Week 3 - Tara

Every week at Weill seems to be unique and mentally stimulating in a different way. This week I spent the majority of my time becoming better acquainted with my research project. This involved learning and performing some initial experiments in the laboratory to optimize the conjugation efficiency of a particular hapten to a carrier protein for vaccination experiments for MS. As I'm sure most people would agree, it's rather interesting to become involved with a mini-research project over the summer as one must become familiar with the background and current lab methods in a very short amount of time. Therefore, I spent a significant amount of time reading papers related to MS as well as refreshing myself with microbiology. Although my background in microbiology is more generalized, I felt that it was necessary to have a better understanding of several bacterial species - in particular Clostridium perfringens, since the vaccination study is derived from understanding essential mechanisms within this microbe.

Also, as part of my research project, I have been on a "treasure" hunt to find a particular piece of equipment - a rotary evaporator that I need for some of my experiments. In the last week, I must have visited at least 20 different labs between Weill and Rockefeller....I thought I had some leads, but the equipment ended up being rendered nonfunctional. So, the search continues...I hope that early next week, I will find what I need. I have to say that walking around all the different laboratory departments at Weill, HSS and Rockefeller firsthand gave me an appreciation for how expansive the research facilities are here. 

I continued to shadow Dr. Gauthier this week during her neurology appointments. This week, Dr. Gauthier was also teaching a neurology resident how to make the diagnosis for MS, which relies on visual evidence (usually from MRI) as well as clinical symptoms. In one case, they were examining a patient with very large "characteristic" lesions for MS who also had some other more exterior cortical lesions that are not typically associated with MS - the net result, however, was surprising. The patient is completely asymptomatic - there are no signs of even early weakness or impairment associated with any CNS dysfunction. The decision, interestingly, then becomes whether or not to treat the patient based on the prediction of how long they can remain completely "healthy." This is the challenging part with MS treatment - it's entirely a preventative strategy to delay the onset of future neurodegeneration regardless of the patient's current symptoms (or lack of symptoms). In this case, the consensus was to start the patient on the first set of medications used to treat patients with mild MS.

This week, we all had the opportunity to learn how to read medical images from Dr. Prince, which was extremely valuable. He has a systematic method by which he approaches all types of images to help gain an understanding of how to interpret any pathology. I found this tremendously helpful - it's very nice to be able to apply his formula and watch an image transform from a sea of anatomical structures to pinpoint the exact place of deformation. 

I ended the week on Friday by shadowing the head resident in the ER during the morning shift. It's pretty astounding to see how the hospital is equipped to handle any range of cases, some minor and others more severe. The limiting factor seems to be space - since it almost seems like the ER is at capacity continuously. It was a long shift, but it was an interesting experience to see the resident perform the rounds and the diversity of patient cases.