3rd Week and it Feels Like Home
So the third week of the summer immersion program has just wrapped up, and the Weill Medical School is beginning to feel like home (a home away from home), but still a home. This feeling of being part of the hospital stems from the daily interaction with the residents on the 8am rounds in 4 North, the group of clinicians that I interact with on a daily basis where we read MRI, CT, SPECT images, and the nurses that recognize me in the different departments where I observe the procedures. The hospital has become a routine to an extent, but each day there is something new to learn and there is always a new experience to be had, which is the main reason that it keeps this job interesting.
Monday and Tuesday were relatively quiet and non-eventful. I started the days off in the cardiology division of the hospital with rounds with the residents at 8am and then moved on to meet with Dr. Weinsaft and read MRI images. Tuesday had something new to the standard MRI images because we had another clinician that joined us and was looking at the lungs that are in the field of view while you image the heart. By looking at the lungs, the clinician was able to diagnose and pick out small nodules that could potentially be lung carcinoma and warn the patient/physician of these growths. Additionally, this same clinician pointed out to me that you can also see variations in the bone structure and can diagnose problems (such as slipped disks which the patient didn't know they had) and then help treat the condition.
One dramatic image from Tuesday was that a patient came in and had a CT scan done and had been complaining of chest paint amongst other symptoms. The patient was also diagnosed and treated for prostate cancer earlier (which I learned from his medical records) and the CT confirmed that the prostate cancer had begun to spread into the liver and bones (bone pain was another symptom that the patient had complained about). The cancer was readily observable on the CT images especially in the liver where normal tissue appeared a light grey, while the cancerous tissue was spherical and dark. The patients heart turned out to be functioning correctly, but from the CT he had to be informed that his cancer had spread. I don't know how much longer the patient had to live, or if he was going to undergo radiation therapy, but the power of the CT scan demonstrated that many of the diseases that a patient has cannot always just be observable from the outside. The technology of the CT machine allows a very rapid way to image the human body and find where the problems exist without having to use invasive procedures.
Wednesday and Thursday began as the other two previous days had, with rounds in 4 North, some more MRI/CT image reading. On Thursday I had a meeting with Dr. Weinsaft and two other doctors that were involved on a paper that had just been submitted to the American Journal of Cardiology. This paper is currently under review, but the project that I am working on builds off of the previous paper. We met as a group to discuss what I had been doing with the database analysis and setup a time where I could work with one of the clinicians to begin tracing the cardiac MRI images that had been acquired. From my database analysis I had found 19 patients that had a normal heart, but their left ventricle walls had increased in size and mass (this can be caused by high blood pressure, genetic predisposition, and coronary heart disease). In the coming week I will take this group of patients and with the help of another clinician begin on generating numerical values that can be used in the statistical analysis to compare against the data that was obtained for the paper.
Friday was a bit different; instead of starting rounds in 4 North as I had been doing for the last two weeks, I headed down the E 55th St MRI building that houses two more MRI machines in the basement of the building. This building is more a clinic rather than a hospital because many patients do not like to attend a hospital to receive treatment. I spent the day observing MRI images, not just of the heart, but also of the brain, the breast, and lower lumbar regions. Each region of the body has a different way in which it is scanned and there is a different program that is used to generate the image. During this time, two graduate students of Dr. Wang's were present and were also running their algorithm on the patients to determine if their imaging programs functioned. These images then could be compared again the images that are currently being used. One thing that I did realize when the patients got off the MRI table was that they wanted their results automatically and the technicians could not tell them what they had found since they were not specialists nor had the power to diagnose what the patient had. However, while the patient was in the machine, the technicians were readily able to pick out what was wrong with the patient (wall abnormalities in the heart, spread of cancer from the breast, aneurysm in the brain), because of the countless scans that these technicians do on a daily basis. Although the technician knows what they see, they cannot let the patient know anything because it brings up the potential of a malpractice lawsuit for a misdiagnosis where a person that is not legally qualified to diagnosis a condition voices their opinion.
