Berkshire Medical Center, Pittsfield, MA
The internship I completed this summer at Berkshire Medical Center in Pittsfield simultaneously broadened my knowledge of medicine and increased my insight into the specific health challenges facing the population of Berkshire County. I’ve spent two years in Williamstown just a short drive away from BMC, but until I started my internship, I had never realized the extent to which the Williams community is isolated from the problems of our surroundings. All of that changed on my first day at BMC, when I was assigned to shadow a doctor in the Mother-Baby Unit for a week.
The first patient I met was a young woman who, although she was only three or four years older than I am, was pregnant for the fifth time. Further complicating the situation, the young woman did not have custody of her other children. She had a history of opioid addiction and was living in a shelter for survivors of domestic violence. Although the pregnancy had been very difficult for her, she had managed to keep up with her methadone treatment, part of a plan to help end her dependency on drugs. Throughout the day, the patient’s friendliness and resilient attitude won her several allies among the nursing staff. When she eventually delivered her baby via C-section, however, the cheerful atmosphere was soon interrupted by three social workers who had arrived to assess the situation. Over the next few days, while issues of custody were being discussed in court, I often visited the patient to see how she was recovering from surgery. On one of these occasions, she told me I could hold her daughter, but when I went to the crib, the baby’s arms and legs began shaking—an indication of methadone withdrawal. I was torn between sympathy for the young woman, who had faced countless obstacles and was determined not to lose custody of yet another of her children, and the instinct to do everything possible to protect the baby, whose health and safety had already been compromised before she was born, from potential further harm. Although I went on to see dozens of other patients during my summer at BMC, this patient and her daughter remain the most memorable.
After my week in the Mother-Baby Unit, I spent a week on the Stroke Unit, where I learned about the mechanisms of stroke and transient ischemic attack (TIA) and the medications used to treat them. A particularly valuable aspect of my experience in this unit was that a new group of Internal Medicine residents had just started their first year there, and they were eager to answer any questions I had about patient care. After completing rounds in the morning with the attending physician and senior resident, I accompanied the first-year residents to their daily meetings, which included presentations on atrial fibrillation and atrial flutter, aortic stenosis, acute pancreatitis, alcohol withdrawal syndrome, and sleep, among other things. The meeting I found the most appealing was a discussion of a particular case that the hospital management felt could have been handled more efficiently. A doctor presented the facts of the case, pausing at each step to ask her listeners what measures they would have taken at that point, then comparing their answers to what had actually been done at the time. This experience impressed on me how receptive the doctors needed to be to feedback and criticism in order to continue improving patient care.
By far my favorite week of the internship was the one I spent in the Operating Rooms observing surgeries. Although this week was the most demanding, requiring that I be at the hospital by 7 a.m. and stand through several hours of surgeries, I also found that the doctors and nurses in the OR frequently made time to explain to me exactly what they were doing as they carried out a procedure. In total, I was able to observe several hysterectomies, cholecystectomies (gallbladder removals), an ileostomy reversal, multiple knee replacements (both total and partial), a femur head fracture repair, a double mastectomy and breast reconstruction, and a ventral hernia repair. I was particularly struck by the advanced technology that assisted the surgeons during these procedures. For example, the hysterectomies and cholecystectomies were performed laparoscopically, which means that the patient’s abdomen was inflated with carbon dioxide before several hollow probes were inserted near the target area. Various instruments, including a light and a camera, could then be inserted through these probes, allowing the surgeon to carry out a complicated procedure in a minimally invasive way. Some laparoscopic surgeries could even be performed using robotic arms that the surgeon controlled from a corner of the room. From these million-dollar instruments to the sutures used to stitch the probe holes closed at the end of the surgery, everything in the OR was designed to produce the best possible outcome and shortest recovery time for the patient.
In addition to the units mentioned above, I also spent time in the Emergency Department, Radiology, the Women’s Imaging Center, and more. In all of these departments, I found doctors willing to involve me in conversations about patient care and go out of their way to explain medical concepts to me. I also appreciated the relationships I was able to form with other staff members, many of whom gave me new insights into aspects of healthcare that I had not previously thought to be directly relevant to the care that hospitals provide. For example, the Stroke Unit had a social worker on staff who spent two full days calling local wound clinics until she found one that would accept a particular patient’s insurance. Her dedication to providing patients with the best care possible reminded me that much of the essential work that hospitals do is not performed by doctors and nurses. Finally, my interactions with patients taught me that a hospital’s patient population often reflects the population of the surrounding area. I was aware that many residents of Berkshire County struggled with opioid and alcohol addiction, but I was startled to learn that one in five BMC patients either arrive at the hospital to be treated for a drug-related issue or are found to have such an issue as a secondary complaint. The problem only became more real to me as I repeatedly encountered patients going through withdrawal over the course of my internship.
As I reflect on the time I spent at BMC, I would like to thank the Williams College Class of 1974 and the ’68 Center for Career Exploration for their generosity in providing me with a grant to pursue this unpaid internship. Without their support, I would have been unable to participate in what has undoubtedly been the most informative and meaningful experience of my Williams career. My experience at BMC has not only informed my passion for medicine and reaffirmed my intentions of going to medical school, but also increased my awareness of the burden that hospitals carry in communities affected by high rates of addiction, obesity, and gun violence. The weeks I spent at BMC have inspired me to continue learning about addiction, whether through classes at Williams or in my future career.