Week 3 - Lainie Eisner

 It's hard to believe that Immersion is already halfway done!  I had a really busy week this week branching out from my "home base" in Radiology to shadow in multiple different specialties.

On Tuesday, I went to the OR for the first time to shadow in Neurosurgery.  I observed a pediatric shunt removal and a spinal fusion.  This was my first experience observing surgery and it was definitely more overwhelming than I expected, with all the nurses/technicians/physicians in the room.  One thing that stood out to me was Dr. Hartl's motion capture system that he used to identify the vertebrae and insert needles into the correct location.

On Wednesday, I shadowed Dr. Spector in Plastic Surgery.  I think a lot of people have the misconception that plastic surgery is only for aesthetic purposes, so it was particulary interesting to see cases where the surgery was for functional reasons.  The first procedure I saw was a fat graft for a patient with scleroderma; essentially, fat was removed from the patient's stomach and thighs and reinserted into her cheek and jaw area to reduce skin stiffening.  After that, I also observed a breast reduction surgery.

On Thursday, I had the opportunity to shadow in Physical Medicine & Rehabilitation, which was one the most insightful experiences I've had here so far.  PM&R deals with non-surgical treatment of orthopaedic injuries, which is very relevant to my research on tendon injury and healing.  One encounter that really stood out to me was a patient who asked if a particular treatment would help cure her osteoarthritis.  Dr. Soo Hoo told her that the treatment would reduce her pain, but there are no known drugs that can actually cure osteoarthritis.  This is something that we often discuss in lab and use as a motivation for our research, so it was validating to hear it in the clinic as well.  I was also interested to see and understand the specific situations where physical therapy is prescribed, since part of my research relates to understanding why some patients benefit from physical therapy and others don't.  Based on my shadowing, I got the impression that physical therapy is the first treatment prescribed for almost all patients with musculoskeletal pain, which also validated my desire to better define the indications and contraindications for this treatment.

Lastly, today (Friday) I shadowed the fracture team in Orthopaedic Surgery.  I've been extremely excited to shadow in Ortho all summer and it certainly did not disappoint.  The first procedure I saw was an open reduction and internal fixation of an ankle fracture.  I learned that there's a lot more nuance than one would expect in choosing a specific fixation method (screws, plates, etc.) for each case.  After that, I watched a quick procedure to remove an external fixation device from a patient's ankle.  Finally, I observed part of a reverse shoulder replacement revision.  I finally learned why a reverse shoulder replacement is "reverse", although I'm interested in learning more to understand why the implant was designed this way.  During the procedure, I also got a chance to talk to the sales rep from Zimmer Biomet who had delivered the custom implant for the procedure.  He showed me the 3D printed reconstruction of the patient's anatomy with the implant, which I was excited to see given my recent interest in 3D printing.

All in all, it's been quite a week of shadowing!  I'm looking forward to relaxing this weekend and getting back in the OR and to Radiology next week!

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