Week 5: Intro to the OR

Week 5 was full of clinical experiences! I watched five orthopedic surgeries, and I spent a day sitting in on appointments with patients in the clinic. This has been by far my favorite week in New York City. It was so different from my usual research work in the lab, and I enjoyed the change of pace.  Also, the staff in the hospital is amazing. I am so grateful they took some time from their clearly busy schedules to include me and answer some of my questions.

In the OR I watched two total hip replacements, one total knee replacement, and one complicated hip revision. I was particularly interested in the methods they used to prevent infection. When the patient has an open incision, they are most vulnerable to infection, so any staff interacting with the patient must wear extensive personal protective equipment. With their ventilated face shields and gowns, the staff almost looks like they are wearing space suits. There are strict rules about what you are allowed to touch depending on what stage of surgery the patient is in and the sterility of your personal protective equipment. The staff is very vigilant about potential sources of infection, and I always knew there was an extra eye watching to make sure I stayed in line. HSS also uses a unique set of sliding plexiglass doors that surround the patient when the incision is open. This plexiglass shield is meant to help prevent the airflow from the vents from blowing dust particles into the air near the incision. The Hospital for Special Surgery has a lower rate of infection than the national average, and it was clear they do everything they can to minimize that risk.

I was quite surprised and excited to meet two other biomedical engineers in the OR. One rotating medical student studied biomedical engineering in undergrad, and the Smith & Nephew representative was also a biomedical engineer. I enjoyed talking to them about what their biomedical engineering background meant in a hospital setting. Both agreed that engineering concepts make a lot of sense in orthopedics, since a patient’s problem and treatment are often mechanical in nature.

Opposed to my experience in the OR, my experience sitting in on appointments in the clinic was very people oriented. When Dr. Bostrom talked to patients, he focused on understanding how a patient’s ailment was impacted their quality of life. He was remarkably good at explaining complex medical issues in understandable ways, he was always offering options. One case in particular stands out. Before entering the examination room, Dr. Bostrom examined the patient’s x-rays. There were clear signs of advanced osteoarthritis. The patient was adamant they did not want their knee replaced, despite the pain. Dr. Bostrom simply said that if the pain became unbearable or caused them to modify their daily life in a way they know longer found acceptable, to come back in if they were ever ready. In the end, all of the treatments are meant to enable a patient to lead the life they want.

The research I do in Ithaca often feels so far removed from ever helping a real human being. It was so nice seeing the OR in action and hearing stories directly from patients. After eleven hours of standing to watch the surgeries, I was tired and sore. I have so much respect for the hospital staff that comes in day after day. Also, it was heartwarming how many patients wished me luck with my graduate studies when they left.