Savage.MD Blog

Last Thursday after clinic, I made a beeline for the airport. I flew to New Orleans, arriving at the hotel around 11:30 pm. The next day I attended the AIAMC (Association for Independent Academic Medical Centers) National Initiative Conference that is presently focused on J.E.D.I. (Justice, Equity, Diversity, & Inclusion) initiatives in medical education. I was able to meet a few leaders in the AIAMC face-to-face for the first time. I also reconnected with Dr. Bill McDade of the ACGME. Dr. McDade and I were on the AMA Council on Medical Education together when I was a medical student. Cafe Du Monde, New Orleans, March 2022 Friday night after the conference wrapped up, I put on my casual clothes for a walk around downtown New Orleans. It brought back so many good memories. My first trip there was in fall 2011 as a third-year medical student. I was getting more involved in the AMA’s Medical Student Section and I was serving as Chair of the Reference Committee. That ended up being a l...

Last Sunday would have been my parents' 40th wedding anniversary. My brother and I tried our best to fill the void created by our father's death last year by staging a game night with my mom over the weekend using Zoom. It felt good to be together as a family, but it was bittersweet. James Savage in 1974, age 18 I was so lucky to have a great father. I've spent a lot of time reading about him and going through his personal letters after his death. I've come to appreciate the depth of hardship that my father faced as a teenager. He moved out of his house at age 16 and was homeless with incredible food insecurity for over a year until he could afford an apartment of his own. He spent his teenage years hungry, poor, and with few friends or family to rely upon.  I don't think my dad would have ever imagined marrying a wonderful woman, owning a big piece of property in the country, making many happy memories with his family, and raising two sons who would become the firs...

This week is NRMP Match Week! This is the week that all the graduating medical students across the country find out where they'll be for the next 3+ years. This week also determines the ultimate specialty of those students, which is a career defining moment. My Twitter feed was full of happy and sad moments today; there were people who matched and those who unfortunately did not. People who did not match will get a second opportunity this week to find a spot through the S.O.A.P. (supplemental offer and acceptance program). I wish them all the best. I can still vividly remember my Match Week from 2018. It's hard to believe that was four years ago. On Monday of Match Week I was in our "Transition to Residency" class at McGovern Medical School when I got an email at 11 am CST saying "Congratulations, you matched!" I was very excited and relieved that I matched, but I knew it would be four more days before I learned where I would be going. The week crept along a...

Friday I finished my ninth month of heme/onc fellowship. Time is going fast, but I really am enjoying my program.  I've learned a lot about the initial work-up, staging, and treatment of a variety of solid tumors and hematologic malignancies. I've learned how to care for benign hematologic problems. I've also become a better listener through the hundreds of conversations I've had with patients and their families. Next week I'll be on a pathology block where I'll be learning by reviewing blood and bone marrow slides alongside our pathologists. After that, I'll have two more months of clinic and two months of consults to round out my first year of this three-year program. It's only too bad that the time is passing so quickly! Speaking of time... Last week I had a really touching conversation with a patient with stage IV cancer. The patient told us that his journey with cancer has made him so much more appreciative of everything in his life -- his marriage,...

Today I took my 200 question ASCO In Training Exam for oncology. This is my fourth year taking an In Training Exam of some sort. The past three years it was for internal medicine. Today's test was an assessment of how much I've learned during fellowship over the past 8 months. With each question stem, I pictured the patients I had cared for this year with the disease in question. What did I do for those patients? That made coming up with the right answer a lot easier. It's amazing how much I've seen and done in 8 months! It's equally hard to believe that in just four short months more, I'll be a second year heme/onc fellow. Next year will be the start of my fellow continuity clinic where I will be the primary hematologist-oncologist for my own set of patients. That both seems exciting and intimating. It'll be exciting to take on more responsibility and independence. Yet, it will be intimidating to guide and care for people who are facing one of the hardest c...

Yesterday I saw a new consult patient in the GI oncology clinic. The patient has a treatable GI cancer, but also had a history of a traumatic brain injury. I listened to the patient's cancer history intently and then asked "How did you get your brain injury?" The patient told me the story and I again listened, taking notes periodically.  After I asked all my questions and did a physical exam, I told the patient what to expect next. I told him/her that I'd discuss his/her case with my attending, and that the two of us would come back to talk about a plan to treat this patient's cancer.  Before leaving the room I asked, "Are there any other questions you have before I go get my attending?" The patient's eyes started to tear and he/she said, "I just want to thank you. I felt listened to today, and I don't always feel listened to."  It was an acknowledgement of the many ways big and small that our health system falls short when dealing with...

July 13, 2020 was my first day of continuity clinic at my new residency at UC San Diego. I was pretty nervous. I had gotten so comfortable at my continuity clinic in Cleveland, OH and I knew the routine there well. This new clinic served a totally different population of patients. The faculty members, the staff, and the residents were all new faces to me. The very first patient I met in San Diego in my resident clinic was Mr. G. He had a lot of health challenges and was a complex first patient. He had just been discharged from the hospital. He had heart failure, COPD, diabetes, and cancer. When my faculty member asked how soon I'd want him to follow-up with me again, I proposed "2 or 3 months." My faculty member knew better. She said, "No, I think you should see him in one month. He's pretty sick." So that's what I did. About once a month for the remainder of my residency I saw Mr. G and tried my best to keep him out of the hospital. I was not always suc...