The first step to summer immersion

First of all, I really thank to all who have contributed to setting up this program which offers me a unique opportunity once in my life, and have helped everything go smoothly. Thanks to Dr. Frayer, Dr. Wang, Mrs. Belinda, Mitch and prof. Claudia Fischbach, who helped us to be a part of Weill Medical College and settle down in NY city without any problems, I already have had an invaluable experience while I was shadowing my mentor, and his residents. Also, I am no doubt that I will have more great experiences that I have never had here in Weill medical college during summer immersion program.

I was able to appreciate the different side of what I have already known such as ‘Ethics’ and ‘Botox’.
On Monday, We had a good start having an orientation meeting and Ethics class. The class was so instructive that I was able to have a great time to rethink about what exactly ethics is for scientist and categories of ethics are. Also, ‘case study’ was really useful to understand what we’ve learned. After class, I met my mentor for this program, Dr. Jason A. Spector who is plastic surgeon and he gave me a chance to see his patients together during his office hour. One of his patients has suffered from Hyperhydrosis which is excessive sweating especially on palm or feet. To treat this symptom, Botox in saline solution was injected to the patient’s palm and sole to block secretion of Cholin from the synapse to the specific muscle that is responsible for stimulating sweating gland. I thought that Botox could be used only for a wrinkle free purpose but I realized that it is used in various ways to treat patients.

It was the first day for me to get in OR.
On Tuesday, Dr. Spector introduced his residents and I went to round with them in the morning. ‘Round’ was one of the efficient ways to interact with patients and learn how patients are treated. After rounding, one of his residents let me in the Operating Room (OR) and observe transverse rectus abdominis myocutaneous (TRAM) flap which was breast reconstruction of breast cancer patient who underwent mastectomy. Also, TRAM flap for patients who have already gone through mastectomy is called ‘delayed TRAM flap’. This procedure was done by transversing endogenous soft tissue from abdomen to the mastectomy side of patient. It was long procedure but at the same time it was really worthwhile surgery that can help the patient reconstruct her womanhood. For the another perspective of this program on the top of the clinical experience, I attended to lab meeting of Dr. Spector’s group and saw what research is going on in his lab. In general, most of his research aims to utilize the state of the art of tissue engineered technique for clinical application. Specifically, his lab is working on protecting muscle or skin from ischemia and side effects of irradiation using H2S. Also, one of his interesting projects is investigating material and geometry of scaffold to make cell survive for longer term with revascularization within scaffold.

What a broad world is beyond plastic surgery!
On Wednesday, I went to Dr. Spector’s office hour which is for pre or post operation of patients. Whenever patient came in, Dr. Spector introduced me as his student majoring in Biomedical engineering who will potentially help patients so that his patients felt more comfortable with me in the room. Thanks to his help, I was able to actively interact with his patients and learn what kinds of problems brought patients to the department of plastic surgery and how patients were diagnosed. It did not take long time that I realized the area of plastic surgery can cover unimaginably wide spectrum including cosmetic surgery, microsurgery for nerve reconstruction, skin graft, removing a wound area and tissue expansion. One of his patients had surgery to remove a brain tumor from the front part of his head. However, the incised part of his forehead was too wide to be sutured so scalp graft had to be done. To use endogenous scalp for grafting, his own scalp was expanded by injecting tissue expander under the skin of his head. While scalp is stretched out expanded, the patient definitely feels painful. However, this procedure will be able to make the patient look better like originally how he looked.

Microsurgery for nerve reconstruction!
On Thursday, I had a great chance to see microsurgery for nerve reconstruction which was rebuilding nerve which was damaged or broken apart using endogenous fragment of vein. In general, microsurgery is proceeded to allow anastomosis of successively smaller blood vessels and nerves. One patient completely lost his sensation on the area of his right thumb since one of the nerves on his right wrist was torn apart. Thus, what was done was taking out the exact same length of vein on his wrist as the broken part of nerve and gapping the disconnected parts of nerve using the vein as a bridge. Microscope-attached goggles played a critical role in this elaborate surgery successfully.

Already Friday!
On Friday, the first patient was Korean old lady and she was not fluent in explaining her status in English so I happened to help her as a translator. Also, I was really pleased to help patients rather than only observing their painful time. The old lady has a couple of health problems such as diabetes and failure on kidney so she has done dialysis. Especially, in diabetic patients, glucose level in blood cannot be controlled to a normal level and subsequently muscles become stiffer and stiffer, which potentially loads abnormally high pressure on feet and ankle. Consequentially, diabetic patients have a high chance to have a severe wound on their feet or legs and their lower wound-healing capacity causes to delay their recovery. Thus, she had a serious wound on her leg so the wound part was cleaned up and skin graft was laid on the part. Also, to make her Achilles tendons more flexible and stretched out, three parts on the Achilles tendons were incised.The last surgery of this week was removing out the wound parts from the abdomen of the patient who had kidney transplanted a couple of weeks ago but got infected in the incised part. It could be much more risky if transplanted kidney was infected. However, fortunately the soft tissue right under the skin was infected so the infected and wound part was scrubbed out clearly and sutured. During this surgery, my mentor let me sterilized scrub on and take a closer look at the wound part and helped him to do surgery. It was a great opportunity to observe the surgery right next to a surgeon and assist him as a part of Weill medical college.

Again I am really honored and grateful to have an invaluable opportunity once in my life during this program and I will take an initiative to develop and progress interdisciplinary study between engineering and medicine.