Week 2 - Young Hye

Monday was a bit uneventful. With the list of surgeons and their regular schedules given by Dr Vahdat, I had planned to watch Dr Elstrom's surgery; however, when I emailed her, I got an automated reply saying that she is out of town until the end of June. It was last Thursday that I got this reply, so Thursday night and Friday I spent emailing other surgeons on the list to make up for my empty agenda. Didn't get any satisfactory replies, so Monday morning I spent looking through Weill Cornell website and contacting different surgeons in hopes of getting anyone's approval to shadow their surgeries. It wasn't a complete waste of time, since from hours of these phone calls I got to fill up three mornings for the week. In the afternoon, I went to Dr Mittal's lab and learned to purify neutrophils from mouse blood. It started from poking the neck of the mice with a small lancet to get a couple droplets of blood, which was done just for the training purposes so we have enough blood to learn the assay without sacrificing any mouse. It was basically a magnet-based isolation process where neutrophils were marked with magnetic beads and the solution would go through the magnetic column, flushing out non-neutrophil cells in blood. Flow cytometry was performed to assess the purity of the isolated neutrophils; we got about 80% purity, which was really good. This is definitely a useful skill for me to learn, since I will be running experiments with freshly isolated neutrophils from murine blood.

Tuesday morning, I shadowed Dr Port in the endoscopy suite. He looked at esophagus of his patients, and it was tough for me to see patients coughing and trying to take the endoscope out while the nurses were trying to restrain them. One patient had a wrap around his esophagus, while the other had digesting issues because there were lots of undigested food left. While looking at the esophagus of the patients, Dr Port told me a story of how he and his engineer friend made a device to detect gauzes by using radio frequency to prevent suturing up the patients with gauzes inside. This happens once or twice a year in this hospital, and this could result in death of a patient. He has raised quite a bit of profit from his company, but he hasn't been able to bring this product into this hospital because of the cost. It made me think first, how doctors and engineers can work together to make a product as doctors see necessary, and second that the accountant in hospitals may need to get better understanding of what doctors need to bring better patient outcome and just not analyze everything in numbers. In the afternoon I went to the breast center to work on my project a little bit. And I got to follow Dr Vahdat in seeing her last patient of the day, who came here for the first time from a referral from her previous doctor. She wanted the patient to partake in gene testing, and it was an art in the way the doc brought up the topic and made the patient to agree to participate.

Wednesday, I followed Dr Bryan Schneider in lung cancer. I was surprised to hear that lung cancer patients, who probably have gotten it from smoking, still smoke even after they know that they have lung cancer and have been undergoing the treatment. It was also interesting to see that there were fewer treatment options in lung cancer than in breast cancer; whereas in lung cancer chemotherapy and lobectomy are the major ones, breast cancer has four different kinds of treatment options. In the afternoon, I went over to Hospital for Special Surgery to watch the total hip replacement surgery of Dr Vahdat's patient that was cancelled last week. I think I made a mistake in saying hello to the patient, which I thought I'd do it because I'd seen them last week at Dr Vahdat's clinic. They seemed unhappy to know that I'll be watching the surgery, and kept asking why I would be in the OR if this surgery has nothing to do with breast cancer. And they wanted to know what exactly is happening, which I didn't have a clear idea of. After I managed to get myself out without upsetting them, I went to get a pair of scrubs. It was a pain getting them, because the admin person there said she'd need a letter from the surgeon himself that I am allowed to observe. After hours of frustration and fruitless effort to reach Dr Lane, I got help from nurses and they got me a pair and took me to the OR. Hip replacement surgery was done in extra sterile condition, where a shield was placed around the surgical table and people scrubbing in wore a helmet looking thing to cover their breathing. I stacked two stools and stood on the anesthesiologist's side to watch the surgery. It was hard to see since I wasn't close enough to the patient, but nevertheless it was an invaluable experience.

Thursday, I was supposed to shadow Dr Pressman in cancer genetics. However, when I went to the clinic I got to know that the morning patient cancelled the appointment last minute, so they told me to call them to reschedule. So I came back, and went to Dr Mittal's lab to try neutrophil isolation and purification on my own. I got a pretty good result, and I was happy.

Friday, I watched Dr Paul Lee's surgery in the morning. I watched Video-Assisted Thoracoscopic Surgery (VATS) right lower lobectomy, which was done by opening the patient in three small segments, into which endoscope was inserted and the entire procedure was done by looking at the screen and deciding where to cut, etc. This patient was originally found to have a lesion in her right lung, but the docs didnt have biopsy to determine whether she had lung cancer as well. When they got to the area of interest and sent the biopsied lesion to a pathologist, they found out that she had lung cancer. So the surgeon took out the entire lower lobe of the right lung instead of just cutting out parts of it. In addition, they took out several lymph nodes on different parts of the lung to send to the pathologist for diagnosis. In the afternoon, I met with Dr Vahdat to update her on my week and the project.