Seattle Children's Hospital - Ava Torjani

Seattle Children’s Hospital 

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“Let’s finding you something to do.” My mentor was all about not being boring. So, it is to no surprise that I was almost always occupied throughout my entire internship. Generally, I would be in the lab every day except for Tuesday wherein I observed cases in the OR and Thursday morning wherein I attended 2-hour conferences at the hospital. It was an effective mix of a scientist’s and doctor’s life, giving me a strong insight into pursuing the path of MD/PhD.

Initially, I was unsure whether I would enjoy working in the lab, mainly because I wasn’t familiar with all the techniques involved and thought that the clinical side would be far more interesting. However, as the internship progressed, I was intrigued more and more by bench work in the lab. This is largely due to my mentor who was extremely patient, friendly, funny, energetic, and optimistic. She taught me more techniques than this internship originally had promised—the reason certainly has a story behind it.

I was originally supposed to learn two techniques that applied to a specific project: Tissue culture (maintaining cells that are used in all ongoing projects) and immunohistochemistry (IHC, to examine protein expression of specific substrates). However, the antibodies required to perform IHC were unavailable, which meant that I could no longer partake in this project. Instead, I was given a new one wherein I had to explore intricate connections between the urea cycle and FL-HCC, a rare sub-type of liver cancer. And so began hours and hours of reading papers; eventually, I was able to create a concept map of what this project desired to discover. I then ordered the materials myself with the help of my mentor and began a series of experiments that required new techniques for me to learn. These included real time PCR and western blotting on top of tissue culture and IHC. Unfortunately, the results were not coherent with the desired outcome, which meant that I could no longer proceed with the project. Unhappy with this outcome, my mentor decided that I should engage in other techniques so that I wasn’t left with nothing to do. This soon led to me learning how to conduct DNA extractions, making complementary cDNA, BrdU staining, MTT assays, and much more. Although I didn’t have a specific project to summarize at the end of my internship, I certainly felt more confident as a scientist. Also, despite not being successful with the Urea Cycle project, I thoroughly enjoyed reading the papers and forming connections between them—they applied all the knowledge I have acquired through my courses in Biochemistry and Cellular and Developmental Biology to the field of medicine, which truly made me appreciate everything I have learned in college so far. Therefore, my time in the lab was effectively spent and I am truly grateful for the unforgettable experience.

I also got to observe several rare and interesting cases in the OR—my favorite was the removal of the rectum and its reconstruction through forming a J pouch using the small intestine, which took over six hours to complete. Dr. Adam Goldin, a colleague of my supervisor, talked me through the reason behind this surgery (the patient had ulcerative colitis, an inflammatory bowel disease) and allowed me to ask any questions I had throughout the procedure. Another memorable case was a splenectomy (removal of the spleen as it was protruding into the abdomen) because a resident began explaining the procedure to me as it was happening and showed me pictures of the anatomy to understand each step being conducted; therefore, I wasn’t simply observing the case, rather I was understanding and appreciating everything that was done. It was a powerful reminder as to why I wanted to pursue a career in medicine.

Furthermore, conferences at the hospital were an absolutely unique experience. I attended conferences directed specifically towards residents, reviewing complicated cases and giving presentations that connected socioeconomic issues to medicine (e.g. racial and ethnic differences in rates of appendicitis and perforations). However, my most memorable conference was related to pathology wherein I sat with the residents, wore gloves, and actually felt the resected livers, colon, and lungs that had been affected by a tumor or injury. It was astounding to physically feel and understand what one would normally see as a picture in a textbook—a unique and rare experience!