Chapter 04: Selecting a Medical School

Chapter 04: Selecting a Medical School

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Description

In this segment, Dr. Escalante explains why she chose to go to Louisiana State University for medical school (MD 1985) and how she was suddenly competing with other top students and had to adjust to not always being the best in the class. Next she describes how her rotations at Charity Hospital led her to focus on Internal Medicine. She speaks at length about the negative impression she had of surgery because of her rotation. She found Internal Medicine the most stimulating because it was intellectually challenging and involved looking at the whole patient.

Identifier

EscalanteCP_01_20140603_04

Publication Date

3-6-2014

City

Houston, Texas

Topics Covered

The Interview Subject's Story - Educational Path; Professional Path; Character, Values, Beliefs, Talents; Personal Background

Transcript

Tacey Ann Rosolowski, PhD:

So after, let’s see. You received your MD in 1985, and then you did your internship at the UT Medical School here at Houston. Tell me how you made that move. How did that opportunity come about?

Carmen Escalante, MD:

Well, in my senior year of medical school, you’re allowed to do a lot of flexible rotations, and so I did internal medicine in Galveston. I had chosen an internal medicine in Houston. I wanted to move, and I thought Houston would be a nice place to go. It’s still, you know, reasonably close to my family. At that time, I was single, I really had nothing tying me, and I had heard good things about the program, so I said, “Well, let me just do a rotation there.”So, initially, I think I did the one in Houston first, and I liked it. I had interviewed with Raber either—I’m not quite sure if I’d already interviewed or not. I can’t remember, because I don’t think I had applied yet to that program. It was early in my fourth year. And I met a lot of people. They were very nice to me. I have a lifelong friend, who was my resident, because I was on a service as a—what did they call it back then? You know, it was an intern—not an intern, but anyway, it was a fourth-year elective. I can’t remember what we called it. But Lucy Juan Camino [phonetic] was my resident, and, I mean, she kind of took me under her wing and we did stuff. She introduced me to other people. Vicky Shannon [phonetic], who works here, was one of her friends, so I met her then. And I had a good time. I mean, they showed me the ropes. She was very patient with me. She invited me on the weekend to do things with her and her friends, and they encouraged me, “Why don’t you come. Why don’t you apply.”So, I think in a large part that’s—I ended up applying, and I actually encouraged my other friends who’s here. Kristin Price [phonetic] and her husband, Earl Mangen [phonetic], were all in the same class, and I told them, “You guys need to look at Houston. It’s a really nice place. I’m going to go there. Come on.” And so they applied. They ended up coming and applying, and we’re all here. We all did our residency together, and then Kristen eventually is the chair of critical care, you know. So it was fun. And Marty Raber was the head of the residency program at that time, and he certainly was very encouraging and very likable. He’s got a very charismatic personality, and I think that was very helpful to us applying.

Tacey Ann Rosolowski, PhD:

Sure.

Carmen Escalante, MD:

So that’s how I ended up at the UT Health Science Center for residency. Then Vicky Shannon, who I’d met with Lucy, was my very first resident when I was an intern the first month with Marty Raber, so I knew Vicky a little bit because I had met her through Lucy, and then Marty had been the program director. But then he left the year after when I was a second-year resident, to come over here.

Tacey Ann Rosolowski, PhD:

So tell me about making the move over to MD Anderson in 1988. So, just to make sure, you were resident at UT Med School here in Houston from ’86 to ’88, and then—

Carmen Escalante, MD:

Eighty-five to—

Tacey Ann Rosolowski, PhD:

Eighty-five to ’88?

Carmen Escalante, MD:

Yeah, ’85 to ’86 was internship.

Tacey Ann Rosolowski, PhD:

Okay.

Carmen Escalante, MD:

And then there’s two years more called a residency.

Tacey Ann Rosolowski, PhD:

Okay, a residency. So tell me about making the shift over to faculty at MD Anderson.

Carmen Escalante, MD:

Well, how that happened I’m not sure. (laughter) I didn’t know what I wanted to do as I approached the end of my third year. I had thought, just for, like, briefly, about doing a nephrology fellowship, in part because it kind of looked at the whole person, but I wasn’t quite sure I really wanted to do that and just focus on one aspect. So I had interviewed at a few private practice things. I’d interviewed in Dallas.George Sarosi was the head of General Internal Medicine at UT, and I remember him telling me when he heard I was coming over here, “You need to do it. It’s much better. Don’t stay here on faculty at UT,” because, you know, I don’t think it was a very happy place. There was a lot of turbulence going on. That’s when all the department chairmen had been fired a couple years. Andreoli, who was the head of Medicine when I was in my second year of residency, he and, like, six or seven of the department chairs were fired all at one time.

