And There Goes the Amygdala

Last Thursday, I had the amazing opportunity to view two surgeries at the Neuro Clinic up at the Bonn Uniklinic.  With all the studying and test taking going on, it was refreshing to get out and get a glimpse of what I am trying to work towards. 

                Collin and I arrived at the clinic around 7:30 in order to meet up with Dr. Podlager, the doctor that would be showing us around that day.  When doctor Podlager came in, we were extremely surprised that he appeared to be no older than 30.  I myself was expecting someone more seasoned, so it was pretty cool to get to talk to a neurosurgeon that’s not a whole lot older than we are. 

                For the next 45 minutes, Dr. Podlager went over his day to day routine.  I was surprised again when he said that surgery is pretty much an 8-6 job there, with the occasional emergency case.  I was expecting crazier hours I suppose, but it was interesting to find out differently.  Doctor Podlager then took us to change for the surgeries.  After we were changed into our scrubs and weird clog/crock shoes, he toured us around the different OR’s before depositing us in the OR where the day’s first surgery would take place.

                The first surgery we watched was the removal of a pituitary adenoma.  Basically, the patient had a pituitary tumor that was pressing down on her ocular nerve and was causing her to slowly go blind.  In order to remove the tumor, the surgeon had to go up through the nose and then through the sphenoid sinus to access it.  First the surgeon showed us some X-rays and talked about how he would approach the tumor.  It was really cool to see the growth on the X-ray since we learned a little bit about how those images are produced.  After telling us his plan, the surgeon then proceeded with the surgery.  First, he made an incision on the inside of the patient’s nose, and then basically cut his way up to the brain.  It was amazing how much septum he removed.  It seems to me that it might be weird for the patient afterwards to basically have a hole from his nose to his brain, but I guess that’s not all that important.  Anyway, when he finally got to the tumor, the whole tumor removal was a lot less calculated than what I thought it would be.  Basically, he said, “If it’s yellow it leaves, if it’s white it stays”.  That didn’t sound all that scientific of a way to go about brain surgery, but he’s the one that knows what he’s doing and has the years of experience.  Maybe a little was lost in translation?  Anyway, after he scooped all the “yellow” out, he cleaned up the septum and sewed up the incision in the nose.  It was fast and pretty simple.  It was awesome to know that that woman would now be able to see better because of the surgery.  In a couple of hours, the surgeon had made this woman’s life drastically better.  That is what makes surgery special to me.

                The next surgery we watched was the removal of temporal, hippocampal, and amygdalin tissue that was causing seizures for the patient.  The surgeon performing the second operation was much less talkative than the other guy.  It was understandable though.  I would much rather him concentrate on the open skull in front of him than talk to us.  I cannot describe how crazy it was crazy to see an actual brain.  It was truly an awe inspiring moment to see the gray lump of tissue that is responsible for everything that makes us who we are.  I would be so nervous having this man’s existence at the tip of my scalpel, but this surgeon calmly and confidently removed what needed to be removed, stopped whatever bleeding occurred, and fixed this man’s seizures that were creating so much suffering in his life.   After the surgery, we changed out of our scrubs, left the clinic, and returned to our lives full of tests and studying.  It’s not as painful now though, knowing what could possibly be in our future.