My first surgical shadow

With all the COVID excitement going on around here, I haven’t had the chance to share my experience about one of the coolest things I’ve had the chance to do thus far in my career! Since starting my PhD I feel like I’ve had all sorts of interesting experiences and while they haven’t helped me publish anything, I’ve learned a lot. Making a jump across fields like I did (design engineering to neural engineering) has had a steep learning curve from the start, but almost three years in and I’m feeling good about the decision.

Publish or perish, that’s the rule around these parts. In science in general if you don’t publish then what are you even doing? I’ve got several first author journal publications in the works, a book chapter I helped author, at least one first author conference paper, a possible first co-author publication (not sure where I fall with that one actually), and a few second author publications in engineering design from my mentoring duties. Yet none of that matters because they aren’t published yet, hopefully that changes soon, but there’s been a lot of setbacks, errors, and of course COVID.

So to make the most of a sticky situation I’ve somehow managed to get a whole heck of a lot of experience in doing other things. I’ve written one NIH small grant and I’m starting a second NIH R21 grant now. And I just was informed that I’m about to write a postdoc/senior PhD student K99/R00 grant. At this point I think my main PI and Co-PI are conspiring to see just how much writing I can do before my fingers and eyes start to bleed. It’s been a lot to say the least, but I’ve also had a ton of experiences that I wouldn’t had if I hadn’t moved across the country to start at the university I’m at now.

Which brings us to the point of today’s post, yes believe it or not complaining about my lack of published writing was not the point. The point is I had the chance to do something I felt was incredible. It was the first time I got to go into surgery without being the person on the table. For those who don’t know me I’ve had two surgeries every year for the past four years. I thought COVID would break that streak, but it did not. This was the first time I got to be fully awake while a surgery was being performed (not on me thankfully).

There were several this past week that I could choose from, or really I had to select one that didn’t interfere with my schedule. The one I sat in on was a spinal fusion, two different levels of the lumbar spine were fused, L1/L2 and L2/L3 if I recall correctly. Unfortunately for me, that was the day after my COVID vaccine and well… I already discussed how that felt. Still, it didn’t dampen my excitement to be there. Since my research with my CO-PI primarily involves neurophysiology I was shadowing an, you guessed it, neurophysiologist.

Overall the experience was amazing, the surgeons and nurses all made me feel welcomed. The tech I was shadowing answered all of my questions and then some! While I didn’t get to help with anything, since I am not qualified, I still got to be right at the table watching everything get prepped and got to see the spinal fusion performed for both levels while they monitored the nerve responses. The person I was shadowing had been doing it for roughly six years, but she said she understood my excitement and still remembered the first time she went into the OR, so it was nice to be told my level of excitement was normal.

Learning how they do invasive monitoring was important for my research because making sense of non-invasive data can be hard due to the small amplitude and the environmental/biological noise that contaminate the recordings we do. Being able to see what the responses look like at the nerves and in the brain without the contamination, or rather a larger signal to noise ratio, gave me a chance to make sure the data I had made sense. It also let me know the limitations of what they are doing and how they interpret things.

That last part is important because as a academic researcher we can be so far removed from the clinical side that the stuff we’re researching has no clinical use currently (it may in months, years, or even never unfortunately), but the application of research isn’t the only reason to do it. I mean we won’t be able to “practically apply” a lot of research, but we do it to expand our knowledge of the way our universe works and it may have use someday. I want my research to be used now though, so for that reason I’m trying to split my time between academic research and clinical research. Frankly, it’s more like 90% clinical and 10% academic at this point and I’m perfectly fine with that.

Having the chance to directly interact with the people I want to help informs my decision making about how I try to improve their quality of life. Ever see crazy wheelchair designs? Wheelchairs that can drive up stairs and the such? Those are amazing feats of engineering that are completely garbage to the user (see the gif below of the chair in action). I say this having used a wheelchair for a period of time myself and all I learned from that experience was that I don’t know how to best help the end user without getting their input.

The problem with that chair and a lot of them that are designed is multifaceted. In this case (the one shown above) there is no front wheel so when the chair dies what happens to the user? The size of the chair is another issue. It’s too high up for one. The size is the biggest issue (no pun intended) here, there is no way you get that thing into a bus, store, or even a house. Normal sized wheelchairs half the time can’t fit into stores or homes, and buses barely have room for them. This monster? No chance.

That’s the difference between academic research and clinical research. Had they consulted with wheelchair users they would’ve known the problem right away. As a mentor I try to pass on one piece of important advice, always design for what the end user wants. You can have the greatest engineering idea ever, if the end user hates it, it’s a crap idea. The simple answer for stairs by the way, build fucking ramps. Normal ramps too, none of that crazy integrated into the stairs artistic crap, those things are deadly to wheelchair users, which again, had wheelchair users been consulted the designers would know that.

Anyway all this to say that I try to practice what I preach and that was the whole reason I started working with spinal cord injury populations to begin with, to engineer what they ACTUALLY need, not what I think they need. The surgery gave me the otherside of that equation though. It helped me understand what the neurologists need and what would be useful for them to be able to help the patients they see. It was a great experience and my Co-PI is already suggesting that I sit in on some more when they have special cases, so we may be coordinating with the surgical department again here in the near future. From a research point of view, this year is already turning out to be pretty amazing!