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Be the change you wish to see in the world.

For years, this motto has served as my inspiration towards becoming a physician, and as the first year closes, I cannot help but reflect on all the training I’ve received that has prepared me for clinical rotations this upcoming October.

There it is! Working on my ultrasound skills in the new Clinical Simulation Center during my free time.

At UMMS, we’re given a wealth of opportunities and experiences, one of which is called Interprofessional Clinical Experience (ICE). The purpose of ICE is to expose us to clinics right from the start by giving students the opportunity to shadow every player in a clinical team on a monthly basis. It’s a way of understanding the role of each player and their contributions to the patient’s care. During M1, I learned about efficient patient flow through the emergency department and snuck a peek into clinical radiology. I got to see some cool stuff, like CT-guided abdominal biopsies and sonographic Murphy signs to check for cholecystitis.  Prior to ICE, these were just words on a PowerPoint, but they now manifested into real-life experiences.

As I walked down the hallway with the ultrasound technologist I was shadowing, I was excited to see what my last encounter of the semester had to offer. Entering the room, I saw a seemingly 60-year-old woman, readily lying down for her appointment. The patient was here on a referral to check a potential abscess that had been hanging around for a few years. Gliding the probe over the mass, the technologist produced an image on the screen via transmitted sound waves.  It was a round and defined circle… makes sense. But… it was also a hazy-white color… fluids should be black on an ultrasound machine, I recalled from my ultrasound elective. I whispered my concerns and subsequent justifications – the technologist responded with a simple nod. She quickly switched to the doppler color flow image mode to view blood flow. There it was: blood vessels running through the mass.

My heart started beating faster and my hands clenched as my mind scrambled to find the one word that could change this patient’s life forever: cancer. Discretely excusing ourselves, we went to share our findings with the radiologist.

What next? I was told that she would be sent home, and her primary care physician would call to convey the news. I understood that this responsibility was outside our scope, but my deep concern still precipitated into a pit in my stomach as I had to silently watch her happily return home unbeknownst of a likely diagnosis of metastatic cancer.

Medicine is a difficult field because of the intense strain on both the body and the mind. While we have the privilege to treat and even cure patients, we also have to see them through their darkest hours. I am grateful not only for the opportunities to develop clinical competency, but also for the continuous reminder to always be compassionate. My training continues to prepare me for the day when I will have to break bad news to a patient in a manner not so different from the aforementioned situation. Fortunately, with the guidance and support from Michigan Medicine, I am confident that we can be the change we wish to see in the world.