Therefore this third week at the medical school has begun to feel like home and although it is becoming routine (with rounds and reading images) there is always something new to observe and a new case that can be examined, so you'll hardly get bored.
Monday and Tuesday were relatively quiet and non-eventful. I started the days off in the cardiology division of the hospital with rounds with the residents at 8am and then moved on to meet with Dr. Weinsaft and read MRI images. Tuesday had something new to the standard MRI images because we had another clinician that joined us and was looking at the lungs that are in the field of view while you image the heart. By looking at the lungs, the clinician was able to diagnose and pick out small nodules that could potentially be lung carcinoma and warn the patient/physician of these growths. Additionally, this same clinician pointed out to me that you can also see variations in the bone structure and can diagnose problems (such as slipped disks which the patient didn't know they had) and then help treat the condition.
One dramatic image from Tuesday was that a patient came in and had a CT scan done and had been complaining of chest paint amongst other symptoms. The patient was also diagnosed and treated for prostate cancer earlier (which I learned from his medical records) and the CT confirmed that the prostate cancer had begun to spread into the liver and bones (bone pain was another symptom that the patient had complained about). The cancer was readily observable on the CT images especially in the liver where normal tissue appeared a light grey, while the cancerous tissue was spherical and dark. The patients heart turned out to be functioning correctly, but from the CT he had to be informed that his cancer had spread. I don't know how much longer the patient had to live, or if he was going to undergo radiation therapy, but the power of the CT scan demonstrated that many of the diseases that a patient has cannot always just be observable from the outside. The technology of the CT machine allows a very rapid way to image the human body and find where the problems exist without having to use invasive procedures.
Wednesday and Thursday began as the other two previous days had, with rounds in 4 North, some more MRI/CT image reading. On Thursday I had a meeting with Dr. Weinsaft and two other doctors that were involved on a paper that had just been submitted to the American Journal of Cardiology. This paper is currently under review, but the project that I am working on builds off of the previous paper. We met as a group to discuss what I had been doing with the database analysis and setup a time where I could work with one of the clinicians to begin tracing the cardiac MRI images that had been acquired. From my database analysis I had found 19 patients that had a normal heart, but their left ventricle walls had increased in size and mass (this can be caused by high blood pressure, genetic predisposition, and coronary heart disease). In the coming week I will take this group of patients and with the help of another clinician begin on generating numerical values that can be used in the statistical analysis to compare against the data that was obtained for the paper.
Friday was a bit different; instead of starting rounds in 4 North as I had been doing for the last two weeks, I headed down the E 55th St MRI building that houses two more MRI machines in the basement of the building. This building is more a clinic rather than a hospital because many patients do not like to attend a hospital to receive treatment. I spent the day observing MRI images, not just of the heart, but also of the brain, the breast, and lower lumbar regions. Each region of the body has a different way in which it is scanned and there is a different program that is used to generate the image. During this time, two graduate students of Dr. Wang's were present and were also running their algorithm on the patients to determine if their imaging programs functioned. These images then could be compared again the images that are currently being used. One thing that I did realize when the patients got off the MRI table was that they wanted their results automatically and the technicians could not tell them what they had found since they were not specialists nor had the power to diagnose what the patient had. However, while the patient was in the machine, the technicians were readily able to pick out what was wrong with the patient (wall abnormalities in the heart, spread of cancer from the breast, aneurysm in the brain), because of the countless scans that these technicians do on a daily basis. Although the technician knows what they see, they cannot let the patient know anything because it brings up the potential of a malpractice lawsuit for a misdiagnosis where a person that is not legally qualified to diagnosis a condition voices their opinion.
Therefore this third week at the medical school has begun to feel like home and although it is becoming routine (with rounds and reading images) there is always something new to observe and a new case that can be examined, so you'll hardly get bored.
posted by Jan Kostecki at 1:27 PM
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