Sub-sub-specialties

The cardiology service at Stanford is partitioned into many sub-sub-specialties. After CCU rounds, we find individual attendings for various services from cardiac transplant to pulmonary hypertension to electrophysiology. Thus, we get to learn about these very specialized patients from those who know their diseases the best. This is especially educational and interesting. For example, I'm only beginning to understand the host of complications and medications associated with heart and heart-lung transplants. One of my patients has been in the hospital over two months for infection after infection, and only now is he finally looking ready for discharge. Although I've learned about rejection from a theoretical standpoint, it is so different than seeing someone who may actually have rejection. It is a similarly educational experience to care for patients with severe pulmonary hypertension on medications I had not learned about or for patients with arrhythmias undergoing very specialized electrophysiology testing and ablation.