metaphor may also help to explain the

person to him and he wanted her better! He was

truth of something profound and inaccessible

so aggressive that for a moment I thought he

Although my initial responsibility had been the

through other means. For example, when asked

was going to attack me! Fortunately, he didn’t,

care of her cancer, my greatest service to her

why I love the medical profession, I tell a story of

and I invited him to sit in on our initial interview

may have been the trusting relationship we

a six-year-old boy, near death with an incurable

as his wife told me about her breast cancer. She

developed, which led to the writing of her tragic

form of lymphoma, who was referred to me at

appeared frightened, depressed and withdrawn.

story, a process that eventually brought her

the National Cancer Institute (NCI). At our first

When it was time for the physical examination,

some relief. Careful, active, directed listening

meeting, the nurses told me his parents had

I asked her husband to step out to the waiting

can be critical for our patients!

promised to get him some French fries so he

room (something I rarely did) so that I could

wouldn’t cry, but they had actually gone home.

speak privately with her. As I suspected, in her

Storytelling can also be helpful for our patients.

The boy was sitting at the end of his bed with his

husband’s absence, she told a different story.

For

patient’s

abdomen so distended with ascites (fluid) that

Initially, she had been reluctant to share her fear

spouse’s suffering with a statement like, “I know

he could not breathe lying down. I had never had

of her husband, concerned about the possible

how difficult it has been for you. I admire what you

a patient with this disease and the six previous

repercussions, should he find out. I reassured

are doing for your husband as he is going through

patients seen at the NCI had all died quickly,

her of the confidentiality of our relationship and

his treatment. You are playing a very important role

even with treatment. I told my new patient that

from that moment gained her trust.

in his recovery.”

his parents had asked me to take care of him

example,

acknowledging

a

for them but first to get him some French fries Active participation and questioning on my

It can be easy to overlook the fact that the

because they had to go home. While my own six-

part helped her tell a story she had previously

families of our patients also suffer. A simple

year-old son was waiting for me to come home

kept secret. With some encouragement, she

acknowledgement with encouragement and

for dinner, I patiently listened to my patient as he

decided to journal her story as her cancer (which

formatting of their story in a manner that

breathlessly told his story while eating the fries I

ultimately led to her death) progressed. Before

shows appreciation can encourage them to

got him from the cafeteria.

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All previous patients with this form of lymphoma

physical signs of his cancer! He was transferred

had died from tumor lysis syndrome, a condition

back to the NIH where his care was assumed by

in which the cancer disintegrates so quickly with

the pediatricians.

treatment it leads to to electrolyte imbalances,

When we encounter the great epics of Homer, Virgil, Dante or George Lucas we understand

including abnormally high potassium levels,

The lesson here is that wonderful science and

that epic story can also apply personally to

which can lead to cardiac arrest.

wonderful people we encounter in our profession

the reader! We can insert ourselves into the

can help us manage the ambiguity, uncertainty

story, empathize with the heroes and learn

My wife, a dialysis nurse, had told me about her

and chaos in our profession, sometimes to an

from their experiences where the hero is often

experiences managing high potassium levels in

extraordinary conclusion! The story of my six-

transformed and wiser. I am especially aware of

her patients with hemodialysis and we decided

year-old patient is metaphoric for my love of the

what Homer can teach us 2800 years after his

to do the same for my patient. The problem

profession. None of the excuses possible (“We

works were recorded, offering profound insights

was that there was no dialysis service at the

never did this before”, “Will the insurance company

into Odysseus’ maturation as he returns home

National Institutes of Health (NIH) at that time.

cover this?”, “What do the regulatory agencies and

from the Trojan war.

I spoke with the head of the dialysis unit at

accrediting bodies say”, “Has this been reviewed by

Georgetown University, who agreed to let me

the ethics committee?”) prevented those involved

In the 20th century, Carl Jung articulated

transfer my patient to their hospital, indicating

from doing the right thing. I have not seen any

the

that although they had never placed a dialysis

of those involved in the care of this patient for

individuation (development) by the influence of

shunt in such a young patient, they were willing

46 years, but I have never forgotten them.

the feminine after midlife that he felt allowed

*

to try. Then I asked that I be allowed to care for

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epic story and tragic plays.

process

of

masculine

psychological

for the completion of a man’s psyche (soul).

my patient at that hospital. The nurses trained

story from literature

me on the use of the dialysis machine and I

“The critic Kenneth Burke once suggested that

spent the next several days with my patient.

literary works could serve as ‘equipment for

With peritoneal and Foley catheters, along with

living’ by revealing familiar narrative patterns

The idea of “epic” can also apply to everyone,

an IV and his dialysis shunt, we monitored his

that would make sense of new and chaotic

including doctors and patients. As we consider

progress on a minute-to-minute basis while he

situations.”

This is especially helpful for

our own story, we remember people, ideas,

was receiving chemotherapy. Two weeks later,

physicians who will often encounter the new

events and transformations that, when put

my patient’s ascites was gone, along with all

and chaotic. Let us consider authors of both

into context, bring insight and balance as we

1

Homer offers us the same truth metaphorically through story!


confront the good and bad, successes and

through his suffering.

good medical practice. We start by taking a

failures. These personal “epics” don’t have to be long, only carefully considered!

history, His story and Her story. Some

of

my

patients

have

a

genetic

predisposition to cancer. Despite this, they have As we become proficient in this “listening to and

been able to work through this catastrophe in

telling of” story, we will find that for our patients,

a manner that leaves them transformed, even

1.) War and the Iliad: Weil and Bespaloff, pp vii. New York

recapitulating the facts from their histories into

grateful for the experience! It is helpful for the

Review of Books, 2005

narratives that acknowledge their suffering and

doctor to know that this can happen and to look

courage can be very therapeutic.

for ways to honor this transformation.

*The National Cancer Institute is part of the National Institutes of Health

The great playwrights tell us story in a different

Hamlet certainly suffers with his father’s

way.

Oedipus, Lear and Hamlet are very

murder, but also because he cannot make

The author would like to thank

different characters. All suffer, but in different

decisions (I simplify this on purpose)! Do we

Stephen Schoenbaum, MD, MPH for his invaluable

ways.

Understanding these similarities and

know patients like this? And King Lear suffers

editorial comment

differences can help the physician understand

because of his assumptions about his power

the dilemma of a particular patient and the

and his relationships with his family.

nuances behind different kinds of suffering and

know patients like this?

Do we

Harmar Brereton, MD is a medical and radiation oncologist and clinical professor of medicine at Geisinger Commonwealth School of Medicine.

respond in a manner appropriate to the privilege of the profession. For example, Oedipus suffers

Homer, Sophocles and Shakespeare have much

from a dilemma preordained by the Fates. He

to teach the student of medicine because they

even knows of the prophesy that he will kill his

know human nature and human story which they

father and marry his mother and tries to avoid

tell in such artful ways, offering the opportunity

doing this by fleeing Thebes and the people he

to learn beyond our personal experience.

believes are his parents. Alas, the Fates have

Understanding the characters of great literature

him predestined!

But the final resolution of

with examples from epic and tragedy, provides

his suffering as he deals with the Furies that

insight into the human condition. This helps us

beset him suggests a profound transformation

to listen to and tell stories, the cornerstone of

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meet the layout designer melissa L sanko, ms Standardized patient program assistant

W

hile Christopher Sullivan’s path to medical school was unique, what drew him to Geisinger Commonwealth School of Medicine

resonates with many of his peers. He states, “Everyone I met while interviewing really wanted to be a part of the school!” Two years into his medical student experience, Sullivan has made his mark as an active member of many clubs and organizations. Serving as layout designer for Black Diamonds is a unique role for a medical student and consumes many hours of Sullivan’s free time… but at some point in his past, he actually got paid for designing the layout of a magazine! Sullivan earned a bachelor of arts degree in advertising with a concentration in art direction from Temple University. After graduation, he worked at several communication agencies and did freelance work, eventually working for Philly Current Magazine. He later enrolled in post baccalaureate studies in the sciences at Temple University and continued to work while taking classes. He then enrolled in Temple University’s master of public health program with a concentration in

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health policy and management. Recognizing that he was a different type

assistant in anatomy during the summer between his first and second

of student, he asked himself, “What do I bring to the table?” His classmates

years of medical school. He loved being in the gross anatomy lab, and

were interested in his past experiences in advertising, and encouraged

would take his time during dissection, recognizing this as a form of art.

him to use his skills in ways that were unique to him. His public health

As a teaching assistant, he collaborated with classmates to start a video

projects included developing software apps for a car-seat safety program

lecture series for first-year medical students.

for Children’s Hospital of Philadelphia and a cancer clinical trial research program at Fox Chase Cancer Center. Sullivan also finds his collection of

Sullivan knows the importance of balancing the different aspects of

1950s public health campaigns to be an interesting blend of healthcare

his life in addition to his studies and many extra-curricular activities at

and communication efforts. His philosophy has always been, “You

Geisinger Commonwealth. He enjoys being outside with the beautiful

only have a few precious seconds to get a message across and effective

landscape of Pennsylvania, and he credits his ability to balance all

communication is key.” That is how his degree in advertising helps him to

aspects of his life to having a stable partner. Sullivan’s fiancée, Jess, is

be more effective in increasing public health awareness.

a practicing veterinarian. He is thankful that she understands the rigor it takes to get through professional school, adding, “There must be a yin

Although he enjoyed studying public health, Sullivan knew that his training

to every yang.”

was far from over and he decided to attend medical school. As a medical student, Sullivan has been able to apply his skills to the benefit of his classmates. His favorite subject is anatomy and he served as a teaching

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the tracks we follow christian bohan md class of 2019 14


when summer yawns and autumn stirs stephen gan md class of 2018

When summer yawns and autumn stirs And earth is wreath’d in smoky plaid, When noon and dusk, their border blurs My soul regales in tidings glad. But winter’s vanguard ironclad Besieges fast bucolic glee And dappled hues in myriad In grayscale rendered miserably. Fall’s sibilantics swiftly flee And winter’s doldrums follow suit So with a forecast eye, decree: Regard their weal and woe acute. So in my summer counting falls, I traipse assuaged toward winter’s halls.

