On the first day of my Princetern­ship I arrived at the Philips­burg office of the Ortho­pe­dic Asso­ciates of the Greater Lehigh Val­ley and was greeted by Dr. Nick Aval­lone ’97. From 8:30 in the morn­ing until 12:30 we saw patients with var­i­ous injuries. I observed two cases of Dupeytren’s con­trac­ture, which hap­pens when there is a thick­en­ing of the tis­sue of the palm and fin­gers. The buildup of scar tis­sue causes one or more of the fin­gers to forcibly bend inward and the patient would have trou­ble straight­en­ing it com­pletely. It was infor­ma­tive watch­ing Dr. Aval­lone go through the process that he uses to diag­nose each patient. He per­formed phys­i­cal manip­u­la­tions to assess what moves cause the most pain. Cer­tain areas and types of pain are indica­tive of spe­cific injuries. Also he uti­lized imag­ing tech­niques like x-rays and MRIs which he then used to indi­cate where the injuries could be seen on the images. Com­bin­ing all this infor­ma­tion he would give his diag­no­sis and inform the patients of the avail­able options. Depend­ing on the type of injury these options could include phys­i­cal ther­apy, steroid shots, or surgery and pos­si­bly some com­bi­na­tion of the three. Dr. Aval­lone also took me to a meet­ing about the Con­cus­sion Cen­ter which was very excit­ing because I had just fin­ished writ­ing my junior paper on the neu­ro­science behind con­cus­sions. I enjoyed lis­ten­ing in and rec­og­nized much of what they were dis­cussing from the research that I had done. I also learned about a new con­cus­sion mea­sur­ing tech­nique they are hop­ing to imple­ment. It was great speak­ing to Dr. Aval­lone about his expe­ri­ence at Prince­ton as well as the med­ical school process. Since I am major­ing in psy­chol­ogy, it was also inter­est­ing to hear about how he used his back­ground in psy­chol­ogy in the ortho­pe­dic field.

On the sec­ond day, I went to Dr. Avallone’s office in Eas­ton. Again we saw patients from 8:30 am until 5 pm with about an hour break for lunch. There was a wide range of cases includ­ing carpal tun­nel syn­drome, ten­donitis, and arthri­tis. I was able to see baker’s cysts which are buildups of joint fluid behind the knee. Also, I shad­owed the physician’s assis­tant, Shan­non, who pointed out pieces of impor­tant infor­ma­tion regard­ing each injury. I watched her give a shot into a patient’s knee to help with pain around the joint. She showed me the anatom­i­cal mark­ers of the body that one uses to find the best spot between the joints to inject. There was also a vari­ety of other inter­est­ing con­di­tions to observe such as Osgood-Schlatter’s dis­ease, rota­tor cuff tears, carpal tun­nel syn­drome, and fibromyal­gia. The cases pre­sented a var­ied col­lec­tion of ortho­pe­dic dis­or­ders, includ­ing many that I never knew existed.

On the third day, I met Dr. Aval­lone at War­ren Hos­pi­tal to observe a day of surg­eries. I was able to watch two knee arthro­scopies, two cyst removals, a fin­ger surgery and the removal of a tumor, to name a few.  The knee athro­scopies are per­formed inside the knee itself with the use of spe­cial tools and a scope cam­era. It was amaz­ing to watch such pre­cise work done in a very small area of space, with the doc­tor using the video image as his eyes. The day of the surg­eries was infor­ma­tive in every way. Not only was I able to see exactly how things were per­formed, but all the doc­tors and the staff work­ing there were will­ing to take the time to point things out and explain them to me. As much as I learned through sim­ply observ­ing, I gained even more knowl­edge through Dr. Aval­lone and the other team mem­bers telling me how every­thing was work­ing and why cer­tain things were being done. I felt very wel­comed and the expe­ri­ence was an invalu­able one. Real­iz­ing how much I enjoyed my time there really solid­i­fied my pur­suit in the field of med­i­cine. This expe­ri­ence in ortho­pe­dics made me real­ize that I could spend my whole sum­mer in this kind of atmos­phere and it affected what intern­ships I am apply­ing to.  I am so grate­ful that I was able to have this opportunity!