A morning with an on-call cardiologist can be as variable and exciting as the days the emergency department has graciously prepared me for. Here’s how I spent my morning:

I started the day chatting with Dr. G’s nurse about the schedule, procedures, and variability in patient cases in cardiology. After Dr. G, an interventional cardiologist, had finished rounding for the morning, I joined him to see his first and only clinic patient of the day. The individual had a new onset of shoulder pain when beginning a new exercise regimen, and after both a negative EKG and stress test, was cleared. Dr. G did an exceptional job of explaining everything to his patient, reaffirmed by the genuine “thank you” and kind words he received. This was an excellent reminder of the clinician I aspire to be.

After finishing up with the sole clinic patient of the day, Dr. G and I headed to the cardiac catheterization (cath) lab. Dr. G was on call, but simultaneously had two scheduled angiograms to rule out occlusions.

The first procedure, I observed from the station with the cath lab techs and nurses who explained the procedure to me. I quickly realized how brief the procedure was (only about 15 minutes start to finish), and then reviewed the pictures with Dr. G. It was negative, but very interesting to watch the contrast flowing through the coronary arteries!

The second procedure, another angiogram, Dr. G invited me in the cath lab. I donned surgical scrubs, gowned and gloved (and masked), and wore lead to prevent radiation exposure. This time, I was able to see Dr. G thread the radial artery and inject dye through and into the heart. Unlike the previous angiogram I saw, there was notable blockage and Dr. G concluded that the patient would need either triple or quadruple bypass surgery rather than cardiac stents.

The photo depicts an image similar to what I had seen on the left.

coronary angiogram – A: before cardiac catheterization (notable blockage) B – after cardiac catheterization; occlusion notably improved **not my image** (see below for image credit)

After talking to Dr. G about conscious sedation, he explained that he uses Versed and fentanyl and only the smallest amounts to start, because it isn’t necessary to completely sedate the patients during the procedure. He explained that he can always increase the dosage if the patient is uncomfortable.

Lastly, Dr. G got a page from the internal medicine doctor for a patient on the floor. This too, presented a learning opportunity for me – I listened to abnormal breath sounds and heard a heart murmur for the first time.

A few things that drew me in:

  • the opportunity to educate patients about their health and how to make lifestyle changes.
  • the near-instantaneously relief that interventional cardiology provides in such a small, minimally invasive procedures.
  • the high-acuity and helping sick, sick individuals recover.


Three takeaways: 

  1. Interventional cardiology is more reactive rather than proactive.
  2. Educating the patient is probably the most effective way to not only achieve greater patient satisfaction, but will also increase the probability that the patient will be motivated to make changes. 
  3. The correlation between heart disease and diabetes is notably strong. 

Shadowing physicians and being in the hospital, especially at the beginning of a long semester reminds me why I still choose medicine every day. The opportunity to spend an entire day with the gift of having the ability to improve someone’s quality of life sounds like a career I still hope to have.

I look like a surgeon.

For my guide to having a positive shadowing experience in the hospital yourself, click here!

Thanks for reading!




**Image credit: https://www.researchgate.net/figure/Coronary-angiogram-A-Total-occlusion-of-the-mid-RCA-and-70-narrowing-of-proximal-RCA_6875106_fig2

My friend over at @heardtohealed on Instagram, Stephen Groner, has combined his experiences of being an ENT patient, and having a career in speech-language pathology and wrote a book full of simple ways for you and I to improve our interactions with patients – making our jobs more enjoyable, and our patients’ satisfaction greater!

Stephen breaks down bedside manner into three chapters:

  1. Starting: Impressive First Impressions
  2. Listening: Giving Them the Mic
  3. Talking: What to Say and How to Say It

In my clinical experience so far, I have found that it can be challenging to relate to patients, relay information, and rationalize a scenario with a patient or their family when they are angry, frustrated, or feeling other hard-to-cope-with emotions. Though these situations tend to get easier the more one experiences them, it remains difficult to know if you are doing or saying the “right thing.” According to Stephen, you’ll learn that sometimes silence is better, and a gesture means more than finding the right thing to say.

Read this book, a quick read (under 70 pages), and reference it when you want to refresh your approachability and success with your patients and your interactions with them. Find it in ebook form here for only $7! I am so glad I read this book, not only for how I can work on the dynamic I have with my current emergency department patients, but also with skills I hope to integrate in my future practice as a physician!

Happy reading! And while you’re at it, go check out Stephen’s page for inspiration and humility!




