Behind the Stethoscope: Dr. G

Niraj Srivastava, Junior Editor-in-Chief|October 7, 2022

Behind the Stethoscope is a series where I interview doctors to learn more about their journey, specialty, and passions. A new interview with a different doctor is released with each edition of the Keynote.

When you think of doctors, what words come to mind? Smart? Hardworking? Driven? These descriptions, while accurate, are banal and fail to capture the fascinating diversity of identities, experiences, and perspectives that occupy this dynamic profession. This series is titled Behind the Stethoscope because I intend to do just that. I want to illuminate the individual behind the white coat. In this series, I will interview doctors from a wide variety of specialties and backgrounds and publish one interview for each monthly edition of The Keynote.

And to kick off this series, I could not think of a more fitting person to interview than my own aunt, Dr. Geetanjali Srivastava, or as she’s better known in the hospital, Dr. G. For most of my life, I’ve known her as someone who is energetic, never lacking an opinion, and always ready to have fun. But it was not until recently that I began to learn about her passion for helping others as a pediatric emergency physician. I hope that, by the end of this interview, not only will you get a glimpse into her passion, but you will also see some of the many reasons why I admire my aunt so deeply. So without further ado, I present to you the first doctor to be welcomed onto this series: Dr. G.

Before we get into your education and career as an emergency physician, I want to briefly talk about your childhood because I think it’s a really unique story. You immigrated from Kabul, Afghanistan to Lubbock, Texas as a child, which I can imagine is a drastic change in lifestyle. How was that transition?

It was challenging. As you recall, the Russians invaded Afghanistan in 1979 and most foreign nationals were fleeing the country. We were fortunate to receive visas to immigrate to the US. It was a dramatic change moving from Kabul, which was a multinational capital city, to a small town in West Texas. My whole family was fluent in English, so luckily, we did not have to contend with a language barrier. What I remember most about the transition was wanting desperately to assimilate as quickly as possible and get rid of my Indian accent, which I believe I did quite rapidly. I do think it was much more difficult for my parents to find suitable jobs to match their education, and they had to learn to drive too!

And for college you went to Bryn Mawr, which is a historically women’s small liberal arts college. I know you really enjoyed your time there, so can you tell us what your college experience was like?

I was smitten with Bryn Mawr from the moment I saw the catalog. I was impressed that someone from the college came to Lubbock, Texas and was awed by the admissions officer’s grace, confidence, intelligence, and warmth; I decided right then and there that I wanted to go to a school where there were women like her. It was the only women’s college I applied to because Bryn Mawr is distinct from the other seven sisters because of its close partnership with Haverford, UPenn, and Swarthmore. What I love most about Bryn Mawr is its commitment to diversity (this goes back to the college’s early days and not just now when diversity, equity, and inclusivity are just being seriously considered as a priority). There were only 300 women in my class, but they were from all over the world and from all over the US. They were from varied financial backgrounds, and my roommate was the first person in her family to be attending college! I received an excellent education (which I think you can get at most US colleges and universities), but the experience outside of the classroom is what molded me as an individual and as a professional.

When and why did you decide that you wanted to be a doctor?

I think the desire was in the deep recesses of my brain from a young age—probably planted by my Indian parents! Growing up in Afghanistan, we were surrounded by people in service to their country (i.e. working as foreign service professionals) and also by peace corps volunteers. That left an indelible impression on my young mind. I always loved babies and children, and I babysat since I was twelve years of age; I had a strong sense that I would work with children in my profession. I also like the sciences and wanted a stable long career—all of which a career in medicine encompasses. I want to make a plug about the importance of humanities in the pursuit of medicine as a career. Learning about psychology, economics, bias, history, and culture are equally important in your work as a physician to provide holistic and empathetic care. My major was philosophy, and I think it prepared me to be a better physician—more so than my pre-med courses!

What was the process of applying to medical school like, and how did you choose which medical schools you applied to?

Gosh. That seems like such a long time ago. I do remember that it was anxiety-provoking and that I didn’t love the process all that much! I only applied to all of the Texas medical schools. I think there were seven at that time. The in-state tuition for medical schools in Texas was so appealing that it made no sense to apply out-of-state. I truly believe that every US Medical School provides excellent medical training, so for me personally, it didn’t make sense to take on $300K in loans/debt.

