Dr. Tatyana Shvilkina joined our Emergency Medicine department in July 2020. Originally from Russia, she graduated from NYIT College of Osteopathic Medicine and completed her Emergency Medicine residency at St. Barnabas Hospital in Bronx, NY. Her love for medicine and critical care led her to join us as one of our newest critical care fellows. We got to sit down and learn more about her.
So tell me about yourself, how did you end up in Emergency medicine?
I was born in Russia and I came to the states when I was 5. I was in New Jersey for a while because my dad was doing his residency and Ph.D and then we moved up to Boston for my dad’s fellowship. He’s an electrophysiologist and he is very disappointed that I didn’t do cardiology. I broke his heart [laughs]. I did briefly think about cardiology but then felt like emergency medicine was more for me. My family is still in Boston but I’ve been in NY for so long I think that I am a New Yorker now.
Who do you think was your biggest role model growing up?
My dad probably would be. He is a physician and an academic and from the beginning I would look up to him. He would bring me into his lab and show me things under the microscope. I remember one time when I was 6 years old he brought me into his lab and I was able to see sickle cell disease and he would show me and teach me about these cells that would sickle and wouldn’t carry oxygen and I thought it was really cool. When I was 10 years old, he got me a microscope that his lab was going to throw out and I got to keep a little diary of things I would analyze under the microscope. He was always nurturing this curiosity in me.
Aww, that’s so sweet. What about the rest of your family?
My mom is like my best friend. I talk to her every day, I send her pictures of my cats. She’s a nurse so she’s also in the medical field. I also have a half-brother in Russia from my father’s first marriage. He’s also a doctor, surprise. He’s a psychiatrist, so he also disappointed my father [laughs]. Between the ages of 5 and 18 we never saw each other and we were estranged for a while. When he came to the states when he got engaged and came to visit my dad when I was 18 it was strange, like I had another family member I never knew about. We’re closer now.
What would you say has been the most challenging time for you?
In college it took me a while to create a balance between socializing and studying. In high school everything came naturally and so I thought that would be the same in college but it was not. I didn’t study as much as I should have. In my first two years my grades were definitely very lackluster, and I had a realization when one of my advisors told me that I would never get into medical school…that I’d never be a doctor. After I was told that I was like ‘whoa, whoa, this can’t happen’ and that was the worst thing to hear. I totally did a 180 and started focusing more. I took it as a challenge and got better. I didn’t have a Plan B. Being a doctor was so important to me, it was my identity, so I needed to make that change.
Out of all of the fellowships you decided to pick critical care, any reason why?
In my second year of residency I did a lot of ICU rotations and I loved being in the ICU. At that point I knew I wanted to pursue critical care. And that’s kind of how I ended up here. I mean I initially started to apply for jobs out of residency and getting offers, but I felt like something was missing, something was off. One of my mentors suggested this program for fellowship and now I’m so lucky to be here.
[Laughs] We’re lucky to have you! We need more female representation in the critical care world. Have you noticed any difference between the staffing from where you did your residency [St. Barnabas] to here at Stony Brook?
I think in general the staff here there’s fewer females here for some reason but fortunately everyone is super friendly and I never feel like I stand out.
How did you feel knowing that your bosses are going to be Dr. Weingart and Dr. Wright?
[Laughs] I was intimidated. I did my interview with Dr. Weingart and obviously I knew about him and listened to some podcasts here and there but in the couple of weeks leading up to the interview I listened to a bunch of podcasts to see what he’s about. As I was listening I was like ‘wow, this guy gets it’ and I became more excited for my interview. I was waiting for him in Starbucks and I saw him but I don’t think he saw me and I felt really anxious and nervous and sick to my stomach. But as we sat down I felt like we connected the most, it felt the most natural, and it was exactly what I wanted to do. Afterwards I briefly got to speak with Dr. Wright because he was coming off of an 8-4 pm shift. He was also incredibly intimidating but also the sweetest human being.
You co-fellows, Ryan and Arman, were residents here. How are you all getting along?
They’re incredibly welcoming and friendly, and extremely open to having both me and Garrett here. I am a little jealous that they got to spend an extra three years with Dr. Wright and Weingart, but hey I’ll take what I can get.
What is the coolest thing that you’ve ever done or seen?
My mind automatically goes to something medical. My pulmonary hypertension patient that I had during my second week of fellowship was the coolest thing I had to manage. Her blood pressure was 40/20 and once the A line went in, it was 45 over something.. When I was in residency we learned about pulmonary hypertension so I’ve been waiting to have the opportunity to take care of this kind of patient. We never learned about it in medical school and I thought it was so cool. When I was working that day both me and Jon [DeAssis] were trying to do everything smoothly, but it was scary. Everything had to be very delicate because one wrong move these patients can easily crash. I felt like I was landing a plane that was out of control, but it landed. It was exciting and it fed my curiosity of right sided heart failure.
