Week 4 Jingwei Zhang

          Last Friday, I observed complete mastectomy and breast reconstruction with Peter. Two pieces of fat tissues with artery and vein, identical in size, weight and shape, were resected from patient’s abdomen.  The tissues were stored in plastic bag for breast reconstruction later. After mastectomy, micro-surgery was performed to connect the artery and vein to the fat tissues, followed by further shaping and removal of excess skin. Doppler was used to ensure blood flow in the implanted tissues. However, the Doppler used was not very sophisticated. SNR was low. We failed to pick up any sign of blood flow in the left breast through skin, despite the obvious pulsing motion from the upstream artery and the Doppler sound from the downstream vein. This incident led to re-opening of the left breast and another hour of operation under microscope. The ultra-sensitive Doppler probe with the size of a thin wire was implanted as the final resolve so doctors could ensure appropriate blood flow for the next few weeks. The Doppler used in the surgical room has a lot of room and needs for improvement.    

          I spent a few days in the ER room Area C. On Tuesday, an aged patient was at the critical stage. He had hypertension, diabetics, and some forms of cancer. His chest cavity was filled with air, preventing him from breathing. He also underwent cardiac arrest. Doctors performed CPR on him for more than 10 minutes, which eventually brought him back. A tube was inserted into his chest cavity to release air pressure for better breathing. He later was moved to medical ICU. His wife was there watching the whole time, praying for him. As the condition of the patient finally became stable, she broke into tears and thanked the doctors and nurses. It makes me realize two things: what makes a doctor a doctor, and what makes a biomedical engineer a biomedical engineer.