Ok, so it's been a while since I updated. I have been pretty busy finishing up my medical school application and a little bit scatterbrained between getting a job and doing some other stuff. In any case, I have done so many things in the past week in a half or so, that I will not be able to talk about it all.
**Reader Alert**
Since I haven't been able to update for a while, this will be a long post! I don't want to ramble on, but I really should have updated more frequently the past week. In any case, if you don't want to read, you don't have to (obviously).
Also, I have been immersed in a lot of medical jargon recently. So for those of you who are not in medicine, I apologize for the overabundance of technical terms. I'm a nerd, so I love learning these terms. But, I realize that not everybody feels this way! Sorry if they bother you.
I'll start with Monday of last week.
In the morning I arrived to the simulation room to find a "syndaver" laid out on a bed. A "syndaver" is exactly what it sounds like, a synthetic cadaver. After working with real (and smelly) cadavers, I was a bit skeptical of synthetic replications. But, I have to admit, the syndaver was pretty real and pretty smelly itself. Instead of the formaldehyde smell that you get with real cadavers, the sydaver smells like seafood or something. I'm not sure which smell is more gross! Just to add to the weirdness, the synthetic materials used to make the syndaver muscles look like the skin of crayfish, or lobster or something. The muscles are kind of spotted and pinkish, just like crustaceans.
However, as I was saying the syndaver is remarkably realistic. And I even overheard some of the doctors talking about how syndavers might replace the need for cadavers in medical schools (although, I think this is unlikely. . . then again, I'm not a doctor). Also, it's hard to imagine a synthetic cadaver ever truly replacing an actual body, no matter how realistic it is.
Anyways, the point of having the syndaver was that we (the interns) got to learn and practice ATLS (Advanced Trauma Life Support) skills. ATLS skills are the kind of procedures that you really hope you never have to have or do to another person. Of course, the surgeon who came in and showed us all of the procedures has to perform these sorts of things on a fairly regular basis. Dr. D demonstrated to us how to place a chest tube to relieve a tension pneumothorax (a condition where pressure builds up in the pleura and can result in an inability to breathe, or more importantly kink the inferior vena cava such that your heart cannot pump blood), a DPL (Diagnostic Peritoneal Lavage), and a procedure to remove the blood from the pericardium with a needle (although she said that surgeons hardly ever did this procedure).
All of the techniques were really cool, but I really enjoyed putting in the chest tube. It's a pretty violent procedure, to be honest. But there's a reason it's a trauma procedure. Dr. D was awesome. She was clearly knowledgeable about all of these techniques, but she was happy to carefully teach us all of them. All of the interns got a chance to practice the different procedures. I felt pretty comfortable doing them, but I was hardly in the high-pressure, high-stress kind of situation that a trauma would be.
After we had punctured most of the syndaver's intercostal spaces for chest tubes, A (the other intern) and I helped run some simulations for training LPNs. It was interesting, but nothing too out of the ordinary.
Tuesday, was my favorite day I've had in this internship. The morning started off "Anatomy Camp." Anatomy Camp is a special four-day long event that Quillen runs for CRNAs from VCU. I'm not really sure why we have people come in from VCU, but the camp is awesome nonetheless. First Dr. K gave a lecture for about an hour and half on the anatomy of the airway (larynx, pharynx, etc.). The lecture was really fascinating, but probably a bit over my head. For obvious reasons, the lecture focused on what nerves controlled what parts of the throat (extremely important for anesthesiology). I can remember Dr. K cracking some corny joke in his lecture: He said, "If I asked you the question, 'what nerves control three out of the four infrahyoid muscles?", could you give me the ansa?" (The ansa cervicalis is the loop of nerves that does this).
After our lecture we went to the gross anatomy lab and looked at the airways on a couple of cadavers. The lab was really helpful because they had people lined up at eight different stations explaining different parts of the anatomy, etc.
In the afternoon, I had some pizza for lunch, courtesy of anatomy camp and helped run a couple more simulations for the LPNs.
Once we were done with the simulations we had another lecture on neuraxial blockades. All of this lecture was, of course, extremely fascinating and mostly over my head. Although, by the end of the week I was starting to remember more and more, and to understand what was going on.
The rest of the week was much of the same stuff. I'll go through some of the highlights.
Wednesday was another day of lectures and labs. We focused on interscalene and supraclavicular blocks.
After our day of lecture/lab, we had a party over at Dr. E's in the evening. The party was great. It was really fun meeting some of the CRNAs and just hanging out with some of the other doctors and interns. Mostly it was just fun to talk to some of these people outside of an academic/medical context.
On Thursday we talked about the brachial plexus mostly. The brachial plexus is fairly complex and I was pretty confused by the whole thing at first. But after seeing it multiple times, it's starting to stick. I even practiced drawing it the other day. It's pretty difficult to draw considering all the posterior and anterior divisions/cords/branches, etc. I'm starting to learn some of the nerves and which regions of the body are innervated by those nerves. For example, Dr. K told us that any time you are dealing with the shoulder, you are dealing with nerves C5 and C6 (cervical nerves 5 and 6).
Friday, I had the notable honor of allowing 20 - 30 CRNAs ultra-sound my femoral. Needless to say, it was a little bit awkward. The femoral artery is REALLY close to genitalia. Despite my anxiety, it wasn't that bad. Everyone was there to learn. . . Besides, I'll probably never see many of those CRNAs again. Even if I do, who cares?
That concludes Anatomy Camp. It was an amazing week and I learned an incredible amount from it. Really, I was pretty spoiled to be able to sit on all the lectures and labs.
Now for a non sequitur:
I've been learning a lot of nifty mnemonics for different parts of the anatomy. Here are the ones I can remember.
Randy Taylor Drinks Cold Beer - This is for remembering the subunits of the brachial plexus: Roots, Trunks, Divisions, Cords, Branches.
NAVEL - This is mnemonic for what you run into in the leg, lateral to medial: Nerve, Artery, Vein, [Empty Space], Lymph
SLI - The three muscles of the erector spinae (medial to lateral): Spinalis, Longissimus, Iliocostalis
SITS - The four rotator cuff muscles: Supraspinatus, Infraspinatus, Teres Minor, Subscapularis.
PAD from the inside out - The layers of the spinal cord from deep to superficial: Pia Mater, Arachnoid, Dura Mater.
I'll be more up-to-date in the coming weeks.
Happy to be a camper again,
Peter
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