Third Week of Internship

Most of us wake in the morning to a breakfast of cereal, toast and perhaps the occasional glass of orange or grapefruit juice. However, my morning is combined with the smell of human flesh being burned using a laser device. It becomes part of the daily cycle of entering the OR at 8:00 a.m. everyday. I mention this tidbit because most of the operations I have seen so far have been about removing certain body parts because they are dysfunctional or unusable.

On Monday, I observed a surgery performed by Dr. Jarrard W. Goodwin the Director of the Sylvester Comprehensive Cancer Center; he also actively practices in ENT surgical cases as well. The procedure was called a laryngectomy which is a removal of the voice box (right). This particular patient has a history of cancer, and radiation from chemotherapy caused scarring of the voice box. So, it had to be excised. This surgery lasted about four hours because it is harder than it looks. It involves carefully cutting the tissues that connect the voice box to the walls of the throat. Each section of tissue is precisely and slowly cut to ensure that there will be no problems upon removal. I would describe this surgery in the same manner as an artist paints something. The artist has to envision what method to utilize before he or she starts painting. A surgeon similarly does the same thing; he or she has to see what is the best route to take before beginning. I definitely saw this as a successful trait to harness, which is also something that has developed throughout my years at school: preparedness and evaluating the situation. Not only being ready but also having patience is essential in surgery. Dr. Goodwin did not at all try to rush the procedure or take shortcuts, even he will have to stay in there for four, five or ten hours. I saw that patience is absolutely a virtue, and it is too valuable to let go.

I also had the opportunity to view the removal of a benign tumor (left) located in the larynx also done by Dr. Goodwin. This procedure was shorter at a length of two hours. A benign tumor is nothing more than an abnormal mass of cells that do not move throughout the body in contrast to a malignant or cancerous tumor. Dr. Goodwin followed the same technique as was done in the laryngectomy; he cut section by section of tissue slowly and carefully. Before starting internship, I never knew that there were so many problems associated with the throat and its components. It shows how much you have to take care of all parts of the body and not just the ones talked about on television such as the heart, lungs, brain, etc.

Tuesday began with a similar removal procedure called a parathyroidectomy performed by Dr. Carmen Solorzano, Chief of the Division of Endocrine Surgery. The parathyroids are the glands responsible for the regulation of calcium in our bodies. This patient had a hormonal imbalance that caused calcium levels to be atypical. The only answer was to remove the glands completely and see if any results are obtained. I particularly found the parathyroidectomy to be fascinating because glands that are extremely small can grow relatively large when an imbalance occurs. Such a regulation in the body has massive effects; one must be careful in dealing with any imbalance as I had learned.

And the end of the day came with, surprisingly, not a removal but an insertion specifically a port insertion done by Dr. Dido Franceschi, Professor of Clinical Surgery. It is a procedure that is given to cancer patients in order to infuse chemotherapy. It is nothing more than cutting a few centimeters into the body cavity (usually on the chest) and placing the port with a tube running into the bloodstream. This port is the mechanism by which medicine will travel through the body during chemo.