Tag Archives: The Children’s Hospital of Philadelphia

Evelyn Siu ’15, The Children’s Hospital of Philadelphia

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Day 1

On our first day at CHOP, we spent the day in clinic shad­ow­ing Dr. Howard Sny­der ’65, a Senior Urol­o­gist in the Depart­ment of Urol­ogy. Every­one was really wel­com­ing, and took time to accom­mo­date our arrival. Dr. Snyder’s assis­tant, Ms. Brown, showed us around the urol­ogy depart­ment, and intro­duced us to all of the staff. Dr. Sny­der had a full day lined up, and we were able to learn about the symp­toms of com­mon infec­tions. Many of the cases were uri­nary tract infec­tions. It was inter­est­ing to see how much Dr. Sny­der relied on ultra­sounds and other types of imag­ing in order to make a diag­no­sis. The nurse prac­ti­tioner, Ms. Rudick, also took time to explain to us how to read the ultra­sounds, and what abnor­mal­i­ties to look for. Through­out the day, Dr. Sny­der also explained to us his work in lob­by­ing Con­gress, and his role on dif­fer­ent med­ical asso­ci­a­tions. It was eye open­ing to learn just how impor­tant gov­ern­ment pol­icy is to the day-to-day task of deliv­er­ing med­ical care.

Day 2

Today we spent the day in the oper­at­ing rooms. This was very excit­ing for me, since I had never observed any surg­eries before. Though Dr. Sny­der him­self doesn’t oper­ate any­more, we shad­owed his col­league Dr. Lam­bert and the res­i­dents. The surg­eries lined up for the day included tes­tic­u­lar realign­ment, and her­nia repairs. We were told that these surg­eries were very typ­i­cal. Dr. Lam­bert and the res­i­dents were very wel­com­ing in answer­ing ques­tions, and made sure we under­stood what was going on. She was also very accom­mo­dat­ing in mak­ing sure we could see what was going on. The entire oper­at­ing room was equipped with video screens, and she also let us stand up on stools so we could view the surgery directly. Through­out the day, I also had a chance to talk with the res­i­dents about med­ical school, and why they decided to choose urology.

Day 3

Dr. Sny­der, and the Princeterns

On our last day at CHOP, we spent half the day in clinic and half the day in the oper­at­ing room. The cases in clinic this morn­ing were more var­ied; there were cases of blood in the urine, a bike acci­dent, and kid­ney stones. In the oper­at­ing room, the cases were fairly sim­i­lar to the ones we saw the pre­vi­ous day. We shad­owed a dif­fer­ent doc­tor today, and it was inter­est­ing to see the dif­fer­ent approaches dif­fer­ent sur­geons had to the same cases. Once again, we had the oppor­tu­nity to talk to the res­i­dents, and learn not only about the case going on, but also about life as a doc­tor. Over­all, this was an amaz­ing expe­ri­ence. Dr. Sny­der is a great teacher, and has an exten­sive knowl­edge in all aspects of med­i­cine. I would highly rec­om­mend this oppor­tu­nity to any­one else inter­ested in medicine!