Just a few short days ago, I asked the surgery residents at work if I could put on a cap and mask on and shadow a sterile procedure in our department. I quickly made myself a fly on the wall and remained out of their way.

One of the residents then asked, since I was in the room, to help hold the patient’s arm out of the way of the procedure underneath the sterile field so her arm would not tire and get in the way. I was a very minimal part of this procedure overall, but the role I held came with standing in the same position for over 30 minutes, and included holding the weight of the patient’s arm up.

I now have even more respect for surgeons who perform lengthy operations and endure gruesome shifts. I am also extremely grateful for the opportunity to have a job that allows me to experience these types of things. Not many people get to go to work and help with sterile procedures every day. It is a privilege to say the least!

But what does this have to do with sweat?

Why do I hit the gym? Well, let me tell you!

1. Stress relief. Feeling good. Endorphins.

Having a busy lifestyle requires some form of stress relief. Lifting weights or hitting tennis balls gives me a a sense of clarity and helps me focus on the tasks I have to complete after I’ve gotten a good workout in. It’s been proven to facilitate good overall mental health and stress relief. If this alone was the only reason, I’d still be exercising.

2. Leading by example.

When we tell our patients to make lifestyle changes such as diet and exercise, we better be doing those things ourselves. I want to be the physician that can help guide patients with proper lifestyle habits by doing them myself.

3. I want to play with my grandchildren.

Whoa. That is a bold and profound statement. Not only does exercise increase longevity, but it improves quality of life. There are chronic diseases that have a strong autoimmune component to them (such as arthritis), but many other well-known chronic diseases such as diabetes, heart disease, and obesity can be prevented with lifestyle medicine.

4. Lastly, to do my job and my future career.  

Helping the surgeons reminded me again, I don’t have trouble doing the physical component of my job. Being physically fit helps me to better help transport my patients without worrying about not being strong enough. It helps me make it from point A to point B with ease in an emergency scenario.

It helps me help others and that’s exactly what I hope to keep doing throughout my current job and future career.

Think about this: why do you work out? And if you don’t, why should you?

Thanks for reading, much love!



The emergency room will always have a special place in my heart.

Regardless of anything I have personally experienced, it is well know that the ED is its own entity; its own unique branch of medicine that is nothing like the other areas of the hospital.

We see people at their very worse, sometimes grasping by straws for a chance at survival, and others, aren’t as patient with the wait time. There are sprains, strains, fractures, and lacerations all day, critically ill stroke codes, STEMIs, and traumas all night – well, not necessarily in that order. The department doesn’t sleep and any emergency personnel can tell you a plethora of stories that you might think are too bizarre to be true, but trust us, they are not!

This is best illustrated in the story by Dr. Paul Austin in Something For the Pain: Compassion & Burnout in the ER.

With my continuing experience in the emergency department, I enjoyed reading the struggles and triumphs Dr. Austin faces as an attending emergency medicine physician.

Dr. Austin discusses specific cases he has faced throughout his career and training, but not only that, he talks about how these patients and their stories affect him as a person and his family overall.

Having a career in emergency medicine is a high-stress at high stakes career. Dr. Austin describes how this career nearly ruined his family. It is a reminder that medicine is a rewarding, yet demanding career that proves that if you do not feel that you are taking care of yourself, you will not be best-fit to take care of others in what may be their most desperate times of need.

Read this one to gain insight into life from the trauma bay, the stories on night shift, the forbidden “S” and “Q” words in the emergency department, and the selfless side of medicine that the doctor taking care of you faces each night they try and sleep.

Dr. Austin’s website describes his book more and will give you a preview of his second book.

Find it on Amazon for about $10.

Happy reading, as always!



If you are planning on going into a medical professional field and your school offers histology for undergrads, I highly encourage you to take it. The content is dense, but I believe it is a great preparatory course for several professional programs. I am happy to share with you a few tips that helped me with the course!

First off, let me explain. Histology, broken down, is the study of tissue. (hist/o = tissue, -ology = the study of). As many of us know, our tissues make up our organs. Studying histology allows us to understand the anatomy + physiology of our bodies better from a microscopic perspective. Learning how different cell types, fibers, and structural units that make up each structural element of the body is remarkable and a privilege!

Here is how I can help!

