How incredible is it that I've already been living in Atlanta for well over a month now??

It's hard to believe that not too long ago, my wife and I packed all of our belongings and hauled ourselves down here from North Carolina to start our new lives. So much has happened between the time we drove into our new driveway for the first time and now. It already feels like we've been here for a while, especially since we made a determined effort to finish unpacking all of our things and sorting out our house soon after we moved in. If you were to come and check out our house, you would think that we've been living here for a year or two. That's how moved in we are, we don't play about having a ton of unpacked boxes sitting around. 🙃

Soon after my last post (and after spending my 4th of July hanging out with my in-laws and watching a super weak fireworks display) I officially started my first year of fellowship training with a general orientation day geared towards all the new fellows in the Department of Pediatrics at Emory. We were given a lot of general information about Emory, CHOA (Children's Healthcare of Atlanta), and Atlanta as a whole throughout the day. Most of the information covered included house staff benefits, resources offered by the Emory and CHOA libraries, wellness initiatives, tips on how to choose a research topic, the Health-Law partnership, professionalism, effective time utilization, mentorship, and fellowship as a whole from the perspective of current faculty and fellows. We also got our pagers and our badges, which made transitioning into fellowship feel all the more real. It was as long of a day as it sounds, but it gave us a chance to get better acquainted with what Emory and CHOA has to offer for us throughout our training and also allowed for us fellows to meet each other and bond throughout the day.

Once that packed day of orientation was finished, I proceeded to begin my three-week period of orientation for my pediatric nephrology fellowship program. I am so grateful that the folks in the program gave my co-fellow and I this extended opportunity to become more familiar with nephrology concepts and with how things work here at Emory/CHOA, because I don't know how well I would have fared if I were to have gotten immediately thrown into inpatient service right after my general orientation day. Okay lemme stop lying, I know how I would have fared. I would have fared badly. But fortunately I never have to experience that because the faculty, staff, and fellows in my program are awesome. 😊

My co-fellow and I have spent the majority of these past three weeks learning how to navigate the Emory and CHOA campuses, getting all sorts of things set up so that we were ready to go once we started our inpatient clinical duties, and listening to a ton of lectures that introduced us to a variety of important concepts in pediatric nephrology such as renal physiology, chronic kidney disease (CKD), glomerular diseases, peritoneal dialysis, hemodialysis, continuous renal replacement therapy (CRRT), hypertension, renal transplantation, dealing with common questions we'll receive while we're on call – you get the idea. These lectures were incredibly useful and gave me a framework to start with as I begin to formulate my own methods of how I will practice medicine in this subspecialty. A lot of these concepts are complex and initially tough to grasp, but I'm hoping that I can gain a better understanding of them as I power on through this clinically-heavy first year of fellowship.

Outside of sitting through these lectures and other divisional meetings that we were welcomed into, we rotated through several outpatient nephrology-specific clinics (CKD, Dialysis, Transplant) where we actively participated in patient care after initially shadowing our preceptors. We've also started to build our patient panels in our own weekly continuity clinics, where we see patients that are either newly referred to us or are being seen for follow-up after a hospitalization. Although there is so much more to learn in each of these clinics, I've surprised myself with how much I've been able to grasp and comprehend in the few clinic sessions I've participated in so far. I've also been amazed at how resilient the kids and families I've met thus far have been, considering all that they have had (and still have) to go through!

Not only have we been able to learn about all things nephrology through lectures and clinics, we were given the opportunity to attend a transplant surgery, a couple of transplantation evaluations, and go to a special overnight camp dedicated to kids with chronic illnesses! Given that I hadn't set foot in an operating room since I was a medical student, it was a bit surreal to be back in one watching a full-blown operation take place. That being said, it was such a great learning opportunity that I felt privileged to be able to take advantage of. I spent a great deal of time in the operating room talking with the anesthesiologists and learning how they work with the nephrologists to manage blood pressures in the perioperative period of a patient's care. My co-fellow and I also watched as the transplant surgeon prepped the transplanted kidney for insertion into the patient's body before ultimately successfully placing it the patient. It was super cool and gratifying to be a part of that experience, especially since there are so many emotions felt and important events that take place leading up to the transplant procedure. One of the most critical events that occur prior to transplantation is the transplantation evaluation, a transplant clinic visit where a patient and their family learn what it means to have a transplanted kidney and what needs to be done before, during, and after the operation to maximize the lifespan of the patient's new kidney. We were able to participate in a couple of these evaluations and gain a lot of perspective on how much work the care team and the families have to put in to ensure the success of this complex process.

In the midst of all the necessary seriousness associated with caring for these kids with complex medical conditions, attending Camp Independence gave us an opportunity to gain perspective on what these kids were like outside of the medical setting. And man let me tell you, they are such a fun and energetic bunch of children! If you've been following my blog over the past several years, you may already know how much of a sucker I am for summer camps designed for kids with chronic illnesses. I was first introduced to this format of summer camp in medical school when I spent a month at Victory Junction Summer Camp for one of my special elective rotations. My experience there was so monumental that I decided to actively seek residency programs who afforded residents opportunities to attend similar summer camps. I got another taste of this type of summer camp during the first week of my intern year, where I spent the whole week at Camp Carefree. While that experience was in a lot of ways different from my experience at Victory Junction, it was still such an awesome learning experience that again gave me incredible insight into the resiliency of the kids we interacted and played with. Then the pandemic happened and summer camps nationwide came to a grinding halt. So you can only imagine how excited I was when I learned that my current program not only offers us the chance to participate in camp medicine, but goes as far as actively encouraging all the fellows in the division to actually go to camp!

