Tuesday, June 26, 2007

Babies and Stuff

My clinician mentor is Dr. Frayer from the department of pediatric neonatology, a field that focuses mainly on the treatment of premature infants. Dr. Frayer will not be on service until July 1, so during the first week I made rounds with Dr. Schulman in the Neonatal Intensive Care Unit (NICU). The unit consists of two teams in which the residents of each are responsible for different patients, but each team is led by a primary physician. Despite the fast pace and the seriousness of some of the patients' conditions, the environment felt quite laid back, with many people cracking jokes (mostly by Dr. Schulman) during the rounds. I even found YouTube to be quite popular among the residents, much to my delight.

The conditions of the patients range from serious to stable. Two of the more serious patients in particular were of interest to me. Baby X (can't use the real name, or I will be fired), for example, was undergoing treatment using an experimental head cooling device called the CoolCap. It allows the baby's head temperature to be regulated by circulating cold water inside plastic tubes in contact with the head. It has been shown to prevent brain damage in newborns who have been oxygen deprived supposedly by reducing brain metabolism, although the mechanism is not totally understood. What is understood, however, is that the CoolCap is far from cool looking. I suggested putting some type of design or insignia on it. If it was my kid, I'd probably write "mofo" on it, just so the other babies would recognize.

Baby Y (again, I'll get fired) was experiencing obstruction in the bowels, though the exact cause was unknown. It was decided last week to schedule him for exploratory surgery with Dr. Spigland (Nathan's clinician) on Monday. Having visited this patient each day last week, I felt compelled to see his operation. So I went yesterday, and it was pretty messy. Dr. Spigland started by first pulling out his intestines and examining them. There were many perforations, and several parts of the bowel were necrotic (it was literally falling apart). At the end, the small intestines were separated between the duodenum and jejunum (which are close to the stomach in the intestinal tract), and a tube was inserted. He was closed up, but will need additional surgery in the future. All of that surgery gave me a hankering for some German blood sausages.

My goal while I am here is to do rounds in the pediatric and adult ICUs as well to see how patients of various age groups are treated. In addition, I am working on a project involving the modeling of infant lungs, but I will have to write about that at a later point.

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