New York, New York

Bronx Lebanon Family Practice Center

Hello all! I’ve just survived my first week in New York City!

Although I’m rotating in the Bronx, I decided to stay in Manhattan due to some people’s suggestions. Because I want to enjoy the perks of being in Manhattan but also be close to the Bronx (and save money at the same time), I’ve decided to stay in northern Manhattan in a neighborhood called Hamilton Heights. From where I’m staying, the subway station is just around the corner, and it’s really convenient because the hospital is just a few stops away by subway, but I can also get to Times Square in 15 minutes by subway.

I’d describe Hamilton Heights as a semi-sketchy area, but it’s a unique place nevertheless. You see all sorts of people here of different colors, languages, and backgrounds: Middle eastern, Asian, Indian, Latinos, Caribbean, White, Black, Purple, Pink, Pink with polka dots, etc.  There are particularly lots of Spanish speakers, which is cool because I love the culture and language. These past few days I’ve been trying out a lot of the street vendors selling some awesome tamales and real tacos for cheap, stuff I haven’t had since I went to Mexico 3 years ago. Unlike other parts of town where the stores keep themselves indoors, the markets and stores here pour out onto the streets, drawing your attention as you walk by. No matter what time of day you go outside, there are always people on the streets, playing the guitar, walking their dogs, preaching, waiting for a bus, selling things, commuting, celebrating a birthday (I kid you not, I walked straight through that party on the sidewalk). The life of New York is on the streets.

Another thing I noticed here that is different from other places I’ve lived is that there seems to be a deli on every street corner. The delis can be as small as a shack, to as big as a seven eleven, and they sell your basic groceries, fruits, as well as make freshly made sandwiches, usually at a great price. Most of them don’t have any place you can sit down to eat at, so people just pick it up and eat it on the go, or take them home. There’s a 24 hour one just down the street, it’s my to-go place when I have the late night munchies. With so many delis everywhere, I’m not sure how Subway can survive out here.

I scheduled to come to New York for family med mainly because I had a 6 week gap in my schedule and Miami didn’t offer Family Medicine elective, which I really wanted to do. And what better place to see everyday underserved (urban) problems than in the middle of the Bronx?

Times Square

Before I came to Bronx-Lebanon hospital for family med (and after I had already scheduled), I had heard some negative things about this rotation from other students, about how the program is tough on the students, having long work hours, making students stand for hours at a time with nothing to do, etc. Perhaps the rumors are true with the inpatient experience, which I won’t know until I do inpatient in three weeks, but with outpatient right now, I’m absolutely loving it. From Day 1, it has been very hands-on, perhaps because my attending knows it’s not my first rotation. I get to take history and do physicals all by myself, input my findings onto the EMR system, and today my attending even gave me my own examination room to see patients in, before sending them off to see the “real doctor.” Unlike in Miami where I get assigned to an attending one at a time, here, I instead get assigned to a clinic, and rotate with whichever attendings are there that day. There’s three of us AUC students in our particular assigned outpatient clinic (which is inside the hospital), and also around 3 attendings that work there at a time, and therefore we each follow an attending. In other Bronx-Lebanon clinics students may follow residents. So far I’ve experienced a few different attendings, and they all teach a lot. Once every while they may ask you to do some scutwork, like relaying paperwork between the doctor and the nurses, but honestly it’s so little that it hardly wastes any time (at least for the attendings I’m with now). Another thing I noticed that is different between Miami attendings and New York attendings is that here in New York, they “pimp” students a lot more, basically ask you questions into further and further detail until you can’t answer them anymore, followed by “you need to look that up” or something like this. So far the pimping hasn’t been too harsh or humiliating, and even if it is, I don’t take it too personally. I think it has its place in medical education because you won’t forget anything that you learn after that, and already, I feel like I’ve learned so much, and it’s only been a week!

The rotation is divided into 3 weeks of inpatient and 3 weeks of outpatient experience. The outpatient rotations usually last from 8am-5pm with a 1 hour lunch break in between, five days a week. The inpatient rotations are 7am-9pm, four days a week. There used to be night shifts where students worked throughout the entire night without any sleep breaks, but they’ve gotten rid of that with our set of new students. So no night shifts 🙂 whew! In the mornings, we have lectures given by residents, and on Thursday afternoons after rotations, we have Grand Rounds. We also have a few assignments here and there to turn in like inpatient PI Chart Reviews, but I have yet to figure out what exactly those are.

I’ve never seen a place with so many drug-addict patients, and people who come in to the hospital for a detox. It makes me sad, and somewhat mad, seeing patients who come in every month for the same detox treatment, getting hooked onto cocaine and heroine again once they finish the detox program, month after month. You try to help people as much as you can, but some people won’t change their ways. There are homeless people who seemingly cannot afford anything, including proper medication that could potentially save their lives, yet somehow can afford drugs or cigarettes. I’ve seen patients whose mothers and fathers die of drug overdoses, and you wonder why the patients end up having the same problems. Sometimes you can’t really blame them, given their situation. Many never had a chance growing up in a decent household with parents who they can look up to as role models, and instead seek to fulfill the attention and love that every growing child needs from the wrong sources. It makes me appreciate what we have.

Besides listening to some of these patients’ stories, so far the most difficult part of this rotation is being away from Irene. I miss Irene so much already, and can’t wait to go back to Miami to be with her again. Miami’s our first home as a married couple and we’ve been there together for exactly a year already (Irene’s been there 2 years for school). New York’s a very different place, and has been somewhat more of a culture shock to me than St. Maarten was, and it’s difficult adjusting to it without a loved one. But whatever doesn’t break us will make us stronger, so hopefully this 6 weeks of endurance will pay off in the end.

Take care guys!