Monday, June 25, 2012

Frank He_Week 3

Friday mornings typically consist of Grand Rounds; a series of lectures, conferences, and group meetings that intend to inform the Orthopaedics staff of the current cases and educate the fellows on scientific topics that might prove useful in the clinic. These are excellent opportunities for me to really immerse myself into the type of discussions that doctors are having about their patients and how they are using newly discovered scientific knowledge in the clinical space. Overall I am very impressed by the basic science expertise of some of these doctors, especially the attending Patrick Boyland, who has given several lectures on bone metastasis already. I also really enjoy the team dynamic at these meetings; a casual professionalism that borders on a semi-collegial feel that encourages free-flowing exchanges between everyone in the group.

I've already been involved in several situations in which I have realized it is mutually beneficial for basic scientists and clinicians to interact. One particularly memorable moment was at the Pathology Conference last week, when we were looking at case studies of bone sarcomas. The doctors there were talking about how a second primary might arise elsewhere in the body, to which I asked if it were possible to tell to discriminate between a second primary and a tertiary metastasis. The lecturer just stared at me, kind of dumbstruck, obviously never had previously considered the possibility before. Finally one of the fellows responded: "it's just not clinically standard terminology." But I told them that it is a scientifically acceptable concept, and more than reasonable to anticipate sequential metastatic events since the cells are already primed to migrate from one site to another. The lesson here is that I've become increasingly aware of the fact that the practice of Medicine is in actuality very much conservative and it is extremely difficult to get doctors to adopt new scientific developments, especially if they haven't received formal scientific training. However, I can see why it is valuable to be more conservative, especially considering the scientific fraudulence that is disappointingly widespread in the global scientific community.

It is my hope that one day scientists and clinicians can really work side-by-side to tackle the issues lying forward, just like how engineers and biologists are starting to truly engage with one another in the newly emerging world of Biomedicine and Genomics.

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