Saturday, July 28, 2007

Galveston Day 6

Day 6

Friday

Last day.

I woke up late today, 7:45am to be exact. I haven’t packed yet either. So in the rush I left my phone. Whoops.

So today we only had a half day. We had our last problem based learning session. I really did enjoy these. I feel like they are a great alternative to large based lecture sessions because they provoke interaction from students. I tend to fall asleep in lectures, or everything else, so these keep me awake.

Then we had our last team based learning session. We finally had the opportunity to sit in on a real class. Dr. Levine had us join her class and participate in the discussions and tests. She broke us into two groups of 5 and we competed against the medical students in the case studies. We definitely have a lot to learn because we were wrong the majority of the time. It was interesting just to observe the learning environment the UTMB students are placed in. The format goes: individual testing, group testing, case studies, group discussion with professor. In the future, they should try to do more of this.



Then we had lunch and filled out our surveys before heading back to the hotel.

I did manage to get my cell phone back. Turns out I left my swim trunks and a t-shirt as well. Whoops.

We caught our ride back to Houston Hobby Airport. Check in was fine.

Highlight of the day:

So we are sitting at gate 27 waiting for our plane. I get up to use the bathroom and on my way back I spot this guy wearing a bucket hat over at gate 26. He seems like he’s trying to act inconspicuous, and he’s a pretty big guy even though he’s sitting down. I catch a glimpse of his face as I turn towards my gate and I stop. I thought it looked like Robert Horry but I couldn’t be sure. I sit down and try to get people from our group to verify, but we are all still kinda iffy. So I get up to check where his flight is going. Sure enough San Antonio. Yes sir, it was big shot BOB. What is he doing a Houston Hobby airport, flying Southwest. Oh well, I didn’t care. So I’m sitting one gate over trying to figure out if I want to go over and take a picture with him. But I was nervous. He seemed like he was trying to fly under the radar and thus far he was succeeding. I mean it’s Big Shot Bob, and no one noticed. He was also on his phone the entire time, maybe he was just talking to people to avoid people coming up to him. I decided if he ever got off the phone, I would go over. I had my window and I went for it.

Here’s what I said, “Mr. Horry, I don’t mean to be rude but would you mind if I took a picture with you.” Response: “Yeah sure man.” So I did, shook his hand and left him alone. I felt really bad though because people looked over as soon as I took a picture with him and started coming over to him. Crap, my bad.

Read more about him here: http://en.wikipedia.org/wiki/Robert_Horry

Thanks Roberty Horry. I forgive you for checking Steve Nash in game 4 of the Western Conference semifinals. http://www.youtube.com/watch?v=hYC95MziMJk

Congratulations.


We landed at 7pm and my bro picked me up.

Anyways I had a great time in Galveston and I’m extremely grateful for the opportunity. I definitely learned a lot about medical school and the application process and about UTMB.

Then stuff happened and I went to bed.

-James

Friday, July 27, 2007

Galveston Day 5

Day 5

Thursday

Breakfast. Today was Biomedical Engineering Research day. We walked over to the biomedical research building on the UTMB campus. Doctor Jack Hart, the assistant dean for the BME department back at UT Austin, came to join us for part of the day.


The first lab we visited had to do with imaging of the eye and seeing what causes degenerative eye loss. Along with that, what sort of measures could be taken to prevent vision loss. Then we went to a lab that did research in imaging layers of tissue. This was somehow used in preventing transmission of STDs.

Next we listened about research in microscopy. Most of what she was saying made sense, but a lot of it was over my head. None of us are track 1, so it didn’t necessarily pertain to us.

Then we learned about cancer irradiation using sonar. And about removal of hair and tattoos using lasers. A lot of what we learned about had to do with lasers.

Then lunch, pizza. During lunch, one of the research professors encouraged us to stick with the path that we are on. The medical field needs more engineers to do research and solve problems. As engineers we have an advantage over just biology majors or liberal arts majors in medical school in that we can provide the problem solving skills interfaced with knowledge of physiology and biological systems. He also encouraged us to do research over medicine. I don’t know if many of us were swayed by him being that all of us were track 2 pre-med. Well, maybe he convinced Travis, he loves research. Anyways the medical field needs more BME-ers.

