Tues­day, Jan­u­ary 10, 2012

This morn­ing I rode the train to Philadel­phia with two other stu­dents to meet Dr. Howard Sny­der ‘65 at the Children’s Hos­pi­tal of Philadel­phia. Dr. Sny­der is a renowned urol­o­gist who helped estab­lish the divi­sion at CHOP. When we arrived, Dr. Sny­der and his assis­tant, Sharon Brown, were very wel­com­ing and showed us around the Divi­sion of Urol­ogy. Eve­lyn Siu ’15 and I decided to shadow Dr. Sny­der today in clinic. By 9:30 am, we were quickly absorbed into Dr. Snyder’s rou­tine. His first patient was a baby girl who had recently been taken to the emer­gency room for a very high fever. She was sus­pected to have had a uri­nary tract infec­tion (UTI). Dr. Sny­der explained UTIs very care­fully to the girl’s mother and I was impressed by Dr. Snyder’s focus on edu­ca­tion. With all his patients, he made sure to explain to the par­ents what was occur­ring. It was clear that the par­ents found Dr. Snyder’s expla­na­tions very help­ful, and reas­sur­ing in some cases. Other patients that came to Dr. Sny­der today ranged in the ages from eight months to thir­teen years old. Some of them had recent UTIs while oth­ers came in for kid­ney and reflux con­cerns. I learned the dif­fer­ences between the symp­toms of a blad­der infec­tion ver­sus a kid­ney infec­tion and how to look at renal scans. I am really impressed by how much I learned today. Shad­ow­ing Dr. Sny­der was very excit­ing and I can­not wait to come back tomorrow.

Wednes­day, Jan­u­ary 11, 2012

Dr. Sny­der and his Princeterns

Instead of shad­ow­ing Dr. Sny­der today in clinic, we were given the oppor­tu­nity to shadow one of Dr. Snyder’s col­leagues, Dr. Sarah Lam­bert, in the oper­at­ing room (OR). We were intro­duced to the urol­ogy res­i­dents and were then shown to the locker rooms where we dressed in scrubs. In the OR, I saw the anes­the­si­ol­o­gist team pre­pare the patient for surgery. Once the patient was anes­thetized and doing well, Dr. Lam­bert and the res­i­dent sur­geons were allowed to pro­ceed with the oper­a­tion. The three surg­eries today included a her­nia repair and an orchiopexy (an orchiopexy is an oper­a­tion to move an unde­scended tes­ti­cle into the scro­tum). The dura­tion of each oper­a­tion ranged from 90 min­utes to two hours and we were allowed to stand near the oper­at­ing table to get a closer view of the oper­a­tion. Through­out each oper­a­tion, the res­i­dents and Dr. Lam­bert explained to me the process of the oper­a­tion and what they were doing. I under­stood the gen­eral idea of each oper­a­tion, but as for the spe­cific steps, I was a lit­tle lost try­ing to dis­tin­guish the vas def­er­ens, for exam­ple! The her­nia repair was very inter­est­ing to watch as well because it proved to be a chal­lenge and more dif­fi­cult than expected. I was impressed to see the team­work involved. The sur­geons and nurses dis­cussed the oper­a­tion and what ought to be done, almost like work­ing through a puzzle.

After Dr. Lam­bert fin­ished oper­at­ing for the day, Dr. Sny­der took us to a meet­ing for the entire urol­ogy divi­sion. The res­i­dents pre­sented dif­fi­cult or chal­leng­ing cases and asked for input. The cases pro­voked much dis­cus­sion among all the sur­geons as they pre­sented var­i­ous sug­ges­tions and ideas. I really enjoyed the oppor­tu­nity to see on a first-hand basis the col­lab­o­ra­tion nec­es­sary in med­i­cine. It was a long and tir­ing day, but I rode the train back to cam­pus feel­ing very enthu­si­as­tic and sat­is­fied with my day.

Thurs­day, Jan­u­ary 12, 2012

In the morn­ing, I first shad­owed Dr. Sny­der in clinic. Many of the cases were very sim­i­lar to Tues­day. Dr. Sny­der once again exhib­ited his exper­tise and ded­i­ca­tion to teach­ing the par­ents of his patients. After see­ing a few patients, I shad­owed another sur­geon in the OR. This time I saw two oper­a­tions, a cys­toscopy and another orchiopexy. The pro­ce­dure for the orchiopexy was almost the same as what I had seen yes­ter­day. The cys­toscopy on the other hand was very dif­fer­ent. The orig­i­nal intent of the pro­ce­dure was to apply deflux inside the blad­der at the open­ing of the ureters to pre­vent reflux. The sur­geon inserted a cam­era through the ure­thra of the patient and into the blad­der. The image was dis­played on mul­ti­ple screens through­out the room and I was able to clearly see the tis­sue lin­ing the ure­thra and the blad­der. The res­i­dents looked for the open­ings to the ureters, which proved to be very dif­fi­cult due to the anatomy of the patient’s blad­der. As a result, they were unable to pro­ceed with the pro­ce­dure and had to fin­ish the cys­toscopy as they dis­cussed fur­ther pos­si­ble treat­ments. After the cys­toscopy, we talked for some time with the res­i­dents about pur­su­ing a career in med­i­cine and surgery. I found that talk­ing to the res­i­dents was very valu­able because they recently had fin­ished med­ical school and were famil­iar with the process in gen­eral. Soon it was time to say good-bye to every­one at the urol­ogy divi­sion of CHOP. We all felt a lit­tle sad about leav­ing, as we had just got­ten to know every­one and we were hav­ing a fan­tas­tic time. I thor­oughly enjoyed my expe­ri­ence at CHOP and I am so thank­ful to Dr. Sny­der and every­one in Urol­ogy for giv­ing me the oppor­tu­nity to really see what a career in surgery entails.