When Francisco N. Alvarez ’11 decided to work at a Miami hospital the summer after his freshman year, he had no idea that a year later, he would be present at Spain’s first cardiac transplant employing the Berlin Heart device, a German-made artificial heart. The transplant took place at El Hospital General Universitario Gregorio Maranon in Madrid, where Alvarez spent this past summer working as a clinical intern. “We put [the Berlin Heart] into one of my patients—by one of my patients, I mean a guy who I had seen from the day he came into the hospital,” Alvarez said. “The transplant worked...[but] it ended really sadly. He died of complications.” The experience was one of many that Alvarez said made him realize how much he valued clinical medicine. “I love the patient interaction,” he said. During the previous summer in Miami, Alvarez met Valentin Fuster, the acclaimed Spanish cardiologist. And through Fuster, he landed the internship in Spain. “I was a strange creature because in Spain it’s not really common for undergrads to do observerships or shadowing or anything like that,” Alvarez said. “At the end of the day many of the nurses would just call me ‘Doctor.’” Alvarez said he had much more opportunity to be involved in medical procedures in Madrid than in his previous internship in the United States. “I was basically a sub-resident in that I didn’t have all the knowledge but I was really hands-on with the patients and going behind the scenes,” he said. Among the techniques that Alvarez learned were how to perform a complete cardiac check-up and how to read an electrocardiogram, which shows electrical activity in the heart. He also worked with a preventative health program. But apart from practical knowledge, Alvarez said that the most meaningful aspect of his experience was interacting with patients. “I was in the post-op ward a day or two before I left and [one of my patients] said, ‘One of these days you have to come visit me...’” Alvarez said. “He told me he’ll remember me.” Alvarez said he is still deciding whether to pursue clinical medicine or focus on research. The internship was funded by the Weissman International Internship Program through the Office of Career Services, which the OCS Web site says is designed “to help foster Harvard College students’ understanding of the global community.” —Staff writer Anita B. Hofschneider can be reached at firstname.lastname@example.org.For recent research, faculty profiles, and a look at the issues facing Harvard scientists, check out The Crimson's science page.