Ok then more research labs. The next research lab we went to was more down our alley. It had to do with designing a device that would better improve monitoring capability of technology. The main problem with the equipment used by surgeons and anesthesiologists to monitor their patients during surgery is non-portability and fragility. These researchers are working to design a machine that is durable and portable in monitor patients whether in surgery, in an ambulance, or on the battle field. The machine is designed to be more compact and could possibly be taken by medics into the battle fields to treat injured soldiers. The machine not only will have monitoring capabilities, but has the ability to replenish the patient with oxygen if levels are low, and the right amount of drugs needed Very cool. They have also designed other tools used by the army to inject drugs straight into the chest, penetrating deep enough with damaging the lungs or heart.

We had some down time before our next lab so we took a real quick impromptu tour of Old Red. Now for those of you who don’t know, Old Red is the original UTMB medical building in Galveston. Fun facts: UTMB, established in 1891, is the oldest medical school west of the Mississippi River. The campus is 84 acres and growing. UTMB has one of the best burn centers in the nation, and it’s patients receive the very best treatment. It has schools in medicine, nursing, allied health professions, and a graduate school of biomedical sciences, as wells as an institute for medical humanities.
During the Great Storm of 1900, the city of Galveston was ravaged and submerged under water. Nearly 6,000 people died. There is a famous story that goes something like this:

In September 1900, a powerful hurricane struck the upper Texas coast. Known as the
Great Storm, it is still considered the largest natural disaster in U.S. history. It devastated
Galveston Island and the Medical Department campus, but also strengthened the resolve of
UTMB to be here for the health of Texas. In the storm’s aftermath Board of Regents Medical
Committee Chairman Beauregard Bryan decreed via telegram to the Galveston campus that,
“The University of Texas stops for no storm.”

Old Red, also known as the Ashbel Smith building, was one of the only buildings that survived the storm and still stands today. The tour was really cool. We first stopped at the grand lecture hall. It was the room where they used to perform surgery on cadavers or patients. The seating is very stadium like so that everyone can see down into the surgery. They still use the lecture hall today, but no for performing surgeries. We also went and saw the dissecting rooms where many students can perform surgery on cadavers all at once. There are dozens of dissecting tables in one huge room. It smells really funky in there. Chanel

Our last research lab was in orthopedics. I was particularly interested in this research because I see myself doing some sort of sport medicine, perhaps orthopedics.

Then we went back to the hotel.

So before we left, some of the medical students we were shadowing suggested that we hit up a place called Sky Bar during happy hour. Apparently their sushi is really good and cheap during happy hour. So we went. And it was. It was sooo good. I haven’t had sushi in too long. During the process I got too excited and I bit a chunk off of my lip. It hurt so bad, especially with wasabi. But it was worth it. Good food.

But, it still was a bit pricey and I didn’t get full. The night was still young, so we walked to Fuddruckers and Michael and I split ‘the works’ burger. It was good. They had a pool table upstairs, so we played a couple rounds. Fun.

But I was still hungry, so we walked over to the ice cream shop for some dessert. The place is huge. They also sell clothing, decorations, and candy. I had an ice cream cone. The girls split this butterscotch sundae. Kim didn’t want any ice cream. Here’s why: her family owns their own ice cream shop. At first I told her that I thought she was lying and I didn’t believe her. BUT she actually does. It’s in Houston and its called Goodies. Her mom makes all the ice cream from scratch herself. She can make around 150 different flavors. That’s pretty freaking amazing.

Kim this was my plug for your ice cream store. You now owe me free ice cream, thanks.

But I was still hungry. I took comfort in the fact that I had leftover chicken in my fridge at my hotel room that I could still eat. The girls went to Starbucks.


Traditional limboWe went back and chilled. At one point, we started working out with my ab slide and did a small 10 minute workout. Then I ate my chicken and fell asleep. Tomorrow is the last day. Holla.

-James




Galveston Day 4

Day 4

Wednesday

Breakfast at 8:00am at UTMB.

