Methodist

On Tuesday I started my fourth clinical rotation at New York Methodist Hospital. (recap: one, two, three) I will be spending my first month here doing a general rotation (meaning that I am in an operating room doing general-type cases, as opposed to a specialty, like trauma). The second month I am going to be doing OB! I am really excited for this rotation, the only downside is this:

Methodist (point B on the map) is in Brooklyn, about an hour away from my apartment (point A on the map) by subway. This isn't ideal but it is doable, especially if I only need to take one train (the first option) but for the next three weeks the 3 train is not running due to construction (this is the busiest time for construction on the subway because the summer tourists have left and the holiday Thanksgiving/Christmas tourists have yet to arrive) which means I need to take three separate trains to get there. The unfortunate part about that is that if any of the trains is late, I will miss my connection... and when you are riding the subway that early in the morning the trains only come every 20 minutes or so. To give myself a cushion, I have been trying to catch the trains in that third option (the one that gets me there at 5:34) but I have yet to make them all so I keep ending up getting there around 6... so by the time I get in and get changed, it is 6:15 and I have already been up for two hours before the day has really even begun! Enough whining. I have a cool video for you from the OR yesterday. I spent the day giving anesthesia for robotic procedures - the way the robot works is that the surgeon sits at a console (picture a video game in an arcade) where she controls the instruments connected to the ends of the robot's arms. The instruments are inserted into the patient's belly through tiny little incisions, the idea being that this type of surgery is much less invasive than having your whole belly cut open. In theory this will make for faster recovery times for patients (since they have less healing to do) which will translate to lower costs to the hospital (because you won't have to stay as long). Since the robotic procedures are still so new, the surgeons are still getting used to using the robots. This means that they are much slower at doing the surgery (than they would be if they just cut the belly open) and, since OR time is so expensive, that is negating any money the hospital saves by getting the patient home sooner. First take a look at this picture so you can get a lay of the land:

You can see my anesthesia machine on the right, then there is the patient's head right in the middle (I am at the head of the bed, so picture the patient laying with his feet away from me, towards the back wall), there is the drape separating my area from the surgical field and then you can see the robot arms - they kind of look like big spider legs - covered in plastic to keep them sterile. I took the video looking over that drape towards the patient's belly. You may notice that his belly is blown up like a balloon, the surgeon injects gas into the belly to open up the space so that she can see what she is doing. The sound you hear is the sound the cutting instrument makes. One of the robot arms is holding a camera, I pan up at the end of the video so you can see the camera feed, this is what the surgeon is looking at in the console (only in much higher definition, and in 3D). They cut using electrocautery (heat conducted by electric current) so that is why you see bubbling/smoke when the noise is happening.