As my time draws to a close, I been asked to put forward some final words about fellowship. It is difficult to place in the words all the different things in which I have encountered, learned, and grown from in the past 2 years but I will make my best effort. It is well-known amongst the fellow’s office that I may be not the most succinct, nor the wittiest of our office, but I would like to say that I hope I am remembered for my earnestness. I mean the following words from the bottom of my heart.
The beginning of fellowship was certainly a rocky one. Having spent my time as an internist I was comforted by the degree with which I could feel certain of protocols, treatment modalities, diagnostics, that generally were expected by my peers. It was a challenge to start into a field with which the questions being asked are by their very nature controversial. With time however, I grew to learn and appreciate that these are the exact sort of questions which make medicine all the more enticing, and real. I have learned how to discern the best course of action amid at best mixed evidence, and in particular difficult situations for our patients. It has been exhausting, but with time rewarding and in the end of life giving. With time and growth, I found myself slowly talking the language of my attendings. Being able to speak to different ways in which my colleagues would approach situations, problems, etc. and being able to find for myself which of these was my own style. It was easy to believe that I had reached the pinnacle after completing internal medicine training where I had very clean endpoints within the realm of practice. However, training within infectious diseases I found myself with time becoming comfortable the controversy and individualize patient care based upon the best evidence that I had available.
Furthermore, this training highlighted to me the significant gaps within American health care. Unfortunately, infectious diseases disproportionately affect the marginalized. This has been highlighted in the midst of a pandemic, racial injustices, and political uprising which were the hallmark of my senior year of fellowship. I have been inspired by my mentors and teachers with their foresight and decision making early on in this pandemic. Their tenacity throughout its course was powerful. I am hopeful that by at least being trained by these remarkable individuals that someday I too may be able to tackle these incredibly complex problems with half the degree of grace that they were able to carry on through the course this crisis. It has highlighted to me the requirement of incredible leadership mixed with empathy and recognition of the fear of both patients and clinicians, providing guidance when perhaps there is no clear evidence of the proper way forward.
I think above all else, my time here has underscored the importance of recognizing the humanity of both our patients and ourselves. I have had to come to grips with my own limitations and realize what I am able and unable at times to do, and when I truly need help. I have repeatedly seen time and time again that no matter the aptitude of the clinician, the ultimate requirement for excellent patient care is the ability to reach the individual. I personally experienced, from those who taught me the significance of this approach, and it is my hope that I have learned at least a partial bit of their skill, and I hope to continue to dedicate my life to this practice.
This training has changed me to the core. It has taught me the skills to treat my patients with confidence, using the most targeted strategies possible. It has taught me to be a scrupulous discerner of evidence-based medicine, to be able to apply the best data available while recognizing the limitations for applying my findings globally to my patients. And finally, it has taught me that I need to be an empathetic and available provider in order to access my patients and provide the best possible care. I have a great deal of gratitude for UNMC Infectious Diseases, and I am very privileged to have been able to train here. I thank you all for your time your expertise in your incredible patience.Dr. Mark Ridder – graduating UNMC ID fellowship June 2021, headed to Marshfield Clinic in Wisconsin