The first thing on the schedule for today was a talk given by William Winslade about the seriousness of brain trauma. Points from the talk: brain trauma is the leading cause of death for teens under the age of 19 (roughly). Usually results from some sort of accident such as a crash or fall and is a relatively easy injury to sustain. Tissue in the brain is highly dependent on a constant supply of oxygen. If the blood supply to th brain is cut even for a few minutes, the results could be drastic and long lasting. William Winslade was telling us how when he was a child he fell off a two story building and suffered serious injury to his head. Luckily the doctors were able salvage his life by putting a shunt in his head to drain the fluid and a metal plate. Somehow William lost no mental capacity or any motor function and lived a normal child/adult-hood. We also watched a video on the effects of brain trauma on other people in the hospitals that they had been seeing. Until relatively recently, we haven’t fully understood the severity of brain trauma injuries. I guess the major incident that has brought the issue onto center stage was the case with Terry Schiavo. We’ve all seen on TV how it drastically change her life and the lives of her loved ones. The video that William made was about 5 years before Terry Schiavo. Some of the cases we saw were very similar to Terry’s. It was just very sobering to watch home videos of this woman who previously was an amateur country dancing national champion to someone who could barely talk and process what you were saying.

Another interesting thing Dr. Winslade talked about was human response while in the vegetative state. We saw on TV how although Terry Schiavo couldn’t respond to any sort of human stimulus, she was awake and her eyes could move and blink. Personally I always wondered if she really could hear her family and the doctors but just wasn’t able to respond. In some cases, doctors have determined that the person isn’t able to see what’s going on around them because their retinas are damaged or detached. However, they have performed MRI’s and other scans on the brains of people in near vegetative states while prompting them to respond. For example they would say, “I want you to think that you are back home somewhere with a loved one.” Then they would step back and scan the person. They found that the certain portions of the brain corresponding to memories and emotions like happiness would light up. Very cool.

We also talked somewhat about the ethics involved with people in vegetative states. Terry Schiavo is a good example that we all know. Another example Dr. Winslade presented to us was of a young man who was jumped by a local gang and nearly beat to death. He was in a coma for about 7 months until he woke up, but was in a vegetative state. Over time, he suffered many complications and had to undergo nearly 30 different surgeries. He had thousands of prescriptions, and required many forms of medical care including been transported back and forth been health facilities. Over the course of three and a half years, his medical bill accumulated to over $2.5 million dollars. SO the issue is that if he had no chance of ever recovering from his vegetative state, how long should his insurance company continue to pay his medical bill? Basically how long should they keep him alive? Well his insurance company wanted to cut him off but his father took ths issue to the press and the insurance company conceited.

Anyways so this was an eye opening talk on the prevalence of brain trauma and the issues that I often overlook.

Then we went to lunch. Afterwards we had our second problem based learning session with the same doctor we had on Monday. I’m a fan of these sessions.

For the rest of the afternoon, we were split up into two groups of 5. UTMB had set up a time for us to go to a learning session with Stan, the computerized mannequin we saw on Monday. I was in the second group, so we sat around for an hour and a half while the first group took their turn.
While we were waiting, playing spin chair pictionary.


Suggestion. This year’s program did have a lot of down time. Please do not misunderstand me, in no way at all am I complaining. A little down time is good to rest and recuperate, but at times I felt like we were sitting around for periods of time with nothing to do. Take this time for example, we sat around for a while. Just a recommendation, I am very grateful for the opportunity.

So during this time Mike Y and I discussed our idea for our quality improvement project. I think we got a good idea, we just need to work out the kinks. It has to do with outpatient discharge from the hospital and their medicines.

When it was our turn we walked down to the area to meet with Rachel, Dr Ainsworth, and the attending doctor, Doctor Levy. This guy is sick. He has done two residencies, one in surgery and one in anesthesiology. Understand this: that’s 5 years for surgery and 4 for anesthesiology. Nine years on top of medical school’s 4 years. Like I said, this guy is a baller.

SO when we get there, we did some random trivia for a while. Did you know that the only other organism in the world that carries leprosy is the armadillo? Yep, and it has 4 baby armadillos, all identical. Nice.

Ok back to Stan. Basically here’s the way it goes down. Dr. Levy will give us a scenario in which a patient has been brought in for a clinical reason. He will then go back to the computer room and adjust the mannequin to simulate the conditions he just described. We weren’t really sure what we were supposed to be doing with the patient, I suppose we were a team of anesthesiologist trying to stabilize the patient. I didn’t figure this out until the end though.

