By Scott N. Loewenstein, MD

A little over 5 years ago, I started my intern year rotating on the vascular service at the VA hospital. I showed up at 5 a.m. to learn that the rest of the team was working on an overnight ruptured aorta call case at another hospital, so I was left alone to round on patients, formulate a plan, and operate with the staff as the most “senior” resident. True to Murphy’s law, my EMR login was not working, my door badge access was not activated, and I could not find my patients. Luckily, I ran into one of the more senior residents (and now hand surgeon) in my training program. Although he was rotating on another busy service, he took the time to help me find the ORs, login to the EMR, and put in orders. If I did not run into him, I am not sure if I would have made it through the day.

My next rotation was on the plastic surgery service, which was staffed by a thoughtful hand surgeon who was passionate about teaching. Every day he would spend hours (without hyperbole) explaining the anatomy of the carpus, pathology of rheumatoid arthritis, and other complex aspects of hand surgery. Before I started the rotation I could not even distinguish between causes of radial-sided wrist pain, but by the end of it I appreciated the subtle differences between basilar thumb and STT arthritis. Having someone point out slight differences between seemingly similar diagnoses helped me to understand the nuance of hand surgery early in training and therefore go through residency being able to decipher and appreciate the gallimaufry of symptoms some patients experience.

Over the next several years, I rotated with a variety of hand surgeons at the county hospital, the Indiana Hand to Shoulder Center, and the Children’s Hospital. I made great strides since my first days of residency. I learned to reconstruct radius bones that start off nearly as bone dust, perform nerve transfers that look like spaghetti junction, and transfer tissue to the upper extremity from donor sites all over the body.  I am amazed reflecting on the things I can do now that I was not capable of 5 years ago. It is hard now to put into perspective the anxiety I felt during my first day as a practicing physician, as I now feel that I am proficient (in more than just finding my patients).

Over the course of residency, I have relied on my mentors to guide my progression through training. I would not be where I am today without the help of Steve Duquette, Sarah Sasor, Josh Adkinson, Adam Cohen, Brandon Smetana, Tom Fischer, and Kevin Knox—to name a few of over 20 hand surgeons with whom I worked during residency. I find it particularly meaningful that I will be continuing to study the nuance of hand surgery next year at the Medical College of Wisconsin with the faculty that first got me interested as a visiting medical student over six years ago. I look forward to applying my training and cultivating an expertise.