Stephanie P.

January 7th – January 14th (13.83 hours) –  One meaningful experience I had in the past two weeks was when Joy came back. A long time ago (back in September/November times), I mentioned that Dr. Price and one of our M.A.’s, Joy, were leaving the office. Well, Joy’s back. So (stepping out of my crazy shyness that literally only happens when I walk into the office and ends when I leave), I ask her what happened. And I was very happy that she was open with me and told me about the other office (it wasn’t a good fit for her). She told me about her experiences and then even went as far to tell me that since she left and then came back, she has to earn Dr. Dyson’s trust back. I felt included and overall, good, because she told me that last part just because she wanted to. It wasn’t part of the question and it seems to be pretty personal, but she still told me.

One major soft skill in the medical field, especially in pediatrics, is the ability to communicate and do it very well. You have to communicate with patients, staff and parents and each of those are very different from each other. Plus with the patients, there’s a huge range of ages and even that can’t always prepare you for the type of personality of the child. Through my last semester, I’ve worked very hard to build up this skill. Dr. Dyson continuously tells me some background from each patient before we enter the room, giving me advice on the type of child, and parent(s), that I will encounter. He also provides insight on his patients with autism and other disorders that I should be aware of before I enter the room. However well I have progressed with communicating with parents and patients, I have equally regressed with communicating with the staff. I feel awkward and so that’s a huge part of the skill that I need to improve on this semester. I have to be more vocal with the staff.

Communication is HUGE in college. Parents aren’t there to email your professors or talk to supervisors or counselors. You have to do it all on your own. So my increasing communication skills through this program is really going to benefit me in college. I will be able to approach people about study groups and classes in general, for advice and help. In my career, this is also very important. I mean, it’s the main component of the medical field. Doctors, nurses, technicians, everyone has to be aware of their words and pick up on social cues and, just overall be able to communicate everything very well to succeed (and not offend anyone or get themselves into trouble). Communication and just overall interpersonal skills will be extremely beneficial to my future.

Dr. Dyson and I were in with a patient for a sick visit and Dr. Dyson mentioned that the symptoms added up to something called “ecthyma”. Ecthyma is crusted sores beneath the skin. It begins as a bilster and soon the hard crust covers the blister, causing “discomfort or pain”. To treat this, he suggested that the patient go to a dermatologist for a firm diagnosis and a prescription.

January 15th – January 28th (6 hours) –  I am a part of the Human Anatomy and Physiology class at school and during these two weeks, we are going over a unit on the special senses. So far we have covered sight (eye anatomy and function) and hearing (ear anatomy and function) and are moving on to taste (tongue/mouth anatomy). What was so cool about this was also during this unit, I went in to Dyson’s and there was a truly incredible family we were seeing. The mother was almost completely deaf (a few noises were all she could hear) and the dad was also deaf (able to make out most sounds to help form words, but still deaf). And their two year old daughter has dancing eye syndrome. It’s so remarkable that when they came in, I had just moved on from eyes to ears and both subjects were completely applicable in this case. I was stunned that this family came in right when I was learning about it all! It was so crazy and I ended up doing even more research on deafness and on the little girl’s syndrome.

As I said in the first question, I met a remarkable family and the two year old had something called, dancing eye syndrome (DES), also known as Opsoclonus myoclonus syndrome (OMS). This is a very rare condition in which the eyes are “dancing” or moving very irregularly and the person cannot control the movement. It causes vision to be blurred and distorted from the constant movement.

January 29th – February 11th () –

February 12th – February 25th () –

February 26th – March 11th () – 

March 12th – March 25th () – 

March 26th – April 8th () – 

April 9th – April 22nd () – 

July 20th – August 13th (9.47 hours) – So far the internship program has been exhilarating. The most meaningful part has been learning how to be in the workforce. Throughout the first few months of being a participant of the internship program I learned more about the real world than I did in the past fifteen years of school. Most importantly I learned about interviews. I learned what to say, what not to say, how to sit, how to act, how to create a résume and much more. I especially liked the pointers on the résume and how it was supposed to be set up and how much to actually add since I have a tendency to add more than what is needed. That has been extremely helpful in my journey to adulthood.

Through this program I hope to learn a lot. Already I mentioned that I have learned about interviews, but hopefully throughout the rest of the program I will learn about the workforce specifically. Mrs. Wahl’s PD meetings and individual meetings will hopefully lead me in the right direction. I want to learn how to act in a more professional environment than a doctor’s office. From Dr. Dyson, I would like to come out knowing if a private practice is right for me or if I should go into a group practice. I would like to learn more about the paperwork and environment of the office. Mainly I hope to learn what it takes to be a Pediatrician and if this is the right path for me to take.

