Week 1 - Hannah

Immersive is definitely the correct word to describe my summer experience thus far. Mere hours after receiving my hospital ID card Monday morning, I found myself dressed in scrubs and trotting after neurosurgeon Dr. Theodore (Ted) Schwartz to see my first surgery. Surrounded by a dynamic flock comprised of nurses, doctors, and students, I attempted to avoid being in the way as the patient was prepped and the surgery started. It shocked me when the sterile wraps used to drape the patient were stapled directly to his skin. The patient had a pituitary adenoma, a fairly common type of tumor that grows from/in the pituitary gland. Dr. Schwartz used the transsphenoidal approach to remove the tumor through the patient’s nose. A stereotactic set-up allowed the location of the instruments inside the patient to be pinpointed. Large screens projected the images that the endoscopes were collecting.  It looked like tedious work as the tumor was snipped, vaporized, then sucked out, piece-by-piece.

Dr. Schwartz usually spends two days per week in the clinic seeing patients. It was interesting to see how he interacted with patients; I could tell how deeply invested he was in their well-being. One of the clinic sessions was especially intense and heart-breaking. The patient was young and had been treated for astrocytoma several months ago. The tumor had been removed, adjuvant chemotherapy and radiation given, and normal life resumed. All seemed well. However, the patient had recently started to have motor and speech difficulties. MRI scans revealed that the tumor had returned, and that it was invading into an area where it would be impossible to remove completely; even partial removal would likely result in paralysis. The family had to make difficult choices about the best route of treatment. Should a biopsy be done on the tumor to determine what type of treatment it would best respond to? But doing a biopsy requires surgery and some chemotherapies cannot be started until at least a month after surgery. If chemotherapy was given, what type would be best? Would it make a difference? Should radiation be used? Should he enroll in a clinical trial? There were no right or best choices. Everything was a gray area. Even a brain surgeon did not know the right answer and could not make everything better. It was an emotionally charged situation. As the visit concluded, the mother turned her attention to those of us shadowing Dr. Schwartz. “Are you sure you want to be doctors?” she interrogated us, “And deal with situations like this, and emotional mothers who will do anything for their sons like me?” “Yes,” we stated somberly. The case underscored the necessity for continued biomedical research. Though I do not want to be a medical doctor, I do want to be a doctor of philosophy. The current treatment options for many diseases are not sufficient. I want to do research that results in products that will provide doctors with increased power and effectiveness in treating and mitigating disease.