Ryan - Week 7

My last week in the city was a pretty slow one. The only surgery I saw was an open heart cardiac surgery performed by Dr. Girardi. The patient’s right mitral valve was failing and thereby disrupting normal cardiac output, so Dr. Girardi and his resident cut through the man’s chest and sternum to expose his heart. Then they shocked his heart with defibrillator paddles to induce cardiac arrest and cooled his heart with ice while syphoning off his blood through an external bypass machine, which kept his body perfused with blood. Cutting through the right atrium, Dr. Girardi exposed the damaged mitral valve and then proceeded to suture in a bioengineered valve support structure. Once this device was secured in place, Dr. Girardi closed up the heart and re-perfused it with blood and test its proper placement and functionality before closing up the patient. By defibrillating the heart, the surgeons monitored the heart’s ability to reestablish normal, healthy rhythm and cardiac output, which took around 15 minutes to accomplish but once established, the heart was doing much better than before. Stephanie and I were apparently lucky to have been able to see this surgery because a lot of other students in our program had canceled appointments.

I planned to go to Multidisciplinary Brain Tumor Conference this week but Mitch emailed us not to go into the hospital because the accreditation committee was here this week and we don’t want to run the risk of them quizzing us. We aren’t properly trained in the hospital protocols and therefore won’t be able to answer the committee’s questions, so by staying out of the hospital we avoid the risk of harming the hospital’s accreditation score. So instead I stayed home and hung out with the guys.

I was able to go in to clinic with Dr. Boockvar because the accreditation committee was only in the hospital and his clinic is in the Greenberg building across the street. In clinic, the consults were all pretty standard preoperation cases, however, not a single one of them went ahead with booking for surgery. Every patient went home to consider their options. So all in all it wasn’t a very successful business day for Dr. Boockvar. At the end of clinic, Dr. Boockvar and I took a quick picture before he had to leave and said our goodbyes. Later, the whole Summer Immersion class got together to take group pictures for the website before heading in to our last weekly update meeting. This time we didn’t go around the room discussing our experiences or projects but instead we talked about our time here as a whole and what suggestions we may have to make the program better for next year’s class. Afterward, we all went out to Pescatore, a really nice Italian restaurant, for a group dinner. The entire upstairs was reserved for us and they put together all the tables in order to seat all 22 of us. The food was fantastic and it was a really nice way to wrap up our time with Dr. Frayer and Dr. Wang.

Since I haven’t been able to go into surgery this week, I’ve been in email contact with Dr. Schwartz and Dr. Pochapin to organize a collaboration between the Departments of Neurosurgery and Gastroenterology. Both of them have agreed to organize an opportunity for testing out the NBI endoscope during a pituitary tumor resection surgery and they’ll notify me of their findings and opinions. I’m hoping that they will be able to do this prior to when I have to present my poster at the Summer Immersion poster session at the beginning of the school year.

This summer was an amazing experience and I truly enjoyed everything I was able to see and do while in the city. I am extremely grateful of the opportunity to participate in this program, which has largely influenced my knowledge and appreciation of the medical field and hospital environment. So I'd like to take this opportunity to thank all funding sources, especially HHMI, and everyone who helped make this program possible. To everyone who followed our blog, I hope you enjoyed it!