Through this program, I have learned that I am not prepared for communication with other professionals in settings like meetings and interviews. I either tend to over-explain every situation or not give the right information. However, I do believe that I am ready for the other aspects of the professional world because of my strengths as a student. I have learned that my organizational skills are not a burden and they can be helpful. Through being organized I tend not to procrastinate and never miss dates (both deadlines and events). Before, I knew organization mattered, but now, I know how much it can cost you to not be organized and prepared.

August 14th – August 27th (8.73 hours) – Through the internship, I have had many meaningful experiences, but I think my favorite one has to be when I met Dr. Dyson’s wife. Dr. Dyson’s wife runs Dyson Dermatology in a conjoined office to Dyson Pediatrics and she stopped by on Wednesday, the 15th, to give Dr. Dyson something. I was having a conversation with Dr. Dyson about technology and the appropriate age to allow screens for a child (which is no earlier than 3 for a child to watch TV/videos/etc. and he doesn’t believe in phones before 13-15 years of age) when she came in. The three of us ended up discussing their children’s anticipation to have a phone and my regrets to getting one as early as I did (13 years old). We discussed what technology does to a person, both factual and what we have observed, and how their son turned 13 recently and wants a phone because their daughter got one at 13. We discussed my experiences with my phone versus their experiences and their daughter’s experience. I mentioned how when my phone broke last year, I wouldn’t have gotten a new one if I hadn’t been placed in this program, which requires the use of a phone. They were surprised by my distaste for phones and technology in general, given that everyone else my age is attached to theirs. It was a lively discussion that put both doctors behind schedule about 15 minutes or so, but it was a great experience and it really made me think about the effects of technology on our society.

August 28th – September 10th (12.3 hours) – One meaningful experience I’ve had at my internship site has been when I interviewed Dr. Dyson. I have been asking a lot of questions lately and I have learned a lot about the profession and his view on vaccines. My favorite part of the interview was when I discussed with him his school choices and his major and minor choices. It was very insightful and helped me when I was applying for some colleges these past two weeks. He went to UC Berkeley, then relocated to Atlanta for medical school and he told me his experiences at both. It was a very interesting discussion and it ended up being very helpful.

My coworkers are always busy–either with paperwork or with patients. When I am with patients, I should be happy and smile. If I have had any previous problems during the day, those are left at the door. Especially since I’m working with kids, I have to be very observant, which means I am expected to be quiet most of the time, but still have questions after we leave the room. This is so the parents are more comfortable with me in the room. If it sounds or looks like I don’t know what I’m doing, parents don’t like that I’m in the room. However, every once and awhile, Dyson asks me a question in the room which means I should be ready to answer. In other cases, I have to be ready to ask a question of the parents concerning the child and his/her condition, so no matter the situation, I have to be observant and attentive.

I believe that this is a natural fit for who I am, both my personality and my conduct. I am a very lively and happy person, even if I have some burdens or problems. Over the years, I have become very skilled at hiding any of my problems to make other people feel more comfortable. The quiet part might be a problem, though. I have been known to be extremely talkative, but right now, since I’m still getting used to the office and the procedures, I have been pretty good at staying quiet. When I continue to come and get more used to what I’m supposed to do, I might be more likely to talk. I will have to work on that and making sure that I am not too talkative and if I do talk, it’s not going to be irrelevant.

Over the past few weeks, I have come to know a few new words, one of which is “fontanal”. Fontanels are the spaces between the bones in the skull. When I arrived one day, Dr. Dyson and he co-doctor, Dr. Price, were discussing a patient that they had earlier that day. We had some down time, so Dr. Dyson gave me a mini-lesson and then had me research it and draw a diagram of it.

September 11th – September 24th (5.42 hours) – I found out during this time period that some of the employees at Dyson’s were leaving. Jess, one of the front desk receptionists, had her last day Friday, the 14th and Heather, the office manager, had her last day on Friday, the 21st. What was really heartwarming about this was that when it was each of their respective last days, they congratulated me on how well I had been doing and wished me well. I was surprised by Jess because I rarely talked to her. I say “hi” and “bye” but not much else since I immediately go into the back to begin with Dr. Dyson. It made me realize that I am being watched and maybe even talked about and thankful that I hadn’t made a fool of myself. Heather was the one who interviewed me and talked with Mrs. Wahl and did all the correspondence between me and Dr. Dyson, so I felt more connected with her and I was sad to see her go. Heather also wished me well. Now I have to get to know the new office manager and receptionist, but I’m just glad that both got to move on to another position.