I love the pathophysiology of right heart failure and I think it really opened up everyone’s curiosity after having Grand Rounds with Dr. Sara Crager. Do you plan to make right heart failure or pulmonary hypertension your niche?
I think everyone has an obsession over the right heart because the physiology is so cool and we never talk about it in medical school. Everyone has left heart failure and it’s the most common cause of right heart failure, so I definitely think we’re under-diagnosing it. Ever since I had that patient I ultrasound everyone. Ryan and I are writing a review article for the management of pulmonary hypertension. I read so many articles on pulmonary hypertension and there’s not a lot of information out there. They’re all from anesthesia or animal studies, so in the future I would love to do some research on people instead. So yeah, right heart failure and pulmonary hypertension would be my niche, they’re my loves.
I know you love your cats too. Tell me about them!
I have two cats, Hailey and Gracie. They’re so sweet and it’s like having children. They like cuddling and they wake me up for attention. The amount of time and attention they require makes me feel like I have children.
Now that you’ve mentioned children, have you thought about it?
I’m definitely someone who prioritizes my career over having children. My grandma may judge me for prioritizing my career over children but I surround myself with like-minded people so fortunately most people in my circle are also career-oriented, so it doesn’t feel weird. I very much admire people who have been pregnant in residency and their early attending years, but I feel like I have been devoting so much time to reading and studying that I don’t think that I would have the time. It sucks because it feels like that when I have children I might have to figure out how to balance my love for medicine and giving my kids enough attention.
Have you thought about what you want to do in the future?
COVID is making things a little more difficult since places are cutting back their hours. Ideally, I would like to work in a place that has a similar setup as Stony Brook with an ED critical care unit and fortunately more hospitals are getting on this bandwagon to have a critical care unit. I know I want to work in an academic setting as well because I love teaching and interacting with medical students and residents. I love being in an environment that fosters learning and curiosity.
I know that you’re in a relationship right now. How does this influence your future plans?
We would like to be in the New York, Boston or Connecticut area but I’m willing to go wherever my job takes me. If I have a good opportunity somewhere outside of those places then I would take it and my boyfriend says that he would support me. He did complain about moving to Long Island because we had to move out of Manhattan, but he works from home so he’s more flexible. He’s been my rock throughout this entire journey, he’s amazing.
Your last name is really hard for me to pronounce! [laughs]
I know! It’s even hard for me to say if I’m not speaking Russian because of all of the consonants. Patients have butchered my last name, or say ‘nurse’ instead.
Have you had patients calling you nurse often? Do you ever correct them?
People always call me nurse. Not as much here at Stony Brook because the roles are more clear and the nurses are more present for the patients so each patient would know who their nurse is. But at St. Barnabas each nurse would have 30 patients and since you would be the one putting in the lines or drawing blood, people didn’t know, especially since I’m a woman. I would be walking to a critically ill patient’s room and I would hear people calling me and saying ‘nurse can you get me a blanket, nurse can you get me a cup of ice’ and it was either that or ignoring them. I couldn’t correct them because it would come off as defensive and after a while it’s exhausting. Sometimes it was just easier just to get them a cup of ice than to correct them.
Did you ever see any guys in your residency program mistakenly called a nurse?
No. And that was something that actually observed. Our emergency department was a big box and completely open so I would walk around and there would be a number of people flagging me down calling me a nurse or asking me for things and I watched my male co-residents walk around and they were never called nurse and no one stopped them or interrupted them. Or even when we were doing bedside rounds patients would always single me out despite other people being there to get them a pillow or something to drink. And the guys were all saying things like ‘I wouldn’t mind if people made that mistake’ but I mean come on, every single day you’re dealing with this. Every single day. You would definitely mind.
That is incredibly frustrating and it definitely does get annoying. What do you do to relieve stress? Do you have plans for your next vacation?
My last vacation was in Antigua, and I love going to Bermuda and it’s only like a 2-hour flight. Maybe I’ll go there after my boards. My wellness is listening to podcasts of course [laughs]. My family has a cabin in New Hampshire surrounded by nature on top of the mountains and so I try to go out there as much as possible to get some of my wellness. Last time I went was in September, but I try to go up there every 3-4 months. Anything involving nature allows me to recharge. When I’m here I play with my kittens or I’ll go hiking locally. I’d like to say I go to the gym but I haven’t gone since residency started. I like reading books, but usually those are medicine related.
So – what’s your deepest darkest secret? [Laughs]
[Laughs] Well it’s not my deepest darkest secret but a lot of people don’t know that I love listening to heavy metal music. I went to Korn, Slipknot, Lamb of God concerts… Lamb of God was my favorite!
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Tatyana Shvikina, MD is a a Critical Care Fellow at Stony Brook Emergency Medicine.
Elizabeth Dalchand, MD is a PGY-2 Resident at Stony Brook Emergency Medicine. She can be found on Twitter @lizdalchand