Still Summer Immersing

Last week I took the opportunity to follow Dr. Schwartz on clinical rounds, and I have to say that it was a pretty novel experience that left me with mixed emotions. Many of Dr. Schwartz's days involve hours upon hours of discussion with patients about their specific cases. I'd say that a good 20-30% of these cases are simple surgery follow-ups in which Dr. Schwartz examines an MRI scan, sees nothing wrong with it, then breaks the good news to the patient. However, a vast amount of cases require him to inform a patient of a tumor and then discuss surgery options with them. While these meetings are somewhat depressing, I actually learn more from them than from watching surgeries. I get the opportunity to see a larger variety of cases, and hear Dr. Schwartz's explanations about the situation and options for surgery.

Some of the surgery options are pretty technologically advanced. A lot of patients ask about the use of a gamma knife, which delivers localized radiation to a tumor to kill its cells. The radiation is delivered over multiple sessions at moderate doses, and can be focused to a millimeter scale. Dr. Schwartz has used this tool extensively, but seemed to generally advise that older patients use it primarily because the long term effects of the radiation provided by the gamma knife are still unknown. Furthermore he said that it can only be used on tumors less than 2cm in size, and there are limitations on where the tumor can be. For example, if the tumor is too close to the optic nerve, it doesn't make sense to use a gamma knife because of the damage that it could cause to a patient's vision.

Dr. Schwartz also talked about a pretty cool endoscope, in which hundreds of tiny lenses are placed at the tip. To explain the tool to patients, he used the analogy of an insect eye which has thousands of small optical units that process spatial information separately. Older generation endoscopes have the drawback that they provide only two-dimensional spatial information, but little information about depth. The thousands of lenses enable the endoscope to process depth, and display 3-D images on a screen that doctors can see with special glasses. Cutting edge tools like these perfectly represent a biomedical engineer's ability to advance the medical field.