Wednesday, May 5, 2010


Posted by Shannon Hough at Wednesday, May 05, 2010

What kind of health care professional gets "woozy" just looking at slides of blood and guts?! In the beginning of pharmacy school I had the hardest time even looking at pictures depicting certain pathologies. I even taped together those color pictures in the center of my DiPiro text book because the book always fell open to them! During my P3 rotation in the ICU at Sinai Grace with alumnus Jim Miller, PharmD, I had to leave rounds at the sight of blood. I also practically hit the floor in the operating room on the same rotation.

Needless to say, when my current preceptor — Larry Diamond, PharmD, Oakwood Hospital — asked me if I'd like to go with him into the operating room to observe an open-heart surgery: a 3-vessel, coronary artery bypass graft (CABG), I was a little nervous. At first, I said that I'd have to think about it. He understood, and we went about our day.

The rest of our day consisted of following up on recommendations with a few cardiologists. We managed to find one physician later in the afternoon in the cath lab. Here, patients undergo catheterization of the coronary arteries. (That's a procedure that allows a physician to determine how occluded the vessels are, as well as perform angioplasty and/or place stents.) At Oakwood, the patient, the cardiologist, and only a few other health care professionals are present in the room at the time of the procedure. However, there is a large viewing window right outside the room, equipped with a microphone and closed-circuit TV screen, where the catheterization can be observed. I was amazed to see the procedure, visualizing the blockages and placing the stents. It was so cool to watch, that I didn't notice that....THERE WAS BLOOD!

This morning, I told Dr. Diamond that I'd like to join him in the operating room for the afternoon CABG case. The patient was part of a clinical trial, where he would receive a drug or placebo during the surgery and monitored for mortality outcomes. My preceptor was the only person unblinded as to whether the patient received drug or placebo, and stays for the surgery cases in case any questions arise. So after changing into scrubs, we spent the rest of the afternoon in the operating room. And it was awesome! It was really neat to see the vessels used in the bypass, being harvested; the heart/lung machine; and all of the drugs used by the anesthesiologist. But the coolest part was seeing a real beating heart! (And not ending up on the floor of course!)