week 1

This week I met Dr. Miller in infectious disease on Monday. We discussed some general ideas about the project and what he would like to show me during the immersion program. Dr. Henry is also in the office and willing to provide assistance when Dr. Miller is not around. Starting Tuesday, I started following Dr. Miller to visit patients around the hospital from floor 5 to 11. Those patients all have orthopedics problem and infected bones, joints or implant hardwares. The general routine for diagnosis is to get fluid from the suspected infection site and then send to microbiology lab for analysis. Some samples have "pus", a yellow fluid that clearly indicate infection. Most samples contain blood and therefore they use blood agar, rather than regular agar for culturing. They have a big machine called microscan that can screen the bacteria and the plate also have wells for antibiotics with different concentration and this helps doctors to know if certain drugs work for treating bacteria. Typically diagnosis requires 7-14 days of culture and treatment plans is usually 6 weeks of intravenous antibiotics followed by 1 week of oral antibiotics.

I also went to a weekly meeting for special infectious disease case study in New York Presbyterian hospital. This is held on every Tuesday at 4pm. On Wednesday at 2pm, we went to "bugs of the week" at New York Presbyterian hospital microbiology lab and saw some samples of usually bacteria or other microbiome found in patients' body. It is a huge lab and is said to be 24 hour operation. One interesting case is a sample from a HIV positive patient who has been infected with three different types of fungi which was surprising to me as I rarely connect Fungi to human body. On Friday morning at 7am, I went to the orthopedic fellow presentation. It is interesting that most of the presentation is about research, rather than clinics and are about data collection and statistical analysis. I like Dr. Nawabi's presentation on using computational imaging to map out the vascular safe zone on femoral head perfusion surgeries. Dr. Nwawka's presentation on utility of lavage in addition to native fluid collection for infection diagnosis is closely related to the project that I am going to be on and it will be nice to have a connection with her later.