Gregory J. Dennis, MD
Director of Clinical Care and Training, National Institute for Arthritis and Musculoskeletal and Skin Diseases, Washington, DC
During my third year of medical school it became clear to me how I would contribute to mankind as a physician. Having been involved in team sports and because of my excellent hand-eye coordination, I decided that surgery was a natural fit.
During the first few months of my internal medicine internship, I began to reconsider. I was having fun in this discipline, so I decided to complete the full three years of internal medicine training. There were three events that occurred over that third year that clenched my choice in becoming a rheumatologist.
The first occurred while I was rotating on the cardiology service. A patient was admitted for consideration of ischemic heart disease, but her only complaints were related to her arthritis and musculoskeletal problems. Each day on morning rounds, I would convey this information to my senior resident - whose opinion I valued - and each day he would say that we should only be "concerned about her heart." My resident had no idea what her arthritic condition was, and after three days and a negative cardiac workup, we discharged a markedly dissatisfied patient.
The second event occurred during elective rotations in my second year of residency. The Chair of the Department of Internal Medicine recommended I do a rotation in rheumatology. I learned more about medicine that month than I had learned at any other time during my residency, and I was truly beginning to understand the diseases that had previously seemed like a black hole in my education.
A third event solidified my career choice. Because of my newfound interest in rheumatic disease, I decided to embark on a research study in patients with systemic lupus erythematosus. While conducting research, I had the opportunity to learn about the patients as well as the current research in the field. I realized that rheumatology was a field in which I could make tremendous contributions in terms of care for patients, while also being able to make academic contributions should I choose to pursue an academic career.
I took several of the rheumatology clinic patients to my internal medicine clinic to manage with periodic consultation by rheumatology. In so doing, I developed a burning desire to better understand the clinical immunology related to autoimmune diseases and the management of musculoskeletal diseases in general. With motivation and enthusiasm, I could easily envision myself embarking on a career in rheumatology and was excited by the possible contributions I could make. All I had to do was connect the dots.