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Diwali

Shailly Gaur, Jena Patel, Jaanki Dave, Tripti Soni, & Namita Bhopal md class of 2019

D

iwali, also known as the Festival of Lights, is a national holiday in India regardless of faith. Hindus, Jains, Buddhists and Sikhs all

interpret the Diwali story based upon where they live and their own personal beliefs. North Indians celebrate the story of King Rama’s return to Ayodhya after he defeated Ravana. As this occurs on a new moon night, villagers light the way with rows of clay lamps. South Indians celebrate it as the day that Lord Krishna defeated the demon Narakasura. West Indians mark the day that Lord Vishnu, the Preserver (one of the main gods of the Hindu trinity) sent the demon King Bali to rule the netherworld. In Jainism, it marks the nirvana or spiritual awakening of Lord Mahavira on October 15, 527 B.C. In Sikhism, it marks the day that Guru Hargobind Ji, the Sixth Sikh Guru, was freed from imprisonment. In all interpretations, one common thread rings true — the festival marks the victory of good over evil!

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Diwali originated as a harvest festival that marked the last harvest of the year before winter. India was an agricultural society where people would seek the divine blessing of Lakshmi, the goddess of wealth, as they closed their accounting books and prayed for success at the outset of a new financial year. Today this practice extends to businesses all over the Indian subcontinent, which mark the day after Diwali as the first day of the new financial year. Indians celebrate with family gatherings, glittering clay lamps, festive fireworks, strings of electric lights, bonfires, flowers, sharing of sweets and worship to Lakshmi. Some believe that Lakshmi wanders the Earth looking for homes where she will be welcomed. People open their doors and windows and light lamps to invite Lakshmi in. Diwali is often celebrated over a five-day period. On the first day, people consider it auspicious to clean the home and shop for gold or kitchen utensils. On the second day, people decorate their homes with clay lamps and create design patterns called rangoli on the floor using colored powders or sand. The third day is the main day of the festival when families gather together for Lakshmi puja, a prayer to Goddess Lakshmi followed by feasts and firework festivities. The fourth day is the first day of the new year when friends and relatives visit with gifts and best wishes. On the last day of

our culture. Our cultural chair, Jena Patel, had the idea of making rangolis

Diwali, brothers visit their sisters who welcome them with love.

in order for everyone to participate! Rangolis are a form of traditional chalk art that many Indians draw in their courtyards during the festival

As a new organization here at Geisinger Commonwealth School of

season. We used dyed rice to get a similar effect. We hope we were able

Medicine, the South Asian Society wanted to bring our celebration of

to bring a little light into the lives of Geisinger Commonwealth students.

Diwali to students here in order for those interested to learn more about

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a day in the life

Jessica bondy mbs-Scranton class of 2017 [8a] Alarm goes off. Snooze. [805a] Alarm goes off. Snooze. [810a] Alarm goes off. Snooze. *This process repeats itself for probably 20 more minutes.* [830a] I finally stop the snooze cycle. The first thing on my brain – “When is the next time I can sleep again?” The second thing – “Coffee.” I act like I’m sleep deprived (and maybe I am a little), but for the most part, I’m not. I generally try to get between seven and eight hours of sleep a night. I’ve figured out over time that that’s how much my body needs for minimal functioning, otherwise I get cranky. So overall, it’s better for all of humanity if I get the sleep my body needs. [930a] By this time of the day, I’ve generally woken myself up, eaten breakfast, and have started getting my day underway. If I don’t have a meeting scheduled at school, I’ll run an errand or stay at home and study before class. Since the master of biomedical sciences (MBS) program is pretty intense, I’m likely to be found preparing for the next upcoming exam or reviewing the previous day’s material.

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[1030a] Check Instagram.

about or eating food...

[1035a] Send out some reply snaps on Snapchat.

[6p] Yoga. Geisinger Commonwealth offers a free yoga class every Monday night. I’m still somewhat of a “newbie” to yoga class, but I have a

[1040a] Reply to text messages. (Miss you too, Mom!!)

feeling I’ll end up being a regular before we know it. I mean, what’s more relaxing than Shavasana, amiright? (I’m a Shavasana pro, by the way).

[12p] Lunch!! If I’m not currently eating food, then I’m more than likely thinking about when and what my next meal is going to be. I’m a foodie

[730p] You guessed it, dinner time. Cooking is one of my favorite things

loud and proud! Most days though, I meal prep. It saves time in the long

to do, especially trying out new recipes. Right now I’m on a big crockpot

run and helps me to stay focused on eating healthy. If I’m going to be a

kick, which is awesome because as soon as I get home from class in the

doctor one day, better start practicing what I’ll be preaching!

evenings, dinner is already ready. (If you have any favorite soup recipes, please send them my way. Thanks in advance!)

[115p] *Walk to school.* Living in downtown Scranton definitely has its perks. I’m roughly a 10-minute walk from campus, so when the weather

[8p] *Review the day’s material. Prepare outlines and flashcards galore.

is nice, I try to get in some extra steps. This is also a good opportunity for

Procrastinate a little by FaceTiming mom/my baby cousins/sister/boyfriend/

a little ‘me’ time as I plug in some tunes and try to not think about school

somebody (anybody), and frequently checking social media. Study some more.*

for a few minutes. [12a] Around this time I start winding down for the night. I try to make [130p] Time for class! As MBS students we have class from around

sure I do something each day that’s for me and not school related. So,

1:30 p.m. – 5 p.m. every day. Having classes in the afternoon is nice

if I haven’t already accomplished this by this point, I’ll take some time

because it allows me to break up my studying (with more learning – LOL,

to watch an episode of something on Netflix (obligatory mention of The

I know). But it’s nice to get to see my fellow classmates and to laugh

Office), turn on one of the Harry Potter movies or read a few chapters of

and joke around while we’re all in the same classroom together all day.

my book for book club.

Spending as much time together as we do, we form some pretty tight-knit friendships in the MBS program.

[1230a] *Zzzzzz* (I don’t snore, I promise).

[530p] *Reach around in lunch box for a snack.* I told you, always thinking

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first friday amelia mackarey md class of 2020

E

On October 7, 2016, Geisinger Commonwealth School of Medicine joined the exciting affair with pieces for its auction to benefit Black Ties for White Coats Gala 2016. The auction for the available art pieces opened on October 1, continued through First Friday, and concluded at the Gala. Drawing from its community-based,

ach month, First Friday is a lively and vibrant

patient-centered mission, Geisinger Commonwealth

community event that highlights the beauty,

accepted works from talented and passionate artists

culture and talent that is so effortlessly evident

from the region or with ties to the area. First Friday

in the greater Scranton area. The event features

provided the perfect backdrop to display their beautiful

artwork from gifted artists, showcases beautiful

pieces. Excited about the evening, appreciative art

venues provided by local shops and restaurants, and

lovers flocked to the Lackawanna County Government

offers delicious food and beverages to complement

Center at The Globe at 123 Wyoming Avenue to enjoy

the evening’s entertainment.

artwork, jewelry, snacks and music. Artwork by Hunt

artwork at the First Friday event. Mr. Chickillo’s works

Slonem, Christopher Ries, Bill Chickillo, Sue Hand,

highlight American landscapes with fluid strokes

Thomas Wise, Austin Burke, Doris Cresko, Amanda

and intense lighting. His focus on local settings

Frieder, Milton Glaser, Debra McGinnis, Rebecca

was particularly pleasing to appreciative viewers.

Mitchell, Marie Mohila, Dr. Peju Simoyan, Darlene

The paintings displayed at the event, such as

Smith, Jill Swersie and others adorned the festively

“Blueberries from Archbald Mountain” and “Baylors

decorated space.

Lake,” illustrated his spontaneous and powerful understanding of the community’s scenery through

One of the token pieces of the evening was a painting

both watercolor and oil paint.

by Hunt Slonem. The painting, depicting a black bunny on a bright yellow backdrop, was proudly displayed at

Other types of art were also represented, such as

the event. Slonem, an internationally-renowned artist,

Christopher Ries’s “Lotus,” a breathtaking optic

is currently working to transform the historic Watres

crystal. When viewed from a certain angle, a lotus

Armory building into a studio and gallery.

shaped flower could be visualized inside the crystal. Mr. Ries, originally from central Ohio, relocated to

Artist Bill Chickillo also displayed some of his

20

Duryea in his quest to discover the best type of glass


sculpting material.

Scranton area, showcased the unique architecture

provided live music. Audience members enjoyed

and inviting landscapes of the area in a series of

their rendition of favorites such as “Wagon Wheel”

An original watercolor by Sue Hand, “The Komastu

paintings depicting local favorites, including the

by Darius Rucker, “Slide” by The GooGoo Dollz, “Stay

Dragon,” was another gem of the evening’s display.

beautiful landscape of Lake Ariel. Darlene Smith,

a Little Longer” by the Brothers Osborne, along with

Mrs. Hand, an avid painter who hails from Luzerne

of Kingston Township, featured a graceful painting,

many others.

County, has her artwork displayed in collections

“Koi.” Another local artist, Jill Swersie, who teaches

throughout the world.

painting to the senior citizens at the Dunmore Senior

Billy commented that it was nice to perform for such

Center, presented “Morning Light,” which showcased

a receptive audience, saying, “It was great to be a

her unique and whimsical style.

part of such a cool event.” Jake agreed and added,

Other artists with community ties were also displayed. Austin Burke, a proud product of the

“We both always enjoy taking a few hours off from A print by Milton Glaser, a celebrated graphic designer,

studying so that we can get out into the community

was also displayed at the event. Dr Gino Mori, a good

for events like art walks. It was also really awesome

friend of Mr. Glaser’s, commissioned the poster as

to see all that was donated from the sponsors.”

a gift to those who donate to the Dr. Gino and Jean Cavalieri Mori Endowed Scholarship. Donors receive

As guests enjoyed the music, refreshments, artwork,

a poster. The original poster hangs in the lobby at

other auction pieces and the lively company of

Geisinger Commonwealth, another symbol of the

visitors and artists, it was clear that the evening was

strong community ties between the northeast and

a success, both for Geisinger Commonwealth and

north central Pennsylvania area and the school.

the community it so proudly serves.

