Week 2 - Ben Grodner

Another week gone! Time is really beginning to move as I settle into more of a routine. This week I experienced my first patient interactions in the clinic. I met with Dr. Rodeo, his resident, his researchers, and his various med students in the morning. He dove immediately into seeing patients, inviting two shadowers into a room at a time to watch as he assessed and interacted with patients of varying joint ailments. There were patients with tendinopathies, ligament tears, muscle imbalances, and arthritis to name a few. Dr. Rodeo would scan the patient's information, then assess the patient's musculoskeletal state with a variety of physical tests designed to pinpoint the muscle, ligament, or tendon of issue. Much of this work was accompanied with detailed explanation for the benefit of both the observers and the patient. After making a (often staggeringly precise) guess at the cause and extent of the patient's issue, Dr. Rodeo would review the patient's imaging history, if any. Generally this consisted of an x-ray radiograph or two depending on the history of the patient's troubles. If the issue was clearly soft tissue, sometimes this was supplemented with MR images. Dr. Rodeo would often discuss the issue with the resident in much more technical language than he had used in the room with the patient and quickly point out the important aspects of the the imaging as they related to the initial musculoskeletal examination. After discussing, Dr. Rodeo would decide on his preferred course of treatment, return to the patient, and explain what he thought was best. This included physical therapy, a drug course, injections, further imaging, or surgery. Most often, physical therapy was prescribed with a highly specific musculoskeletal target and the patient was recommended to a trusted PT. In the case of an injection, the nurse was called in and Dr. Rodeo would skillfully and often painlessly administer cortisone, steroids, or some other cocktail at a precise location. Often in the case of injection, pus was drained from the synovial joint to relieve the pressure of inflammation. In one case, a startlingly bright spot of fluid appeared on the MRI at the junction between the acromion and the clavicle and Dr. Rodeo performed a painful injection at the site. He also indicated that if the pain persisted, he could perform a simple surgery to shave down the clavicle and reduce the contact point!

One of the biggest takeaways from my experience this week was the confidence and wealth of knowledge Dr. Rodeo and his resident possessed. Dr. Rodeo, especially, possessed an almost "Sherlock Holmesian" ability to collect patient information, relate it to his knowledge base, and deduce causes. His communication skills were similarly astounding. It was quite inspiring to watch him shift effortlessly between different forms of communication from patient to peer to student. It was a sign of his skill with communication that he would write patient reports by rattling off a series of paragraphs describing his findings with no reference to notes...always in perfect grammatical sentences replete with highly descriptive scientific language.

I am quite excited for next week, as I will begin experiments with PJI samples and get trained on various equipment. I will also attend some of Dr. Rodeo's surgeries. Furthermore, I hope to explore some of the radiology department via connections made through my fellow BME students.