Week 4- "Scalpel Bitte" my last week in Bonn

My sister, "Cardiac Girl", the most inspiring superhero.

I am shocked that this is my last full week here in Bonn. It's only Wednesday and it has flown by. Monday we shadowed at the UniClinic here, and I was blown away. First of all, if you would have asked me 3 years ago if I would be a doctor I would have said absolutely no way. But, I fell in love with science, and saw how medicine can impact the lives of my loved ones, especially my sweet little sister.
I don't feel like I chose medicine, but as I ran away from it, medicine chased after me and snatched me up- or I guess "chose me". Over time, I've really grown comfortable with the pursuit of an MD and I couldn't see myself spending my time, talent, and effort doing anything else. Last week I was sitting on the shore of the North Sea having a conversation with a friend who wants to go into surgery and spoke the words "no I wouldn't be a surgeon," without even giving it a chance or any thought.

Gigs with the roomie.

Monday was different. If we exclude parts of a C-section, then I would say that I had not yet seen a surgery before. I got to see a 7 hr long hip replacement and a few other surgeries and I was ecstatic. It didn't even feel like 7 hours! Orthopedics was the most fascinating and incredible thing I have ever seen ever. The surgeons made a large incision on this man's leg and started cauterizing and drilling away. The patient was older, had heart problems, and lost over 2 liters of blood- needless to say the surgery was complicated and the patient's blood pressure was a low-riding roller coaster. The anesthesiologist handled it very well, but you could visibly see his stress by the amount he sweat through his scrubs. The head surgeon was worried that they would need to order a custom piece, meaning they would have to do a second operation, but the patient was not stable at all and it would be risky to open him up again. So there was a lot of trial and error on what piece would fit and the surgeon would hammer in various different parts sequentially. Any time he would hammer a new metal piece in to see if it would fit, some blood would go flying or squirt up. They got covered in it. I was standing about 6 feet away or more by the wall, but at on point I even got it with a few drops myself. It was amazing to see the surgeons at work, and the teamwork between the scrub nurses, the various levels of surgeons, and the anesthesia team. It was even more amazing to see the intricacy of the human body and how it truly is a mixture of science and miracle. I was blown away. After that day I will most definitely be looking more into a career as a surgeon, but no commitments just yet.

Arrival at the Clinic

Two other things. I cannot imagine how hard it was to get 30 students cleared for shadowing so thank you so much Dr. Wasser & AIB. Second thing, all of the patients I saw were men in their 80s. Germans are on average way more active and fit than Americans, and during the case I just described I couldn't help but think that if it were an average 88 year old American then the patient would not have made it through. With the combination of obesity and diabetes alongside with many organ system and circulatory issues it is hard to imagine the outcome. The German nation however is one of countries with a large rise in obesity, nevertheless they have taught me a lesson. Take very good care of your body.

Historical operating room, Anesthesia Museum

Tuesday we started class at 14:00 so I slept from 18:00-22:30 Monday evening and then from 2-10:30 Tuesday morning. I usually hibernate on the weekends, but since we have been traveling every weekend I haven't had the chance. It was fantastic to get some rest. Class was really fun and engaging as usual, but it was bittersweet because it was the last in-person class we will have with our beloved Dr. Fajt. She was an awesome instructor and I wish all of our classes could be like the ones this summer- traveling with our professors, going on adventures with them, and laughing with them. It has been a true privilege.

Wednesday we had our long lost history of medicine sit-down traditional lectures again. Today was a heavy day. We had two lectures, and they were about the evolution of Anesthesia and about how different ideologies post-WW1 allowed for the acceptance of Nazi policies and the horrors of Nazi medical practices and eugenics. What really hit me were the practices of forced sterilization (which was very common to many countries at the time including the US), and the euthanizing of those with a genetic disease or a mental illness. It broke my heart and nearly brought me to tears hearing about the physicians who specialized in euthanasia of children. I don't think it would be as real if it wasn't taught by Dr. Wasser who is as knowledgeable and passionate as it comes, and it wouldn't be the same learning this back in the states. Being here and living in Germany it makes it easier to process so harder to learn more about. There is something profound about being in the place where it all happened- it feels different, deeper.

Anesthesia Museum, Obstetrics Collection

The rest of our day was spent on an excursion to Cologne to tour the top of the Dom Cathedral. First of all I have very few fears, second of all heights is one of them. Well, I braved the creaky service elevator, the numerous steep spiral staircases, the walks across (basically) ledges on the sides of the cathedral, and finally to the top to the wonderful breeze and neat view of the Rhine and the entire city of Cologne. Many eye witnesses can confirm hysterical tears as we walked across this glorified pirate-plank to the death cage of an elevator and rode it down to the sweet heavenly earth. The tour guide was super cool and taught us about the different materials used to build the different parts of the cathedral depending on the availability and the time period that were building in. It was crazy that they made the plans for this massive architectural feat all the way back in the 1200s.

Reaching the top of the Cologne Cathedral

Thursday we had the privileged to meet a living artifact at the Horst Stoeckel Anesthesia Museum. Dr. Stoeckel himself. It was really cool to get a tour of the museum and to learn about the history of the instruments, and the physiology of how many of them aided or harmed a patient. In some cases, like in 1846 when Thomas Morton introduced ether as one of the first analgesics, the medicine would nearly knock out the surgical team along with the patient. It was incredible to see how far we come in such little time. Another interesting thing was that, as we learned in class, women were believed to require the pains of child birth or even deserved it, so when the epidural was first suggested many physicians thought it was blasphemous. God bless modern medicine. Truly. Congrats, you survived to the end of the post. Message me for your prize.

"Iron Lung", a device that lowers the air pressure to allow patients to breathe easier.