Tag Archives: University of Arkansas for Medical Sciences

David Thomas ’13, University of Arkansas for Medical Sciences

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I arrived in Lit­tle Rock, Arkansas on Sun­day the 19th of March, a lit­tle unsure of myself in a part of the coun­try that I haven’t explored very much. I felt wel­come from the first night on, though, after a warm din­ner with fel­low intern Chris Diehl and our Princetern­ship host, Dr. Erika Petersen ‘96(’96). We learned about the oper­a­tions that Dr. Petersen had sched­uled through­out the week and got a taste of her favorite pizza place in Arkansas. Once we had the week out­lined, we started talk­ing about some of our com­mon expe­ri­ences at Prince­ton and what we could look for­ward to in med­ical school.

We started the first day early for me at 6:45 am, but I soon became aware that this was a bit late for by hos­pi­tal stan­dards. Chris and I put on scrubs and met with Dr. Petersen’s patients for the day. Pretty soon I was observ­ing my first surgery, and Dr. Petersen was care­ful to explain what she did and gave us a first­hand view of the pro­ce­dure. I was thor­oughly impressed with the expert knowl­edge of the body that Dr. Petersen dis­played in replac­ing an elec­tronic device that had been implanted in a patient. After fin­ish­ing with the first patient she imme­di­ately got to work on a more com­pli­cated case which made full use of the cut­ting edge tech­nol­ogy of deep brain stim­u­la­tion. The patient whose surgery we observed had a notice­able alle­vi­a­tion of symp­toms for a dis­ease that I did not know could be treated so effec­tively, and I was really impressed to see it. We fin­ished off the day by observ­ing a spinal surgery that made use of another advanced tech­nol­ogy to stay min­i­mally inva­sive while mak­ing a dra­matic inter­ven­tion in the struc­ture of the spine.

On the next day at the hos­pi­tal, we got a broader sur­vey of what sur­geons at UAMS do. We started a bit later than the day before and split up between dif­fer­ent sur­gi­cal teams. Between me, Chris, and Arthur, another stu­dent observ­ing surg­eries for the week, we saw uro­log­i­cal surgery, car­dio­tho­racic surgery, and more neu­ro­surgery. This packed day wrapped up with Dr. Petersen per­form­ing a spine surgery on an awake patient while explain­ing each step to Chris and me. We said good­bye to Dr. Petersen but hung around the surgery wing to observe an open heart surgery. Watch­ing the heart beat inside a patient while the sur­geons went to work was a really inspir­ing expe­ri­ence, espe­cially hav­ing stud­ied the heart so much with­out ever see­ing one in action. Later on Dr. Petersen took Chris and me to din­ner at a really impres­sive sushi restau­rant, and we had a good chance to debrief a lot of our expe­ri­ences and get a lit­tle more per­sonal insight on the life story of a doctor.

On the Wednes­day morn­ing of our Princetern­ship Chris and I man­aged to wake up early enough to fol­low the res­i­dents for morn­ing rounds. I’ve heard a lot about the intense lives of res­i­dents, so I was eager to see what things were like first hand. After find­ing our guide, a par­tic­u­larly help­ful res­i­dent named Dr. Gandhi, we started vis­it­ing patients and lis­ten­ing to their symp­toms and sta­tuses. The res­i­dents on rounds dis­played an impres­sive abil­ity to take in and put together a stream of infor­ma­tion about patients that needed diag­no­sis or treat­ment. Refresh­ingly, they all also seemed to enjoy their daily rou­tine a lot, despite the inten­sity of life as a neu­ro­surgery resident.

David, Dr. Petersen, and Chris

Fol­low­ing this, Chris and I observed the removal of a brain tumor by Dr. Day, the chair of neu­ro­surgery at UAMS. We watched him per­form the pro­ce­dure while fol­low­ing the steps in a book describ­ing the pro­ce­dure that a res­i­dent had pro­vided. Toward the end of the surgery we were sur­prised to learn that the author of this text­book was none other than Dr. Day him­self! This was a really art­ful surgery, with a lot to appre­ci­ate how much the patient’s life would improve directly as a result. We ended the day with a visit to Dr. Petersen’s clinic, which really put more of a human face on the prac­tices we had observed. Dr. Petersen seemed to really do her best to explain the tech­ni­cal side of com­plex pro­ce­dures to patients, who in turn really appre­ci­ated the trans­parency and com­pas­sion she showed.

