Thursday, June 28, 2007

It's hot and humid outside, but so cool in the OR

For the last two weeks I have been shadowing Dr. Schwartz, a neurosurgeon and research scientist at the hospital. So far it has been quite an experience. The first day was extremely hectic. None of us had any idea where anything was. I was nervous about meeting my clinician, mainly becuase I had no idea what to expect. I was given a yellow post-it note telling me to meet him at "Greenburg OR 3." It took me a while, but being a graduate student, I was able to find my way. I showed up at the check-in counter confused and lost in a dress shirt, tie and slacks, receiving just as confused looks from the staff. I told them I was supposed to meet Dr. Schwartz where they then proceeded to tell me that I would not be able to get into the OR with the attire I was currently wearing. After scrambling around, I was able to get some scrubs and head into the OR Room 19. When I first entered, I again received some of the same confused looks from the nurses and residents. The resident came up to me and told me my face mask was put on incorrectly. I felt pretty dumb, but he was nice about it and proceeded to show my how put it on correctly. Dr. Schwartz finally arrived and before I knew it, I was experiencing my first surgery: a muscle biopsy. The first day were relatively simple surgeries. The next two surgeries, were similar ones in that they placed a chemotherapeutic reservoir between the skull and the skin. From there, a catheter was connected and implanted into the brain to help release the drug deep into the brain.

The next day, I observed an endoscopic removal of a tumor through the nasal cavity. The operation consisted of the entire removal of the pituitary gland, which the tumor had infiltrated. The entire surgery took about 7 hours. It was amazing to see how much the doctors were capable of doing despite the size of the tools and how little degrees of freedom they had. Later that week, I saw a removal of the lesion (possible tumor) in the temporal lobe in one patient and the removal of the amygdala and hippocampus in another. I observed a clinical experience in which electrodes were used to stimulate and record electrical activity of the epileptic tissue. As a part of my project, I wll be analyzing some of the clinical data, which should be very interesting.

This week has been just as interesting. Monday there was a case in which the patient had to be kept awake while the brain tumor (near the motor cortex) was being removed. The doctors had to make sure they did not commit any collateral damage to the brain. I also observed a patient that had surface and depth electrodes implanted into the brain. I believe they will be used to monitor his brain activity to hopefully map the focal point of the seizures.

It has been a great two weeks so far, and I expect it to get even better.

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