It's time again for a round of "What has Taylor been doing this week?" I'll have to start with last weekend.
I told you in a prior post that I signed up for a Whale Watching tour. Let's get some trivia out of the way, first. Dominica lies on the boundary of two tectonic plates: the Caribbean plate and the South American plate. This boundary is the site of a subduction zone; that is, the Caribbean plate is moving east and meeting the South American plate, and as they approach, the crust of the Caribbean plate is forced down beneath that of the South American plate, which hits the Caribbean plate and is forced up. This subduction zone is the whole reason why the islands of the Lesser Antilles (including Dominica) even exist! I'll talk about that a little more in a future post. Anyway, all of this takes place in very deep water - about 2 km deep not far off the coast of Dominica. This depth is awesome for big whales, which like deep waters to fish and play in. Supposedly, species like sperm whales and even whale sharks will spend a lot of time in the deep waters off the western coast of Dominica.
The tour started at 9am, and about 50 of us took off on a about a 50-foot twin hull vessel. It was a beautiful day, but no whales. These guys told us that they see whales on these tours about 95% of the time, but we batted a big fat .000. The nice thing is that I got some good pictures of the island from the boat. I'll load them onto my me.com gallery, and put the link up later this week.
Classes are going fine. There's a lot of up and down in the quality of lectures, mostly because the lectures are given by different professors a lot of the time. It really varies. We've only had a single histology lecturer so far, but we've had 4 biochemistry lecturers in only 2 weeks!
My first exam is coming up in about 2 weeks, and we have a day off today, so I'll be studying. All. Day. Long. Exciting, right? I was afraid this would happen: the blog would start off all adventure-laden and fun, and then the reality of medical school would come crashing down upon us all, blogger and reader alike. Not so, my friends! I haven't even told you about Anatomy Lab this week!
So, there are about a million students in my class, and we have to be subdivided into 3 lab sections. I'm in Group C, so my first dissection was the latest. Group A dissected the superficial and deep muscles of the back, Group B did the suboccipital triangle, and we as Group C were supposed to perform a thoracolumbar laminectomy to reveal the spinal cord and meninges. I was excited, because the laminectomy is a procedure that is performed on live humans! It has also garnered a lot of attention recently with the treatment of Buffalo Bills tight end Kevin Everett - he received a nasty blow during a game against the Miami Dolphins, and to take pressure off of his swelling spinal cord, physicians induced a mild hypothermia, administered methylprednisolone (an anti-inflammatory steroid), and did a laminectomy. Well, things started out pretty poorly - we weren't properly instructed on how to remove the deep muscle layer to expose the vertebral laminae, and so that part was really slow-going, and the cadaver got pretty beat up. In fact, I was feeling pretty inhumane before we even got to the next part: we had to use a chisel to cut through the laminae. Unfortunately, we severely overestimated the size of our patient's vertebral canal, and made cuts that were too vertical and too lateral. We got really far behind as we tried to correct this, but we had already cut through almost every spinal nerve he had. We didn't get far enough inferiorly on the cord, so we couldn't demonstrate the end of the dural sac. We only barely showed the cauda equina and conus medullaris. And, in the end, the video we produced was pretty shoddy, because I was doing the speaking and pointing, and I didn't know we were recording. So, in the middle of the video, I said, "wait, Khalid, have you been taping this the whole time? Oh, uhhhh, HERE you can see a dorsal root ganglion..."
All in all, if he hadn't been delivered to us in his current state, we would have lost him on the operating table. Gotta do better next time.
Until then, guys & dolls, take care! Pictures to be posted later this week!
EDIT: Quick note on Kevin Everett. The hypothermia may not have been "mild," as I described it. It appears that he was intravenously injected with ice-cold saline, according to the wikipedia entry under his name. The anti-inflammatory agent he was treated with WAS methylprednisolone, according to an NPR Science Friday interview from September 14, 2007. The same interview described the surgical treatment on him, though, as "decompression" of the spinal cord; it may not have been a laminectomy. Laminectomies, however, are performed on patients suffering lumbar spinal stenosis, as a means of alleviating pressure on the spinal cord arising from the narrowing of the vertebral canal in the lumbar region.
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