Week 6

It is the week following the conference I attended and it pretty much went right back to same routine I had before I left. Monday afternoon I attended the weekly genitourinary tumor boards where radiologists and pathologists inform the doctors of their patients’ test and biopsy results. The doctors then propose what they think is the best treatment plan for the patient, or ask the other doctors for their advice on what to do. As long as everyone agrees on the plan they move on to the next case. As I attend more and more meetings I am starting to understand more of the details that the doctors are discussing, which is rewarding.

This week I also followed residents and Dr. Lindsay Lief on medical ICU (MICU) rounds. The rounds were a little slow paced; we only covered about 6 patients in 3 hours. Interestingly, the MICU hosts a wide variety of patient cases. The previous night a young 30 year old woman was admitted after overdosing on anti-depressants and was now experiencing seizures. The only treatment plan for her was to closely monitor and follow up with psychology and future therapy. Only right next door there was an older man with what was described as “explosive lymphoma.” Unfortunately, the cancer has spread all throughout his body and he is now in multiple organ failure.

As with every Wednesday, I spent the day in the clinic with Dr. Nanus seeing patients. I have now been able to see some of the same patients week after week and track their progress.

I was also able to get into the OR and see a robotic prostatectomy with Dr. Scherr on a patient with prostate cancer. First, the residents and PA made 5 small incisions all along the patient’s abdomen to insert the camera and robot tools. Once inside they cut around the bladder and fascia. They had to cut his urethra since it was attached to the prostate. Dr. Scherr then cut all the fat and tissue around the prostate to remove it whole. The prostate was put into a plastic bag to be removed later through an incision next to the belly button. The last step was to physically move the bladder and urethra close together, sew them together and to hold them in place within the abdomen. After all this was done the tools were pulled out and the incisions sewn closed.