Savage.MD Blog

I wrote this poem April 26, 2020.  The green & gold elephant with its crown sits above my fireplace mantle. Small enough to fit in my palm, but weighty because of its metal base.  This token brings good fortune to our home. It reminds me of my Texas friend John.  I have known him since age 10.  He gave this as a parting gift before we came to Ohio two years ago. I wrote the poem as a part of a "poetry workshop" hosted by the House Staff Association at the Cleveland Clinic planned Dr. Abarna Ramanathan. Poetry is a "way to observe things around you that you take for granted," and I was asked to describe the meaning of the first thing that met my eye that day. I thought of the poem again this week when I got a wedding invitation from Dr. Ramanathan for November 2022 in New York City. She was one of my first friends in residency, and I am so happy for her. The poem describes another very dear friend named John who I first met in the fifth grade. Like me, he was...

Today ends Block 5 of fellowship. It's amazing to think I've already been in fellowship for five months. It's been a really great experience so far and I'm so proud to be in my program at Scripps. This week was especially busy. Early Saturday I attended the tail end of the AMA-CME meeting. We were supposed to have met in Orlando, FL, but the meeting became virtual because of the COVID-19 pandemic. Sunday afternoon the AMA had a really excellent forum on Health Equity. Saturday night I worked my fist moonlight shift as an attending at the VA San Diego. I still fondly remember going to the VA Dallas with my grandparents as a kid. My grandpa got all his care there and thought the world of his doctors. It really means a lot to me now to be a VA doctor, even if only part time. I worked with UCSD residents and had a great time as we cared for our patients. I look forward to working at the VA again next month. Sunday after taking a nap I continued working on my NIH grant appli...

 There were a lot of great things that happened this week, but two in particular stand out. Wednesday I was seeing a patient in a faculty clinic. This means that the faculty member is the primary hematologist/oncologist, while I'm just a guest in the clinic for the month. I try to explain this to patients when I first meet them so they understand my role on the team. In this instance, mid-conversation with the patient, our team's nurse entered the room to draw blood. I was just about to examine the patient, when her partner asked, "Could you tell me again what your role is, doctor?" I again explained that I am a rotating physician in the faculty clinic for the month. Then the nurse spoke up for me and provided some additional context. She said "Well actually, Dr. Savage is a fellow, which means he's already a fully board certified doctor in internal medicine, but he's getting extra training in this field." This put my patient at ease, but it was also...

Today I was elected to be the next Chair of the CMA Resident and Fellow Section (RFS) . This will be my first chance to participate in a leadership position within the California Medical Association and I'm very excited.  The slate of leaders that were elected alongside me are phenomenal physicians and advocates for medicine and trainees. It's also a bit of a homecoming. I have known many of the people actively involved in the CMA-RFS for years because of our work together in the American Medical Association. I've been a proud AMA member since 2009, and the first national meeting I participated in was Fall 2009 in Houston. In 2012-2013, I was Chair of the Texas Medical Association Medical Student Section (MSS). In 2019-2020, I was Chair of the Ohio State Medical Association RFS. It'll be fun to lead now in my third state of California. Each of these positions has helped me grow as a leader, advocate for meaningful change for my colleagues, and grow my network of profess...

Today a physician mentor told me a story of some local oncologists who recently had their practice turned upside down by venture capital. It was formerly a private practice group of three physicians. One physician owned the practice. The other two physicians were employed. The owner decided to retire and rather than selling to his employees, he sold the practice to a venture capital firm. The VC firm owner is a businessperson and not a physician. The VC investor's goal was to make as much money as possible from the practice. So the VC firm shortened all the appointment slots and introduced untenable "production goals" for the employee physicians, requiring them to see a certain large number of patients per day. These are cancer  patients, some on treatment and experiencing complications. The thought of such appointments being cut short for the sake of profit broke my heart. The thought of two well-meaning physicians being forced to cut corners to make money for the VC own...

Last Monday I got the most exciting news earlier than expected. I am now a Board Certified internist! This was the culmination of three years of training in internal medicine at Cleveland Clinic and UCSD, and the next step in a lifetime of learning to be the best doctor I can be for my patients. I became "board eligible" after June 2021 when I graduated from residency at UCSD. I started to study using ACP's MKSAP in Jan 2021, but I took it up a step starting July 1 once fellowship began. I studied 2-3 hours each weeknight and spent each weekend studying throughout the two months before my exam at the end of August. By the time test day arrived, I had completed 2400 practice questions (from MKSAP and UWorld) and read each chapter of ACP's Board Basics  multiple times. I felt as ready as I could be. It was so gratifying to find out that I'm not Board Certified. Our residency class at UCSD had a 100% pass rate this year, which is a remarkable achievement for my progr...

I was discussing the natural history of a newly diagnosed cancer with a patient this week. She said "Well, I thought I'd have longer to live than that," but then said I guess "even czars get buried with a shovel."  This much is very true. No matter how successful or lives and no matter how long our lives are, all of us have one certain destiny: death. It's up to each of us to decide how we spend the precious time we have on earth. Even if you know that your life is now limited in duration by cancer, there is still much that can be done with this precious gift of time. My goal for these patients is to help palliate symptoms so that they can enjoy each and every moment. This patient's statement made me think about my father's funeral. He had a big impact on many lives. The church at his memorial was packed with friends, former coworkers, and family. We didn't talk about money or material things in his eulogy. Instead, we focused on the deep and mea...