Dr. Peju Simoyan, a practicing physician and associate professor of family medicine and epidemiology at Geisinger Commonwealth School of Medicine, displayed a photo panel of different shots capturing monuments in London, Paris and Scranton. Two students from Geisinger Commonwealth’s second-year class, Jake Parrick and Billy Preston (both members of the band known as Paradocs),

21


heartbreak // teacher // edward vanessa velez md class of 2018

22


pura vida // innocence // la vanessa velez md class of 2018

23


After hopping on a plane to tour the countryside of Italy the day after my STEP 1 exam in June 2016, I visited Umbria, a province that is not visited by many tourists. Unfortunately, many of the places I toured were destroyed by an earthquake shortly after my trip. I am glad I was able to capture some of Umbria’s beauty prior to this devastating event.

italy ann-marie cittadino, MBS md class of 2018 24


25


HEALTH BENEFITS OF FASTING peter j patitsas, mba md class of 2017

T

religions of the world include some form of fasting in

which food is consumed freely, alternating 24-

their practices and while fasting is usually undertaken

hour periods of fasting, during which food intake is

for spiritual reasons, some studies have shown that

restricted or halted altogether. “Dietary restriction”

fasting may have physical health benefits.

limits the types of food that can be consumed, but not the volume or timing of meals.

The increasing prevalence of obesity across America has been accompanied by a rise in the prevalence

Given that there are more than one billion Muslims

hroughout history, people from different

of various diseases. According to the World Health

worldwide who participate in a 28-30 day period of

cultures have dealt with questions regarding

Organization, 20 percent of all cases of cancer are

fasting known as Ramadan each year, studies have

what it means to be human. While many in

associated with obesity. Many individuals suffering

been conducted to determine the impact of this

the modern day take the existence of “mind-body-

from psychiatric disorders such as depression,

type of fasting, (considered a variation of alternate-

soul” for granted, this has not always been the case.

anxiety and psychosis are also obese, defined

day fasting), on health. The fast requires observant

as having a body mass index (BMI) greater than

Muslims to avoid food or drink during daylight hours,

In healthcare, the interrelationship between mind

30. Although fasting is not recommended as an

and is broken with an evening meal (iftar) at sunset.

and body, in addition to the cultural and religious

approach to weight loss, this may be a secondary

Between sunset and sunrise, those observing the

beliefs of patients, often plays a significant role in

benefit with the associated improvements in

fast can consume as much food as they desire,

the diagnostic process and subsequent treatment

health status.

with no restrictions on the type of food. As a result,

i

ii

iii

plans. The ancient practice of fasting has its roots

there is great variability in the diet of Muslims who

in religion and historically, attempts were made to

While there are numerous approaches to fasting,

fast during the month of Ramadan. While evidence

improve health by utilizing the relationship between

studies have generally focused on caloric restriction,

for health benefits is mixediv, the positive aspects of

mind, body and soul. Today, adherents of various

alternate day fasting and dietary restriction.iv Typically,

sharing meals with family and friends should not

faiths around the world engage in fasting for various

these studies have involved taking blood samples,

be overlooked.

reasons. Many Christians fast when seeking answers

along with weight and blood pressure measurements

to specific prayers, abstaining from food and/or drink

before, during and after a fasting period.iv

Greece

is

geographically

part

of

the

Mediterranean and similar to many neighboring

in order to spend more time in prayer. Some churches

26

While

encourage their members to fast on a regular basis,

“Caloric restriction” does not limit the type of food that

countries in climate, the prevalence of coronary heart

e.g., weekly, as a form of spiritual discipline. Others

can be eaten, the only requirement being a reduction

disease and cancer are lower, with life expectancy

abstain from certain foods during Lent, the 40-

in the volume and the amount of food. “Alternate day

being higherv.

day period preceding Easter Sunday. Most major

fasting” involves 24-hour periods of “feast,” during

country’s

This may be related in part to that

historical

connection

with

Orthodox


Christianity, which promotes a form of fasting that

The potential benefits of fasting on physical health

i Bennett, M. (2007, December). Development of the concept of

requires participants to avoid all foods that are

deserve further study. In addition to understanding

mind. Retrieved November 22, 2016, from https://www.ncbi.

derived from meat and dairy for 180-200 days a year.

these health benefits, healthcare providers should be

nlm.nih.gov/pubmed/17999267

These practices tend to primarily lower body mass by

aware of the various religious and cultural practices

decreasing the amount of protein and fat in the diet.

of patients that may impact patient care, such as

ii World Health Organization Report Confirms Obesity Is a Cause

Total and low density lipoprotein (LDL) cholesterol

the need to modify treatment plans or medication

of Many Cancers. (2016, August 24). Retrieved December 01,

levels have been found to drop consistently during

schedules during periods of fasting.

2016,

these periods of fasting.

iv

Statistically significant

from

http://www.aicr.org/press/press-releases/2016/

who-report-confirms-obesity-cause-of-many-cancers.html

decreases in BMI were also observed. However,

The ancient philosopher Plutarch may indeed have

researchers found that fasting in the tradition of the

been ahead of his time when he advised: “Instead of

iii Simon, G. E., Korff, M. V., Saunders, K., Miglioretti, D. L., Crane,

Orthodox Church does not have a significant effect

using medicine, better fast today.” He was also quoted

P. K., Belle, G. V., & Kessler, R. C. (2006). Association Between

on lowering blood pressure.

as saying: “What we achieve inwardly will change outer

Obesity and Psychiatric Disorders in the US Adult Population.

reality.” Regardless of whether we agree with these

Archives of General Psychiatry, 63(7), 824. doi:10.1001/

The biblical “Daniel Fast,” as the name implies, is

statements literally, it is apparent that Plutarch

archpsyc.63.7.824

modeled after the fast observed by the Prophet Daniel,

understood something about the mind-body-soul

who, during the Babylonian captivity, consumed only

connection. Centuries later, these relationships are

iv Trepanowski, John F., and Richard J. Bloomer. “The Impact of

vegetables and water and refrained from alcohol.

still being explored and a deeper understanding

Religious Fasting on Human Health.” Nutrition Journal. BioMed

Given its straightforward parameters and short

on our part will likely impact the way we practice

Central, 22 Nov. 2010. Web. 12 July 2016. http://www.ncbi.nlm.

duration, this fast has been thoroughly studied.

medicine and ultimately, the health of our patients.

nih.gov/pmc/articles/PMC2995774/

iv

vi

One study followed subjects before, during and after a 21-day fast and found that both systolic and

v Simopoulos, A. P. (2001, November). The Mediterranean diets:

diastolic blood pressures dropped significantly.

What is so special about the diet of Greece? The scientific

Decreases were observed in total cholesterol and

evidence. Retrieved November 28, 2016, from https://www.ncbi.

LDL levels. Insulin and the inflammatory marker,

nlm.nih.gov/pubmed/11694649

C-reactive protein levels, were also reduced, and although not statistically significant, the authors

vi Sarri, K. “Does the Periodic Vegetarianism of Greek Orthodox

felt these findings were clinically relevant.iv Fasters

Christians Benefit Blood Pressure?” NCBI. Preventive Medicine,

also reported an improvement in mood and

19 Dec. 2006. Web. 12 July 2016. http://www-ncbi-nlm-nih-gov.

satisfaction after meals.

ezproxy.tcmc.edu/pubmed/17184829

iv

27


[5a] The false alarm — my first warning that in a half

a day in the life

Rainya Heath mbs-Doylestown class of 2017

hour I will have to get out of bed. [630a] “Girl, I know you’re not a morning person, but if you don’t get up right now you will be late for work, and then you will be unemployed, and then you can’t afford your favorite all-you-can-eat sushi spot. (Think about the spicy dragon roll!)” [650a] Shoot. [730a…okay…742a] I arrive at work and check on the way to my cubicle that I still beat my bosses to work. Score! I go through the morning ritual: pack lunch, thermos of Bigelow black tea, power on the laptop, and dive into the world of clinical research. By day, I am a clinical research associate: I monitor clinical trials remotely to make sure the pharmaceutical company that owns the new investigational drug (IND), the doctors administering the drug and the study team do not accidentally harm or violate the rights of the study participants. It is a job that is at once very cool, tedious, involved, annoying, innovative and rigid. I often simultaneously wonder if I am qualified to do this and why everyone seems to be asking me what to do, then I remember the message on the graduation cake I was presented with at the end

28


of my new hire training: “Fake it, ‘til you make it.” I often work up to 10

out that they’re discontinued. Who discontinues cookies? Luckily, there

hours a day, but today is Tuesday and I have class, so I’m out by 4 p.m.

are also Five Guys, Subway, Chipotle, Edible Arrangements (smoothies!), Rita’s, Panera, Starbucks, Dominos and a really good Pho place nearby so

[430p] By night I’m a Geisinger Commonwealth School of Medicine

I’m not too disappointed. One thing I have learned in my 23 years is that

master’s student. Hello, Baruch S. Blumberg Institute, Hepatitis B

you know you are exactly where you need to be in life, if when you look

Foundation and my classroom. The cool thing about taking classes in a

around you see all your favorite foods.

biotech center (besides feeling like a mad scientist when you walk down the halls) is that you get the coolest teachers to guest lecture. I mean, who

[830p] I hop into my car and listen to “Are We Smart Enough to Know How

better to teach you about virology than a doctorate that makes a living

Smart Animals Are?” by Frans de Waal on my way home.

figuring out how to fight them off and owns a sheep farm in Ireland. Our small class size (22) allows us to get to know our teachers in a way large

[9p] Ha, you thought my day was over. It’s time to work on term papers,

science lecture halls in undergrad never did. Sharing a “hello” with a Nobel

epidemiology homework sets, genetics case studies, and something else

Prize nominee or scientists with an investigational new drug application

I just know I am forgetting. Luckily a group chat with my classmates and

filed with the FDA is nothing to scoff at either.

funny Snapchat filters keep me motivated. Just kidding, I’m going to break to watch Charmed and regret it at 5 a.m. when I’m trying to finish my epi

[5p] At the graduate student council meeting, as community service co-

homework before work.

chair, I share updates on our Halloween Blood Drive. [530p] Genetics lecture with 116 slides. Well, our professor is feeling

[Postscript] This is not what a typical day for a student in the MBS-

mighty ambitious today.

