Shadowing an Orthopedic Surgeon

I. Shadowing

A small anatomical model of a foot sat on the shelf next to me. Other than the foot and a few medical supplies, the small office in the orthopedic clinic in the Texas Tech University Medical Pavilion could fit only Dr. Grimes and me. I sat in his office and watched Dr. Grimes look at a patient’s digital chart of personal medical history. As an orthopedic surgeon, Dr. Grimes worked on bones, tendons, ligaments, and muscles. I felt excited and nervous since this, the summer of 2022, was the first time I was able to shadow. Despite my excitement, I sat, quiet and still, causing no distractions, just like an actual shadow.

After he finished reading the chart for the first patient, Dr. Grimes left the office and headed for the first exam room. I followed and closed the door behind us. He introduced himself and me to the patient and performed an extensive physical exam to confirm previous findings and possibly create a new diagnosis. As he thoroughly explained the cause of the patient’s pain, he used a touch screen to sketch the anatomy and detail the proposed procedure, including where any plates or screws would be used. After confirming a treatment plan, I followed Dr. Grimes back to his office.

Dr. Grimes reviewed the next chart and stood up to head to the next room. I followed. As I walked in, a smell comparable to a dark sewage tunnel filled my nose. After Dr. Grimes removed a discolored bandage, I saw a gaping wound on the bottom of the patient’s foot. This, I later learned, was called an ulcer. Dr. Grimes excused himself from the room and came back with a scalpel and forceps. Despite the sickening smell and the image of the wound, I could not look away. I wondered what had caused the wound and how it would be healed. To my surprise, Dr. Grimes began cutting away at the flesh around the wound. He explained that debridement, or the removal of damaged tissue, was necessary for such a wound to heal. As he did so, he pulled back the skin and revealed the dark cavity into the foot. My stomach churned. I felt lightheaded. Still fascinated, I kept watching. Suddenly I realized I had to leave the room. I walked into Dr. Grimes’s office, grabbed the trash can, and threw up.

II. Motivations

The article “How to Shadow a Doctor as a Pre-Med Student,” published in The Princeton Review, explains that many medical schools view applicants as “more competitive in the admissions process” if they shadow a physician. Any physician can be shadowed because the importance of shadowing is to learn about the inner workings of a career in medicine and to have a memorable time to talk about during medical school interviews. But, to be the most competitive applicant possible, I needed to shadow a specialty that actually interested me so that I could express my enthusiasm to the application committees. However, after throwing up, I doubted my ability to handle a career in medicine.

My episode of sickness, according to the article “Vasovagal Syncope” by Steven Kang and Stacey Wojcik, is called a vasovagal syncope, or vagal response. The many triggers, including the “sight of blood,” “a needle,” “standing for long periods of time,” and a relatively empty stomach can cause the vagus nerve to send incorrect signals to the heart and blood vessels. These signals can slow the heart rate while also dilating blood vessels, causing a drop in blood pressure and a lack of blood supply to the brain. It was undoubtably this lack of blood supply that caused my symptoms. As an instinctual response outside of my conscious control, my episode of sickness made me question my motivations to shadow and even to pursue surgery as a whole.

III. Deciding on a Specialty

Ever since I was a kid, I have wanted to become a doctor. During the summer before I entered third grade, I broke my leg. The orthopedic surgeon who helped me heal, Dr. Whatley, was very kind and impressively knowledgeable. His ability to help me make a full recovery left a deep impression on me and has served as inspiration for my pursuit of a medical career.

Led by to my personal connection to orthopedic surgery, I was excited to ask many orthopedic surgeons for the opportunity to shadow. Dr. Grimes was one of the few who answered and accepted my petition. I chose him because his practice would be useful for my medical school application.

I am not a squeamish person. The sight of blood or gore had never bothered me. Was this the result of my poor breakfast choice, a pop tart? Was it the smell, or the sight, or both? To add to my confusion, I wondered if I would be able to stomach similar instances as a medical student or doctor. More than that, would I be able to continue shadowing for the entire summer? I did not want to distract Dr. Grimes or embarrass myself further.

I was supposed to be a shadow, but I couldn’t even control my shadow self. The part of me that acts primarily by instinct seemed to betray me. Although I could not influence my shadow directly, it is a part of me, and is affected at least partially by my actions and perceptions. I was disappointed that I did not consider this possibility, yet how could I have known? I was there to learn after all.

After I calmed down, I realized that I was not actually disgusted by the wound itself. I was, in every way, intrigued by it and the treatment method. Orthopedics covered a wider range of treatments than I had thought. If I could bear the sights and smells, then orthopedics would certainly be a challenging and intriguing specialty to pursue. I decided that I would have to push my shadow self and occasionally expose it to the light to overcome my instincts. The only way to acclimate myself, then, would be to expose myself to all of the medical field’s vile, gut-wrenching wounds.

After getting sick, I immediately felt better. More than better, I felt strangely energized. I tied up the trash bag and asked the nurses where the bathroom was. The nurses, after offering some playful teasing, provided the directions. When I returned, Dr. Grimes was in the office.

“Are you OK?” he said.

“Yes, thank you. I’m sorry I left like that. I got sick.”

“Don’t worry. It happens more than you’d think. Do you want to keep going?” he said.

“Yes, I’d love to,” I said.

Dr. Grimes gave a quick nod and turned to read the next chart. I sat patiently, looking over his shoulder at the x-rays, ready to follow him to the next room.

Works Cited

“How to Shadow A Doctor as a Pre-Med Student.” The Princeton Review, https://www.princetonreview.com/med-school-advice/how-to-shadow-a-doctor-as-a-pre-med-student.

Kang, Steven, and Stacey Wojcik. “Vasovagal Syncope.” Cedars Sinai, https://www.cedars-sinai.org/health-library/diseases-and-conditions/v/vasovagal-syncope.html#:~:text=You%20might%20not%20feel%20normal,vasovagal%20syncope%20in%20their%20life.

---

Michael Steward is an undergraduate senior in Biology at Texas Tech University. He regularly volunteers and shadows at the Texas Tech University Health Sciences Center. In his free time, he enjoys playing sports and percussion instruments.