Missoula was my second WWAMI month and quite different from the first.  Missoula is a university town and significantly bigger than Livingston.   There are multiple hospitals, plenty of subspecialists, and even some UW students running around;  it has less of the “small town doctor” feel.  That said it’s quite different from Seattle, and the exceedingly well-connected Dr. Schlesinger is eager to customize the rotation – I did two weeks of sports medicine and two weeks at a Community Health Center.  But one gets the sense Dr. S could arrange anything from the ICU to podiatry, probably with someone not used to having a resident and excited to do some teaching.   Go to Missoula to get away, see a different place, do some hiking/skiing, and all of that, but also take advantage of the opportunity to learn whatever you want.

I was putting in a lot of hours, by my choice, because I was learning so much. The community doctors constantly impressed me with how good they were at everything. They were amazing diagnosticians. The oncologist I worked with, John Trauscht, was an outstanding teacher, and I loved his curiosity. John had a great way of communicating with his patients, bringing everything to their level, and always gave patients the choice of doing nothing. I saw all of his new patients and performed bone marrow aspirates and biopsies, so I was first to see and diagnose patients rather than the fifth or sixth person down the chart. One memorable patient was a middle-aged man with Burkitt’s who continued to decline despite aggressive chemo. He developed PCP in the hospital and then an HIV test came back positive. The diagnosis was incredibly devastating and it was interesting to see everybody’s reactions. He died three days before I left. Taking care of him made a huge impact on me … I loved Montana. Everyone in Missoula loves living there, and I felt very much a part of the land.