  1. Learn the terminology.

I can’t reiterate the importance of knowing WHAT you’re talking about enough. Knowing the difference between what endothelium & epithelium are may help you with a test question. Endothelium (endo- = inside) lines the inside of the blood vessels and has very diverse properties. Epithelium (epi- = above), is the usually the outermost layer of surfaces such as skin, glands, and lines ducts. What do reticular fibers do? Reticular means “to form a net” and that’s exactly what these fibers do. Reticular fibers form a meshwork for migration of immune cells throughout organs. What about looking at cancers? An ADENOcarcinoma is a glandular cancer. (aden/o = gland, carc/o = epithelial origin, -oma = tumor). When seeing abnormal tissue that is attempting for form glands, you’ll know instantly it is an adenocarcinoma.

2.  Know your stains.

The most basic stain (ok, maybe I shouldn’t use the term basic in this case), is H & E – hemotoxylin/eosin staining. That’s the stain that makes everything look purple/bluish. Knowing what stains darker and what stains lighter, or what stains with special stains will help you to determine what you’re looking at.

PAS – stains PINK/MAGENTA; stains carbohydrate (specifically glycogen).

Nissl staining – stains RER (nissl bodies in the nervous system).

Reticulin – stains highlights reticular fibers in the bone marrow.

If you know what you’re looking for, and what stain is attracted to chemically, it will make the process much more understandable.

nissl stain
nissl staining in the nervous tissue! 

3. Learn the cell types.

The digestive tract is full of different kinds of cells that are fundamental in the role of the organ. The stomach has chief cells, parietal cells, enteroendocrine cells among others. What do each of these things do? Where are they located? What do they secrete? What do they look like?

For example, parietal cells are “fried egg cells” with a small, centered nucleus, abundant cytoplasm, bubbly appearance, and are found in the gastric glands of the stomach. They secrete HCl, or stomach acid.

gastric chief and parietal cells
PC = parietal cells, CC = chief cells. Do the parietal cells remind you of a fried egg? 😀

4. Look for landmarks.

How do you know you’re looking at the gallbladder? What is distinct about the appendix? Where are the smallest, primordial follicles in the ovary? Finding distinct features about each organ will help you to determine what you’re looking at if you aren’t sure from 40x or more.

The gallbladder is highly folded with no submucosa.



The appendix is a muscular tube rich in GALT, or gut-associated lymphatic tissue. What is the cause of appendicitis? Why are appendectomies the medical solution? Think about it in relation to this slide!

appendix histo .jpg
appendix 4x. Pink = muscular layers, purple = GALT. 


The primordial, or most immature follicles are found around the ovarian cortex. They are smallest in size. As the follicles mature and get bigger, they also move inwards closer to the middle of the medulla of the ovary.

primordial follicles along the outer edge of the ovary, Graffian (or mature) follicle in the medulla. Notable size difference? *the oocytes, or egg cells, are found in the middle of the follicles; the small purple dots. 


5. Use available online resources.

Below are links to the websites I have used to help prepare me for lab practicals. There are plenty out there, but these were the most helpful to me.

Histology Guide – a virtual slide box with zoom capabilities, labeled diagrams, and thorough explanations. Helpful to view slides from lab at home on the computer.

Histology World – quiz resources, lecture outlines, and more slide images. Practical quizzes that help prepare for lab exams.

Blue Histology – description and visuals of more slides

knowledge is power 😀

I wish you all the best of luck in your studies, and I hope you learn to love histology as much as I did. It’s truly beautiful. As you learn it, this branch of biology, you will probably find yourself admiring the stain colors, and the seemingly-minute details of the human body.

PS: if you’re interested, read about my experience shadowing in PATH after I finished the semester of histology – something I recommend 😀

*Photo sources:

Nissl staining: New York University Medicine

Parietal cells: Austin Peay State University

Gallbladder: John’s Hopkins School of Medicine

Appendix: Concordia College, Moorhead

Ovary: University of South Wales

Header image is my own: taken at the University of North Dakota. Shows the corneal endothelium/iris junction. 


As my followers, you guys know I am a firm-believer in the importance in shadowing. In fact, I wrote a guide to shadowing a few months ago! Though I am still an undergrad and do not yet have to make a decision about what specialty I am choosing to pursue, I find that exploring different medical specialties has helped with my undergrad education, and will help me discover my best interests in the medical field I love so much.

As I have just finished histology, I wanted to explore the world of disease. After familiarizing myself with the normal appearance of tissue under the scope, I could not wait to see some forms of abnormal tissue.

Dr. L. began our time by showing me around the histochemical lab so I was able to observe the processing of the histological samples. In my histology course, we were taught the steps of processing & staining, but never actively fixated tissues ourselves. Being a visual learner, I found this very helpful!

