Ciao from Milan (finally)!!!

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HI EVERYONE!!! :-)

It's currently a dreary, rainy, and chilly day here in Milan... so rather than venturing around the city like I usually do after work, I decided to come home, get cozy with a glass of wine, and finally start my travel blog!

As all or most of you know, I'm here on a scholarship given out by my medical school (the Philadelphia College of Osteopathic Medicine) studying Neuroradiology and Neurosurgery at the Instituto de Neurologico C. Besta. The institute is super busy and English-speaking neuroradiologists are tough to come by. As a result, the first two weeks I worked from about 10am-2pm and then went exploring around Milan. I started Neurosurgery this week and it's much more up my alley 😊 My first day, the one female neurosurgeon introduced me to everyone, after which time we all sat down around a table in the lounge and had espresso. Almost everyone, me included, then proceeded to light up a cigarette. (Ha, just kidding about the me included thing... no WAY was I smoking... just wanted to see if you were paying attention!) Along those same lines, I actually saw one of the scrub nurses BREAK scrub today and go sneak a cigarette in the bathroon- can you imagine!

So far I've seen some pretty interesting cases:

• correction of Spina Bifida Occulta... meningomyelocele and fistulous track to the medulla in a 6mo old baby (by the way... they use something called "Dura-tex", similar to gortex mesh we use in the belly, except they sew it to the arachnoid and then close the dura over it... it's supposed to prevent reoccurrence!)
  
• craniotomy (btw, they do NOT make Burr Holes) with excision of a meningioma closely approximating the pre-central gyrus
  
• V-P shunt for a pt with obstructive hydrocephalus s/p excision of a posterior fossa tumor
  
• frontal craniotomy with excision of a v. large meningioma in the midline olfactory region, sitting on the ethmoid air cells. To access the tumor, the surgeon had to transect the sagittal sinus and also resect a piece of the faulx cerebri!

Best OR quote so far (from the female neurosurgeon):
"Heaven is a Spanish lover, an italian stylist, a french cook, a swedish masseuse, and a swiss business partner!"

How is training different in Italy? Well at least here, it's quite different. They have 6 years combined undergrad/medicine and then residency. Neurosurg is 5 years, and interestingly they basically get NO, get NOOOOOOOOO operative experience the whole time. For example, the second year resident told me that "first assist" means you squirt water, use the suction, and suture up the SKIN only. Today in the case, the first assist was a full-fledged neurosurgeon and that's what she was doing... it was her first year out. Apparently, the chairman of the program gets to decide when they can start doing more. Other differences? No music in the OR (boo!), the surgeons are actually nice to the OR nurses!, this one is funny... the patient who goes AFTER the current patient actually just lays in his/her bed outside the OR the entire time until the room is ready. are there any hot, McDreamy type... nope!

okay... enough about work for now... next entry will be the good stuff!

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Photos

good advertisement
everyone goes out and smokes on this stoop... the doctors, the patients, the EMS people, the staff, EVERYONE...!

VW ambulance!
I almost died when I saw this... how cool... a VW ambulance. omg. I've also seen mercedes, fiat...

Comments

[Lori]

WOW!
What an amazing experience! The cases in the OR sound fantastic and the people sound so different!