Grace Fink '17

As the 2016 recipient of the Ali Sacco '05 Internship, Grace spent two weeks at Children's Hospital in Boston, shadowing the physicians and staff in the Cardiology Department. Following is her account.

Grace Fink '17 with Dr. Marshall

The average heart beats about 60 to 100 times per minute; however, I can say that when I first walked into Boston Children's Hospital this summer, my heart rate doubled its normal speed. Just like right now.

I was about to start a two-week internship working with some of the greatest cardiologists in the country, and I had no idea what I was doing. As I sat in the lobby waiting to meet Dr. Marshall, my hands were shaking, either from nerves, or the iced coffee that I drank immediately beforehand—probably a combination of both.

I was given a brief tour of the Cardiac Wing of the hospital, and then went to the Catheterisation Lab with Dr. Marshall. Before we entered the lab, Dr. Marshall turned to me and said, "Wait, I forgot to ask if you get squeamish around blood."

"I think I'll be okay," I responded.

"Oh okay, good. Don't worry, we've only had one person faint before."

"Oh really?" I said. That was comforting. We pushed the doors open, and I was met by a dozen doctors and nurses dressed in scrubs scurrying around while yelling out what seemed like random numbers and taking blood samples, surrounded by giant x-ray machines and monitors. The patient lay flat on the table in the center of the room, hooked up to countless wires and machines. I watched the lines on the various screens as they moved up and down, beeping with each beat of the patient's heart. I assumed that the one labeled HR was heart rate, but other than that, all the terms seemed foreign to me. I was lost. Literally. I didn't even know which building I was in.

The catheters were in the patient's heart and other surrounding arteries, and the doctors were injecting a contrast dye into the bloodstream, in order to see where any leaks were.Dr. Marshall pointed to the screen showing the x-rays, and asked me if I knew which chamber the catheter was in.

Suddenly, I came to a horrible realization: I had missed the first day of Chapter 33 in bio because I was giving a red key tour. That chapter? Cardiology.

"Um... left... uh... ventricle?" A complete guess, my mind was blank. I'm surprised I even remembered the word ventricle.

"That's right!" Dr. Marshall replied. "How did you know?"

"Oh, well, I just got lucky."

In fact, I was very lucky. Each day thereafter, I learned more and more about cardiology. I sat through meetings, went on rounds with the doctors, and observed clinical appointments. I saw patients ranging from 12 hours old to 42 years, each with his or her own story and unique cardiac defect. One boy, just a few days older than I, had been referred to a cardiologist after his pediatrician noticed a small murmur when listening to his heart during his annual sports physical. Little did he know that he had been living with an Atrial Septum Defect, a hole between the two upper chambers of the heart that allows un-oxygenated blood returning from the body through the superior vena cava to mix with the oxygenated blood coming from the lungs and pulmonary veins. This mix is sent through the aorta to the rest of the body and the brain, preventing the body from receiving as much oxygen as it needs, leading to constant fatigue, shortness of breath, and frequent respiratory infections. See? Slowly, all these terms were starting to make sense to me, until one day, when it all finally clicked.

During a routine appointment in the clinic, I was entertaining a toddler while Dr. Marshall talked to her parents. Their daughter had one of the loudest heart murmurs that her pediatrician had ever heard, due to her congenital heart defect. But because it sounded so much louder than it had before, they decided to bring her to the clinic. Dr. Marshall explained to them that this was totally normal: since she was growing, her heart was growing, too, and it was okay for things to sound a little funny. Her murmur was caused by the hyperextension of her valves as they closed, so instead of the blood being pumped, it was constantly flowing.

"After the textbook terms, the numbers and screens and machines, here was the real thing, a living human heart. I could hear it, and picture it working in this little girl."I must have looked confused, because Dr. Marshall asked me if I would like to take a listen with her stethoscope. When I put the earpieces in and placed the diaphragm on the girl's chest, I could instantly hear the rushing that Dr. Marshall had described. It finally all made sense. After the textbook terms, the numbers and screens and machines, here was the real thing, a living human heart. I could hear it, and picture it working in this little girl. I saw the smile on Dr. Marshall's face as she realized that my eyes had finally been opened, just the way that hers had when she was my age.

I guess what I'm trying to say is that ignorance isn't bliss. Take it from me, it can be pretty nerve-wracking to be the only one who doesn't understand in a room full of some of the most accomplished people in their fields, but not knowing is also an opportunity. If you can overcome the fear and anxiety of something new, you may learn something life-changing.