Cardiology Conference 10/27/15, 3:45 PM 6:30 PM

I probably shadowed more doctors in three hours today than I have ever since I first
shadowed a physician in high school. I had the opportunity to sit in on one of the weekly
cardiology conferences at Seattle Childrens, where cardiologists and cardiac surgeons (at the
very least, there may have been more cardiac-specific health professionals there) gathered to
discuss patients and their treatment plans.
This is the first time for me that the difference between childrens medicine and adult
medicine has been so boldly defined. Adult cardiology is all about the management of chronic
diseases that have arisen due to poor lifestyle or an aging body: CHF, CAD, COPD, all these
conditions can be traced back to the wear and tire of life. But in childrens cardiology, all the
cases were ones in which the heart in question was never healthy to begin with. Some recurrent
themes were hypoplasty (an underdevelopment of any structure in the body, which spelled
significant disaster since if ventricles, atria, valves, leaflets, or several of these structures were
malformed), congenital heart defects, ventricular septum defects, situs ambigus (which just
means an organ not being in its normal position, something Id never heard or seen before but
was startled to see a heart on the right side of the body, with everything flipped), and more.
It was definitely interesting to see a room full of specialists discussing these cases. For
one thing, Ive never really seen this kind of collaborative medicine taking place. Or in some
cases, argumentative. There were a lot of different opinions on what should and shouldnt be
done, which is interesting because I would have thought that theres always one right answer. But
a lot of considerations need to be taken into account when performing surgery on kids, such as
how old they are, whether their bodies can handle such surgeries, etc. It was definitely interesting
to see such a clash of egos. Everyone in the room was the best of the best. To be a doctor is one
thing, but to be a top specialist at a top institution renowned for specialty medicine, thats an
entirely higher plane of greatness. And so to see these doctors at times brutally battle it out with
their medical knowledge was intimidating and humbling.
That really ties into my main takeaway from my experience from the conference. In this
setting, where the focus was specifically on the medicine and science aspect of the profession,
the amount of knowledge was staggering. I mean, these people were talking about minute details
on complicated imagery. The echos and angiograms that we reviewed were all moving so rapidly
that I was counting myself lucky just to catch a glimpse of the heart, let alone whatever tiny
detail we were supposed to be analyzing. It makes the idea of doing a fellowship in cardiology
pretty scary.
I will be honest, after a while the cases got to be pretty repetitive and I found them all
bleeding into one. Just because of the nature of the presentation, it started feeling like the same
echocardiogram over and over. I think this was because the actual patient was so displaced from
the experience, and I think that if I had had the opportunity to see them, I wouldnt have found it
so monotonous. One of my concerns with specializing is that the career wouldnt have enough
variety to it for my liking, but I think the patients would bring that to the table for me. And its
clear that the cardiologists in charge of these patients love them. We had one guy who was
almost choking up because the cardiac surgeons werent warming up to the his idea of
performing surgery. So I can rest easy knowing that if I pursue this path, the human aspect will
definitely be present.
One final note: I really loved one other difference between children and adult cardiology.
Whereas adult cardiology has always seemed steeped in pessimism and cynicism because theres
no cure, only management, theres so much hope in childrens cardiology. Obviously, these

children are in dire situations, but theres a palpable belief that we can make a change in their
lives that will greatly increase their outlook. And that to me would make this a field worth
specializing in.