Savage.MD Blog

Last weekend I had the chance to visit my alma mater for Homecoming 2022. It was my first time back to campus in 5 years. It's now been 15 years since I graduated! My college opened a new science center called the IDEA Center (Inquiry, Discovery, Entrepreneurship, and Access) in fall 2013. I had not seen it since it opened, but this weekend I got to tour the beautiful building. The labs, study spaces, and faculty offices were so nice! One of the display cases in the IDEA Center had pictures of the college majors from 2005, 2006, and 2007 that include me. These used to be on the wall in the chemistry student lounge of the now retired chemistry building. I have so many memories of late night studying in that old room. It brought back a lot of great memories from early in my academic career to see these pictures again. 2007 2006 2005

Today I finished a month on the palliative care service. It was a really great rotation. I spent the first two weeks at Scripps Mercy doing consults and the last two weeks in the palliative medicine clinics in La Jolla and downtown San Diego. A few things I did/learned this month... Received mentorship in leading Goals of Care conversations Learned about symptom management - especially pain, nausea, fatigue, loss of appetite, and insomnia Learned about Advanced Care Planning Learned how to explain a POLST (Physician Order for Life Sustaining Treatment) Learned how a palliative physician approaches a new consult with a patient and their family Learned about how physician-assisted end of life care works in California One of the most touching patient encounters happened this week. I met a patient with metastatic esophageal cancer and his wife. They have been married 50+ years and had a beautiful relationship with one another. They were answering questions for one another, while also respe...

When I was in graduate school I worked after hours as an MCAT teacher for the Princeton Review. I really loved teaching. I especially enjoyed when I met and connected with students who stayed in touch after the class was finished. One such student was named Luna and we met in Spring 2015. At the time that she was in my class, I was really into podcasts and had just started listening to the short series "Serial" about a man wrongly convicted at age 18 of murder. The story was well told and I mentioned it to my MCAT class one evening. Luna started listening and told me that she enjoyed the podcast as much as I did.  After the class finished I lost touch with Luna. Like many students, I wondered how she did on the MCAT and whether she achieved her dream of getting into medical school. She wrote to me in 2018 after seeing me on LinkedIn. I let her know that I was almost finished with my MD/PhD program and would soon be headed to Ohio for residency. Today I got a surprise email fr...

Last week I lost my first patient from my continuity clinic. It was sudden and unexpected. When I got to work I had a notification on the EMR that the patient had just been seen in urgent care and was admitted to the ICU. I checked the chart again at noon and the patient was intubated and her labs were quite abnormal. At 4 pm, I got a notification that she had passed away. I was very sad about this, and I was also sad for her husband. I called him as soon as I got the news to tell him how sorry I was for his loss. It happened so quickly and I know he was not expecting it. He and I had just touched base about how things were going last weekend. It's such a privilege to take care of people with cancer.  There's always the chance that cancer might progress despite treatment, but usually it's an incremental process and everyone has time to prepare. I think sudden loss is the most difficult. I've thought about this patient and her family a lot this week, and I know their sto...

This is Labor Day weekend! Last year I had just finished my internal medicine board certification exam and celebrated with a trip to Houston. It's hard as always to think that another year elapsed. Yesterday I went to the Getty Villa and Getty Museum in Los Angeles. My dad visited the Getty in Nov 2009 when he was in LA for a work trip. I was in my first semester of medical school back then. At that point in my life I had only been to San Diego and never LA. The pictures he showed me were really impressive and surreal. Yesterday I imagined him walking through the same galleries as me and it really was special.  I also saw a famous sculpture the 18th century artist Franz Xaver Messerschmidt. I learned about him during my psychiatry course in medical school. He had schizophrenia, and his sculptures after developed this disease were considerably different than the very typical busts that he made earlier in his career. 

Tomorrow I'll start my third month of my second year of fellowship. The past two months have gone by quickly. Last Friday I was on top of the world - I had caught up on emails, patient logs, and held several productive research meetings during my research time. It felt like a great wrap to a month in the clinics. Then I experienced a setback. I got some late day feedback from a preceptor (who also helps me with my research) that I did not expect. It was well-meaning and I know it'll help me be a better doctor, but it was disappointing. In the midst of reading that feedback, I got a call from my brother. He was having a bad week at work, and he made some disparaging remarks toward me and my work. This really piled on at the worst time. The rest of Friday I really felt sad and had a very hard time sleeping. I write this all so that I can remember that the road to improvement is often paved with setbacks. Today was good for my soul and allowed me to reset from the setbacks of Frid...

Fridays at the hospital can be busy as people try to wrap up things for the weekend. Today was quite the example of that.  I'm currently half way through my month on the BMT inpatient service. I woke up around 7:00 am and had a message and phone call from one of our junior fellows. She had admitted a patient with acute leukemia overnight. I got sign-out on this patient and our fellow did a great job! However, it was clear there were quite a few things to get done to take care of this patient today. I got to work just in time for morning division rounds on Zoom. While I listened to conference, I pre-rounded at the computer. I had several existing patients to see, and I needed to take care of things for this leukemia patient. Then I got a message that a new patient was on the floor and needed admission orders. I put those in, finished pre-rounding, and made my way to the floor to round with the team. After rounds there were many things to do. First, I did the bone marrow biopsy. I’ve...