Doylestown program is like, because we simply do not have a typical student. I greatly admire all my classmates who work full-time or part-time,

[6p] Slide 34.

who serve in the Armed Forces, who contribute to their community, and seek out opportunities to expand their minds outside of the classroom.

[615p] Slide 34… still on the same slide, 15 minutes later!

They are some of the smartest, kindest, funniest and most interesting 21 people I have ever met and thankfully we have a good class vibe, because

[730p] Slide 78. “Can we get a break?” I hop in my car and head down the

we’re only halfway there: two semesters down, two to go.

street to Dunkin’ Donuts for a warm chocolate chip cookie, only to find

29


like jets fly Christian bohan md class of 2019

Like jets fly, your life goes by. Leaving a wake, you cannot fake. What will I see, when you go by me? Is what you’re doing something worth viewing? For when you are gone, and life moves on, What you leave behind, will remind Of things you’ve done and carried on. So make a picture, that depicts your Life the way you want it told. For when you’re flying high, What will I see? But what you’ve done to change me.

30

an everyday shooting star christian bohan md class of 2019


T

he Geisinger Commonwealth School of Medicine garden club started in 2014 as a small plot of empty land on Gibson Street, and has grown into not only a relaxing oasis for

students, but also an integral part of the community’s food culture. This has been due in large part to the partnerships and support provided by the community and a group of dedicated students, faculty and staff. The wonderful donation in 2014 from the Kiwanis Club of Scranton allowed for the installation and expansion of the student-engineered rainwater catchment and automated watering system this past August. The filling of this system was only made possible through the cooperation of the garden’s neighbors, who offered us access to their hoses and gutters (and who graciously kept the club members well-fed with cherries during installation day). With seeds and plantings donated from other community gardens in Scranton, and with the nutrients made possible by the expanded watering system, the garden club enjoyed our largest harvest yet, and we were able to donate hundreds of zucchini, tomatoes, eggplants and peppers to the United Neighborhood Centers and our newest partner, the Community Intervention Center

make yourself at home erica townsend, mshe MD/MPH Program Coordinator

of Scranton. Working with these groups has allowed us to get needed and nutritious food to those in our community who need it the most, directly impacting the health of the Scranton area. This year was also significant for the addition of our “little free library,” curated by Allyson Urie, former web services librarian, with healthy cookbooks, and gardening guides to share and exchange, as well as our beautiful birdhouses built and donated by Maryann Miller.

community roots robert parajon md class of 2019

As this year’s cold weather progresses and the garden is closed up, we are all planning for another great spring harvest. We hope that you all can join in the bounty, alongside the community that has made it possible.

31


anthony A cernera, meD director of annual giving and alumni relations

O

ver the last 16 months, I have spent 316 minutes and 22

my year in the sky

seconds in freefall. I have fallen 651.6 miles, roughly the

driving distance between Scranton and Indianapolis. I have jumped off of three hot air balloons and out of 344 airplanes in 17 states, making countless friends along the way. I’m not an “adrenaline junkie,” nor do I have a death wish. I have faced my fear and emerged stronger for it. I have learned that falling down isn’t so bad, it is just how you learn to fly. As a practicing Buddhist and meditation instructor, I would say that skydiving is the most natural extension of my meditation practice. It is a singular experience, fully and completely in the present moment.

32


33


“T O N Y” christopher sullivan, mph md class of 2019

“H

and me that Kelly clamp,” said an unfamiliar

Serving primarily as the director for case-based

voice.

learning for the second-year curriculum and as the assistant chair of surgery for third and fourth years,

I looked up to a motioning, gloved hand and then

Dr. Gillott is a busy man; however, he is always one

down to the cluster of tools before me as students

to stop on a dime in the hallway and ask about how

whirred about in the anatomy lab. “It’s the one right

everything is going, no matter what he currently has

in front of you,” the voice insisted. Clearly sensing

on his own plate.

the fact that I was stalling and didn’t know one from the other, the hand glided across the table,

I started working with Dr. Gillott during the summer

delicately lifting the appropriate instrument from

of 2016 as a teaching assistant for the physical

the bin. “This right here, this is a Kelly clamp,” the

therapy program of The University of Scranton

voice affirmatively stated. I examined the face that

and the physician assistant program of Marywood

the hand and voice belonged to, noting a peppery

University, and got to know him better.

beard and smiling eyes. No sooner did I make my observations than I was warmly greeted with, “Nice

A student of the Jesuits, Dr. Gillott graduated from

to meet you — I’m Tony.”

Scranton Prep and The University of Scranton. He attended the Medical College of Pennsylvania,

34

Anthony Gillott, MD — or “Tony,” as he often

completing a surgical residency at the Guthrie Clinic

prefers — is a familiar face in the halls of Geisinger

before moving on to a fellowship in trauma and

Commonwealth School of Medicine these days.

surgical critical care at Lehigh Valley. Following this,


he went back to Sayre in 1987, and started Guthrie’s

saw this beautiful set of blue Pearl drums, and long

dreamed about doing this,’ and all of that youthful

trauma program which he would run for 20 years,

story short, I went and bought them. Around that time,

enthusiasm came back again, and it was great.”

along with their surgical ICU. Knowing that he had

I met a guy who was a professional musician, one

been in medicine for the past 35 years — especially

thing led to another, and I ended up building a place

At this stage in our nascent medical careers, it is

in several high-profile capacities — I wanted to know

off the back of my house, and basically converted it to

important to recognize that balance must maintain

how Dr. Gillott went about maintaining a sense of

a recording/mixing room.” After that, Dr. Gillott joined

a central role no matter the course we take. We

balance in his life as he progressed through his rich

a professional mixing group out of Nashville, and has

would all benefit from following Dr. Gillott’s lead by

professional career.

now mixed more than 450 songs.

aiming to apply ourselves to our varied interests outside of school. While crucial for success in

“When I finally finished medical school, my residency,

Dr. Gillott also looks at teaching as something else

medicine, studying and schoolwork must also be

and my fellowship, I came back on staff [at Guthrie].

that allows him to achieve a level of balance in life,

complemented by other things — whatever they

And probably about three years after that, my

and in addition to his work with the medical school,

may be — that nurture our mental, emotional and

wife basically said to me, ‘You know, you gotta do

also teaches students at the undergraduate level.

physical health. Not only do these passions provide

something more than eat, work and sleep...you have

He confessed, “15 years after practice…I was getting

us with a much-needed reprieve from “the grind,”

other passions,’” he explained. I then learned that aside

jaded. I was probably getting burned out, even with

but they also give us the depth and perspective that

from medicine – and his wife, of course – a great love

all the variety I was seeing. I was starting to feel

will only strengthen our roles as compassionate

of his had been music. Dr. Gillott played the drums and

it. The kids I started teaching at The University

healthcare professionals.

was the lead singer for bands up until medical school

[of Scranton] did more for me than I did for them,

began: “I hadn’t been to a music store in probably 15

because in about a month’s time, it was like, ‘I

years. So I was driving by a music store one day, and

remember when I sat in those very chairs, and just

35


Trying heather m davis, mfa director of marketing and communications 36


‘I’m running late this morning. On my way!’ The first five minutes of my morning I spend with space. I’m on my bed. On either side of me no one else is spending the first five minutes of their morning. Next, I’m heavy. Lids not wanting eyes. Body cannot lean in. Don’t make it. I’m so heavy. And this day, it needs too much of me.

OMW HEATHER M DAVIS, MFA

director of marketing and communications

I can’t, I say. The day nods. I can’t?, I ask. It nods. The four alarms I set take turns. Building camaraderie. Next round’s on me. Come on, now. Now, come on. I’m running late. On my way.

37


a day in the life kristina lake borham md class of 2020

[615a] I see sunshine. Time to get up! (Yes, I am one of those few blessed individuals who does not need an alarm but sets one just in case.) What was that dream even about? Man, my brain is crazy. I definitely can’t run that fast. And there’s no way I would be across the country. And I’m pretty sure I can’t do a backflip. [630a] Ok. Enough day dreaming about sleep dreaming. Run to the shower as fast as you can. This whole sleepy exhausted thing will be over shortly. I can do this! [645a] Coffee, on. Lunch, packed. Backpack, ready. [7a] Running back and forth between the bedroom and kitchen trying not to burn my eggs and deciding what will keep me warm enough today in the lecture hall. Scarf? Do I want veggies in my eggs? Is the coffee ready? Should I wear that big cozy sweater? Oh shoot, back to the kitchen!