One of the days I was at the office, Dr. Dyson and Dr. Price were discussing “floating knee” and how and when it happens. They began to talk about if the patient had it or not and what it would look like if a person did. Floating knee is a flail knee joint that happens because of fractures of the bones around the knee like the femur and the ipsilateral tibia.

September 25th – October 8th (51.12 hours) – One thing that happened these past two weeks was my site visit. Because of the topics that were discussed with and without Dr. Dyson, I was able to step it up. I’ve been uncharacteristically shy these past few months interning at Dyson’s but after openly discussing it, I was able to step it up and ask more questions. I realized that everyone there was just trying to show me how the healthcare profession works. I have been able to ask more questions with both Dyson and some of the MAs, mostly Joy since she seems to know more (and I sit right in front of her on the bar-like counter around the MA desks). Unfortunately I learned just last week on Wednesday that she will be moving practices so I have to step it up and ask more of the other MAs. The site visit overall pushed me to do more and say more.

We talk way more than anything else. The front office staff with sometimes page the phones in the back to ask a quick question or tell one of the MAs that a parent is on a line and they need to answer their questions. Other than that, there aren’t any phones in any of the exam rooms and that means that Dr. Dyson or I have to open the door and ask the questions. Normally, Dr. Dyson will have me leave the room to ask questions of the MAs or to get things that he needs. It wouldn’t be appropriate to email or text since this is an active workplace, so in-person conversation and the occasional phone use is used. I normally don’t use the phone just because I can run around and I’m not tied down to working or using the systems or to a patient.

Well, since this workplace is solely based on verbal communication, I haven’t had such a hard time with it. I have had some issues with asking questions but that was just at the beginning because I wasn’t familiar with being a part of the practice. In the past two weeks however, I’ve gotten a lot better with asking questions since I’ve spent more time there. During the down time in between patients, I take notes and when I have a question, I can ask either Dr. Dyson or Joy since both of them are usually logging their interactions with the patients. Being there for full days has really strengthened my relationship with the staff there. Hopefully, as the year progresses, I can gain more knowledge so that communication will come easier because I think that the main reason I was so hesitant to talk was because I have almost no knowledge of the field.

These past two weeks have allowed me to ask more questions and experience a wider variety of patients and conditions so I learned about more medical terminology than I had before. During one of the days I was at the office, I learned about “ventriculoperitoneal shunt”. This is a medical device that relieves pressure on the brain caused by fluid accumulation and primarily treats a condition (hydrocephalus) in which excess cerebrospinal fluid collects in the brain’s ventricles. This was mentioned as a treatment that one of Dr. Dyson’s patients was undergoing at TMC and I got to read the report.

October 9th – October 22nd (5.67 hours) – On Friday, October 12, I had a sad day. It was Joy’s last day at Dyson Pediatrics. Joy was the MA that sat in front of me, answered all my extra questions, showed me the ropes of her side of the Pediatric profession, and basically put up with me since I got there. She was the one who I liked the most and who was a lot more welcoming on the first few days (next was Priscilla–let’s hope she doesn’t leave too!). I was sad to see her go but I still wish her well in her new office (she followed Dr. Price to his office when he left a few weeks before). That makes four people who have left since I’ve been there so I have definitely got to memorize new names and get to know more people. What was nice about her last day was that I got to sign a goodbye card and I wished her well. It was interesting to see how the medical field is fluctuating so much. I learned about Poland Syndrome during a wellcheck on a new patient (not really new they had just been seeing Dr. Price and now that he’s gone, Dyson has been working with all Price’s former patients).

Poland Syndrome is when a child (usually male) is born with missing or underdeveloped chest muscles (usually the right side). This is a rare condition and doesn’t normally cause alarm and this case is so slight that there is no true worry.

October 23rd – November 5th (13.47 hours) – Halloween was in these past two weeks and that was amazing. Since I intern at a Pediatrics office, I was very interested to see what they did for the children on Halloween. It was really fun. Elva dressed up in a hippo onesie, Kassandra dressed up in a unicorn onesie with a headband instead of wearing the hood, Priscilla dressed up in a Yogi onesie (from Mario), Alma dressed up as a black cat, and our office manager, Vianey, did some AMAZING makeup as a deer (or doe since she’s a she). It was so cute! I just wore a candy-corn scrubs shirt and my black pants since all my costumes are too elaborate for the office setting, but it was fun nonetheless. The best was Dr. Dyson. He’s very professional and I have to mention that he said that he tries to be very professional even though it’s children and his patient families are pretty familiar because he is a African American man who is running his own business (he says he doesn’t see much anymore, but he is still on the edge). With that being said, he is always in professional-casual (button down and slacks and nice shoes but no tie and fun socks for the kids). But on Halloween he was dressed in a teddy bear onesie! It was awesome to see him dressed up, but in a onesie? Wow. Halloween was a great let-loose day (but more rushed than usual so everyone could get home for their kids).