Tacey Ann Rosolowski, PhD:

Wow.

Carmen Escalante, MD:

So there was still a lot of unrest. But how I found out about this was Tati Lucci [phonetic], who was a year ahead of me, had taken a position over here in General Internal Medicine. It had just started, like, in ’86. They’d never had a General Internal Medicine until 1986, and Ed Rubenstein was the first one. I didn’t know him.

Tacey Ann Rosolowski, PhD:

He was head of the section?

Carmen Escalante, MD:

He was head of the section. And then Tati had come on the year following as the second person, and Tati had been a year ahead of me in residency, and her husband was a gynecology resident, and he had decided to do a fellowship in gynecologic oncology, so they were moving to Los Angeles. So she contacted me and she said, “Carmen, you really need to look at this position. I’m leaving, so there’s going to be an opening, and I liked it. See what you think.”Well, I wasn’t sure, because as an intern, we did a month here. Well, back then, your interns and your residents, you had no supervision at night. You were by yourself. There was no resident that stayed in house, and the resident I had was—

Tacey Ann Rosolowski, PhD:

So you were—I’m sorry to interrupt, but you’re talking about you actually did a brief stint—

Carmen Escalante, MD:

A month.

Tacey Ann Rosolowski, PhD:

A month here at MD Anderson. And what year was that?

Carmen Escalante, MD:

I was an intern, like ’85, ’86. In November ’85, I did a month. I was rotated out here. We’d all come out here for at least one month. Some people did more than one month through their three years, but in my three years, I did one month, and it was in November of my internship. So I had just been like three or four months an intern, and it was very anxiety-provoking because it was a totally different set of patients in the sense of neutropenic fever, and we were interns. We were by ourself. During the day you had a resident, but he didn’t stay or she didn’t stay in house with you, and it was like the resident would say, “Yeah, call me if you need me,” but nobody wanted to call their resident. And the resident I had really didn’t want me to call him, you know. He was working, part moonlighting, somewhere else, and he was gone half the time, you know, early, and so I was really on my own. And we used to do it on 10 Lutheran. I think it was 10 LP, 10 Lutheran Pavilion, so really the nurses were the ones that kind of guided you a lot and said, “This is what you need to do.”And back then, depending on who your attending was, that’s the kind of patients, so, one, I had Lega [phonetic] and [Robert] Benjamin [oral history interview], so our patients were sarcoma and melanoma. And, you know, you’re an intern, you have no clue what is a sarcoma to begin with, or a melanoma, and we were on and we took care of these patients. It was around the holidays, and, you know, I had a really hard time adjusting to—and many of the sarcoma patients are young, you know, are younger. Adjusting to these people dying, not doing well, I was here around Thanksgiving, oh, I really thought, “I don’t know if I want to ever do this.”

Tacey Ann Rosolowski, PhD:

Yeah. I mean, from what you’re describing, as you’re describing this, I’m saying, “How did this person ever end up taking care of oncology patients?” (laughs)

Carmen Escalante, MD:

Yeah. And, you know, because I vaguely thought maybe I’d be interested in oncology, and after I did that month, I—because I did a month of oncology. My very first month as an intern was doing oncology with Marty Raber at UT, the Health Science Center. And then I came here in November, and I was like, oh, all these patients had just sarcoma or just melanoma. Part of it was my resident wasn’t very there or supportive, and it was the holidays, and everybody was—you know, they were sick, they were dying, they were young. And I thought, “Oh.” I left without a good impression.So when Tati called me, I thought, “Oh, I don’t know. I mean, you know, is this really something I want to do?” Because I wasn’t too sure about it. So I came over and interviewed with Ed, and it was Gerald Bodey [Oral History Interview], who was over Ed at the time. And, you know, I said—oh, I didn’t know what I wanted to do, I said, “Okay. Maybe I’ll do this for a year, and that will give me some time to think about what I really want to do.” Because I wasn’t convinced at that time that this was going to be my career, you know.And GIM was new here. I mean, this was—there was only two of us because Tati left, so I took Tati’s place. So it was me and Ed Rubenstein, and I was on call the very first weekend I came, by myself, because it was around July Fourth, and Ed was going out of town. He said, “Carmen, you’ve got to take this.”I said, “I don’t even—.” You know, it was like throw you in the water. (laughs) I mean, we have orientation for our faculty and, you know, all this kind of easing into it [unclear]. No, it was two of us, and, you know, it was kind of like jump right in.

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Chapter 04: Selecting a Medical School

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