38


[730a] Out the door and off to school! I stop to

it. How can I help? I AM SO EXCITED. I jot down

[630p] Let the previewing and reviewing begin. What

pet my neighbor’s white cat, named White Cat.

all my thoughts and plans in my journal.

did I totally miss today? What is most important

He meows “hello” and gives me leg nudges

that I focus on for team-based learning on Friday? [130p] The training module last week talked

What can wait until Saturday to be reviewed more

about strong emotions and angry patients. I am

thoroughly for repetition? Oh wow, this podcast for

[745a] Stop to take a photo on the fourth floor

praying my standardized patient does not yell at

tomorrow is one-hour long. Well, here we go. What

of the sunrise over Scranton. Promise myself

me today. Can they even do that? Oh God, I’m

did I eat for breakfast this morning…wait. Kristina.

today will be good and I will give it my best.

so nervous. Or what if they are fatally ill? What

Focus. Only five more minutes!

every day. I miss my cat.

would I even say? [8a] How are there already people in the

[930p] All right Pinterest, what inspiring quotes

library??? Ugh, I knew I should have woken up

[3p] On my way home to change for hot yoga.

do you have for me to get through this week?

earlier. Ok, focus. There are e-mails to check,

That patient session was AMAZING. I can’t

“Working hard for something we don’t care about

blog posts to draft, previewing (again) to be

believe I’m actually good at this. I was worrying

is called stress. Working hard for something we

done, and planners to fill!

for nothing. I AM GOING TO BE A DOCTOR!! But

love is called passion.”

first, I need to study. [9a] Class. Class. And more class. [11a] Tea break! Must. Warm. My. Body. More class.

[10p] Can’t. Keep. Eyes. Open. This bed is [350p] Heat is good. Yoga is good. Sweating is

glorious and I am thankful for its infinite

good. What is medical school?

comfort. I wonder what I can do this weekend. I should call my mom tomorrow. I wish my cat

[1150a] Ok what room is that meeting in again?

[5p] Dinner as quickly as possible. Throw some

was laying on my pillow with me. I’m excited

It has to be the lecture hall. I’m going to wander

kale into a pan with onions and sausage. Mix

for that continuing medical education on Zika

over there. But wait first, how quickly can I heat

with leftover quinoa from yesterday. This counts

tomorrow. Doctors are so smart. If I fall asleep

up my pasta…challenge accepted.

as healthy, right?

exactly right this second, I can wake up at 6 a.m. and be ready to take on the world.

[12p] Wow, this is really cool. I want to do that.

[6p] Rummage through my closet for the comfiest

Let’s do that service project! Oh my gosh, I have

clothes I can find. Big sweater, fleece leggings,

the greatest idea. We should do it. We have to do

wool socks. Set up my desk and boil water for tea.

39


David’s Chili

I

first tried this delectable, homemade chili when a close friend, David, prepared

a batch for a potluck among friends. This hearty dish definitely delivered as we easily cleaned out the crockpot without leaving any trace of its existence. In addition to keeping us warm and full during those frigid, southern California winter nights, it is also a perfect recipe for anyone who enjoys a generous helping of a filling meal. Ingredients 1 medium onion -- diced 2.5 lbs beef chuck -- cubed 2 cans of red kidney beans (14 oz each) 1 cooked Kielbasa sausage (16 oz) -- coined 2 cans of diced tomatoes (14 oz each) 1 tsp black pepper

cooking with ken kenneth lam, mbs education instructor

* Ken is a graduate of the master of biomedical science program who has been accepted into the doctor of medicine program

40

4 tsp garlic powder 2 tsp cayenne pepper 4 tsp paprika 3 tbs chili powder 1 tbs crushed red pepper flakes Salt Canola oil


Optional Ingredients

brown crust -- it will not be fully

the breakfast om-nomelette

Directions

-Tortilla chips

cooked.

This recipe was created after a

Use the ingredient list as a

-Cheese

-Place beef chuck into slow

5:30 a.m. gym session when I

guideline; add in as much as

-Pita bread

cooker.

just wanted food. In grabbing

you like, take out whatever you

-Naan

-Cook the onions until translucent

several leftover ingredients I had

dislike, and substitute whichever

(in the same pan the beef chuck

in the refrigerator and throwing

ingredients you want and create

Cooking is an art, so just as you

was seared in, if applicable) and

them into a nonstick pan, the Om-

your own “Om-nomlette!”

would with other creative outlets,

place into slow cooker.

nomlette was born. The beauty of

have fun with the process and

-Coat the beef chuck and cooked

this recipe is that the ingredients

-Add enough olive oil to coat

cater your dishes to your own and

diced onions with the spice

can be prepared days in advance

the pan and lightly saute the

your guests’ liking!

mixture.

so the actual cooking time is only

mushrooms and green onions.

-Add in the entirety of the canned

around five minutes -- perfect for

-Place the coined sausages around

Directions

diced

drained

a quick breakfast. Pro-tip: eating

the pan and let them brown.

-Practice “Mise en place” (i.e.

kidney beans, mix well, turn the

from the pan means less dishes

-Crack and beat two eggs in a bowl

preparing all of your ingredients

slow cooker to high, and cook for

to wash.

and pour it into the pan, ensuring

before

a total of four hours.

starting

the

cooking

tomatoes

and

the entire pan is evenly covered.

process).

-Two hours into cooking, slice the

Ingredients

-Crack black pepper and sprinkle

-Measure out and combine all

Kielbasa sausage at an angle into

2 jumbo eggs

red pepper flakes over the egg

spices into a mixing bowl.

“coins” of desired thickness, place

Mushrooms -- sliced

mixture.

-Dice onions and set aside.

into slow cooker, and mix.

Green onions stalks -- cut into

-Place a lid over the pan and turn

-Drain kidney beans and set aside.

-During this time, taste for salt and

1-inch pieces

the heat down.

-Slice the beef chuck into cubes

adjust to your liking.

Cooked sausages -- coined

-Cook the omelette to desired

and season it with salt and pepper.

-After four hours of cooking, scoop

Cheese

doneness, sprinkle some cheese

into a bowl, add any optional items

Olive oil

over the omelette, and enjoy!

and enjoy!

Black pepper

Optional but recommended -Sear the beef chuck with canola

Red pepper flakes

oil so that it develops a nice dark

41


flying over the alps gina m osif, ms clinical education coordinator 42


building healthy communities:

and enrich the patient-centered nature of the curriculum

Less o ns f r om t h e ag e of e n li gh t e n me n t

and deepen students’ understanding of the social determinants of health. The IHC will bridge the academic

A conversation with ida castro, JD, Ms by elizabeth zygmunt

T

and clinical to the applied and practical.” In addition to focusing student research on health

he Age of Enlightenment (1715-1789) ushered

person who lives within “a matrix of family, friends,

issues endemic to northeastern and north central

in many blessings, not the least of which

jobs, homes, neighborhoods, geographical areas,

Pennsylvania, another priority of the IHC will be data

was the creation of modern, liberal democracies.

psychological

An

collection and analysis to measure the impact of

One

our

understanding of the matrix through an appreciation

IHC interventions, including those that are student-

fundamental belief that there’s a difference – even

of history, culture and socio-economic principles,

driven. “We will fulfill our promise of transparency to

a chasm – between science and the humanities.

will provide insight into why certain diseases afflict

the community,” Ms. Castro said. “We are not just saying

Enlightenment thinkers tended to prefer hierarchies

specific populations. This approach, strengthened

‘we’re committed,’ but being true partners – and we

and ordered “boxes.” The same reasoning that

through the melding of science with the humanities,

need to show that the things we are doing are actually

gave us the Declaration of Independence, for

is necessary to achieve tangible improvements in the

enhancing the health of the region.”

example, also elevated reductionism, the process

health of communities.

unfortunate

byproduct,

however,

is

and

cultural

environments.”

1

of simplifying complex organisms to the sum of

IHC will also house Geisinger Commonwealth’s

their parts. Reductionism is a good way to learn

“The concept of the IHC is to provide students with a

highly successful Regional Education Academy

how an impairment of the pancreas can result in

direct connection to the community with the intention

for Careers in Health – Higher Education Initiative

diabetes, but it does not explain why diabetes is so

of improving the quality of life,” said Ida L. Castro,

(REACH-HEI) program, which Ms. Castro established

prevalent. This is one of the problems that Geisinger

JD, Geisinger Commonwealth’s vice president for

at the college shortly after its founding. “This pipeline

Commonwealth School of Medicine’s Institute for

community and government relations and chief

program for economically disadvantaged high school

Healthy Communities (IHC) intends to address.

diversity officer. “The idea is for our students to

and undergraduate students has a demonstrated track

dedicate their mandatory volunteer hours to focused

record,” Ms. Castro said. “We have REACH-HEI students

The IHC intends to empower medicine to reclaim its

interventions that translate to positive results for the

now assuming healthcare careers and maintaining their

ancient prerogative to view the individual as a whole

community.” She explained that the IHC will “amplify

commitment to the community.”

43


REACH-HEI continues to serve high school students

outward, to be more giving and empathetic. Both groups

in Hazleton. Thanks to the overwhelming student

go home better than they were when they walked in.”

support, it will now be expanded to include seventh and eighth grades in two distinct efforts intended

What Ms. Castro is describing is essentially

to benefit medical students as much as it does the

medicine out of its “Enlightenment box” – healthcare

disadvantaged children they will serve. One will be

practitioners who are able to discern the myriad factors

a REACH-HEI partnership through which medical

beyond physiology and pathology that determine the

students will mentor and teach eighth graders

health status of individuals and the communities in

enrolled with Big Brothers Big Sisters of Northeast

which they reside. The modern world is rediscovering

Pennsylvania at Northeast Intermediate School. The

the art of medicine, and only when this is effectively

second program will provide mentoring sessions

blended with science can we expect to have truly

to seventh graders at Scranton School District’s

healthy communities.

*

Northeast Intermediate School. This program is a partnership between the school and two student groups at Geisinger Commonwealth, the Student

1

The Bravewell Collaborative

National Medical Association (SNMA) and Latino Medical Student Association (LMSA).

