Wednesday, July 28, 2010

Week 6: XLIF - The final fronteir

This week, was composed mainly of research, learning about histology, and spending time in the E.R.

In the E.R., I met up with Dr. Lemery, who gave me a tour of the various units that constituted the emergency room. We also discussed various pieces of technology he thought could be improved in the E.R., as well as finding ways to optimize patient flow in the E.R.. I was then paired with Dr. Heath, as senior resident, to shadow for most of the day. Most of the cases were fairly standard; bumps and bruises sustained through falls. However, I did meet a fairly chatty Nazi concentration camp survivor, who refused to believe a fall would do him in. Additionally, I saw a woman who presented with back pain that had all the signs I've come to recognize as a spinal stenosis in her cervical/thoracic spine. However, she was adamant the pain was related to an infection. I was struck by how multi-talented E.R. doctors have to be in terms of interacting with patients across various barriers (i.e physical and emotional state of the patient upon arrival, language) and having knowledge of all the various maladies they might encounter in the E.R..

This week, I spent some time in Dr. Stephen Doty's laboratory in HSS. Dr. Doty's lab specializes in the evaluation of bone, cartilage, and other connective tissue by means of histology and immunohistochemistry. A particular research interest of Dr. Doty's is to find a way to quantitatively evaluate histological samples. In Dr. Doty's laboratory, I spent some of my time familiarizing myself with various histological instruments, such as the microtome, and various common stains for these types of tissues, such as Alcian Blue, Picosirius Red for collagen, and the standard Hematoxcylin and Eosin. I also learned what the intervertebral disc and end plates of the vertebrae would look like under each of these stains. Dr. Doty is truly a master of histology, and I hope to use his expertise in my research at Cornell.

Most of the rest of this week focused on my research project. After extensive searching and refining, I finally narrowed down the 12 patients I could use for data, and began to compile as many demographics as possible. Already, there are some statistical differences in terms of pain pre- and post-op. Additionally, I have narrowed down 8 more patients that could be added, but may need to be called to gather additional data. I also began to write the abstract for SMISS, although it is becoming apparent that there may not be enough time for me to write this abstract or work on a paper for these findings. Dr. Hartl suggested that another fellow might collaborate with me while I am in Ithaca to get both these things done.

Looking ahead to the next week, I plan on getting back into the O.R. to see a few more cases, finish up what data collection I can, and learning how to use MRI and CT to look at Cobb angles in patients. Already, it has been quite a summer, and I look forward to wrapping up next week.

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