Savage.MD Blog

Fellowship is going fast. I'm now nearly 7 months in to my first year as a heme/onc fellow. I'm still very happy I chose this career and I love my program. Treating patients with cancer is such a privilege. I often imagine myself in the shoes of my patients. How intimidating and scary would it feel to have a diagnosis of cancer? Would I be as strong as my patients in confronting such a diagnosis? One thing I know for certain is that I would want the expert guidance of a seasoned hematologist/oncologist. Each day I try to learn from the patients I am caring for so that I can be the guide throughout my career. I've had a lot of touching experiences recently.  Last week I met a man with widely metastatic colon cancer. I took the time to get to know him, his values, and his family support system. Ultimately, he decided to start hospice care. Time seemed to stand still in the hour I was sitting in his sunlit room talking to him. I turned off my pager and phone and just listened....

 Yesterday I worked my first ever shift as a medicine attending. My hospital was looking for extra weekend help, so I volunteered to cover one of the gen med teams on Sunday. It was really a lot of fun. When I was an intern I occassionaly had to cover the whole list (up to 12 patients) solo with an attending on the weekend. I remember those days being very stressful and busy. I felt like it was a lot to round on 12 patients, write 12 notes, update families, manage discharges, and be sure that all orders were placed. Plus, I had to make time to "round" with my attending and see the patients together. That usually took about an hour.  Yesterday I was providing care for 10 pretty complex patients. I arrived at 7 am to "pre-round" and chart review. Then around 9 am, I walked the hospital to meet each of the patients, examine them, and update them on the plan for the day. Around 10:30 am I took a pause to call into the multi-disciplinary rounds to update the case manager...

Today was a whirlwind. I'm on the Bone Marrow Transplant Service this month, and that alone would make any day busy. Today, though, was a little different. The day started at 7:30 with me pre-rounding on my patients before going to see them on the floor an hour later. Rounds started at 9:15 am. Half way through rounds, the nurses from our apharesis unit let me know that one of my patients from a few months ago was on site for labs and hoped to see me. I made a note of this and continued with rounds. Rounds finished at 10:30 am. I went to see the patient in apheresis. He's had a complicated course with advanced cancer and I was worried he might not make it through the Christmas holiday weekend. It was so good to see him! We talked about his family. He also told me that he'll be starting hospice care this week, which means today might be the last time we might see one another. I walked his wife and him to their vehicle to say goodbye one last time. It was truly the highlight ...

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...