The last day of my Princetern­ship was in some ways the most excit­ing. I was lucky enough to see Dr. Petersen her­self remove a very seri­ous tumor from a patient in a very involved pro­ce­dure which I was able to observe start to fin­ish. Also, Dr. Petersen sent a sam­ple of the tumor down to the hospital’s pathol­ogy unit, and I got a chance to see this other part of the hos­pi­tal as well. The pathol­o­gist there clas­si­fied it and explained what to look for and the sever­ity of dif­fer­ent types of brain tumor. Luck­ily for me, Dr. Petersen fin­ished this very thor­ough tumor removal in time to grab a final bite to eat with me before I made my way to the air­port to fly home.

We ate with Arthur and Dr. Gandhi and had a con­ver­sa­tion that was enlight­en­ing for me about the role of research in med­i­cine. Dr. Gandhi, an MD/PhD who worked on metab­o­lism of neural cells dur­ing his PhD, had a lot of insight to share with me since I’m inter­ested in pur­su­ing an MD/PhD and I’m involved in metab­o­lism research. Dr. Petersen also shared a few thought pro­vok­ing sto­ries about the his­tory and future of neu­ro­surgery research. I left that night with noth­ing but pos­i­tive expe­ri­ences from my Princetern­ship, for which I really have to thank Dr. Petersen for care­fully set­ting up such an inspir­ing expe­ri­ence for under­grads. I would highly rec­om­mend this Princetern­ship to future stu­dents as an oppor­tu­nity to get a first hand view of the prac­tice of med­i­cine and the pos­i­tive things it can bring about.

Christopher Diehl ’13, University of Arkansas for Medical Sciences

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Shortly after I arrived in Lit­tle Rock on Sun­day evening, I met Dr. Petersen ’96 and the other Princetern out­side the stu­dent hous­ing dorms near the Uni­ver­sity of Arkansas for Med­ical Sci­ences (UAMS).  She drove us to a nearby restau­rant where we dis­cussed the sched­ule for the next few days over pizza.  Dur­ing our con­ver­sa­tion, we also talked about the path that Dr. Petersen took to become a doc­tor, and I was sur­prised to learn that she was a his­tory major and that she spent a few years in con­sult­ing before going to med­ical school for neu­ro­surgery.  After din­ner, she drove us back to the dorms, where we pre­pared for an early start to the next morning.

Day 1

We started the day by meet­ing Dr. Petersen in the 2nd floor lobby at 6:45 am.  From there, we changed into scrubs and observed Dr. Petersen as she met with the patients on whom she would be oper­at­ing that day, which was my first real intro­duc­tion to how doc­tors and patients inter­act.  One of Dr. Petersen’s areas of exper­tise is deep brain stim­u­la­tion, which involves implant­ing elec­trodes in cer­tain areas of the brain to coun­ter­act things like tremors and seizures.  The first oper­a­tion was rel­a­tively quick, and it involved chang­ing the bat­tery (located near the pec­torals) that pro­duces the elec­tri­cal sig­nals to block seizures in the patient.

The 2nd oper­a­tion was prob­a­bly one of the most inter­est­ing oper­a­tions I saw on the entire trip, and it involved con­sid­er­able prep work.  They were installing elec­trodes in the brain of a patient with Parkinson’s dis­ease who had sig­nif­i­cant tremors in his left arm.  Because the tar­get area of the brain was so small, they had to be very pre­cise when implant­ing the elec­trode, so Dr. Petersen and her col­leagues ana­lyzed MRI results to deter­mine the nec­es­sary mea­sure­ments.  One of the things that stood out to me about this oper­a­tion was that the patient was actu­ally awake the entire time, even as holes were being drilled into his head.  With­out a doubt, though, the best part about this exper­i­ment was that once the elec­trodes were installed and turned on for test­ing, the man’s tremors stopped imme­di­ately (he even said that he “felt finer than a frog’s hair”).  It really was amaz­ing to see the trans­for­ma­tion, as all the stiff­ness in his arm dis­ap­peared too, and his motions were smooth.

