Farewell Atlantis Project

I am so lucky to have been able to combine two of my passions into one epic summer internship: medicine and travel. Continue reading

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Orthopedic Surgery

Wow.  The first word that comes to my mind.

Orthopedics was absolutely jaw-dropping.  Every surgery was dynamic and intense, yet generally short and sweet taking anywhere from 45 minutes to 2 hours.  I am not sure if it was the bone sawing, the prosthesis, or the encouraging doctors, but I could totally see myself becoming an orthopedic surgeon, maybe even a pediatric orthopedic surgeon.

The orthopedic surgical team was a fun group of individuals who are all very good at their jobs, but still have a good time.  There was often music in the background of the OR and the surgeons and nurses all seemed to be good friends.

The surgeons and scrub nurses really went the extra mile to explain the medical procedures to me.  One of the scrub nurses was one of my students in the English class so she introduced me to the staff, told them to not say anything bad in Portuguese since I speak it, and basically explained that she loved me and they should too.  I was extremely flattered.  She showed me how they fit the prosthesis and pick the sizes from the storage.  They also let me have a birds eye view at the surgery.

Surgeries:

  • Partial Hip Replacement
  • Complete Hip Replacement
  • Femur reinforcement – DHS (dynamic hip screw) & EMOS (Extraction of Osteosynthesis material)
  • Shoulder Dislocation – acromioclavicular dislocation
  • Total Knee Prosthesis

These surgeries were absolutely incredible.  Dr. António Melo and Dr. Luis Soares even let me take a photo of the knee replacement surgery.  It is quite graphic so *trigger warning*. Knee Replacement

Gynecology

Gynecology was a very different experience than what I expected.  There is such a hype about child birth, about the miracle of life, yet I found that the doctors and nurses were so accustomed birth that it did not phase them.  Since only some gynecological procedures are planned and some can happen at any instant, the department has many slow, quiet days and other busy days.  The doctors explained to me that you can never really anticipate any activity unless it is a planned procedure.  

While in gynecology I was able to see what I will consider 3.5 different procedures/events.  

  • Curettage – this is a procedure to remove tissue by scooping or scraping.  This was once an abortion technique, but now they use vaccum aspiration for that.  We were told that the patient had miscarried and that was the reason for the procedure.
  • Cesarian Section- a few cuts right below the abdomen and boom there is suddenly a baby! Quite literally felt that way.  
  • Tubal ligation “tubes tied” – after the C- section she had asked to have this procedure.  They tie a string on two sections of the fallopian tubes and then cut the region between the ties.  This is considered a permanent form of birth control. 
  • Natural delivery – it happened simultaneously with the C-section so I only saw the baby who was born at an early age and taken to neonatology.  (I only saw 1/2 thus the total of 3.5)

Although gynecology was very interesting, I think the babies were much cuter than the birthing process as a whole.  I do not think I will become a gynecologist, but sometimes it is just as important to find out what you like as it is what you do not like.

Week 4: Neurosurgery

This week I was in Neurosurgery, which introduced me to many new characters around the hospital and led to patient interactions where the patients were usually twice my age or older.  Dr. Cruz was very interesting man who truly is fascinated by the brain.  Unfortunately, the more routine consults and surgical procedures focus on the spine, which is barely neurosurgery in his eyes.  Since there is not a large volume of patients with neuro disorders that require surgery, the small population limits the number of surgeries.  Unlike Los Angeles which has a population of about 3 million and LA county which was upwards of 9 million, The Azores have only 250,000; 150,000 of those are on São Miguel, the largest island.  Regardless of my doctor’s outlook on life, I was able to see a surgery and learn from him.

 

Surgery:

I watched a surgery of a herniated disk removed.  A herniated disk requires surgery when the disk applies pressure onto the nerve root in the spinal canal.  Surgery is quite an ordeal since you have to go in to the space between the appropriate vertebrae and pull out the dislocated piece of bone.  Dr. Cruz tries to avoid surgery because afterwards it is common for the body to treat the surgical area like a break and try to mend it fusing the back through osteophytes.  The surgery took about 1 hour and 15 minutes and it looked like the incision would heal very nicely with little scarring.

 

Consults:

  • Hernia (multiple)
  • Degenerative lesions in the lumbar spine
  • Osteoligamentous Hypertrophy (lumbar)
  • Dislocated lumbar disk
  • Spinal listesis
  • Nodules of Schmorl
  • Disk Prolapse and Hernia

During each consult Dr. Cruz would go through CT scans of patients called (TC scans here) and would follow with either pain management, another consult, or schedule surgery.

Sweet bread and wine: The Holy Spirit Festival

Today was the festival of the Holy Spirit, which traditionally had more of a religious significance, but today in Ponta Delgada it manifests itself as a giant parade and gathering where people give out free soup in the morning and in the afternoon sweet bread, wine, and even beer.  Each town in São Miguel has a representative float of a craft or product and goes down the main street by the marina.  We had an amazing time exploring this parade.  This is something that was so genuine to São Miguel and I know could never happen in the United States.  Giving out free wine poured from barrels from the back of the float? Even with a permit, people would need wrist bands and tight security.  Here the people just come together, celebrate, dress traditionally, drink wine and eat bread.  Here are some of my favorite pictures from the festivities.  Honestly the bulls were my favorite.

Bull wagon

Crown of Divino Espirito

Arches

House of Soup

Throw a stitch

Fishing off the truck