How was your medical school experience? What was the worst part, and what was the best?

During my first year, I could not make the connection with the actual practice of medicine while sitting in a classroom listening to lectures. I dreaded the “block exams” which I think happened every six to eight weeks. It’s a blur because my mind is blocking the memory! Second year was much better because we started a new program at that time (I think it’s standard at most schools now), called problem-based learning. That helped us make connections between our coursework and its application to caring for patients. I loved third and fourth years because it was hands-on, and I learn best by doing. Once I started caring for patients directly, I was hooked and knew 100% that I made the absolute best decision.

When did you fall in love with pediatric emergency medicine, and what attracted you to it? Just pitch to all the future doctors out there why they should go into pediatric emergency medicine.

As I mentioned before, I always loved working with children, so deciding on pediatrics was not that difficult. I had an opportunity to shadow a pediatric emergency medicine physician while I did research on Lyme disease at Yale School of Medicine between my first and second years of medical school. I loved it immediately—because it was fast-paced, allowed you to work with your hands (doing procedures), and the range of the actual work was so varied—caring for minor complaints/injuries as well as serious and life-threatening disease and injuries. I love the “instant” reward of making a child/family feel better in a matter of minutes or hours. Leading a multidisciplinary team through resuscitations in providing life-saving care is humbling and an honor.

You experienced an unimaginable challenge in the midst of your education. You lost your dad when you were in medical school. How did that affect you, especially with so much riding on how well you did in medical school?

I was grief-stricken. But it was my dad’s dream that one of his children grows up to be a physician, so I threw myself back into my coursework; I knew that is exactly what he would have wanted, and I wanted to make him proud. Navigating the challenging and frustrating US health system during my dad’s illness taught me more about the importance of treating patients and families with compassion and kindness than my formal medical education.

Can you explain what residency and fellowship is for a doctor, and then talk about your experience in them?

Residency is a three-to-four-year training program after medical school that provides hands-on, supervised clinical experience in your chosen field of medicine. All physicians must finish a residency program to practice medicine in the US. All the hard work and sleepless nights come to a culmination when you get accepted into a residency. It’s a great feeling. I completed a three-year pediatric residency program. It’s intensive and difficult, but as with all things in medicine, it is rewarding and life changing. It’s when you finally feel like you have “arrived” as a doctor.

Fellowship is a sub-specialization program someone may choose to pursue depending on their clinical interest. Most fellowships are two to three years. I completed a three-year pediatric emergency medicine fellowship. I really enjoyed my fellowship because it was so clear that I chose the right field. I’m passionate about my work and that makes all the years of training and sacrifice worthwhile.

You actually started rock climbing during your fellowship years as a stress reliever, right?

Yes! I used to run for exercise, but I found rock climbing to be an even better distraction from stress. While climbing you must focus all your thought and energy into the task/path ahead. It’s all-consuming and thus forces your mind/body to work in concert and literally leave all your worries behind!

You were actually working in New York during 9/11. Can you briefly tell us what you remember?

All the hospitals activated their disaster plans to prepare to care for thousands of injured patients, but no patients arrived. I remember feeling frustrated and sad because I wanted to use my medical skills to help. That was devastating—so many casualties yet there was nothing we could do to help.

What are things you usually see in the emergency department?

We see patients with minor complaints—such as cough, fever, sore throat, chest pain, headache. We also see complications from chronic illness—such as asthma, diabetes, and cancer. We see quite a bit of traumatic injuries—both minor cuts/bruises to major multi-system trauma.

I’m sure you’ve seen a LOT of crazy things as an emergency medicine doctor, but what is the craziest case you’ve ever had?

Gosh. We see unusual things on a regular basis—so after 20 years, it’s become a blur!

Has there been a particular patient interaction that really changed your perspective?

That’s a great question. For me, I would have to say that it’s more that I take a small nugget from an experience and then overtime those nuggets together have informed me and changed my perspective slowly.

