Who did my eyebrows? | Subash Bhandari

 

As I overlook the enchanting East River from the Neurosurgery OR suites at Greenberg Pavilion, I really hope the river with its currents takes away the pain of the patients at New York Presbyterian. 

I spent my 7th week shadowing Dr. Marciscano at the Radiation Oncology Clinic in David H Koch Center and reading papers on radiation biology and immunology. As usual, I observed radiation beams being delivered through an MRI-guided Linear Accelerator to treat prostate and rectal cancer patients. 

Apart from my regular clinical experience, on one of the days every week, I prefer to shadow doctors at a different medical department to diversify my clinical experience for the summer immersion term.

Today,  I had an opportunity to watch a supraorbital craniotomy performed by Dr. Rohan Ramakrishna. Supraorbital (eyebrow) craniotomy is an invasive surgery that is used for the removal of certain brain tumors located in or under the frontal lobes of the brain and around the area of optic nerves and above the pituitary gland. Upon creating an incision on the supraorbital notch region of the scalp, the anterior portion of the orbital bone, a medical drill was used to remove a section of the bone termed as 'bone flap'. After removing the bone flap, Dr. Ramakrishna went inside the patient's brain and removed an almond-sized tumor. The blood vessels feeding the tumor were zapped and removed as well. Upon the complete resection of the tumor, bone flaps were put back and screwed together using titanium plates. Hydroxyapatite cement was later coated on the surface and crevices of the bone flaps to ensure stability. The muscles and skin were sutured back together. 

As one of the residents, I believe, completed the suturing process and imagined the patient asking- "Who did my eyebrows?", he replied- Dr. Ramakrishna. I looked at Dr. Ramkrishna's face, who was ready to hop onto a different OR for a craniotomy procedure, and wanted him to reply- part of the job. As the patient was being taken to the ICU, I left the surgical ward and headed for the Radiation Oncology Department's quarterly retreat and listened to presentations about the U45 ROBIN (Radiation Oncology and Biology Integration Network) Grant.

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