Unlike the previous two times I attended camp where I spent extended periods of time in the middle of nowhere, my schedule only allowed me the opportunity to spend 24 hours at Camp Independence, which was located, you guessed it, in the middle of nowhere. But man did I make the most of those hours! As soon as I got to camp (after being slammed with the scorching heat of the summer sun), I was assigned a cabin team of two counselors and three campers to hang out with, those of whom I spent the vast majority of my time there with. They were a fun, diverse, and hilarious group to be with! We had a blast playing water games together, swimming in the camp pool, eating meals together, and ziplining! We all also danced our night away during dance night, where a surprisingly lit DJ and hype man played energetic songs that kept everyone dancing and singing for hours! I felt like I was back at my eighth grade dance. 😂

Just like in my past two camp experiences, I was in awe of how much fun the kids were having at camp and how resilient they were at such a young age. As I talked with some of them, I listened to how they had to go about taking multiple medications on a daily basis, with some of them taking many medications multiple times a day. I also learned what conditions they had and how it led them to have to receive organ transplants at such young ages, altering the way they could live their lives. What really amazed me was how nonchalant they described what they were saying, as if it was a simple fact of life. The thing is, it was a simple fact of life to them. Man. These kids are the reason I keep coming back to these summer camps. I'm looking forward to caring for these kids over the next several years and to going back to camp in the future, hopefully for more extended periods of time!

I have only a few more days to go before I start my first inpatient service, where I will be working with my attending to manage all of the nephrology consults at CHOA. After that week, I will be doing another inpatient week where I'll be the fellow working with the resident, medical student, and attending physician to manage sick kids on our inpatient nephrology service. On several nights throughout those two inpatient weeks, I will be the fellow-on-call, meaning that I will be receiving consult calls from various emergency departments in the area, calls from the main hospital for patients being admitted to our service over night, calls regarding kidney transplants, and overnight calls from families who urgently need help with managing their child's care.

Yeah sounds like a lot, doesn't it? It certainly does to me. It also doesn't help that I keep getting told that the inpatient services will be really busy, though I have also been told that I'm not expected to have a strong foundation in nephrology at this time and that the attendings are fully expecting to serve as strong pillars of support as I start off my fellowship journey. To be honest, I'm not too worried about inpatient service. I've done time on service all throughout residency and I've even served as the attending on inpatient services while I was a chief resident (I miss my UNC folks and my chief squad 😭). I know it will be challenging at times, especially since it will be a new role I'm taking on that requires a whole new set of skills. That being said, I'm confident that I'll be able to learn what I need to learn to manage my patients effectively as time goes on.

The thing that I'm actually most anxious about is night call; less so what I'm going to be called about because again, I've been an attending at night and served as the pediatric admitting coordinator, where I gained some experience with coordinating calls from areas outside of the hospital and figured out solutions to problems that arose. Plus, I'll have an nephrology attending on call with me helping me out whenever I need it, so I'll never actually be alone. What makes me anxious about night call is that I may not get adequate sleep during those nights due to the number of calls I receive, which may ultimately impact my mood and clinical performance the next day. Yes you read that right, I have to go in and work a regular workday the next day after working in the hospital the previous day and taking night call from home that night.

It's not really that ideal, but it's a call system that current and past fellows have successfully worked in. If they can work night call and come in the next day ready to help the team care for patients, so can I. As daunting as it may seem, I do have to remember that I've worked wild hours before in residency, including numerous 24-hour call shifts. So I certainly have it in me to succeed in this endeavor.

As I've been getting oriented to my new life as a fellow in this new hospital system, I've also made sure to take time to reconnect with old friends, build relationships with new friends, and to make the most of my free time in my new city before I start grinding it out on the inpatient services. I've been able to go to various social functions, brunch with friends, attend cookouts, and check out tourist attractions in Atlanta like the College Football Hall of Fame. When I wasn't doing any of those things, I spent valuable time with my wife fixing up the house and just hanging out together. Throughout this time, I've also continued to make some major moves on the blog by creating a new page that provides a list of gift ideas for students and professionals studying and/or working in the healthcare field! Hopefully the page can be a helpful resource for those of you who may want to show a loved one some appreciation! I'm also hopeful that the page can start generating some revenue for the blog because running Black Man, M.D. is starting to get a biiiiit pricey 😅

Those are all the updates I have for you today, hope you enjoyed catching up on my life! I'm excited about starting the voting round of the this year's Desire To Inspire Scholarship soon and ultimately awarding three deserving young scholars the scholarship award! I'm also looking forward to my birthday trip coming up later this month! You'll hear all about it in my next post 😉

I hope that you have a wonderful week and that this month treats you well!

Wish me luck as I embark on my first week of inpatient service! 😬

Sometimes overcoming a challenge is as simple as changing the way you think about it. – Anonymous

– Black Man, M.D.