Week Four: This Engineer + Emotions = Error

The past few weeks have been a whirlwind of on my feet, running around the hospital but that is not an accurate representation of what my field of science usually is. When I am in Ithaca I am usually in a lab collecting data before sitting down at a desk in front of a computer to analyze data. Research in a hospital setting can sometimes look like this but a lot of times it looks like collecting patient data, either through interviews and testing or from medical records. This is my way of telling you that things slowed down this week and I really got to work on my contribution to science for the summer: data analysis. 

I did one more round in the ICUs with the Infectious Disease consult team and saw my most emotional case yet: a 26 year old woman in her third trimester of pregnancy with a high fever. Fever almost always implies that the body is trying to fight off some kind of infection, but a fever alone can’t tell you what kind of infection nor how to treat it. The strangest thing about this case is that the patient had no other symptoms. No cough, rash, sore throat, aches, nausea etc. Usually these other symptoms help doctors determine a diagnosis and prescribe treatment, but the lack of information made it hard in this case. When I last saw her, she was being treated for suspected Listeriosis, caused by eating food contaminated with the bacterium Listeria monocytogenes (Figure 1) that can result in pregnancy lost. This can be common in pregnant woman because they are slightly immune compromised. She began treatment on antibiotics and her fever was improving and there was talk of sending her home soon. I really felt for this woman because I could imagine being in her shoes years from now and knowing how nervous I would be. Luckily, she seemed less worried about her condition than I was, but it made me remember why I am not a doctor: I sympathize with patients too much. While sympathy can be good, it can also be very exhausting.

Figure 1. Listeria monocytogenes, the bacteria that causes Listeriosis. From CDC.gov.

After a few days, I was able to move forward and start working on my data set of older adults with HIV. I have been learning a new programming language, R, which is good for statistics and data analysis. So far, I have worked out the general demographics (Table 1). Our population is a large majority male, which is not unexpected. Most patients are between the ages of 55 and 64. The more interesting data will come in the following weeks when I start looking at body composition using Bioelectric Impedance Analysis (BIA) data. BIA is capable of estimating total body water under most conditions. In BIA a low-voltage, alternating current is passed though the body where it is transmitted by electrolytes in lean tissue and body fluids. The current is opposed by non-electrolyte containing components of the body such as skin, fat, and bone. Using height, weight, age, and gender and the values from BIA, predictive equations estimate the weight of various components of the body including fat, lean dry mass, bone mineral content, and skeletal muscle mass (Figure 2). With this information we can see how our population of older adults with HIV are aging, their level of frailty, and if their weight is being properly distributed.

Table 1. ROAH Cohort Demographics. Note: some patients had more than one analysis done at different ages, hence why total samples and total patients are different.

Figure 2. Break down of total body weight into mass of components. From RJL Systems Body Composition 4.0 User Guide.

I spent most of last weekend avoiding the extreme heat and staying inside with the air conditioning, but on the Fourth of July a group of us walked the Highline Trail, an elevated linear park created on a former New York Central Railroad spur. From there we went to the Chelsea underground market where I had some of the best tacos I’ve ever had. In the evening we took the tram over the East River to Roosevelt Island to watch the fireworks from the lawns of the new Cornell Tech campus (Figure 3). This weekend there are plans brewing to explore Coney Island and Brooklyn.

Figure 3. Fireworks over the East River as seen from Cornell Tech on Roosevelt Island