Fourth Week of Internship (Cont'd)

Shocked by the realization, we find out that something we thought as grand and magnificent turns out to be the complete opposite. Nonetheless, the discovery is canceled out by the new realization of the truth and becomes more amazing than what our imaginations could conjure. There is a reason to why I give this sort of complicated introduction. I guess you can call this learning and partly that is what surgery is all about. For example, the surgeon goes into the OR knowing he or she has to remove a tumor. He or she already has an idea of the size, but once it is excised, that notion can change; he or she learns new about that type tumor. I felt this on several occasions these past two days at the Sylvester Center.

Thursday morning began with Dr. David Arnold, Associate Professor for Otolaryngology. He performed an esophagoscopy, a procedure that involves the surgeon using these red, snake-like tubes to dilate the esophagus. The ultimate goal is that patient can pass substances to the stomach better than his or her current situation. By the way, the constriction was primarily caused by chemotherapy given to cancer patients. At first, when the tubes (shown left) were revealed, I was a little baffled as to how Dr. Arnold was going to use them. But he passed different sized ones down the esophagus to enlarge it. Before I discovered this, I believed they were some kind of cameras that he was going to use to look down into the esophagus and then assess the patient accordingly. Anything that ends with “-oscopy” is supposed to be a noninvasive search using an endoscope. But Dr. Arnold explained that there are always exceptions in surgery and pretty much everything. For me, this was expecting the unexpected, and I learned about what I did not know. This internship has helped open my mind to new ideas and rare insights that many high school students do not see. Who would have thought that is the proper method of dilating an esophagus?

Later I got to view Dr. Arnold remove a tumor from the area close to the ear known as a parotidectomy. The tumor was benign but causing a number of complications for the p

atient. It was a standard operation that goes in four basic steps: incision, cutting of tissue until reaching the core, carefully excise the tumor, and stitch from deep back to the epidermis. I mention this procedure not because of the process but what came after it. Dr. Arnold suggested that I go see how pathology prepares (shown right) the specimen (the tumor), and what findings we can uncover. I arrive at the lab, and it was smaller than I expected (TV shows often depict a large lab with test tubes and numerous chemical instruments). But this lab only contained a freezer that instantly freezes specimens, a work desk with jars containing

chemical preservatives, and in the back a little desk with a microscope and two viewers. The pathologists start inking the tumor and then prepare slides for the microscope. I kind of remembered what Mr. Garcia had taught us about microscopes and how to view a specimen. I felt proud of myself that I could understand the process and the usage of the microscope. He was right about having to use it in the near future outside the realm of the classroom. While the pathology may not have been what I envisioned, it certainly taught me about the importance of what you learned in class and being able to apply it in the future.

Lastly on Friday, I witnessed a hysterectomy, a removal of a woman’s reproductive system, by Dr. Karen Nishida, Assistant Professor of Clinical Obstetrics and Gynecology. I got to see bits and pieces of it because the surgeons were huddled around the area. But despite the traditional way of doing it, they decided to do it laparoscopically because it would be less trauma for the patient. They basically went in, cut the areas that needed to be removed and the entire system was placed on a table for inspection. I was amazed by how different it was! It was the same picture from the textbooks but much smaller in retrospect. I began to wonder how a baby grows in such a tiny place. This had to have been the most incredible thing in all my weeks of different surgeries: seeing an entire body system and discovering its actual size. I guess it goes to show that you learn something new everyday.

Overall these past two days have taught me that success to surgery is more than just focusing in on the actual procedure and already knowing what you are going to do. One must be open-minded and always be willing to learn something new or gain new knowledge on an existing topic. I believe that this can apply to almost any job. One’s learning does not end after college, and if followed, it can ultimately make us a better population ready to take on the situations of now and later. Surgeons, especially, cannot be stuck in the ways of the past and must make room for future techniques. I will take this with me during my next two years in high school, college, and beyond.