One of the slides that had just finished its last step of processing was specially stained with reticulin stain which stains (YOU GUESSED IT) reticular fibers.

reticular fibers
Vitro Vivo’s image of reticular fibers

The doctor was concerned that the bone marrow biopsy would show a pathology of early myeloproliferative disease. This classification of disease can include bone cancers and other blood-forming pathology. Dr. L. explained to me that though many bone marrow biopsies are performed, many are not necessary and give negative test results. However, in this case, performing the biopsy may have caught an early stage of this patients’ disease. Though it is the sign of early disease for the patient, I am grateful I was able to view a slide of this special stain. Some other things I saw were H. Pylori slides, appendix slides, other stomach pathology, and a mouth lesion.

Dr. L was trained as a pathology resident, but also did a fellowship in hematopathology (blood/blood forming cellular pathology). The doctor I shadowed was passionate about his speciality and showed pride in work. He had a close relationship with the technicians in the laboratory and was clearly appreciative for the work they do which directly impacts his work. I would definitely have considered him a people-person, despite the stereotype that pathologists spend their days in the hospital basements in their offices 😉

Dr. L.’s dual binocular scope. A little bit of an upgrade from the ones I used in my lab! 

Again, I am so grateful for this experience and that the hospital I work for has been so gracious in teaching area students. If you had not gotten your feet wet in the hospital, do yourself a favor and explore the world of medicine. 😀 The connections you can make between your studies and applications are amazing!










Medicine is an exciting, thrilling, and a sometimes dramatic field. We as humans are drawn to these things and tend to crave to know the “whys” in life. As a result of this, there are several fictional TV dramas that highlight these elements of medicine. People love medicine. Some of these shows include Grey’s Anatomy, House, Chicago Med, The Night Shift, Scrubs, etc.

In the shows I mentioned above, actors are playing doctors and patients alike and at the end of each episode, each case is solved. So we can take a deep breath, just like real-life medicine, right? 😉

I am as guilty as anyone that can indulge in watching these shows. As future and present clinicians, we know these shows are just for entertainment. Alike other medical dramas and comedies, there are a few shows I am sharing with you that are also television series, but show you a more realistic side of medicine. And hey, you may even learn something new!

  1. Hopkins:

Many have heard of John’s Hopkins University and hospital in Baltimore. Hopkins is a series done by ABC in both 1999 and then again in 2008. I was first introduced to this in high school (thank you, again, Mrs. Adams) and since, I have watched several episodes. You will get an inside look at the life of highly specialized doctors, medical residents, and the patients they take care of.

*find full series on YouTube – search “Hopkins” or here!

2. New York Med & Boston Med 

These two shows are follow up series of Hopkins and are also produced by ABC. As you watch them, you will see a lot of the things you saw in Hopkins, just even more technologically advanced. Another plus to these series is that you are able to see some of the real-life problems that practitioners face in issues like insurance, social media, and limitations of their practices.

*find full series on YouTube – search “New York Med” and “Boston Med” or here +also right here 😀

3. Dr. G.: Medical Examiner

Dr. Jan Garavaglia’s TV show displays her work as a forensic pathologist. Many of her cases show the time and manner of death as she uses her highly specialized training to solve each case.

This show gives the viewer an inside look of the morgue and the details of what a medical examiner does. It shows you the intricacy of forensic medicine from things like gun shot wounds’ point and angle of entry, what injuries are consistent with foul play, and a basic pathological analysis on each case.

Though this show is educational and informative, it has been dramatized to respect the deceased and their families. There are plenty of scenario recreations to help you understand the bigger picture.

You’ll also learn there is much more to being a medical examiner than simply performing an autopsy. Dr. G. shows other components of her work life including speaking with other physicians, gathering evidence from authorities, and communicating with friends and family to collect data, and put clues together. It isn’t uncommon to see some of Dr. G’s personal life where she’ll mention her husband, a pediatric trauma surgeon, and her children. She will often mention that her line of work has taught her how important life is and how much she values her family and the time she gets to spend with them.

Many of mention how kind and intelligent Dr. G is in communicating and providing answers to them.

This show is great if you’re interested in seeing some interesting medical cases, and because it is TV, you will get a suspenseful thrill with each case. 😉

*Unfortunately, you will not find this show on air anymore. Dr G. retired from her practice in 2015. However, you can find full length episodes on YouTube – search “Dr. G. Medical Examiner” or here!

Questions, comments, other show suggestions? I’d love to hear from you!

Contact me @medicinemyosinmadeline@gmail.com !