Like many faculty within the Division, Megan Brooks, MD, MPH is constantly active. This week alone, she taught second-year medical students, coordinated care plans, helped develop the curriculum for the Duke Physician Assistant (PA) hospital medicine rotation, and seen patients with everything from heart failure to complications of knee replacement. Thankfully, she took time to speak with us about her training, the works of William Osler, and being a foodie outside of work.
What are your responsibilities within the division? What does a typical day for you look like?How long have you been at Duke? How long have you been at the Division?
I have been at Duke since starting residency in 2009. I joined the Division in 2012 after residency and have been with the Department of Hospital Medicine ever since.
My responsibilities are primarily clinical and teaching but I am involved in a number of projects at DRH. Most of my days involve rounding on 14-16 inpatients or admitting 5-8 patients on an admission shift.
This week I rounded clinically but I also coordinated a complex care plan for our Familiar Faces program, taught the pulmonary exam to the second-year medical students rotating at DRH, met with Dr. Poonam Sharma about developing a PA student curriculum for the Duke PA program hospital medicine rotation here at DRH and met with the Food Services committee about rolling out order on demand. Every day is different which is one of the things I love most of my work.
Do you have a clinical area of focus? What kinds of patients do you see most often?
As a hospitalist, I am definitely a generalist and at DRH, where I most often practice, we don’t have subspecialty admitting services so I see all types of patients. This week I have treated patients with STEMIs, heart failure, COPD, lymphoma, syncope, intracerebral hemorrhage, GI bleed, aspiration, and complications of knee replacement.
Our typical patients are often elderly and generally have multiple co-morbid conditions in addition to their presenting problem – fairly typical for hospitalized patients. I particularly enjoy caring for patients with complex problems requiring difficult decisions and end of life care.
In addition to your medical degree, you have a master’s in public health from Johns Hopkins University. What did you study? How does this training influence your current practice?
My focus during my master’s was on infectious disease and epidemiology. For my master’s project, I analyzed hand-washing compliance rates during a hand washing campaign using a “secret shopper” model to record compliance.
My MPH training helped me to focus of broader issues and place even my individual patients in the context of our health and social systems as a whole. I also serve on our infection control committee at DRH, which is right in line with my MPH focus.
What made you decide to enter the field of internal medicine? How does your current work compare to what you thought it would look like as a medical student?
I was drawn to internal medicine because our job is to treat the whole patient and try to balance multiple possibly competing problems. We also get to spend time communicating with and educating our patients and their families so that they too can understand their medical conditions and make informed decisions. Clinically, my work is similar to what I expected as a student but like most people, I didn’t anticipate the volume of paperwork and billing.
Have you recently read any books, websites, articles or other material that would be of interest to the division?
I recently read a fascinating and terrifying article from JAMA Internal Medicine titled “Research Misconduct Identified by the US Food and Drug Administration: Out of Sight, Out of Mind, Out of the Peer-Reviewed Literature,” which attempted to review the number of clinical trials that have ethically concerning violations of research protocols and if those lapses are acknowledged or addressed in the literature. The upshot is that many trials of prominent new drugs have concerning violations and these are rarely acknowledged in the literature at all. It really underlined just how cautious we should be when reading the medical literature and adopting new treatments. We also need to advocate for more transparency from the FDA.
I have also recently been re-reading Aequanimitas, a collection of William Osler’s speeches, since I gave the title speech to my gen med team recently to illustrate the importance of imperturbability during crisis. Much has changed in the practice of medicine since Osler’s time but the fundamentals of human and professional interactions truly have not in many ways.
It’s easy to get caught up in paperwork and EMR documentation but Osler’s words remind me that our true focus is our patients. Despite the fast pace of medical advancement, our human fears, motivations, and goals remain constant.
What passions or hobbies do you have outside of the division?
I am a professed foodie and my subscription to Food and Wine magazine is definitely a guilty pleasure and a source of great recipes to try and restaurants to visit. I read a great deal of popular fiction as well – I’ll likely have finished 2 or 3 more books by the time this newsletter comes out. When the weather is nice, I love to hike or walk outdoors and you can find me at Eno State Park or the Al Buehler trail.