Week 5

Week 5 was a very interesting week in immersion. It was nice to hear everyone's immersion experience during our weekly meeting. It seems that we all had similar observations, even though we were all in different departments. I knew from my own observation experience that there was a heavy use of CT Scans, PET Scans, and X Rays. in the thoracic surgery department. Specifically as a diagnostic tool and a tool to support surgeons to determine surgery plans. If the nodule are deep in the lungs, it makes it difficult to cut a simple wedge and also difficult to find the nodule. This information is given by CT Scans. On X-rays you can see if someone has a hiatus hernia. Physically, the stomach is higher up in the X-ray. In conclusion, for any diagnostic radiology can be used to support the doctors. During the weekly meeting this week, I learned that this was true also outside of thoracic surgery.

In shadowing surgery:

This week I shadowed Dr. Altorki in the OR. It was an extremely interesting case, a lobectomy of the upper right lobe. The upper right lobe is a very big lobe with respect to the other lobes on the right. A lobectomy is when the surgeons remove the entire lobe. This was the first entire lobectomy that I watched. The first step was to find all the arteries and veins connecting to the lobe. This was very interesting because from an untrained eye, a vein, artery, and airway all look very similar. When Dr. Altorki found an artery and vein he stapled it. This step is very important because otherwise when you remove the lung first the blood from the veins and arteries will go everywhere. Some difficulties still continued with the video camera and screen. Because of the contrast and coloring, it's harder to determine one part of the body or another and even see everything properly. Dr. Altorki being well trained was able to move forward with the surgery, but many surgeons under this conditions may not have been able to. Because they are dealing with vessels and arteries, the surgeons have to be extremely careful when cutting tissue to get to the vessels or arteries. It was also interesting to watch their methods to finding the veins and arteries. For example, finding the aorta first and then looking where it branched off into the upper lobe. One all vessels and arteries were stapled closed, Dr. Altorki was able to cut off the airway and remove the lung. Seeing the upper lobe outside the body was incredible, it is so large, even deflated. Then the surgeons had to make sure the middle and lower lobe were in the proper positions before re-inflating the lungs.

In shadowing clinic:

I shadowed Dr. Lee in clinic last week. Dr. Lee is American-Chinese. A lot of lung cancer patients are chinese because many chinese (especially women) or EGRF+, a gene that is very susceptible to lung cancer. Dr. Lee speaks Mandarine and Cantonese. As someone who has been studying Mandarine since the 6th grade, I was very excited to shadow him and see him interact with Chinese-speaking patients. Generally speaking, if the doctor does not speak the language of the patient, doctor's use a virtual translator. However, you can immediately see the difference in patient-doctor connection when the doctor knows the language of the patient and can communicate with them. I also saw this when Dr. Altorki spoke Arabic with some patients a few weeks ago. As Dr. Lee spoke with his patient in Chinese, I understood the entire conversation. It is exciting to see a language that you have dedicated yourself to come to use in the real world.