Monday, July 18, 2011

Week 5 - Joseph

Well, the transition back to life in Ithaca is looking like it will be easier than previously expected, because here I am at the end of my third-to-last week and I’m already back to being a graduate student! This week the majority of my time was spent on research-related activities in the Dr. Kaplitt’s lab. The beginning of the week saw the final pieces of design for how to approach the multi-step creation of an adeno-associated virus gene therapy vector platform that could penetrate the blood brain barrier from a systemic circulation origin fall into place and the ordering of the related supplies (custom peptides and genetic mutation primers that represented an… evolving approach). Following that, there was nothing left to do but hit the bench. Not much interesting to talk about, honestly; chemical reaction monitoring, site-directed mutagenesis, and cell culture all built off previous knowledge for modifying and creating viral vectors and basic cellular and molecular engineering skills I use on a regular basis back in the lab in Ithaca. Not to say it wasn’t satisfying work, just that there’s not really much to talk about. I’ve been working hard on the project and will continue to work hard, though it will legitimately be interesting to see how much of the project can be completed in the coming weeks. As an undergraduate I spent months on similar projects only to find them requiring a steady stream of back-tracking and revising. That being said, it’s a different environment and I’m much wiser in the approach now, even teaching the students here a couple things about rational design approaches using modeling techniques. I have high hopes, but only time will tell.

I attended several surgeries to keep up my interaction with my mentor and neurological surgery in general, but did not see anything new in terms of problem and solution. I used my experiences this week as a test for how much I had learned, to see if I could remember and predict the various steps of tumor resection or spinal decompression surgery by craniotomy from first incision to close. New students shadowing Dr. Stieg proved to be an excellent medium for explanation to test my knowledge, and I was pleased to see that I had picked up far more than “oh, well they cut into the skull with a drill and, you know, suck out bad stuff”.

Of final note was a continued experience in the NICU, again shadowing Dr. Frayer like last week. It was of continued interest to me to see the difference between “healing” medicine and “growing” medicine, because the latter really was what was going on with the majority of cases. Premature babies weren’t necessarily sick by default; quite the contrary. However, the fact of the matter was they simply weren’t ready to be born into the world yet, and that required a very different form of medical intervention that the standard, say, craniotomy. Following cases across multiple days provided an additionally satisfying portion of the greater hospital experience that I had not really had in my more narrow focus on neurological surgery, and I found it quite satisfying to see a pair of premature twins gradually proceeding down the road to being ready to go home with their parents. Not all the cases were necessarily proceeding ideally, to be sure (I intend to continue to follow the case of one mysteriously sick child who was suffering from chronic immune function issues resulting in being covered in damaging pustules for reasons that had yet to be fully ascertained, with all cultures consistently coming back negative), but the experience was comforting nonetheless. This was truly a frontier of hospital medicine that was making a positive difference on a regular basis, with success and comforted parents behind the majority of stories to be told.

The next two weeks should be an interesting mix of new hospital experiences (MICU, ED, and open heart surgery at the least) mixed with continued long days in the lab, hoping for a complete project by the end. I admit, I’m looking much less forward to the lab work I’ve gotten myself involved in at this stage than the original surgical immersion at the beginning of the term, but rules are rules and I’ve got a virus to make!

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