So the first scenario we got was a man involved in a car wreck. He sustained some injuries and complains of pain in his abdomen. Then Dr. Levy went to the back. While we were checking the monitors, Dr. Levy started talking to us through the mannequin It was great, he even pretended to injured. So we had no idea what to do. We would talk back. He wanted something for the pain, so we gave him morphine. Then his blood pressure dropped and his pulse went up. His O2 saturation also started dropping. We really had no clue what to do. We started giving him a random assortment of drugs, trying to slow his pulse and raise his blood pressure. We relied heavily on Dr. Ainsworth to guide us. Eventually he suggested we call in a surgeon to give an analysis, so we did. Dr. Levy came in and was like how am I supposed to give him an examination if he can’t tell me where he feels pain? He’s also asleep. Whoops. We then debriefed the situation and discussed the best options.

Next scenario, I forgot. Last scenario: chest pains, possible heart attack. We did better with this one and successfully stabilized him.

This was a great experience and I felt like I learned a lot more from this session than I would from reading a textbook. It provided a real life environment with unknown conditions and also pressured us to think harder and focus because a patient’s life was at risk.

Then we caught our ride home. We did absolutely nothing until dinner and we walked to a wings place for dinner. I had a whole chicken. It was spicy.

Michael and Travis

These guys are never on time.

Michael limbo.

Then we went back and went to sleep.

-James

Galveston Day 3

Day 3. Tuesday.

Today we got picked up at around 8 and had breakfast again over at UTMB. The first thing we did was team based learning where we were split into groups and given questions to answer. Basically the message was we always perform better as a team than as an individual.

Lunges while waiting.

Then we had lunch with Dr. Ainsworth. During lunch Dr. Ainsworth prepared some trivia for us to do. We used the IR clickers that we use in Dunn’s BME 335 class to click in. It was actually really fun. He had a lot about Galveston, UTMB, and Texas history. I discovered that I have forgotten everything about Texas. For example, do you know what Austin would have been called?

Answer: Waterloo. You didn’t know that.

Austin and Galveston were voted by the people to be home to the state’s university and medical university. What town came in third in the voting?

Answer: Tyler, Texas. Are you kidding? We almost had to go to school in Tyler, Texas

Then we went to see the Harvey Simulation. Harvey is also a mechanical simulation used to train medical students and staff. It’s basically a rubber dummy that has the capability to produce a heartbeat and pulse. You can change the conditions that Harvey operates under. For example you could give him a heart murmur or simulate conditions after a heart attack. The pulse can be seen through the skin and raises up at various spots on Harvey’s body. The purpose of Harvey is mainly for diagnosis training. The teaching physician and the students are all give stethoscopes attached to a radio receiver that plays the heart beat for each individual person so that 10 people can listen in at the same time instead of one at a time. We learned how to diagnose different types of heart murmurs such as aortic stenosis or regurgitation. We also learned about where the aortic, pulmonic, tricuspid, and mitrial valves are. Harvey costs around $125,000. I forgot to mention that the simulation that we saw on Monday costs $250,000. Pretty expensive.

Then we went to have our badges made. This took forever and was incredibly boring. We talked to one of Dr. Ainsworth’s assistants Cheryl for a while. She’s awesome. So we finally got our badges made.

Here’s mine.

Notice the resemblance to this guy? Dwayne Johnson aka The Rock.

We went back to the hotel and hung out for a bit before going out to dinner. Since Chanel was the only person who drove, she took a group of us out first, then went back for the other group. I went with the first group and we walked around looking for a place to eat. Along the way I lost the Frisbee and had to climb into an enclosed area under a fence to get it. The rust on the bottom of the fence got all over me. I was pissed.

We ended walking 18 blocks and decided to eat at Salt Grass. Chanel and the rest joined us.

Waiting outside

Food, good. Dessert, good.

Then we decided to go bowling. We had to fit 7 people into Chanel’s 2 door civic. This was interesting. Bowling was a great choice. ISLAND BOWL. It was so much fun. Mike Y, Clair, Jing Jing, myself, Chanel, and Kim all bowled. Michael A did not partake. The reason is he bowls a lot and is pretty tired of it. However I think he’s really good and didn’t want to embarrass us. But he helped all of us improve our game. Pretty good instructor actually.

The bowling alley was kinda small, and we were pretty much the only ones in there. It was awesome. Then we headed back to the hotel in Chanel’s car. Along the way we somehow ended up in front of the really scary building in Galveston and got really creeped out. Then we went back and to sleep. Later.

-James