Ashley - Week 2

Week 2 was again filled with shadowing Dr. Lane’s clinics and surgeries scheduled for the week. However after meeting patients the first week, I was able to follow a lot more cases more closely. During week 1 we had several patients scheduled for surgeries during week 2.  I’ve been able to see the patient experience go from clinics, which involves diagnosing the patient’s problems to the treatment options available to them. Most of the time, fractures involve the patient going into surgery the following week to relieve pain and correct the fracture. 

The most exciting case I witnessed this week was seeing a patient with a tumor in her foot that she’s had for more years than she can remember go into surgery for the removal. A biopsy during surgery would be done to determine whether or not the tumor was malignant. The determination of this biopsy was crucial to how Dr. Lane would proceed with the treatment of the tumor. If there was any chance it was malignant, he would have the patient do some minor radiation to free her of any cancer. The tumor was carefully removed to ensure it was completely gone and not comprised. Immediately after surgery, we went to the pathology department within the hospital in order to determine the severity of the tumor. I was able to witness the pathologists stain the mass according to the location of the body, and then take a chunk out in order to put slices on microscope slides. The chunk that was cut out was embedded in paraffin wax and then sliced into 5 microns. The pathologist pointed out to us what seemed to be atypical cells. I could see very clearly that certain cells were going through mitosis, and that the sizes of some of the cells were significantly larger than the cells it surrounded. Although she would need to do some specific staining to find out whether the tumor was malignant or not, her preliminary examination indicated there is a possibility the tumor is malignant. She could not at the time confidently tell Dr. Lane the tumor was not malignant. With the information given to Dr. Lane, he was able to proceed with closing up the incision and waiting on the results from the pathology department. Next, we went to go talk to the family to inform them of the outcome of the surgery. They would have to wait a few days to determine if the tumor was malignant or not, if so she would receive a few doses of radiation to ensure she was free of cancer. If not, then she was taken care of.

It was just really amazing to see the whole process of a patient entering the hospital with a problem, and leaving with a solution. Every week, each case is unique and the solution never exactly the same.