”Patients here are very sick, which is both a good and bad thing; good because the work we do here everyday is very exciting; bad because patients are indeed very sick”; these were the first words I exchanged with Dr. Salemi, a charismatic cardiothoracic surgeon and my clinical mentor for the summer. Needless to say that my first steps at the Ronald O. Perelman Heart Institute have been very immersive! After meeting with Dr. Salemi Monday, he kindly introduced me to the staff on his floor: other surgeons, nurses, operating room (OR) technicians, as well as the four resident fellows. I also met people from the valve center and the cardiac catheterization lab, which specializes in minimally invasive procedures. The next morning I was surprised to find myself already in the OR. I attended a mitral valve repair procedure using a device called MitraClip. This was the very first medical intervention I saw in person. I was fascinated to see how the procedure went as well as to observe the team dynamics within the OR. The MitraClip is inserted in the atrium of patients that suffer from mitral regurgitation and that cannot be operated otherwise. I was impressed how the surgeon could judge whether the MitraClip was correctly “clipping” the patient’s valve leaflet by only looking at the echocardiogram monitor. I also asked a nurse to explain me how to read an echocardiogram; she laughed, and explained me that it requires a lot of experience. People were almost cheering when finally the device was properly delivered!
The next morning I met Peter, a German resident fellow, at 7am in the intensive care unit where patients recover after surgery. One of the first tasks fellows do in the morning is to check patients vitals and test results, to then prepare a digest of all the information collected overnight for the surgeon in charge. We then “rounded the patients” with a battalion of nurses and other caretaker. We visited every patient to check how they were recovering from surgery. We were often more than ten around the patient inside a tiny room! After the patient round, I followed Peter to the OR for another mitral valve repair. This time, however, the procedure was done with a robot. Dr. Guy, a surgeon that loves robotic technologies and that has a R2D2 model in his office, was in charge of the case. I was extremely impressed by the technology, in particular how Peter and Dr. Guy were suturing parts of the valve leaflet from inside the heart using the four remotely controlled robotic arms. I saw the interior of the heart on a monitor thanks to a laparoscopic apparatus. The heart was also arrested and on bypass. The case lasted over 5 hours and I hadn’t properly eaten that morning. Standing still in the OR for so long was also very exhausting. When I went back to my room around 5pm, I crashed on my bed only to wake up the next morning...
Same routine on Thursday: I met with Peter at 7am, rounded the patients, and then watched a lobectomy (the excision of a lung lobe from a cancer patient).
I have a meeting scheduled with Dr. Salemi next week to discuss about my project.
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