We had another patient yesterday morning, so I came in really early again. There was a talk I wanted to go to in the morning about translational research, but unfortunately it didn't work out. This patient got the interventional treatment, so we had a lot of work to do. One resident stayed with the patient, and the other resident and I went to consent another patient for today. The patient agreed to participate, so I had to come in really early today too. Today's patient was another control though, so again I had some extra time to read before class.
Yesterday's class was epi and covered more about clinical trials. Right afterward, I had to go back to the hospital for a research group meeting. It turned out that I was the only one there for my project, because both residents were still in the OR. So I was the one who gave the update on how our project was going. Then I ate lunch and went back to the OR too. This was a pretty long surgery. The patient got up to the ICU around 3:30 PM after a 7 AM start!
Our patient for today got a late start, so I left for class this morning without knowing whether he would be a control or an intervention. We had our normal Friday journal club, and it was good. One paper was about a drug that is used to prevent clotting by inhibiting platelet activity. The other described a really huge clinical trial where they screened older men for abdominal aortic aneurysms. The aorta is the huge artery that comes out of the heart. It travels down into the abdomen before branching and heading into the legs. Some men, especially if they smoke, can develop weak spots in the wall of the part of the aorta that is passing through the abdomen. Because it is under very high pressure, the weak spots can start to balloon out, and this is the aneurysm. Large abdominal aortic aneurysms are very dangerous. If an aneurysm bursts and the man isn't in a hospital (most of these abdominal aortic aneurysms are in men), he has a good chance of bleeding to death before help arrives. Anyway, it turns out that screening men who are in their late 60s with ultrasound does detect aneurysms and lead to lives being saved. There were over 60,000+ men in this study, so it's a pretty impressive trial! Men are being screened in the US now too.
After class, Dean Franco showed the same movie about the history of the Cleveland Clinic that I saw a few weeks ago. I went and saw it again even though I had already seen it once. Watching it this time with just the other medical students was a very different experience compared to watching it with the CCF employees. For example, the movie mentions that one of the founders of the Clinic graduated from the predecessor of Case's medical school in just nine months with highest honors. Naturally, that part was particularly amusing to all of us, considering that we will be taking 58 months to get through med school! The part near the end of the movie where they showed the first class of CCLCM medical students doing PBL got a bunch of laughs too.
I didn't have much to do this afternoon except that I went with one of the residents to consent two more patients for next week. One was there with his wife, and she was even more scared about his upcoming surgery than he was. It is going to be his first surgery, and of course heart surgery is a pretty major operation. So it's completely understandable to be frightened. Even though CCF is one of the best places in the world to get heart surgery done, they can't save everyone. As the resident was explaining the research project, all of a sudden, the wife pointed at me and right in front of me, blurted out to the resident that she and her husband didn't want me to be the one doing the procedure on her husband! I was trying so hard not to laugh that I couldn't even be insulted. She has no idea how many more years of training I have to get through before I'll be able to do anything to a patient without supervision! I'm just glad that I didn't laugh in front of them though, because I don't know how I would have been able to explain that I wasn't really laughing at THEM.
I am dead tired. There is a CCF cruise on the Cuyahoga River this weekend, but I'm not going to go. I have too much work to do. Plus, since it's on Sunday night, with my luck, I'll wind up having to get up at 5 AM on Monday for our next patient. It's bad enough to be this tired on Friday, but I don't really want to start out the whole week feeling like this.