Week 7: Shock and Awe

It is unbelievable how fast this summer flew by. Week 7 was all about cranking out work on the project and knocking off the last of my hospital bucket list. I spent Monday attending a qPCR seminar and working on the project. I am still working out some bugs in the pulse oximeter, but it is able to detect pulse and I am able to filter and amplify (bottom waveform) the transimpendence amp output (signal from the photodiode after current-to-voltage converter, top waveform).

All day Tuesday was spent with Leah in the Surgical ICU (SICU). It was a busy day with rounds in the morning, followed by journal club, then Trauma conference and lastly Clinic in the afternoon. One of the more interesting cases during rounds was a middle-aged man who came in from another hospital after experiencing a “fall,” which I later found out was most likely “externally induced” in the hospital bathroom. The patient was admitted for resuscitation of hemorrhagic shock and needed an emergency thoracotomy and evacuation of hematoma (blood build-up in the tissue) the following day. Incredibly, the patient seemed to be showing signs of improvement when I saw him. Adding to the “shock and awe” visuals of the week, one of the residents presented a case of “degloving of the foot” at the Trauma conference which even grossed out most of the doctors. In this type of injury, the skin is completely removed from the underlying tissue. This patient in particular had her foot run over by a bus, leaving her toes in a sack of skin and her bone and flesh exposed. OUCH! Later during rounds, I had the opportunity to examine a patient with Calciphylaxis, a horrible disease of unknown cause where everything in the body becomes calcified. This patient had large sores on her abdomen and legs which she kept bandaged. These consisted of both necrotic and infected tissue and looked extremely painful. The patient also had ESRD which is often common in patients with Calciphylaxis. Not much could be done for this patient aside for managing the pain and discomfort and minimizing infection.

The wide spectrum of rare diseases fascinates me and can be a serious challenge for health care providers, especially when there is no known cause or cure. I spent Wednesday with Dr. Girardi in Cardiothoracic surgery, first going on rounds in the Cardiac ICU and then in surgery. Dr. Girardi removed a left atrial myxoma (connective tissue tumor) from a patient with Carney’s complex. This rare genetic disease results in reoccurring tumors of the heart (and other organs) which must be removed via invasive surgical procedures. This patient was on their fourth open heart procedure and already had significant scar tissue, making each subsequent procedure that much more challenging. Dr. Girardi was well aware that this patient was “his problem” for the next 10-15 years and should be operated on accordingly. During the procedure, Dr. Girardi noticed that the patient had tricuspid insufficiency of an unknown mechanism, but nothing could be done to address this at the time. It was incredible how this patient could live a relatively normal life with such a recurrent, multifocal disease; however, the time, energy and cost of treating a disease of this nature must be acknowledged. Seeing cases like this reaffirmed the need for a lot of the research we do in Cornell BME, seeking to understand the mechanism of various inherited diseases so that we can nip the problem at the bud. While excising a tumor from somebody’s heart is very gratifying, finding a way to prevent the tumor in the first place, while this may require a lifetime of diligent research, would be incredibly impactful in the long run. Biomedical researchers and clinicians have a lot to learn from one another’s approaches to addressing disease. If nothing else, understanding the financial, emotional and physical burden of a disease, drives me as a biomedical researcher to do everything in my power to improve the quality of life for others.