I do have a recent patient encounter that reaffirmed my commitment to being a better listener and being compassionate. There was a mother of a patient who had come to the emergency department many times, and she was frustrated and not treating our staff in a respectful manner. The bedside nurse recounted and shared her personal experience before I stepped into the room. I was feeling defensive and wanted to advocate for my team. I tried my best to be compassionate and listen, but the mother was angry, and we were not communicating effectively. I finally said to her that I did not know how to help her or her child and that was the only reason I was in the room. I kept repeating that every person on her medical team cared about her and her child and only wanted to help. She finally trusted me after I told her that I wouldn’t leave the room until we came to an understanding and agreement on how to care for her child; she broke down crying and shared her personal familial circumstances and financial struggles. Once she trusted me and was able to disclose what was heavy in her heart, we were able to address her concerns about her child. The mom and I shared a hug as she left the ER feeling relieved and with a smile on her face.

You recently were the emergency medicine director at a hospital, correct? How did you like that job, and would you ever consider being in a leadership position again?

It was an incredible honor and a sobering experience to be the medical director for one of the busiest pediatric emergency medicine departments in the country. It was grueling, challenging, and rewarding. I would absolutely consider taking a leadership position again, but it would have to be in a different context because I like varied challenges and experiences. Right now, I’m contemplating volunteering overseas for 9-12 months!

How did the COVID-19 pandemic affect emergency physicians like you—in terms of how you practiced medicine and how it affected you mentally?

There were countless lessons learned. As ER physicians, we never took personal precautions seriously. We have learned the importance of keeping ourselves healthy, so we can take care of patients. For example, now I cannot imagine examining a child with a cough, cold, or fever without donning a mask, which I used to do routinely before the pandemic. No doubt—the pandemic has contributed to physician fatigue and burnout. I have had several young physicians, who just finished their fellowship, tell me that they can’t imagine working in medicine for more than five to ten years! Unless we do something to curtail physician burnout, we are going to face a significant shortage of physicians in the very near future.

About 50% of medical students are women, but only 27% of emergency medicine physicians are female, and only 16% of emergency medicine chairs are women. Why do you think that is? And have you personally experienced any barriers to medicine as a woman?

I personally haven’t experienced any barriers in my career. I think it may be because pediatrics is majority women, and thus as a profession, it has been more accommodating of women. As long as women remain the primary childcare providers and responsible for the majority of the housework, there will be a disparity between men and women in the workplace. Societal norms will need to keep shifting to chip away at the disparity.

What do you think has most changed in the medical field since you started your medical education, and what are you excited for about the future of medicine?

The advancement in diagnostic and therapeutic imaging has been phenomenal. Teaching holistic medicine to our medical students and residents is going to cause a monumental change and shift in patient care and outcomes. That’s exciting! Also, learning about self-care and the importance of sleep hygiene is going to make sure the next generation of physicians are more resilient and have a much more balanced approach to medicine and to life!

Thank you so much for sharing your story and remarkable insight, Dr. G. You are fascinating. We wish you luck in your future endeavors!

One “nugget” I took away from our conversation is that compassion is essential to the practice of medicine. The challenging, yet rewarding, patient interaction Dr. G described exemplifies the importance of connecting to people in this profession. Dr. G’s medical knowledge, despite its vastness, could not help her care for the child initially. Instead, she connected with the mother and was eventually able to provide medical care using empathy, derived not from the sterile walls of medical school classrooms but from rich life experiences.

But what struck me most about our conversation was that Dr. G fully immersed herself in every step of her education. The path to becoming a doctor can be daunting and overwhelming: from college to medical school to residency, adding up to twelve years of rigorous education after high school, or possibly even longer depending on the specialty. It is comforting to know that even though the education is difficult, she found that the end result was entirely fulfilling—it was clear that her job is one of her greatest loves in life. Whether or not you are considering becoming a doctor, it’s too easy to focus on all the obstacles that lie ahead. Instead, we should direct our focus on taking advantage of the present in order to reach the final goal that makes all the trials and tribulations worth it.

I hope you enjoyed the first interview of this series, Behind the Stethoscope. We have so much more to explore about the field of medicine and the journey to become a doctor, so I hope you will continue following along with each interview. The next interview of this series, featuring another captivating doctor, will be published in the November Edition of the Keynote.