* Big Brothers Big Sisters of Northeast Pennsylvania at Northeast Intermediate School is a volunteer program proven to help students

“From the child’s perspective, they get to meet a diverse group of medical students who have overcome their own challenges, so these kids can see themselves in that role. They enter our building in awe – they can’t see themselves as part of it – then they ask our students pointed questions and suddenly it’s not a building, it’s their dream. Their curiosity is totally awakened,” Ms. Castro said. “Our medical students get to see that light bulb go off in the child’s head. It forces them to take time to look

44

avoid risky behaviors and focus on academics.


contents of a cockroach iris johnston library assistant

did you go iris johnston library assistant

45


I am thoughtful and kind. I wonder where I’m going to college. I hear my mom talking to her patients. I see myself helping people. I want to be a doctor. I am thoughtful and kind. I pretend that I’m at the beach. I feel the sand in my toes. I touch the waves. I worry about getting a bad grade in school. I cry when I’m frustrated that things are unfair. I am thoughtful, kind and grateful. I understand that people are different. I say “Be who you are.”

reflection

poem by maya hemak, age 12 photo by antoinette hemak, age 9 daughters of founding board member linda thomas-hemak, MD 46

I dream about being a doctor. I try to do good in school. I hope I’m a great doctor. I am thoughtful and kind.


it takes a community margrit shoemaker, md regional assistant dean, west campus

A

(CHRPs) which are informed by community health needs assessments, under the mentorship of Geisinger Commonwealth faculty and leaders of the community agencies. Second-year (M2) students engage in projects focused on patient safety and quality improvement (QI), which they continue to work on in their third year. Inter-professional educational (IPE) experiences progress with a developmental

t Geisinger Commonwealth School of Medicine, we recognize that the

approach across the four-year curriculum, beginning with introductory experiences

education of physicians of the future cannot be limited to the classroom or

which include simulation exercises and culminating with a capstone rotation in

clinical settings. To fully address the needs of patients, it is crucial to understand

the fourth year, during which students participate in patient care as members of

the socioeconomic and political context in which they live.

inter-professional teams. Through all these experiences, students at Geisinger Commonwealth gain a deeper understanding of the impact of illness on patients

With clinical training sites spread throughout 17 counties in northeastern and

and their families, while learning about community health needs and resources;

north central Pennsylvania and a state-of-the-art Medical Sciences Building

their knowledge base expands well beyond the mechanisms of disease.

in Scranton, Geisinger Commonwealth is unique in its deliberate approach to community engagement as a critical element in the curriculum.

Geisinger Commonwealth embraces its regional communities as partners in education, rather than “clinical sites.” This attitude is rewarded by high levels of

Medical students select one of four communities (population ranges 5,000 –

community commitment to the medical school and a unique relationship in which

80,000), in which to spend their core clinical year (M3). During the first two years

community members refer to Geisinger Commonwealth, not as “the medical

of medical school, students spend five weeks in these communities to facilitate

school,” but as “our medical school.” Our recent integration with the Geisinger

engagement.

Health System will further strengthen our relationships with the community as we continue to strive together to improve the health of the community while training

First-year students, in addition to early clinical experiences with faculty mentors,

compassionate, world-class physicians.

visit agencies across the spectrum of support services. They also participate in the Family Centered Experience, during which they learn about the impact of illness on patients and their families. First-year (M1) students also conduct community health research projects

47


left to right - Alex lucas, jaanki dave, gabriella logroño

a day in the life

amusement of our fellow “gym rats,” we watch either How It’s Made or Phineas and Ferb. But Fridays are special. We “play” racquetball in the same sense six-year olds “play” soccer. Our enthusiasm and effort makes up for our lack of talent.

gabriella logroño md class of 2019

[658a] My frustration exceeds my desire to

[6a] I wake up to the soothing symphony of

I sulk in the corner. Jaanki lets her inner John

Fuzz 92.1 and angry phone alarm violins.

McEnroe out and plays aggressively by herself.

become a professional racquetball player and

That’s my cue to stumble to the bathroom. I come out and gently knock on my roommate

[715a] The sun is finally out, but our energy is

and fellow second-year medical student’s

gone. However, we have to rally. This is done

door. Jaanki mumbles incoherently.

by brewing Colombian coffee the second we get home. We shower, eat breakfast, pack a

[615a] Even the sun isn’t crazy enough to

nutritious lunch, and start the arduous half

be out at this hour. Only me, Jaanki, and the

block journey to Geisinger Commonwealth

nurses from Regional Hospital of Scranton

School of Medicine.

are out and about. They’re going to work and we’re to going to work out at the Jewish

[815a] Jaanki and I make ourselves at home

Community Center.

in one of Geisinger Commonwealth’s luxurious study suites and begin reviewing the week’s

48

[630a] Monday through Thursday we emulate

material. The “flipped classroom” model forms

hamsters and run on the treadmill, sometimes

the basis for our curriculum. Blackboard (an

while reviewing Pathoma notes. (Pathoma

electronic

is essentially our “Bible” for pathology, a

contains our pre-recorded podcasts for the week

textbook authored by Dr. Husain A. Sattar

that we watch on our own time. During class,

with accompanying videos). Much to the

a guest speaker, usually a physician, poses

learning

management

system)


questions that we answer in our small groups.

don’t contract Staphylococcus aureus, botulism or any

up like a standardized test answer sheet on which

of the other foodborne illnesses we’ve just reviewed.

one’s choice of currency can be used to scratch off

[9a] “Phun with Pharm” commences. Medical

answer choices. My group chooses an answer, I start

school is inundated with stress and being a little

[130p] Time to review with the rest of the class!

scratching, and we wait with bated breath for that

silly occasionally, such as coming up with strange

Groups of students prepare questions related to all the

friendly star to appear. Sometimes the space is blank

names for our study topics, helps us get through.

immunology, pathology, microbiology, pharmacology

and we are crestfallen. Luckily we can earn partial

We draw concept maps with all the drugs we

and clinical information we’ve studied this week. This

credit and try again when our first choice is incorrect.

learned about this week. (Pharmacology can be

session is a little bit like The Hunger Games. With a

overwhelming at times, so we try to come up with

randomized list of numbers in hand, the presenting

[4p] Freedom! The school day is finally over and my

mnemonics or word associations to help us better

group shouts out group numbers. Someone in the

roommates and I head home. Since we’ve worked

remember the plethora of drugs thrown our way

group calls on volunteers to answer the question.

so hard all week, we reward ourselves by having a

each week.)

(For my group, that’s usually me!)

nice family dinner together. Our house’s favorite is taquitos with avocado crema.

[10a] On some Fridays, I interview prospective

[225p] It’s time to test if I retained any knowledge this

medical students. It really puts a “pep in your step”

week! Team based learning (TBL) is our weekly quiz

[6p] My stomach is slowly eating itself. I haven’t

when you interview potential students better qualified

that serves as a good check on how effectively we’ve

eaten anything since snack time and that feels like

than yourself.

studied the week’s material. First, we take the quiz

years ago. The oven dings and I’m ready to go to town

individually and then we take it again within our small

on these taquitos. They never stood a chance. Jaanki,

[11a] Snapchat break to show off how studious we

groups. So much at Geisinger Commonwealth is

Alex, Sarah, and I talk about anything and everything

are! (Geisinger Commonwealth geofilter where are

group-based, that when I sit down to take my TBL as

as long as it isn’t school-related.

you??) The occasional dance break occurs as well. It’s

an individual, I don’t know who I am. But I look up and

extremely important to take breaks and be mindful of

Dr. Cerra’s reassuring face restores my confidence in

[9p] I wind down for the night and wonder if a Law and

our own wellbeing in order to survive medical school.

my medical knowledge.

Order: SVU rerun is on. Of course it’s on because the

Then it’s off to quiz each other on the pathology of all the different critters that can wreak havoc on our intestines!

sun never sets on SVU reruns. [245p] Whew! It’s finally over. I get my group’s folder and we start the group portion of TBL. The

[1030p] Hello, bed! It’s been so long since I’ve last

[12p] LUNCH TIME!!!! It’s time to interact with other

folder contains a hard-copy of the quiz, a scratch-

seen you. Let’s at least stay together for the next

people and not talk about school. Jaanki and I eat

off sheet, and two appeal forms in case we think

eight hours.

our healthy packed lunches, while secretly praying we

any of the questions weren’t clear. The sheet is set

49


Always take flight mosammat taher mbs class of 2017 50


eggs benedict esther good md class of 2020

laughs in all the right places. Her laughter is sweet

“A quiet and gentle spirit.” These were the words

and melodic – but it’s not the laughter I know. It’s not

under my picture in my high-school yearbook. I

the bellowing irreverent laugh with head thrown back

thought, then, that it was high praise. I chased after

and mouth wide open.

that praise, and taught myself to bite my wayward tongue. (You can accomplish great things with a

She portions the food on her plate carefully, taking

little self-sacrifice.) The words inspired me. And then

just a little bit of everything. A very little bit.

haunted me.

She is perfect. And quiet. And gentle.

I lost my voice.

and her smell. I stroke her cascade of golden-brown

And I wonder if my eyes are playing tricks on me, or

I learned that the secret to a happy marriage was

curls. She keeps it long – almost to her waist.

if she has grown smaller, the better to fit under the

to not need too much. I learned to fight until my

crook of his arm as she leans against him. Has she

most basic needs were met, and then to surrender

learned the secret of taking up less space? Of cutting

and go no further. I learned to speak my mind, but I

off pieces of herself to make room for him? Did she

never learned to insist. I learned to ask, but never to

learn this from me?

demand. I learned that my dreams could easily be

S

he is beautiful. My breath catches in my throat at the sight of her standing in the doorway. It has

been too long, and I embrace her to erase the distance and time that was between us. I drink in her nearness

Like me. But she is not alone. She steps back and introduces

replaced, and the scars they left behind were never as

him. She steps back and allows him to enter in front of her. Somewhere in my mind I feel a pause – the

I showed her how to be brave and strong, and hard

first hints of hesitation.

working. I showed her that some things are worth

This “stepping back” is

painful as I expected.

fighting for, and that she is up to the task. I showed

Now I, one half of a very happy marriage, sit across

her that a woman can cut out a place in the world big

from my daughter. And I see, for the first time, how

Sitting across from me now, with him, she seems

enough for her to stand up in. Big enough for her to

very thin the line is that separates self-sacrifice from

happy. When he looks at her, she smiles – but it’s

stand to her full height. And in the world, I do stand to

child-sacrifice.

not the smile I know. It’s not the smile that makes

my full height.

something new.

her eyes small and wrinkled and shows both rows of teeth. She watches him as he speaks and she

But at home, I am very, very small.