Katherine Pogrebniak ’14, The Children’s Hospital of Philadelphia

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Day 1

On the first day of our Princetern­ship, the other Prin­cert­erns and Itook three trains, walked about fif­teen min­utes, and arrived at nine o’clock at the Children’s Hos­pi­tal of Philadel­phia.  Sharon Brown, one of the admin­is­tra­tors who works with Dr. Sny­der, greeted us and gave us a tour of the Urol­ogy Depart­ment.  She showed us around the clinic, includ­ing the exam rooms, sched­ul­ing desks, and physi­cian offices, intro­duced us to the res­i­dents, who would, later in the day, take me to the OR.  After the tour, the other two Princeterns spent the day shad­ow­ing Dr. Sny­der in the clinic, while I spent the day in the oper­at­ing room.  Due to the small size of the exam rooms, all three of us could not shadow Dr. Sny­der at once, so we took turns alter­nat­ing between the clinic and the OR.  I spent the first day observ­ing three surg­eries by Dr. Pat Casale.  Before today, I had never observed a surgery or been in an OR, so this was some­thing I was look­ing for­ward to expe­ri­enc­ing.  I felt quite pro­fes­sional in my blue scrubs and mask!  Dr. Casale is the Direc­tor of Min­i­mally Inva­sive Surgery for the Urol­ogy Depart­ment: he spe­cial­izes in laparo­scopic and robot-assisted surg­eries.  Today I was for­tu­nate to see him, as well as the res­i­dents and fel­low, Dr. Tasian, per­form two laparo­scopic surg­eries as well as one surgery that required a larger inci­sion due to the par­tic­u­larly com­pli­cated nature of the case.  Every­one in the OR was very wel­com­ing, and Dr. Tasian was kind enough to explain to me the basics of each surgery before it began.  It was inter­est­ing to see how an OR is run with the urol­o­gists and anes­the­si­ol­o­gists work­ing together.  Care is put into every surgery.  For exam­ple, before an inci­sion is ever made, the attend­ing physi­cian has to do a “time out” rec­og­niz­ing the OR team mem­bers present, review­ing the pro­ce­dure that is to be done, and any rel­e­vant patient his­tory.  After the surg­eries for the day had ended, we returned to Dr. Snyder’s office and dis­cussed var­i­ous aspects of med­i­cine, includ­ing his per­sonal life story, pub­lic pol­icy, and the Mut­ter Museum of Med­ical Sci­ences in Philadel­phia.  He explained to us how there is a need for more young urol­o­gists.  Right now, the num­ber of urol­o­gists is in decline and the aver­age age of urol­o­gists is get­ting older.  This first day was an incred­i­ble way to start my Princetern­ship!  My biggest accom­plish­ment:  not faint­ing or feel­ing sick dur­ing the OR pro­ce­dures– Yeah!!

Day 2

Dr. Sny­der, and his Princeterns

I spent today shad­ow­ing Dr. Sny­der in clinic.  Dr. Sny­der works closely with Nurse Prac­ti­tioner Kris­ten Rud­nick, so I was able to observe them work­ing together as a team.   Dr. Sny­der was often able to con­sole anx­ious patients, telling them that surgery was unnec­es­sary after review­ing the patients’ charts and med­ical tests.  Dr. Sny­der explained that radi­ol­o­gists tend to report pathol­ogy instead of explain­ing what is actu­ally seen on the ultra­sound, caus­ing patients to end up in Urol­ogy for a nor­mal vari­ant, rather than a patho­log­i­cal kid­ney.  I watched Dr. Sny­der read mul­ti­ple renal ultra­sounds that day.  Dr. Sny­der inter­acted ami­ably with both the patients and the par­ents, tak­ing the time to make sure that the patient’s par­ents under­stood the diag­no­sis.  He then dic­tated a let­ter on each patient, while the patient was offered a sug­ar­less lol­lipop!  In the evening we attended a radi­ol­ogy rounds meet­ing with the res­i­dents and attend­ing physi­cians.  Dur­ing this meet­ing, var­i­ous res­i­dents pre­sented the radi­ol­ogy images from par­tic­u­larly com­pli­cated cases so that all of the physi­cians could dis­cuss the case and help the treat­ing physi­cians ensure that they are fol­low­ing the most appro­pri­ate course of treat­ment.  I noticed dur­ing the meet­ing the amount of respect that the other physi­cians had for Dr. Sny­der, the most senior attend­ing physi­cian.  They often said, “What do you think, Howard?”  What I learned today:  being a physi­cian is not like what is seen on the TV show House.  Respect and team­work are essential!

Day 3

On the final day, I spent the morn­ing in the OR and the after­noon in the clinic.  In the morn­ing, I observed Dr. Kolon, another of Dr. Snyder’s part­ners, in the OR.  I observed two of his pro­ce­dures.  We spent some time talk­ing about the best way to pre­pare aca­d­e­m­i­cally for med­ical school.  In the after­noon, I shad­owed Dr. Sny­der again, learn­ing more about meth­ods for effec­tive patient care.  Dr. Sny­der gave me arti­cles to read con­cern­ing com­mon uro­log­i­cal con­di­tions that we had been see­ing in patients that day.  Final thought:  this Princetern­ship crys­tal­lized my desire to become a physi­cian.  I rec­om­mend this Princetern­ship to any­one inter­ested in an up close and per­sonal med­ical expe­ri­ence with mul­ti­ple doc­tors and per­spec­tives in a pre­mier med­ical setting!   

 

Marina Nogueira ’15, The Children’s Hospital of Philadelphia

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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.