Before leav­ing, we also observed some of Dr. Petersen’s col­leagues per­form­ing a spinal surgery which required insert­ing rods and screws in the ver­te­brae.  This pro­ce­dure involved the use of some very high-tech equip­ment that used some­thing like a GPS to allow the sur­geons to see where the screws were being placed in the ver­te­bral col­umn on a TV screen.  It was really cool to see the inte­gra­tion of cut­ting edge tech­nol­ogy into med­ical pro­ce­dures to make the surgery less invasive.

Day 2

We were able to wake up a lit­tle later on the sec­ond day, but as soon as we arrived and changed into our scrubs, we were imme­di­ately whisked away to watch surg­eries.  The first surgery I saw was prep work for a deep vein har­vest, in which a vein in the patient’s thigh was iso­lated from all the other side veins.  In the actual har­vest and sub­se­quent surg­eries, this vein would be used to repair/reconstruct the patient’s aorta.

After that surgery, we met back up with Dr. Petersen, who was per­form­ing spinal surgery on a patient who was also awake.  Dr. Petersen and her col­league were installing a device against the spinal cord to help reduce some the patient’s chronic pain through the use of elec­tri­cal sig­nals.  Through­out the pro­ce­dure, Dr. Petersen was com­mu­ni­cat­ing with the patient both to make the patient feel com­fort­able with what was going on in her back and to assess whether there were any problems.

Fel­low Princetern David, Dr. Petersen, and Chris

After Dr. Petersen’s surgery was com­plete, we moved to another OR to observe a heart valve replace­ment.  This was a very inten­sive pro­ce­dure, so every space around the patient was filled, which pre­vented us from see­ing much, but one of the anes­the­si­ol­o­gists offered us the chance to observe some of the surgery from their posi­tion.  Although we didn’t see the whole pro­ce­dure, which was sup­posed to take a fairly long time to com­plete, I still appre­ci­ated the oppor­tu­nity to see an open heart surgery.  It’s not every day that you actu­ally get to see a beat­ing heart inside someone’s chest.

Later that night, Dr. Petersen took us out to din­ner again, where we talked some more about the types of pro­ce­dures she does.  We also got a chance to find out about her med­ical school expe­ri­ences and what it’s like try­ing to bal­ance work and school respon­si­bil­i­ties with a social life.

Day 3

We had our ear­li­est start yet at 5:45 the third morn­ing when we went on rounds with the neu­ro­surgery res­i­dents.  Because they only had a lim­ited amount of time to meet with each patient, I saw that they were very effi­cient when it came to check­ing up on the con­di­tions of their patients.  Fur­ther­more, they were very help­ful in explain­ing what was wrong with the patients and answer­ing any ques­tions that we had.

Most of the rest of the day was devoted to watch­ing a brain tumor removal.  Before the surgery, I was sur­prised at how long it took to posi­tion the patient, but one of the sur­geons explained that they needed to make sure that the patient wouldn’t lose cir­cu­la­tion or pinch any nerves if held in the posi­tion for a long time.  It turns out that their prep work was cer­tainly nec­es­sary, as this was the longest oper­a­tion that we saw by far.  Pro­ce­dures like this reminded me of the incred­i­ble patience that a sur­geon must need.  I also real­ized that wear­ing com­fort­able shoes in the OR is a must, since stand­ing around for long peri­ods of time def­i­nitely causes some foot pain.  Because the surgery required was so pre­cise, the sur­geons had to use a sort of micro­scope to view their work, which was great because it also showed a pic­ture of what they were see­ing on a TV screen.  Other res­i­dents in the room were very help­ful in explain­ing what parts of the brain we were see­ing, and what the sur­geon was doing.  There was a bit of trou­ble remov­ing the tumor all at once, but after a long time of remov­ing it bit by bit, it was finally gone.

Shortly after the surgery ended, we took the oppor­tu­nity to shadow Dr. Petersen in her clinic at the end of the day.  Watch­ing Dr. Petersen meet new patients and check up with post-op patients was again a very enlight­en­ing expe­ri­ence and taught me more about patient care, which is one of the most cru­cial aspects of being a good doctor. 

This Princetern­ship was an amaz­ing expe­ri­ence, and I’m sure that many of the mem­o­ries I have of it will stay with me as long as I live.  It was incred­i­bly reward­ing and gave me more insight into what the life of a sur­geon is like, and for that, I would like to thank Dr. Petersen and all of her col­leagues at UAMS.