Thursday, July 11, 2013

Week 4 - Hannah

Though this week was a short one, I still managed to see and learn a lot.  The highlight of the week was when I received my clinical research project.  After weeks of feeling guilty and spinning my wheels as I sought in vain for a reasonable research project, I now have a specific task to accomplish: writing a literature review about xanthogranulomas versus craniopharyngiomas and other similar tumors.  Though this project has no relation to my PhD thesis or research interests, I am grateful for it, and it will be useful to practice writing a literature review.  Additionally, the knowledge I gain will be extremely beneficial the next time I attend a seminar on distinguishing factors in rare brain tumors. 

This week, I attended rounds in the OB ward.   It was nice to be in a part of the hospital where most patients were there for a positive reason.  Listening to the attending and residents on the round, I quickly realized that doing a bit of preliminary research on common abbreviations would have been helpful.  During my time spent shadowing Dr. Schwartz, one surgery stood out in particular because it emphasized the importance of robust engineering.  The surgery used a transphenoidal approach to remove a craniopharyngioma from a young patient and was a team effort between Dr. Schwartz and otolaryngologist Dr. Anand.  The surgery was complex and lasted over eight hours.  Near the start of the surgery, Dr. Schwartz noticed that the tip of one of the scalpel-like devices had broken off.  He was not sure if it had been like that before, or if it had broken off inside of the boy’s head.  It was necessary to have an x-ray taken to ensure that the piece was not lodged somewhere inside and in need of retrieval.  The x-ray ended up not taking place until the end of the surgery.  Fortunately, no metal shard was detected, meaning that the tool must have been broken from the beginning.  Several hours later, when Dr. Schwartz had reached the tumor and was slowly removing chunks of it, the vacuum that provided suction to his tools stopped working.  This meant that he could not see his workspace as well because it was filled with fluid and he had to progress at a much slower rate.  Meanwhile, nurses were trying to figure out why the pump was malfunctioning and calling the company to troubleshoot.  Eventually, they were able to retrieve a new pump from a different room, but it took a lot longer than I anticipated.  Once the new pump had been set up, the surgery was able to proceed as planned, and the remaining portion of the procedure went smoothly. 

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