Priscilla, Alma, and Elva are our MAs and they handle things like shots, records, referrals, basically anything you can think of. So every once and a while, I’m asked to do something for Dr. Dyson that I don’t know how to do or need just a little guidance. The most frequent of these situations is asking for shot records (ever since Dr. Price left, most of his patients are now Dyson’s so Dyson doesn’t have the same records as Price did so it can get a little complicated). In fact, this week, I asked Elva to print a shot record for me. I had to tell her the name and date of birth of the child (since she wasn’t the one who roomed him) and explain to her the situation. It was challenging because I didn’t have his birth date (only his age) and I didn’t have much information (since I’m not the one who is on the computer during the time that we are talking with the parents and patients). This has happened pretty regularly lately so I’ve gotten the hang of how the conversation should work.

Priscilla and I have discussed the gender of her baby (girl) and the due date (February 14). We have talked in the past about this so it’s been an ongoing conversation. Before she found out the gender she mentioned that she wanted a girl since she had three boys already and this was for sure going to be her last. So she got her wish. I’ve also talked to Elva about her wedding. She actually was talking to the other women about her dress then asked me to choose between two of her possible dresses (and it was cool because she actually took my opinion into consideration). I also followed up with her on that conversation just a couple weeks ago and it turns out she isn’t going for either.. She’s choosing to have her dress styled the way she wants it (almost designing it herself but not really because it’s just piecing parts of the dress together). I would have to say that starting up the conversations is difficult (I’m still trying to get out of the strange shyness I feel there) but continuing with it in one sitting I’m pretty comfortable with.

This time, the vocabulary I learned was not from something that was mentioned in a room or from someone, it was from a pediatric doctor magazine. It’s called Kawaski disease and it causes inflammation in the walls of blood vessels. It’s most common in infants and young children (which is why it was main focus this week) and some of the early stages can be hard to determine from a viral infection (mainly fever). However, some of the later stages the skin can begin to peel which is a bug tell-tale sign.

November 6th – November 19th () – I met one of Dr. Dyson’s son. One of his sons, his youngest (6 years old), has really bad asthma so he had to stay home from school. Since he went out for Halloween the night before, it had gotten really bad. So since he was at the office I got to talk and interact with him. He is soo cute! Anyway, I got to see Dr. Dyson interact with a child in a different light: his own son. He was a little more stern one time since he had to explain what not to do and how he should know better. Overall though, I was in a state of shock at how the little differences in the way he interacts with his patients/parents of the patients versus his child really makes a difference. I guess even though I knew he had a family, it seemed so strange to see him interact that way that I must’ve never fully realized that he had a whole other side.

Well, at first I think I did pretty good. I went in every Monday, Wednesday, and Friday. Then fall break happened and I went in every day, all day which was amazing, by the way. After that, I think it got a little shaky. I continued with the Monday, Wednesday, Friday thing, but with breaks and half days and schedule changes and overall the craziness of my life I have had to cancel on my days so many times, I honestly feel really bad. And a lot of the time I had to cancel last minute through a text to my office manager instead of telling Dr. Dyson myself the last day I saw him. I definitely always told them all i couldn’t make it and normally at least the morning of at the absolute latest (normally though it was the day before). Even though it seems normal, I just feel really bad about doing it so I’ve definitely tried extra hard to stick with the schedule. Overall, I did an okay job but I can definitely do way better.

At first I was great. It all fit very well and it was smooth sailing. Then after break, I began to get overwhelmed with everything I took on this year. I am the event planner for a club at school and this quarter I took on a huge project and balancing that with the internship, two instruments, homework, and family took a toll on my time management. Then I went on a trip and it got even more off. I had to cancel twice on my internship days because I had meetings with people and then I just got so overwhelmed with homework, that I had to cancel another time to spend 4 hours on homework instead of the internship (and I still didn’t get all I needed done by the way. It was a lot). Overall, I can do a lot better in the future but I have to say that I was impressed with my first quarter.

I learned more about ringworm these two weeks. We had a patient with new cats who came in claiming they had issues with ringworm (it was true). Cats can carry ringworm from person to person. Ringworm in a “highly contagious” fungal infection of skin (normally the scalp).