Week 1

My mentor for this week has been Dr. Roger Hartl in Neurological Surgery at Weill Cornell. He is the director of spinal surgery at the Weill Cornell Brain and Spine Center as well as the official neurosurgeon for the Giants. I have yet to see any football players in the clinic but at least that means that everyone's healthy for the offseason. It seems that lots of wealthy and famous people see Dr. Hartl and I'm sure that other doctors experience the same. It only makes sense to choose one of the best hospitals in the world when you can afford it...
To begin the week I shadowed Dr. Hartl in the clinic, see new patients and follow-up visits from patients weeks-removed from surgery and also years later. It's interesting to see the spectrum of people that come in with many different kinds of pain. Younger people with extreme leg pain, older people that are losing their ability to walk, and some folks that can't even move their necks without wincing in pain. It seems that people from all walks of life can be united by neck and back pain, unfortunately. Nerve compression does not discriminate.
Dr. Hartl goes through a routine of tests with each patient to determine the extent of their pain and weakness. And depending on which part of the exam that patients feel pain or relief, he can isolate in his mind which part of the spine they likely have a problem. Then he pulls up MRI scans on the computer to confirm his suspicions and explain what is likely causing the problem. Then he offers some potential solutions to patients; usually to try physical therapy if possible, to avoid needing surgery. But if he thinks the patient is a good candidate for surgery, and that the risks of surgery are worth the improvement in quality of life for the patient, then he goes into detail about the types of procedures possible and what he would recommend. He spends as much time as the patient wants, where some have few questions to ask and other have multiple pages of questions they want answered before committing to having spine surgery. Also, since it's summertime, many patients ask about Dr. Hartl's availability so that they can plan surgery around their vacations abroad.
I was also able to see a few surgeries so far. They have been minimally invasive spine surgeries (MISS) so it's not very obvious what I'm looking at. However, there is another spine surgeon that I have been asking questions and he does his best to explain what's going on and identify different parts of the anatomy. It's all just different shades of slightly-red to me but I'm learning to distinguish between dura and ligament and muscle and bone. I am looking forward to seeing some larger surgeries, like a spinal fusion, in the coming weeks.