Editor’s note: In the run-up to Final Exercises on May 16 and 17, UVA Today will introduce readers to some of the outstanding members of the Class of 2015. All of the stories, plus other information about Finals Weekend, will be compiled here.
It’s probably not a common experience for a medical student to save a patient’s life. Even more unusual – how many have saved their own?
While taking a fourth-year elective course, “Advanced Physical Diagnosis,” University of Virginia School of Medicine student Cullen Timmons placed his stethoscope over his heart and heard a troubling sound: a very irregular heart murmur.
Further tests showed that Timmons had a thoracic aortic aneurysm, meaning the main blood vessel out of his heart was far too large. A normal human aorta is roughly the diameter of a banana. Timmons’s was the size of a coffee mug. Without the repair surgery he received at the University of Virginia Medical Center in November, Timmons likely would have died.
His own diagnostic skills not only saved his life, but also forever changed his view of the doctor-patient relationship. Suddenly the Athens, Georgia native was seeing things from the other side of the gurney.
Q. What first brought you to the University of Virginia?
A. I went to the University of Georgia for undergraduate, but my dad and my sister both went to college here. I came up to visit a couple of times and really loved it a lot. When it’s time to apply to medical schools, you kind of just apply all over the place and U.Va. was actually my first interview. I knew about a week after that I was in, so I decided to come here pretty early on.
Q. The class where you heard your heart murmur, “Advanced Physical Diagnosis,” was an elective. What made you choose it?
A. I’m going into emergency medicine and one of the areas I wanted to work on during my fourth year was my physical exam. That class focuses a lot on auscultation, which is basically listening to the heart. That’s a skill that is really easy to be OK at, but really difficult to be very good at. I really wanted to improve that skill more than anything and it just coincidentally led me to the diagnosis.
Q. When you realized you had a heart murmur, what was it like to have the tables turned and be the patient?
A. Being in the patient role is a really unique experience for someone who is used to being the caregiver. You really get to see what care providers do well and what they do poorly. A lot of times it’s really hard to put yourself in the patient’s shoes. Even when a caregiver has the best intentions at heart, it’s hard because the patient may not always know what’s going on. Even understanding medically what was happening to me, as a patient I still sometimes felt a little like I didn’t know what was going on. That was the most interesting thing for me. I can’t imagine what it’s like for someone with no medical background to go through that whole experience.
Q. Do you think having your own medical scare has affected how you plan to interact with your future patients?
A. I think it definitely has. Everyone was so caring and nice through the entire process. When I was going in for surgery, one of the scrub nurses came and held my hand while I was going under anesthesia. It’s little things like that. You don’t think those gestures are a big deal, but they really make a big difference to the patient. As a doctor, I think being more conscientious and providing as much information as possible to the patient are important things I want to focus on.
Q. How have other experiences at U.Va. shaped your ideas about practicing medicine?
A. There’s a definite identity at the U.Va. Health System of being very conscientious. It’s a very nurturing place to go to school. All the professors are really kind, especially the ones that teach the medical students. I think that’s kind of shaped my view and made me eventually want to go into academic medicine.
Q. Why are you drawn to emergency medicine now?
A. It’s more for me just a personality fit. It’s the type of medicine I really enjoy. It’s really broad. I think a lot of the people that attend medical school are more OCD on the spectrum and they’ve got to do everything exactly right all the time. Those people kind of gravitate toward surgery and areas where you can do one skill and practice it and get better at it.
I’m on the opposite side of the spectrum. I love how broad emergency medicine is. You don’t necessarily know what’s going on all the time. I love that challenge. It’s a place to keep learning. A patient can walk in with some crazy disease that you’ve never heard of at any point in the day.
Q. What’s next?
A. I’m headed to Vanderbilt for a three-year residency in emergency medicine. My plans may change after that, but right now I’m planning on doing an ultrasound fellowship and potentially a critical care fellowship as well.
Q. Why ultrasound?
A. There’s a lot of push for rapid diagnosis in the emergency room, especially a non-invasive way of doing that. In the ER, we get criticized for doing a lot of CAT scans. CAT scans are great because you can get the information really quickly. You can get the results in 30 minutes, but they expose the patient to a lot of radiation, which could lead to cancer down the line. It’s also an expensive test. But if you’re experienced enough with an ultrasound machine, you can get a lot of information very rapidly. Also, you can do it yourself without having to send the patient to another area. You can keep your eyes on them the whole time. I think it’s really the future of where critical care and emergency medicine are headed.
Q. Now that you’re back to full health, are there any favorite Charlottesville activities you are going to start up again?
A. One of my good buddies and I go fly-fishing. We like going down to Moorman’s River and down on the Rivanna as well. Golfing at Birdwood is great. Everything here is perfect. It’s an outdoor dream.