Week 5 - Rounds, Rounds, and More Rounds

On Monday, I had back-to-back rounds in the pediatrics ICU (PICU) with Dr. Perlmann and the emergency department (ED) with Dr. Jared Rich (resident) and Dr. Halpern (attending). Personally, I didn't find the PICU all that interesting. Many of the babies were premature, and all of the doctors were essentially monitoring their calorie intake and ensuring they are gaining weight. However, there was one notable case. There is a brain-dead child that has been there for 8 months, and the parents has yet to show up. Judging from the others who has also made rounds in this department, there is talk about finishing up paper work to terminate treatment.

With very little break, I went straight into the ED rounds. Although it was a seemingly slow day at the ED, I found it highly fascinating. There are patients everywhere--up to two in a room, and several outside the hallways. Doctors and nurses, likewise, are constantly running around helping patients. Despite the busy nature of the department, it was interesting to note how often the doctors are at the computer documenting and updating notes. For that particular day, I would estimate that 60-70% of the time, the doctor was writing notes.

There was one emergency notification when I was rounding. At the sound of the notification, all the doctors in the specified area flocks into one room and prepares to operate on the incoming patient. The male patient (~40-ish) was working and had broken some glass, one shard of which cut his anterior wrist. At the scene, it was reported the blood was squirting out in a pulsatile fashion, but by the time the patient arrived at the ED, the bleeding had stopped. His arm was in a tourniquet and elevated.

Anyway, this situation also shed light on some communication gaps in the ED. Case in point: the patient needed surgery. ED wanted to send him to vascular surgery. Vascular said no, it's a plastics case. Plastics said no, they don't operate distal to the elbow; go to orthopedics. At this point, the doctors just referred the patient directly to a vascular surgeon or resident because they believe that's the optimal care for the patient.

For the rest of the week, I was mainly in lab attempting to help with the decellularized skin flap project. Unfortunately, without materials (i.e. the decell flap), it's difficult to try any methods to help cellularize the tissue.

On another note, I've also been watching the second season NY Med. Good show. I'm proud to say that I've observed Dr. Spector (plastic surgery), Dr. Halpern (emergency department), and Dr. Girardi (cardiothoracic surgery). Highly recommended. Also, why can't we meet some of these nurses and doctors? Just saying.