Luke - Boston Medical Center

Lucas Pasch – Blog Entree
Medical Internship

I enrolled into CE Internships to get a better perspective of what medicine has to offer. It has been my intent to follow an educational path to medicine for many years now, and I have participated in many extra-curricular activities to confirm my interest in that field. Last summer, I attended the National Youth Leadership Forum on Medicine at Babson College and sat in on “med sessions” taught by some of the leading physicians in this country. I also enrolled in mini-medical school at UMDNJ this past spring. While these experiences have been instrumental in my path towards M.D., I still lack insight to everyday life of physicians in hospitals, operating rooms, private practices, or wherever else my future takes me.


This was until I learned that a month-long internship at Boston Medical Center was a quick application away. It wasn’t long before I met Carol Daly R.N., my advisor in the Menino Pavilion of the expansive BMC campus. Because of her interest in preserving the teaching facilities of BMC, Carol is always happy to set up Shawn (my CE co-worker) and I with our interests in the medical field. On the first day of work, she told us to go home and think of everything it is we would like to experience in the ensuing month. So I went home and called my mother, a registered nurse herself, and asked her to tell me what I was interested in. I created a vast list of specialists I would like to shadow, from neurologists to oncologists, and a greater list of surgeries to view, from appendectomies to spinal fusions. Carol was thrilled to see such a list of interests, as she was eager to get me going on the learning process.


So now, the meat of this blog entry… I was talking to Todd one day after work last Monday about a gruesome gall bladder removal that I scrubbed in to observe. He paused me halfway through the story and said, “Whoa whoa whoa….stop right there….just write all this on the blog,” or some variation of that. So here it goes.


I walked in as they were prepping a patient for gall bladder removal. A first year resident, better known as that “know-it-all intern fresh out of med school”, was also standing off to the side explaining the surgery to me step by step. The two surgeons began be going in laparoscopically, meaning there were three minimally invasive incisions: one near the belly button and two further up and to the right near the gall bladder. They stuck a camera into the incision near the belly button and clasping utensils in the other two. The camera in the first incision was used to produce video footage on the television monitors of what they were doing with the tools in the other two incisions. However, to the surgeon’s dismay, the gall bladder was far too bloated and inflamed to be removed through the tiny openings in the belly. So, he was forced to redo the procedure the old fashioned way. He proceeded to remove his laparoscopic equipment and started over with an incision that ran from just below the rib cage all the way down near the belly button. Now please note that if you get queasy from gore, it’s tough to explicitly state what I witnessed in the operating room from that point forward without being incredibly gruesome. Considering the patient was overweight, the operation was not easy. The surgeon had to turn off the boom box playing in the back of the room to fully focus on cutting through many layers of tissues and fat and into the abdominal cavity. After working diligently for another 25-30 minutes, he used tweezers to remove a massive gallstone. The surgeon held it in front of his eyes and chuckled for a few seconds. It wasn’t until after the surgery that the intern explained to me that the size of your average gallstone is a couple centimeters in diameter, while this one was about the size of the pit of a peach. To put it in perspective, you could only imagine how much pain the patient was in leading up to the surgery.


Well that was one case…and I’m hungry for more.