Senior, Biomedical Science
I went to Dublin, Ireland from June to August to conduct clinical research at Our Lady's Hospice for my Mack Lipkin Fellowship from Sophie Davis. The ongoing study aims to assess the risk factors for falling in cancer patients. My role was to work directly with patients to gather information about many aspects of their health and daily functioning: This process is called a battery. The research team and I spent two hours with each patient measuring vibratory sense, peripheral sensation, balance, mental status, assessing mood and continence status, testing vision, calculating BMI, and using highly sophisticated machinery to measure blood pressure at each pulse beat while the patient performed various tasks. When the research team wasn't working directly with patients, we were analyzing ECG's, enrolling new patients in the study, and conducting preliminary statistical analysis on the data already collected.
The Fellowship was hard work: on early days I was at the hospice at 7:15am, and most days I worked until 5pm or later. But I managed to fit in plenty of fun (or craic as the Irish say). I attended an Irish story-telling evening, visited museums and cultural institutions, traveled to many different counties across Ireland, and of course ate lots of fresh potatoes.
I was fortunate to take the fellowship to Our Lady's Hospice in Dublin as my research site. It is considered the world's first hospice of the modern era and remains a renowned and cutting-edge institution. The concept of hospice care has a long and developed history in Europe. I wanted to go straight to the source to see how palliative medicine works in the ideal setting.
My time in Ireland was an intense journey. Working with seriously ill patients during the most vulnerable time in their life takes personal fortitude and inner strength. I was also impressed by how generous of heart the patients were, despite the struggles that they face. Patients volunteered to be participants in research because they believed in education and the pursuit of knowledge. One patient reminded me that even when people look like they've come to terms with their illness, they still need a lot of support.
One patient decided to stop the research session after he became very upset in response to questions about depression. I was able to sit with him and console him, and of course get him a good comforting cup of Irish tea.
I learned a lot about the practice of clinical medicine in addition to clinical research. I listened through my new stethoscope to a pleural effusion, a pleural rub, pneumonia, and many other health conditions. I elicited clonus at the Achilles tendon of a patient with glioblastoma. I saw lots of bags - no, not shopping bags - ileostomy, colostomy, urine and nasogastric bags. I examined the legs of a patient who was paraplegic due to spinal cord compression, and an HIV patient who turned blue due to cyanosis. I talked with a patient who had been intent on suicide due to severe bone pain, but who now had the will to live because her pain had been relieved by methadone. I saw a 16 year-old girl suffering from rhabdomyosarcoma who was still mourning the recent death of her father. In addition to seeing palliative care patients at my primary site at Our Lady's Hospice, I was also able to see inpatients at two major Irish hospitals, outpatients in a palliative care clinic, and outpatients in their own homes.
What I'll remember most are the patients, their stories and their illnesses. The goal of the research I was involved with was to discover what factors contribute to cancer patients falling down. Compiling information about patients in order to analyze it on a larger scale, with the goal of reducing falls for future patients, is a significant way to find good amongst all of the sadness.
What I'll also remember is that it is the responsibility of a future physician to be strong for their patients, whether it is in the clinical or research setting. Irish medical students and residents in their early years of training are considered too inexperienced to have placement in such an intense environment as the hospice. So I was really lucky I was able to spend time there and learn what it is like to be with severely ill patients. I will also remember how kind and respectful the staff were to the patients. The patients and their families often expressed aloud how important that attitude was in their overall care.
Go for it! Traveling is a great way to learn about the world and about yourself. Conducting research in a different country is an interesting lens through which to view a culture and to learn more about your topic of interest. And, try Ireland. Dublin is a hidden gem in terms of world capitals, and there is so much to discover. Ireland is a beautiful country with cosmopolitan and sociable people, so you always feel welcome. Watch your budget, travel light, and get a good map & you're ready to go!
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