On Monday, we went to
the hospital to observe surgeries. I was assigned to see an orthopedic surgery.
I was excited because it would give me a glimpse of what a patient's body goes
through before they come to physical therapy. I ended up observing a scoliosis
surgery. The surgery was nine hours long from the time the patient went under
to when she woke up. Scoliosis surgeries are normally long; however, this one
was particularly long because the patient had had the surgery previously, so
the surgeons had to remove the old pins before putting in new screws. For the
first part, I really enjoyed observing the procedure. The anesthesiologist
explained everything that he was doing and answered my questions. The surgeon
was singing, and they were all making jokes. The anesthesiologist made sure
that I left periodically to drink or eat something. In the middle of the
surgery, I suddenly got nauseous and dizzy, so I left the hospital completely.
After resting and eating, I felt up to going back to at least tell the doctors
that I was leaving. I ended up everything the rest of the procedure. It was
amazing. The doctors used a lot of technology to monitor the patient. The
anesthesiologist did blood tests periodically to see what kinds of fluids the
patient needed. He also monitored the patient's muscle tension. He did this with
a sensor that was in the patient's hand. A small shock was administered to the
patient's forearm. Then, the sensor would read if the patient's hand clenched,
and how hard the hand clenched. This data gave the percentage muscle tension.
The patient had to be given muscle relaxant regularly so that the surgeons
could access the spine easily. They had a machine that filtered and
cleaned the blood and fluids removed from the surgery site so that the blood
could be transfused back into the patient! Two of the patient's disks had to be
fused during the procedure. In order to fuse the disks, the surgeon replaced
them with titanium. The titanium had pieces of the patient’s bones from the
removed disks in them. The bone served as a graft that would help the body form
new bone where the disk was removed. I was amazed at how much the surgeons were
able to reuse from what was removed during the surgery! It was very efficient.
The surgeon was training a student, so they took a lot of x-rays to make sure
things were going in the right places. I enjoyed seeing all of the pictures. We
all had to wear lead tunics to protect from the x-rays. We also had to wear
runner shoes that were sterilized. So, you can imagine that after standing for
eight hours (at least) in uncomfortable shoes while wearing a heavy tunic all
while trying to comprehend what everyone was saying in German, I was exhausted
by the time I got home. I was proud of my German comprehension though!
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| Obligatory scrubs selfie! |
On Tuesday, I bought
stereotypical German stuff! Andrea and I went to the Haribo store in Bonn. We
each got a bag and filled them with assorted gummy candies. I got a ridiculous
amount of candy considering I don't usually like gummies that much. Oops. But I
must say, Haribo gummies are pretty good! I also only spent 4 euro, so I think
it is okay. After class, Mary-Cate, Andrea, and I went to the Birkinstocks
outlet. It was about an hour away from Bonn. I really didn't expect to find
anything I wanted to buy. I was pleasantly surprised to find a pair that I
really likes. I was even more pleased to find out that they cost less than half
of what they cost in the US. Well, needless to say, I bought them. I am happy
to report that I wore them on the twenty-minute walk back to the train with no
problems!
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| So much candy! |
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| Mary-Cate and I got the same Birks! |
Also on Tuesday, we had
our last pharmacology class. We talked about how doctors find information on
drugs. Specifically, we discussed evidence based medicine. I incorrectly
assumed that all medicine was evidence based. Apparently, the shift from expert
based medicine to evidence based medicine is an ongoing one.
We learned
about the history of anesthesia in history of medicine this week. Ether was the first widely used anesthetic, and it was
administered for short surgeries starting in the 1800s. At that time, doctors
would soak a sponge in either before putting it over a patient's mouth. The
ether would then aerosolize and anesthetize the patient… and the surgeons.
Oops. On Thursday, we visited a museum dedicated to the history of
anesthesiology. The museum is part of the Bonn University Medical School
complex. We got to meet the founder and curator before Dr. Wasser guided our
tour through the museum. We saw everything from the glass devices that were
used to soak sponges in ether, the first anesthetic, to a machine that
administers anesthesia automatically based on the patient’s vital symptoms and
brain waves. We also saw many nebulizers from through the ages. I thought that
was particularly funny because I was trying to get one myself that morning. The
museum had an iron lung on display. Apparently, polio patients who were in iron
lungs could temporarily wear a portable device to help them breath. I mean, portable,
but still really bulky. We saw a glass tube with what was meant to be a
portable blood transfusion. It was carried by Soviet soldiers during WWII, but
Dr. Wasser didn't know of it actually worked. We also saw a dart gun from an
African tribe. Apparently, the muscle relaxant on the darts comes from
poisonous frogs. The frogs themselves are produce their toxins from the folic
acids in the ants they eat. This means that the frogs in captivity are much
less poisonous or possibly not poisonous at all!
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| This was used to administer ether anesthesia in 1846 |
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| Equipment from a 20th century operating room |
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| Mandrake root |
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| The iron lung |
We
discussed the Nazi Extermination Program and subsequent doctor’s trials this
week. They are an important part of history that I didn’t know very much about
prior to our lectures. While these lectures were much heavier than our normal
ones, I think it is important that we learned about this time in history. Everyone
should know about it, but I think it is especially important as future medical
professionals since so many doctors turned a blind eye while their patients
were bussed away to be killed.
On Wednesday
afternoon, we returned to Cologne. My group
went to do the cathedral tour. The cathedral towers are 157 meters tall. It was
built starting in the 1200s and then finishing in 1880 (after a long hiatus).
The ages of the different parts of the cathedral could be identified by the
type of stone they were made of. The original stone came from a local quarry
that was turned into a protected natural area. Builders later used sandstone
and limestone, but these softer stones are more easily damaged by acid rain.
The cathedral is being repaired with the original type of stone from a
different quarry. We went up the cathedral in stages. This gave us the
opportunity to really appreciate how high we were by the end. It also gave us a
view of the interior of the cathedral from above, which allowed us to see the
organist. After the tour, we wandered for a while. We needed to find somewhere
I could eat inside since my lungs aren't happy. Eventually, we decided on Hard
Rock Cafe. It was silly and overpriced, but we had all hit the wall and needed
to eat. I had the best burger I had ever had there. It tasted so good! They
even had a good quality gluten free bun for me. It was seriously delicious. I
mean, yes, I was famished and anything would taste good, but I really enjoyed
that burger.
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| Here you can see a gargoyle and the different stone colors and types used for the cathedral construction |
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| One of the two towers that are 157 meters tal |
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| So many flying buttresses |
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| The organist! |
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| Here you can see the entire length of the interior of the cathedral |
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| The best burger ever |
After a weekend in Amsterdam and a
day in Cologne, my asthma was really acting up. It was so bad that my rescue
inhaler was not helping. So, my firsthand experience with the German healthcare
system. I went to see and ENT with Katarina, a student
worker. She translated all of the forms while I filled them out. Then, we went
in to talk to the doctor. She was amazed at how much medicine I am already on
for my asthma. The doctor ended up prescribing a nebulizer for me since I could
not get in to see another doctor. Now, I am feeling significantly better!
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| Look at my snazzy new nebulizer |
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