51


WEEDING iris johnston Library assistant

Weed the books that never circ, throw away the broken blush, delete from your phone the numbers whose presence make you wince. Even a foxglove can be pulled up if it’s in the wrong place if it steals sunshine from an iris. Just leave alone the green mascara the comics you haven’t read, the sushi joint you can’t afford. They’ll never hurt you, and if they catch your eye, they may, like chicory or dandelions, delight you with their possibilities.

52


study views kristina lake borham md class of 2020

53


a day in the life Dominic jose, mbs md class of 2018

As a medical student, meeting the patient and the [530a] First alarm goes off.

family is where I feel like I can really have an impact on healthcare. Patients can be nervous about the

[540a] Second alarm goes off.

prospect of surgery, and understandably so. I try to walk patients through the process of going into the

[545a] Third alarm goes off. Hop in the shower then

operating room, going to sleep, then waking up in the

get dressed.

recovery room. I tell them that when I had surgery on my knee, I was terrified initially, but ended up in

[615a] Make some coffee, grab some yogurt and

the recovery room before I knew it, and didn’t even

pack a lunch. Head to the operating room (OR) to

remember going to the operating room. I sincerely

grab scrubs and check out the OR board/schedule.

hope that sharing my personal experience helps

Change into scrubs and wrap my stethoscope around

alleviate some of the stress these patients are facing.

my shoulders. Grab a surgeon’s cap, shoe covers and mask for the day.

[715a] Follow the patient, nurse anesthetist and anesthesiologist into the room. DO NOT touch

[630a] Meet my preceptor in the short stay unit. Go

anything that is blue and DO help nurses move the

over the OR schedule with the anesthesiologist on call

patient from the stretcher to the operating table. Help

and see which patients he will be taking care of.

set up patient and equipment for spinal anesthesia and adductor canal block.

[7a] Meet the patient and family with my preceptor and the nurse anesthetist. Verify patients’ information, the

Preceptor: “What layers are passed during a spinal?”

surgical procedure they will be undergoing, review

*Whew, thank God I looked this up yesterday!*

their past medical and surgical history, allergies,

“Good job.

current medications, family history, and smoking

aspirate and then inject.”

history. Review lab values and results of any other

*I totally could do this doctor thing.*

Take the syringe and when I say so,

recent studies. Finally, assign a Mallampati score

54

(predicting the ease of intubation) and American

[745a] Stop by the OR board to put a check-mark next

Society of Anesthesiologists (ASA) score, the latter

to the room number, letting the OR know the patient

being an assessment of overall health.

is in the room and procedure is underway. Meet the


new patient and family members with the anesthesia

[1030a] Tip: look for cases where you can join the

[5p] Time to go home, head to the gym, go for a run,

team.

nurse anesthetist and anesthesiologist for induction

take a nap, or just simply relax. Lucky enough for me

and/or for the case. If the OR team knows you are

I have a wonderful girlfriend who loves cooking, and

“This patient has really good veins, want to give an

really interested and are actively trying to learn, they

a great family who is always willing to have me home

IV a shot?”

are much more willing to teach you and seek you

for dinner. (The older I get, the more I appreciate

*YES YES YES PLEASE, YES*

out when there is a chance to intubate (especially in

home-cooked meals!)

“Definitely, as long as the patient is ok with it.”

patients without teeth!). [7p] As a third year-student, I began to fully grasp

*Don’t blow the vein, Don’t blow the vein, Don’t blow [12p] Head to the student lounge and catch up with

how much I don’t know about medicine. There is

classmates. The third year of medical school can be

always something to study and learn! This is the time

[8a] Robotic cholecystectomy. Put on mask, help

an isolating experience. (Here’s some advice: enjoy

to listen to online lectures, do practice questions,

move patient, DON’T TOUCH BLUE, help strap patient

your time with your classmates and talk about your

complete assignments required by the school,

to operating table. Place oxygen mask on patient

experiences. You can learn a lot of useful tips for

including the assigned readings for Friday afternoon

and watch preceptor inject medications. Practice

future rotations.)

quizzes. Finally, it is always a good idea to read about

the vein.*

bagging (breathing for patient before intubation) and

something I will see the next day.

await the go ahead for intubation. (While there is a lot

[1230p] Accompany preceptor as he follows up

more to anesthesia than just intubating, one of the

with patients in the post-op area. Continue to meet

[9p] Play some FIFA, watch TV, put on Netflix,

best moments of my third year has been getting the

new patients and learn how an anesthesiologist can

whatever helps me relax and recharge. It is easy to

breathing tube in the right spot!)

supervise three operating rooms at once. This is a

forget to take care of oneself. (More advice: third year

great way to ask questions and answer questions

is a marathon, not a sprint, so you should always

[815a] Learn patient management while the patient

about different cases and learn a great deal of

reserve some time that will help you calm down and

is asleep, paying attention to blood pressure, oxygen

information!

get ready for the days ahead.)

[4p] This mainly depends on how busy the OR

[11p] Bedtime.

and carbon dioxide levels, cardiac rhythm and tube positioning. Robotic surgery is awesome!

schedule is, but also can depend on how long I choose [930a] Follow preceptor to the third floor labor

to stay. Fortunately, the preceptor won’t chase me

and delivery area.

down if I choose to leave early and I am always

Assist with spinal anesthesia

(C-section) or epidural anesthesia (normal delivery).

welcome to stay until the scheduled procedures have been completed.

55


rescuing a kitten gina m osif, ms Clinical Education coordinator 56


community building

through quilting melissa L sanko, ms Standardized patient program assistant

M

each other. The sense of community demonstrated

study and reflection, dedicated in Jennifer’s memory.

by this project reminds us that “the whole is greater than the sum of its parts” (Aristotle).

As we are integrated into the Geisinger Health System, this quilt remains a reminder of our original purpose.

Recently, the quilt was relocated to the Jennifer Sidari,

In addition to educating future healthcare providers

MD Memorial Reflection Alcove and encased in a

who are clinically competent and well-rounded, we

glass frame that was donated by the Sidari family.

hope to continue to foster an environment that is

*

embers of Geisinger Commonwealth School

supportive of developing kind, caring physicians,

of Medicine’s charter MD class of 2013, along

who will, “strive to cure sometimes, relieve often and

with several of the early employees, contributed to

comfort always.”

the success of our learning environment through their passion for the arts. The pioneer students, staff and faculty of our medical college developed

*Editor’s note: Jennifer Sidari, MD was a member of the

friendships with each other and within the community

charter class, who tragically passed away a few weeks

that strengthened their ability to deal with some of

after her graduation in 2013. Although her life was cut

the growing pains associated with being at a new

short before she was able to practice medicine, as a

institution.

student she touched countless lives, both at home and abroad. Her legacy lives on through The Jennifer A.

Joanne Muellenbach, MA, who was the director of

Sidari , MD ‘13 Endowed Scholarship, set up by her family

library services at the time our first students enrolled

and the memories on display in the reflection alcove

in 2009, spearheaded a quilting project to which each

referenced here.

member of the class contributed. Students explored their individual characteristics, skills and talents while creating individual squares. Muellenbach and

The alcove is located on the third floor of the Medical

her colleagues hand-stitched the squares together.

Sciences Building and is adorned with photographs

After all the squares were sewn together into one

that speak to what a remarkable, well-rounded and

large quilt, the students discovered new attributes in

generous person Jennifer was. It is a quiet place for

57


1 - With each One You must wipe your eyes clean To come open is to leave unburdened To leave unburdened is to close your eyes 2 - What when that most minute matters most Best not to miss nor forget 3 - Each One unique yet cyclical Plan with no end Look forward And be surprised 4 - What One will take when the worst comes to them What else matters

m e d r e l at e d tyler crissinger md class of 2020

5 - Use what you know Do what you can Teach and be taught Learn and be remembered If only If nothing else Accept Yourself, your world Each and every One

58


serenity mosammat taher mbs class of 2017 59


H

ere you are as you are admitted to medical school, the “cream of the crop” - with numerous accolades,

an impressive academic record and equally impressive accomplishments

outside

the

classroom.

You

are

accustomed to being successful and enjoy the admiration of your instructors, the envy of your peers and the pride of your parents. Doing well comes easy, sometimes without much effort on your part because you are naturally endowed with intellectual prowess and the accompanying self-confidence. Then – boom! – you endure the first semester of medical school and no longer feel special, especially since everyone else is the “cream of the crop.” How do you cope with meeting the increased demands on your intellect, energy and time? How do you obtain the medical knowledge and the clinical and communication skills you need

Work – Life Balance for

Medical Students What Does That Mean To You? marika handakas, LCSW, PsyD Assistant Professor of Family Medicine

and still find time to feel like a human being? You are making a whole new life while trying to rise to the next level, which always seems to arrive before you are ready to meet it. You need something to carry you through that will last throughout your entire medical career: work-life balance. That is a catch phrase which is very popular now, so popular that it may sound like just another “buzzword.” But I think it can be personalized to each one of you, and it begins with some personal meditation and reflection on your part, regardless of the activities you engage in to achieve balance. (Several

60


options are described in the accompanying piece by Betsy Mead, RN,

What aspects of yourself are you aware of that others are not?

BSN, an instructor in the Patient Centered Medicine course). What aspects of yourself are you not aware of that others are? Here are some questions you might ask yourself – think about them in a quiet place or write down your answers journal-style, and return to them

What aspects of yourself are you not aware of that others are also not aware of?

from time to time: Obviously, you cannot know things about yourself that you do not know, What does my desire to be a physician mean to me?

but with these questions, you can begin the process of internal exploration. The way to find out what others know about us that we might not know

What values inform my decision to be a physician?

is through disclosure and feedback which, in medical school, can happen through small group reflection sessions. You begin with self-discovery

How do I define healing and what sort of healer do I want to be?

and sharing as you feel safe. Next, you solicit feedback from members of your peer group who have agreed to the ground rule of reciprocal kindness.

