Trust me, I'm a Brain Surgeon.

This has been pretty much a lazy week in preparation for my weekend in Brussels.

On Monday, I had to run a few errands that resulted in me going back to a tea place in north London named Yumchaa. It is a hipster tea place that reminds me of New York for some weird reason. It is super hipster with UCL kids all around doing work. The best part about tea places here is that when you buy a pot (usual with leaves instead of a bag) they give you free water refills. It doesn’t seem like a big deal, but it results in 2 hour-long tea sessions and you only pay like 3.50 pounds for it.

At Yumchaa I did some work aaaaand here is some proof.

Tea, Lunch, & MCAT

The next big thing of my week was going to the Old Operating Theatre in south London. Basically, back in the day (19C) when anatomy schools didn’t really exist, in order for surgeons to learn the trade they had to observe others doing it. This resulted in operating theaters. The theatre is almost like an amphitheater with a table in the middle where the patient would lay. From there, the poor and destitute who needed surgery, but couldn’t pay for a personal doctor, would go to the medical school and offer up their broken bone as a lesson. A lot of the times if a bone was broken it would result in an infection, so to prevent this the leg or arm would be amputated. The amputation was really just as dangerous as the infection since the theater is the dirtiest place ever.

They would lay the patient down on the table as doctors would stand around and watch. Since there was no anesthesia, the trick of surgery was doing it as fast as possible. The most skilled surgeons were those who could do it the quickest. On our tour, one of the kids in my class got to go down to the middle, lie on the table, and pretend to be a patient getting their leg amputated. From there, the tour guide pulled out the knives they used back in the day and showed the different techniques. They were obviously crude, septic, and extremely painful. To give you an idea on how unsterile the surgery was, they would wrap the final wound up with cloth that was just ripped up used bed sheets from the hospital! If you survived the surgery, the blood loss, and shock then you still had to fight for your life as there was in a 1 in 3 chance of survival. It ain’t lookin’ too good. The tour guide said that one doctor in the 1800s could take off an arm in 17 seconds! This was obviously all done before germ theory was founded and doctors had no idea what caused infection. But still, it makes you appreciate modern medicine and sterile environments.

The operating Theatre

Classmate getting her skin 'cut open'

Classmate getting the bone cut through.

Various knives used in the 19C.

Medical kit from 19C

Today, I got to sit in on open-heart surgery. Let me just say, it was breath taking. I had to wake up at 6:30 AM to make it on time to the office, which now is just too early for my existing properly. One thing that is weird is that this surgery office is a part of the NHS and Guy’s Hospital….but it’s not in a hospital. It is its own personal building. It is almost like where my dad does his cataract surgery, but the surgeries done there are not really outpatient ones. The office does gyno, thorax, and heart surgeries, which obviously requires a couple days of recovery and I did not see any rooms to keep the patients?

Another girl from my health and society class were going to sit in on the surgery, so we got suited up and then waited for an hour until everything was set. We got to watch the 16-year-old boy get put to sleep and watch as the nurses and anesthesiologist work at him, putting in all the IVs and tubes.

The surgery that was going to be done is called the Ross Procedure, named after Dr. Donald Ross who actually worked and founded the procedure at Guy’s Hospital London in the 1960s!  The patient was born with a faulty aorta, which caused his heart to overcompensate and enlarge. The Ross procedure is a pulmonary autograft, which means the aortic valve is replaced with the patient’s own pulmonary valve. Then another pulmonary valve (taken from a donor or an artificial one) is put in to replace the old pulmonary valve. The procedure is mostly done in children since it lasts longer. The doctors were saying this procedure is becoming more popular since you can’t sue the medical companies for faulty valves.

The girl and I got to literally be up close and personal with the patient and doctors. We were standing at the patient’s head looking over him to view the surgery. Seeing the doctors saw open the chest and cut the peritoneum to heart is truly breathtaking. Seeing the heart work is just amazing. In order to operate, the doctors had to stop the heart so we got to see the potassium slow down the heart until it was no longer beating. The blood was flowing through the heart/lungs machine, which took blood from the vena cava, oxygenated it, and then sent it back into the body. It is weird to think that the boy was conventionally ‘dead’ in front of me, as he was no longer breathing and his heart was not beating.

The weirdest thing for me was learning that the machine that kept the boy alive was also cooling his blood and making him cold. Almost how we freeze meat to preserve it, they were cooling the boy's body temperature to preserve him. The doctor told me to touch my forehead, which is the proper 98 degrees, and then touch the boy's. He was freezing! It turns out his body was almost 10-15 degrees colder than a normal persons. Creepy.

A couple notes on this is that after seeing surgeries in the states, compared to this, I felt like this was a very unsterile environment. At home, even though I wasn’t participating in the surgery, I still needed to scrub in and wear gloves. Well…in the heart surgery I did neither and half the nurses in there weren’t either. Moreover, people were walking around with their coffee and were texting! Whaa?! Big change.

I learned today that I do not think I could ever be a surgeon….well a heart surgeon. I have little patience, there is no human interaction, and I cannot stand on my feet for 4 hours at a time. Seeing the doctor stitch the valve into place at a pain staking pace made me realize that I am not delicate enough and not that good at sewing (8^th grade Home Ec did not pay off). I mean, I can see why surgeons are haughty because they literally do magic for a living. They kill a man, rebuild his heart, and then bring him back to life. It was weird though seeing the doctors during the surgery joke around and talk as the boy was lying cut open in front of us. I mean…they didn’t look worried, but it was almost like they forgot that the body in front of them was real. I guess that is good since it doesn’t make you too attached or stressed, but it is just a weird atmosphere. On a lighter note, the doctors were super helpful and went out of their way to explain every step and machine to us. Thank you doctor for explaining the procedure to us, as you cut out someone’s pulmonary valve at the same time. Very impressive.

[Side note: If I WERE to do surgery, it would most definitely be orthopedics. It is a nice combination of athletics and medicine and it would give me a reason to keep on lifting after college…right?]

After surgery, I met up a friend at Strand and we went to the Somerset House Courtauld Institute Galleries. We were afraid that we would need to pay, but alas, it was free to UK students! We are super lucky. I loved this small museum. It had Van Gough, Degas, Seurat, Monet, Cezanne, and Mondrian. You know that famous self-portrait of Van Gough when his ear was cut off? Yeah, this place has it. And the building was gorgeous itself. I caught myself looking at the ceiling just as much as the actual paintings.

Somerset House

A flower exhibit in front of the Somerset House

Ceiling on the gallery.

Inside the Courtauld Gallery 

From there, we tried to go on the Belfast, which is the Royal Navy ship docked in front of Tower Bridge, but we found out that you could not get a tour of it. Oops! Rejected, my friend and I got tea and scones in Borough Market. One thing that the Brits have here and we don’t get at home is the clotted cream! When you have scones, you always have clotted cream, which is just heaven on earth. I can’t even describe it. I am going to try to bring some home and spread it to the masses.

Here is wikipedia’s account of it:

“Clotted cream (sometimes called clouted cream or Devonshire cream) is a thick cream made by indirectly heating full-cream cow's milk using steam or a water bath and then leaving it in shallow pans to cool slowly. During this time, the cream content rises to the surface and forms 'clots' or 'clouts'. It forms an essential part of a cream tea.”

The Belfast.

The Belfast.

Tea, Scones, and Clotted Cream

Well, anyway London is GORGEOUS in London today. It is the perfect temperature and everyone is out and about enjoying it. I love London right now.

Tomorrow I have a lab for my physiology of exercise class that requires me to not only give blood, but also to exercise so they can measure my pO2 and pCO2. Wish me luck!