This week I got to explore two departments in the hospital, the medical ICU and surgical pathology, and get some work done on my summer project for Dr. Gauthier.
One of the new places that I got to explore was the medical ICU, intensive care unit. Going on rounds here I got to see patients that were in critical care situations, which is somewhat different from meeting patients calmly in Dr. Gauthier’s office. During rounds it was interesting to see how doctors utilize the hospital network to update and keep track of information on each patient. This was particularly interesting not only because I am an electrical engineer and I can appreciate the vast quantities of information that are constantly pushed along the network, but it also helps me appreciate what the doctors need the network to do for them. Understandably, information is critical to continuing care in a situation where a patient is in such a condition where even breathing requires assistance. For this reason having a fast and reliable means of obtaining the latest test results, images from radiology, updates or notes from other physicians can make a drastic difference in the care of these patients. When the system works everything seems to go smoothly, but one day when several of the workstations that supply this information were out of order this slowed down rounds as phone calls were made to ITS try to get the terminals up and running. One of the issues that this situation showed me is that hospital computers can be no more reliable than home or office computers, which is certainly undesirable in a situation where such information can improve the quality of care that a patient can receive. From an imaging standpoint computers have improved the way radiological images are interpreted by physicians. Computers not only allow physicians to access the digital (x-ray, CT, MRI, Ultrasound…etc.) image of the patient that was taken anywhere, but it also allows physicians to manipulate the contrast or measure areas in the films in ways that were not possible with the physical films. From my time in the ICU it is clear that reliable, accessible and fast means of getting information from the patient to the physician is critical to advancing care in this particular department of the hospital.
In surgical pathology I got to observe a more diagnostic side of medicine. This floor of the hospital seemed to be a hub to which all of the other departments in the hospital turn to figure out, literally, what is in their patient. I am quite serious, from outpatient procedures where biopsies were taken to the OR’s where the surgeon wants to know immediately if the patient still has tumor left to remove. I got to sit by the window where these samples pile in from all over the hospital to be analyzed and observe how residents and fellows prepared these samples, which ranged in size from whole organs to the tiniest spec of tissue or blood. Interestingly it was here that I could detect a certain halt in technological advancement. The slides were prepared in a way that any lab could prepare a biological sample, with stains and a microtome, and the samples were primarily viewed with a brightfield microscope. Samples were assessed based on the report of where in the body the sample was taken and what the pathologist sees on the slides that were prepared. Stains are a key aspect of this means of assessment; immunohistological stains for example, are capable of delineating between different possible tissue origins of a particular sample. In biomedical engineering I am in the unique position of being able to work with researchers who are also concerned with the microscale structure of samples. Even from my more electrical engineering prospective I cannot help but think that there should be a way to combine these efforts to provide an imaging technique that could provide a streamlined assessment of the tissue that requires less manpower to achieve and has a more quantitative aspect than a visual interpretation.
On my project I have been able to generate a simple fit for the MRI images of the mouse that was taken at the 7T scanner. I look forward to presenting these maps at the lab meeting next week. Hopefully by the end of the summer I will be able to implement a more interesting fit for this data, which will provide more information as to the content of each voxel in the MRI image. It is hoped that this kind of map will be able to assess the health of the brain tissue in patients who have MS.