What does work-life balance mean to me and what might it look like in my

Through the observations of others, self-discovery, and shared discovery,

own life?

self-knowledge and self-awareness can improve significantly.

This

increased self-understanding will be useful in determining what type of How do I want my medical education to transform me?

work-life balance is necessary for you personally as you progress through your training and prepare for what promises to be a very rewarding career.

How well do I know myself? This last question may be the most important, because most of us are

Reference: Luft, J.; Ingham, H. (1955). “The Johari window, a graphic model of

not in the habit of thinking about our own personalities, assumptions

interpersonal awareness”. Proceedings of the western training laboratory in

about life, quirks, fears or fantasies. In order to increase your own self-

group development. Los Angeles: University of California, Los Angeles.

awareness, I suggest you consider the following questions: What aspects of yourself are you aware of that others are also aware of?

61


A time for reflection betsy mead, rn, bsn instructor of Family Medicine 62


W

hen my position at Geisinger Commonwealth

Mindfulness-Based Eating - taught by Lisa Rigau, a

School of Medicine evolved into assisting

local sports and wellness nutritionist

with the Patient Centered Medicine (PCM) course, my eyes were opened wide as I watched committed

Mindfulness-Based Stress Reduction - taught by

and dedicated students transition into the rigors

Phillip Sallavanti of CALM of NEPA (CALM stands for

of medical school. Yes, they were all at the top of

Cultivating Awareness by Living Mindfully)

their game, mentally prepared and ready to “hit the ground running.” Yet every year, about eight weeks

Perfect Postures - under the instruction of Mike

into the semester, my nursing instincts (and perhaps

Marcinek of NEPA Fit Club

my mothering instincts) are triggered as I begin to see some of the initial smiles fading. My thoughts were validated when one student stated,

Yoga Club - under the direction of Dr. Sonia Planey

“It isn’t a

each other. Regardless of the activity in which they had taken part, the common thread that emerged

commitment that we take lightly, but the pace and study

Christian Spirituality - a Bible study organized by the

was the power of reflection.

schedule we have to adopt to try and keep up with the

Christian Medical and Dental Association (CMDA), a

evident that routinely connecting mind, body and

workload leaves me drained, bitter and homesick.”

student group

spirit is essential for wellbeing. It is our hope that this

And so it became

learning experience will continue as a life-long “habit I was inspired this year when Dr. Jennifer Joyce,

Body & Jewish Spirituality - under the direction of

of practice” and that the importance of self-care will

the course director, partnered with the Office of

Ziv Ben-Dov, a licensed clinical therapist

remain with our students as they progress through

Student Affairs to create a mini wellness course. This

their training and ultimately enter the practice of

mandatory segment of PCM required the students to

This mini course culminated in an interactive

choose a “wellness activity” and attend four sessions

session

between October 17 and December 6. The six

thoughts, emotions and lessons learned with

during

which

students

shared

medicine.

their

options were:

63


a day in the life shannon lanzo, mbs md class of 2017

64


[550a] Hit snooze.

[1130a] Yay! Rule out malrotation of the

films as the residents and I can get through.

intestines with the attending physician [6a] Get up and tuck away pullout couch at a

and the residents…excitedly stand by as

[5-6p] Readout of the afternoon films with the

generous sister’s apartment.

the attending physician communicates the

attending physician.

findings to the nervous parents. [7a] Arrive at the hospital. Pray I find the

[601p] Feel thankful that I don’t have to take

correct room for morning conference before

[12p] Readout of the morning films with the

heading to the radiology department.

attending physician…try not to act surprised

call on this rotation and walk home.

when they can read an entire film in 90

[630p] Eat dinner while watching reruns of

seconds.

Real Housewives of Orange County.

[1230p] Hurry to afternoon conference after

[7-930p] Prepare patient presentation and/or

grabbing lunch.

read up on topics for tomorrow.

study. Try not to act surprised when the baby

[130p] Return to the reading room and feel

[945p] Ask myself if I can get away with not

actually drinks it.

thankful that no one called on me for that

washing my hair for another day…looks like

really hard anatomy question.

I’ll be using dry shampoo tomorrow morning.

[2p] Grab a coffee and question how anyone

[10p] Rinse off…bed…

[8-10a] Review films in the reading room with the residents. [10a] Feed newborn preemie a bottle of barium for upper gastrointestinal contrast

[1030a] Patiently wait for the barium to make its way through the baby’s GI tract.

gets work done in the dark. [11a] …still waiting…

…REPEAT. [230-5p] Caffeine kicks in…examine as many

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A patient Thank you alex slaby md class of 2017

P

atients don’t always have to let us into their rooms. This week I had one of those moments where I had to take a step back and appreciate

some of the unique life experiences that patients have allowed me to share with them. As medical students, I think we don’t give enough acknowledgement or praise to the vulnerable individuals that allow flocks of medical students to bumble around their bedside. But our perceived ineptitude is the last thing on the patient’s mind; a friendly face who is willing to listen to their story is just as important. Let’s not stress that we may not know the answer to every one of their questions, rather let’s make sure we do our best to ensure that they get the care they deserve. When I entered the room of a pregnant woman in her second trimester with vaginal bleeding and an incompetent cervix, I had no idea what to expect. I was on my third day of my OB/GYN rotation and just a few hours earlier, I had witnessed the beginning of life in a room across the hall. After reporting to my attending and a few imaging tests later it became clear that this patient’s baby was not going to survive. Even worse were the overwhelming emotions that cut through the room when we informed the patient that, due to complications, she would have to deliver her baby right away.

66


After minutes that seemed like hours, there I stood. Crammed in a small

in trying to make them feel a bit more comfortable in their new (and scary)

room full of nurses, doctors and other students I watched as a single

hospital setting. Stop by a patient’s room before your lunch break. Give a

mother cradled her tiny, underdeveloped and dying child. It is an image

quick wave to that person you saw at the ER that morning. Smile at the

that will forever remain in my memory.

patient you interviewed a few days earlier. Too often, unfortunately, many of the patients I’ve encountered either have family members that have

Powerful experiences like these should not be taken for granted. I can’t

passed away or aren’t able to make it into the hospital. The extra five

even begin to imagine the fear, distress and pain that this woman was

minutes we spend with them might give them a chance to unload their

going through — and yet she allowed a budding doctor to be involved and

worries and maybe even help them forget they’re in the hospital, isolated

to learn from it. Patients like this admirable woman are gracing us with

from their loved ones. It’s the little things like this that make the difference

an opportunity to understand diseases and pathologies we’ve only ever

— treating the patient like an actual person rather than a textbook case is

read about. Their willingness to let us learn extends beyond allowing us to

not only good medicine, but it shows your appreciation.

partake in personal moments — they also let us next to their bedsides at the most inopportune times. A patient may have just seen the hospitalist

So I urge everyone to take a step back and think about some of the

and consulting specialist, the nurse who took vitals, and the phlebotomist

personal situations patients have allowed you to take part in. I think too

who drew blood. As I’m about to percuss the abdomen the dietary aide

often as students we can get caught up in a sea of jaded healthcare

walks in with the patient’s long-awaited lunch. Over 90 percent of the time,

workers, OSCEs and question banks — taking for granted how much a

the response I get is something along the lines of, “Don’t worry, I’ll get it

“real-life” patient can help us learn. They teach us so much; let’s do all we

when you’re finished.” I think situations like this speak volumes to how

can for them. Someday we may be the people changing their lives, but

patients perceive us. They treat us with respect and dignity; in their eyes

right now they are the ones shaping ours.

we are a part of the medical team even though we ourselves feel sub-par in comparison to residents and attending physicians that are teaching us. Let’s give them the same recognition.

Previously published by in-Training, an online magazine for medical students at: http://in-training.org/a-patient-thank-you-10814

This is why, as often as possible, I like to take advantage of being a thirdyear medical student. We aren’t necessarily bound by time constraints and have the opportunity to spend a few extra minutes with a patient. Getting to know a patient’s interests, hobbies, friends and family goes a long way

67


a scranton oasis christian bohan md class of 2019

68


a quandry trail walaa ahmed mbs class of 2017

Our filaments keep missing each other Then I catch you from my periphery As our gazes overlap I can feel the tension in my palms Sifting through my fingers As time refuses to be on our side Remember that one day? In the rain When you tried to explain the displacement of our lives I get it now. We’re back where we started Sinking within the lines of this paper As our pieces chip away With each fractional decline We accumulate this loss of function This collective denial That we are not who we hoped to be

And you know what scares me more than failing? It is, if this path was not meant for us Because there’s this pull On the tethers of my chambers Every time you are around Are you it? Because this is not what I expected You, are not what I expected Take this hold on my posture This wielding of my joints This draining of my fluids Take our temporal summation. because how can I write our story If I haven’t written my story? There’s this battle between my recoils Hoping the air that surrounds you Never reaches my insides Can you grasp on to these brakes? While there’s still room for error Just until we’ve mastered this balance Can you keep this faith? and hold it steady Because I think we may find a way out of here

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long way home seth colon, age 14 son of Geisinger commonwealth staff members trent and cheri colon 70


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Kristina Lake Borham - Student Editorial Assistant Kimberly Watanabe - Student Editorial Assistant Olapeju Simoyan, MD, MPH, BDS, FAAFP - Editor in chief Christopher Sullivan, MPH - Layout Designer Alysha Nicholls, mshe - Staff Editorial Assistant Heather M Davis, MFA - Production Manager Debra C Tierney - Staff Editorial Assistant Melissa L Sanko, MS - Managing Editor (Absent From Photo) Amelia Mackarey - Student Editorial Assistant


Profile for GeisingerCommonwealth

Black Diamonds 2017  

Black Diamonds, Geisinger Commonwealth School of Medicine’s arts and literary magazine, features the creative work of students, alumni, facu...

Black Diamonds 2017  

Black Diamonds, Geisinger Commonwealth School of Medicine’s arts and literary magazine, features the creative work of students, alumni, facu...