Week 4: Carolyn

This past week, I was immersed in various aspects of the clinic. Monday was spent in the operating room with Dr. Bostrom. I observed more total hip and total knee replacements. The amount of bone tissue removed from the body during these operations is incredible. This tissue is then sent to pathology to confirm diagnoses such as osteoarthritis and test for any other diseases. If these tests could be modified so that the amount of tissue required was minimal and the tests were able to completed quickly, this tissue could be useful in many scientific studies.

Tuesday was spent in a new operating room – I shadowed Dr. Cammisa, who performs spine surgeries at the Hospital for Special Surgery. The drastic differences between the arthroplasty operating rooms and the spine operating rooms were shocking to me. Due to the much lower infection rates in spine surgeries, there is no need for specialized air flow and physical dividers between the sterile and non-sterile portions of the room. Additionally, the Dr. Cammisa and his staff were not wearing the full face-masks that assist with sterility in the arthroplasty operating rooms. The circulating nurses here informed me that the expected higher infection rates in the arthroplasty rooms is due to the more common patient comorbidities, such as higher BMI and diabetes.

There were more employees working in the non-sterile areas in Dr. Cammisa’s operating room than the number which work in the non-sterile areas in the arthroplasty rooms. One reason for this could be that these surgeries require the use of intra-operative x-rays, so the C-arm needed to be used every so often. There was always at least one person there to manipulate this large piece of equipment. Interestingly, the hospital uses a portable wall which shields people from radiation. I had never seen or heard of this before, but greatly appreciated the convenience.

Dr. Cammisa was very helpful in pointing out specific tissues to me and answering questions throughout the operation. He even had his nurses stack some stools for me so that I could try to see into the surgical site during the operation. Unfortunately, it was not perfect, but it certainly did help me see a little bit more! This experience also emphasized to me how much more invasive the arthroplasties are compared to spine surgeries, as arthroplasties are generally easy to see from across the room. This invasiveness and exposure to the air in the room could also contribute to the higher infection rate in the arthroplasty patient population.

Wednesday was spent mostly in the clinic, and I was able to get my first round of patient interactions. While it was very interesting, it fully convinced me that I could never be a doctor. Several patients were rude or came into the clinic with preconceived notions of what should be done. Overall, most were appreciative of Dr. Bostrom and his time, but I know that I personally would not be able to deal with the more difficult patients. Seeing these patients also re-enforced the fact that no two patients are alike – nearly all of them had significant health issues in another aspect of their body. I believe that there will likely never be a “cure-all” for many diseases – instead patient specific therapies will become the best option for complete healing.

Outside of the clinic, I spent a few days learning some new techniques in Dr. Otero’s lab. Specifically, I learned how to obtain murine cartilage samples for RNA extraction. This process is much more difficult than I had imagined. Today, I spent the day trying to dissect my own cartilage samples so we can perform the extraction next week. This has also given me an appreciation of micro-surgery!

This past week, I went to the Metropolitan Museum of Art for the first time with Tibra. We made it through a very small portion of the museum, so I cannot wait to go back and try to see more before I head back to Ithaca!

Tibra, Regan, and I also went to go see Anastasia on Broadway and absolutely loved it! It is probably my favorite show from this trip!

My dessert recommendations from this week include cupcakes (pictured below) from Two Little Red Hens. Patrick and I also split some really great desserts at Billy’s Bakery, and I got an amazing cookie from Schmackery’s! I was lazy with my camera this week though, so you will have to go try them yourself!