Yende Grell ’16, Massachusetts General Hospital

Yende-GrellDay 1

We met Suzanne Morrison ‘89, our Princeternship host at 9 am sharp. As we commenced our “2-cent tour” as Suzanne likes to call it, and walked through the bustling halls of the Yawkey Center of Massachusetts General Hospital (MGH), I could imagine myself, chart in hand, comfortable scrubs on, one day roaming the halls of a great institution such as this one. The presence of residents and students was refreshing, and it reminded me that both as an aspiring and actual physician you are continually learning. Suzanne showed us the Lunder, Ellison and White buildings of MGH.  From the 22nd ‘VIP’ floor of the Ellison Bbuilding we saw a magnificent view of Boston and Cambridge. The highlight of our tour was when Suzanne took us to the Ether Dome, which served as the operating room of MGH and was the sight of the first anesthesia administration by Dr. W. Morton using Ether.

We then spent the rest of the day with Bobby Lucas ’13, a research coordinator and Princeton alum. Go Tigers! Bobby and his research partner Jordan were working on a variety of studies including the PROMISE program aimed at effectively and efficiently collecting patient reported outcome measures,and the Radiostereometric Analysis (RSA) Distal femur study. I really enjoyed learning about the RSA Distal femur experiment that tracks the movement of beads in patients with distal femur fractures to measure healing. These beads are inserted at time of surgery when the bone is still soft and spongy. We had the opportunity to see the set up of the process that uses X rays to measure the healing of these fractures. A shot is taken of the femur, then one with pressure against the femur. The beads in both films are observed, and based on how much they move, one can see how much the bone has set since the last films. This method is being used currently in hip replacements, and it was great learning about such an innovative approach.

Day 2Grelle 1

My day started bright and early at 6:30 am. I met my host for the day, Dr. Torri an obstetric anesthesiologist, and was immediately struck by his warm, bubbly personality and beautiful Italian accent! He took me to rounds with his other attending Dr. Leffert and a few of his residents. Although a lot of the medical jargon flew right over my head, Dr. Torri took the time to explain the terms that had just been thrown out. He would do this throughout the course of the day, also showing me diagrams in anatomy textbooks, incisions on models, and diagrams on a white board.As an obstetric anesthesiologist Dr. Torri’s day consist mainly of administering epidural and spinal analgesia to women in labor. I saw at least 4 of these procedures done, and the extreme intricacy and dexterity involved. A local anesthetic is first given to the area in the lower back, and then the actual opioid analgesic must be inserted into the epidural space. This space is tricky to locate and is found between the lumbar bones, between the yellow ligament and dura. Once the epidural space is found a catheter is placed in it to allow for the continuous supply of the drugs. I also had the opportunity to observe 2 cesarean sections, one of which was the delivery of twins. These twins were forced to be delivered by C-section since one of the two was breached and there was an obstetric complication called vasa previa which increases the risk of fetal vessel rupture. This was my first time seeing a surgery firsthand, and instead of feeling queasy or uncomfortable, I thought it was amazing, and even got teary eyed when the babies were pulled out.

Day 3

My day started again at 6:30 am with rounds on the orthopedic trauma service. I spent the morning with nurse practitioner Kathy Burns checking up on patients and attending interdisciplinary meetings. I was not familiar with the nurse practitioner specialty before then, and was amazed by the great amount they can do, including prescribing and diagnosing. Kathy has been in healthcare for almost 29 years and is great at her job. We saw patients with external fixators, fractures and those in need of knee and hip surgery. The interdisciplinary meetings were very interesting to me. During these meetings members from various services like orthopedics, occupational therapy and physical therapy all report to each other about patients and come up with decisions on course of treatments and discharge. It makes sense that orthopedic patients need to be assessed and treated by physical and orthopedic therapists since having injuries to your bones affects your motor skills which in turn affect your basic life functioning.

I spent the afternoon in Pediatric Orthopedics with nurse practitioner Allison and Dr. Rebello. I was surprised by the variety of cases we saw. I went in expecting pediatrics to involve things like children with broken arms and feet and simple fractures. Yet I saw a neonatal case where a swollen fetus foot was being explored as an indicator for other complications and a post-surgery cerebral palsy patient was being treated for left leg spasms. The cerebral palsy patient was an anomaly for Dr. Rebello who had never in his career seen a response like this to the surgery. This patient was in a great deal of pain, and the pain service had to be called in for a consult. Despite some of the difficult things I saw, I found that working with children was very uplifting. Most of them were bright and funny even when in pain, and come on, they’re so cute!

Dr. Rebello and I then chatted about a children’s book that he recently published called Dare Bone’s Big Break. I would recommend it to anyone with children or who works in childcare. He uses humor and rhymes to explain what actually happens when a child breaks a bone, and how it is treated. He explains that his aim with this book is to help children become familiar with and comfortable in using medical language and terms. He believes that if this sort of language is introduced and understood at an early stage in life, then children will be better versed in their understanding of the body and less frightened to go to the doctor. Writing this book was his passion, and he says it is the first of many such works to come.

I ended my day by accompanying Dr. Rebello to check up on a post-surgery patient. This patient was born with no arms and had surgery to correct a hip complication that would allow him to walk more comfortably. When we visited he was cheerful in spirit and was excited by the thought of soon going home. I loved seeing the interaction between this patient and his caregivers and his great optimism despite his circumstances.

All in all, being at MGH for 3 days was an eye-opening learning experience for me about the field of medicine.  I learned so much from the physicians and nurse practitioners that I shadowed, and I want to thank them for being so patient with me, a pre-med student who was not accustomed to the medical jargon. This Princeternship has shown me that medicine is multi-faceted, and requires a team-based approach. I have also come to see the more personal side of medicine, hearing the stories of physicians and seeing their interactions with their colleagues. I would definitely recommend this Princeternship to anyone interested in medicine. This experience has only confirmed my interest in medicine and my commitment to pursuing it. A big thank you to my host Suzanne who gave me the opportunity to come to MGH and shadow these amazing physicians, and to Bobby for all his help.