My Kind of Medicine: Real Lives of Practicing Internists: Cristin Mount, MD.
In the Army, they have a saying: “Be all that you can be.” As a captain in the United States Armed Forces, Dr. Cristin Mount uses this statement to hold herself to a personal standard. The statement leaves room for error, but none for carelessness or disregard. As is true for all physicians, many of Dr. Mount’s patient cases have produced successful results, while others have not; it is a part of being a doctor. But while the end result may vary, a physician’s purpose never does.
Dr. Cristin Mount with her husband, Dr. George Mount, in Kauai, Hawaii.
It was this purpose that guided Dr. Mount one evening during her resident ICU rotation, as she sat by the bedside of a patient through the night. The patient was suffering from septic shock and a severe case of pneumonia. Dr. Mount and her colleagues did everything by the book, but nothing seemed to turn the patient’s condition around. By the morning, the patient passed away. “She was the sickest person I have ever seen,” recalls the 30-year-old from Silver Spring, Maryland. “We did all the right things, but in the end the pneumonia was too overwhelming. It was a humbling moment for me because I realized that there will be times when even if I do my best, it might not be enough.” It was a hard lesson to swallow but she never lost sight of her job.
As a young girl, Dr. Mount loved to listen to her father talk about his job. He was a doctor, an obstetrician. The more she watched her father, the more interest she developed in becoming a doctor. “I always knew what I wanted,” she says, “and for me, there was nothing else. I decided I would go into family medicine. I tend to be a stubborn person, so once I decided on family medicine, I was determined.” With soldier-like exactness, she set out after her goal, all the way through college, medical school, and finally residency. But then something happened she had not counted on: she fell in love with internal medicine. It was not an epiphany and it did not happen overnight. In fact, she was not really aware of it until a fellow student pointed it out. “We were making rounds on our ICU rotation and he asked me why I was taking notes,” she recalls, “and I told him, ‘because the ones here aren’t detailed enough!’ He said, ‘You can’t go into family medicine—you have the mind of an internist.’” Because she was stubborn, the comment bothered her for a while since she had already made up her mind. But finally, she gave in to her gut feeling. “Deep down I knew he was right, so I changed my fourth-year student rotation around and that was it.”
A few years later, Dr. Mount is once again on a mission. This time it is studying for an ICU fellowship in a two-year program offered by the Army. Once finished, she plans to split her time between working in the ICU, teaching, and working in the general wards. Working in the ICU, she says, exposes her to the best of the best. “I get to work with some of the best staff in the hospital and interact a lot with my surgical colleagues,” she explains. “I’ve always been drawn to the ICU because it has the sickest of the sick and so it’s a challenge. As an internist, I’m expected to know a lot—I like that. And working at a teaching institution, I really have to think on my feet and be able to apply knowledge in rapid fire succession, so to speak.”
Because Dr. Mount’s father was also a military physician, she grew up in and around the Army healthcare system. She thinks highly of it. “It’s a robust system; it works well,” she says, adding further that as the Iraq War churns out patients with new types of war injuries, the brunt falls on the military medical system. “Soldiers come back here with mind-boggling injuries,” she explains. “Most are blast injuries, and many times you’ll have to treat multiple injuries in the same person. The Army has improved the body armor since Vietnam, so we do a great job protecting the head and chest. Now they are all extremity injuries, and we’ve had to develop a multi-disciplinary approach because they are multi-trauma injuries—stuff you don’t normally see in the civilian world.”
Although she has been on active duty for eight years, Dr. Mount has not been deployed to a war zone; her status as a student, resident, and now as a fellow, precludes her from eligibility. The Army does this to minimize the disruption of training, which, in Dr. Mount’s case, you find yourself somewhat relieved to hear. She is cheerful, open, and easy going; her voice is sweet and full of happiness. She epitomizes “the girl next door.” But in reality these qualities make her congruous with the culture, because as those in uniform know, the military is more community than machine.
“When I was in my residency at the Madigan Army Medical Center Program in Tacoma, Washington, I ran into a doctor whom my dad had trained, who knew me when I was a little girl,” she says. “It’s a small world and you really get to know people.” At the Walter Reed Army Medical Center in Washington, D.C., she treats more of her extended family—every generation of it, from World War II veterans to soldiers returning from Iraq. She finds joy in all of it. “It is extremely rewarding to work here,” she says. “The veterans have done some amazing things and I love talking to them and treating them. Treating the soldiers coming back from Iraq can sometimes be hard to handle because they are so young, but it is extremely rewarding to take care of these men and women. My father told me to always do the best I could do, and so that is what I strive for.”
At age 30 with just over one year of experience as a practicing physician, Dr. Mount is in the toddler years of her professional life. She is a bit of a “newbie”—she has not yet had the big peaks and valleys that pepper one’s career. She says the most rewarding experience for her so far in her career has been simply the opportunity to practice medicine in the military medical system. It is an honest and sincere statement that shows her devotion to the system and the institution she works for, but it also reveals her relative inexperience. She has not suffered a big hit either—the closest was during her residency when she cared for the patient with pneumonia—which while significant, was something she technically was not directly responsibly for. But what is telling about the episode is the way she handled it. By staying at the patient’s bedside through the entire night, she claimed responsibility. She saw it through to the end, because in her mind, she was ultimately responsible for the patient. Some might call that “touching” or “dedicated.” In the military, they call it doing your job. And so while Dr. Mount might still be a little green, when those peaks and valleys do come, she will be ready for them.
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