Week One: So it begins

I can guess with this post the first week has ended, and well it has been pretty interesting so far. My clinical mentor is Dr. Jim Hu M.D., and I have learned a lot about some of the more minute details involving prostate cancer cases. I’ve known about the screening processes such as measuring PSA levels and the digital rectal exam, but the steps beyond that I’ve for the most part ignored. However, being immersed this past week in the hospital has allowed me to see some of these other steps. In particular, I have seen and learned more about the process of MRI Ultrasound Fusion Guided Biopsy. For this procedure, patients undergo an MRI scan to segment the prostate and help identify regions of suspicion. The scan is then used to construct a 3D rendering of the prostate with suspicious areas identified. Using this data, the oncologist then uses an ultrasound probe to guide the biopsy needle to both the suspicious areas and the routine systematic biopsy sites using the MRI scan as a kind of roadmap. Seeing this and learning more about it was a new experience with some minor discomfort in seeing that biopsy needle (yea I am not that great with needles). However, seeing this precision and how much goes into getting accurate locations for the biopsy samples was exciting and something I had never thought about before.

Beyond understanding more about fusion biopsy, I have also watched a laparoscopic proctectomy utilizing the Da Vinci Surgical System (see below). Seeing the robot in action was something I had always been excited to see, but I did not expect to see it in my first week here. The surgery itself involved using only a few small incisions to allow instruments and the camera to enter the body cavity, and then careful maneuvering to move the bladder and remove the prostate. Once the prostate was removed, the urethra and the bladder were reconnected followed by the incisions closed. While I make this sound simple, there were a lot of tiny details that make this procedure much more complicated to show the expertise required for it.

Figure 1: The Da Vinci Surgical System
(image source: www.davincisurgery.com)
Outside the hospital I have taken to exploring some of the local areas particularly the coffee shops to find not only the best coffee, but the best chai. With the summer heat that hit earlier this week I had to resort to iced drinks, which for me taste very similar regardless of quality mainly due to the sugar that I end up putting into them. However, these past couple of days have been fine to try hot drinks again. I have visited a few places, but the one I have frequented the most has been Gregory’s Coffee. While the coffee, chai and atmosphere is great, I think the main draw for me to them has been the proximity to the hospital. This will have to change if I am to find the best. Beyond the coffee shops I have also visited Rockefeller Plaza, Central Park (such a nice little park), and countless restaurants. I’ll end this post here and with a picture of the city I took around sunset during this past week.


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