Week 7 - Ben

The last week! As I said goodbye to friends and colleagues this week, I realized how quickly I grew close to the scientists I worked with. The atmosphere of intensity and communal intellectuality makes it easy to build strong connections. I also realized that I will remember  The City fondly. Again, there's a sense of purpose that pervades everything and infects me, which is both exciting and stressful. 

This week I shadowed Dr. Michael Cross through knee and hip replacements. Dr. Cross was both highly personable and shockingly knowledgable, which made for an excellent experience. He was able to narrate much of the knee procedure as an experienced Fellow did most of the procedure. He explained that the Fellow was about to move and start his own practice. Another key point of Dr. Cross’ minimal involvement was that the procedure precisely followed Dr. Cross’ established technique, and he could be completely sure of the quality of the operation. It was shocking to me how much the procedure resembled carpentry. There were power saws, cutting guides, rasps, and drills. I was particularly interested by the electro-cauterization tool, which was grounded to the patient and hence could not deliver a charge to the operator as they cut through soft tissue. The sheer number of tools used and the necessity for absolute sterility was impressive. The technician in charge of delivering tools to the surgeon’s hands had to be completely sure of the procedure in order to preempt the needs of the operation. The method of selecting and purchasing the implant was also interesting. The sales representative for the company, a younger man, would provide information and recommendations, then the doctor would select dimensions for the implant and a technician would purchase the items, unwrap them, and deliver them to the sterile area. Due to the number of joint replacements, the company keeps a complete stock of inventory at the hospital at all times. 

This week I spent a lot of time taking images of synovial samples. I worked out some good positive controls for the method and was able to confirm the baseline efficacy of the technique. One important step was the establishment of a connection with a group generating a mouse model for PJI. Incredibly, they are able to implant a tiny prosthetic in the knee of a mouse, then inject  S. aureus to model an acute infection. That was exciting for me and bodes well for the continuation of this project beyond the summer. In that line of thinking, I also set up a plan with Dr. Donlin to exchange samples and keep pushing the project forward when I return to Ithaca. All in all, summer research was great for establishing connections to exchange samples and expertise. 

S. aureus (pink) infecting mouse muscle.