Week One: New to New York

Moving to New York City has been an experience. Not having my car has caused my step counter to go way up and grocery shopping has never been such a workout. My terrible sense of direction is causing me some distress, but luckily those around me have been very kind in showing me how to get around the hospital and the city. Central park has been my favorite place so far as well as anywhere with a view of the river. Luckily, no matter where I end up good food is never very far away.

For the next 7 weeks I will be working with Dr. Marshall Glesby, an expert in complications of HIV disease and therapy. He is part of the Infectious Disease and Clinical Trial units here at Weill Cornell Medical in New York City. I will be assisting him on one of his current projects called Research on Older Adults with HIV (ROAH). We hope to examining data for correlations between frailty, lean dry mass, skeletal muscle mass, testosterone use, and time since diagnosis in older HIV patients.

Shadowing Dr. Glesby while he conducted appointments with patients at the downtown clinic was very insightful. I was grateful that the few patients we saw were so willing to let me sit in on the appointments. I was most taken by the gap between what Dr. Glesby recommended from a medical standpoint and what steps the patients were taking to maintain their health. For example, on patient frequently missed doses of his anti-retroviral medication once everyone to two weeks. I was initially concerned that he may be at risk for spreading his HIV since he frequently has unprotected sex. Luckily, his viral load has remained undetectable and, therefore untransmittable. As patients mentioned concerns of ear infections, colds, and sexual transmitted diseases I found myself realizing how much an HIV or AIDs diagnosis could affect their overall health and susceptibility for other medical conditions. Before a few weeks ago I hardly knew what HIV or AIDs was and already I have a much deeper understanding for the challenges facing doctors, patients, and all of us and the questions that have yet to be answered.

In addition to focusing on HIV, I have had the opportunity to attend seminars and presentations by other members of the infectious disease community. Attending the Case Study discussion was one of my favorite parts of the week because I got to see exactly how doctors work through a diagnosis and see them interact with each other. The meeting reminded me a lot of lab meetings back home where everyone is free to ask questions and respectfully disagree with each other. During the meeting I heard at least six different lapses in research that could potentially be addressed by someone like me such as: a single diagnostic test for all tick-borne diseases (perhaps in a point of care manner) and strong data on why antibiotics are given for 10 days in certain disease and 14 in others. I have every intention of attending this Case Study meetings every week because I know there is so much more I can learn from them and so many more interesting people to meet.

Next week, I plan to go on rounds with the infectious disease consult team and in the medical intensive care unit. I am excited to see how doctors and patients interact in each of these settings, especially because my main project back at Cornell Ithaca involves sepsis diagnosis and other infectious diseases. I will also start inputting and analyzing the data for ROAH using RedCap and R, two programs which are unfamiliar to me but that I am excited to learn about.

Figure 1. The view from the 24th floor of New York Presbyterian Weill Cornell Medical Center