Today picked up tempo quickly and suddenly. We began by meeting Dr. McElveen at Duke Hopsital, and had difficulty finding the entrance to the Same-Day Surgery building. We arrived 10 minutes early, so he hadn’t arrived yet and we were instructed to ask another nurse in the back about his whereabouts. Each nurse directed us further and further in the building and eventually we were in the middle of the building, surrounded by surgeries and doctors. Dr. McElveen laughed when he found us and led us through the labyrinth and towards the changing station. We put on scrubs and were thrown into a room where Dr. McElveen began surgery on a patient who suffered from damage towards the ear drum. I couldn’t quite tell whether or not it was cochlear implant surgery, but whatever it was was fascinating to me and Kiran. Ear surgery is far too cramped for me, it gives absolutely no room for error or else the patient could go deaf. All surgery is precise and requires steady hands, but there is nothing in accord with watching ear surgery. Dr. McElveen does the entire procedure under a microscope, which Kiran and I tried afterwards on a temporal bone. Carolina Ear & Hearing Clinic has one of the two temporal bone labs in the country, and Kiran and I were given the chance to mimic Dr. McElveen’s surgery procedure. We were given microscopes and tools to understand how difficult it is to do surgery under a microscope with such limited movement.

Afterwards Dr. McElveen had to go to South Carolina so Kiran and I were sent back to the hospital to resume our experience. We were assigned a paper on Stapedectomy’s and Otosclerosis, and we learned what the procedure is for dealing with it. Otosclerosis is the buildup of bone tissue in the outer ear around the stapes. This prevents the stapes from transmitting sound energy to the inner ear, causing the victim to suffer from either conductive or mixed hearing loss. Stapedetomy is the procedure done to continue the flow from the outer ear to the inner ear. The surgeon does an incision on the two arms of the stapes and cuts a whole in the stapedotomy which is a wall connected to the stapes. A piston-like object, called the prosthesis, is then connected to the incus is strung through the stapedotomy.

Dr. McElveen had to go to South Carolina for the rest of the week so Kiran and I split up and spent the rest of the day with separate doctors. I saw some interesting patients, some were impatient and curt white others were amiable. Nicolle, the doctor I was working with, knew all of the patients well because she’d spent so much time with them, and it was interesting seeing her interact with the ones she was fond of and the ones she wasn’t as fond of.

All in all I learned a lot about diseases in the ears and about how to deal with certain patients and how to be patient.

Day 1 was an enriching experience with Dr. McElveen and his numerous patients. When Kiran and I arrived, we were nervous entering the enormous, winding office that the doctors worked in. We began with a staff meeting, where Dr. McElveen and his associates organized everyone’s schedule for the month. The staff worked well as a group, they were quite supportive and the staff meeting was a great way to observe everyone interact. During the meeting they celebrated the engagement of Kate, an associate, and commemorated John-Thomas Junior for the graduation of his children. Finally, the meeting was over and everyone split up into their own work spaces in the winding and confusing office.

Next, Kate gave us a tour of the building and showed us where Kiran and I would set up our stuff for the week. We didn’t spend much time in there at all, though, we were often on our feet and participating in check-ups with patients. In fact, Kiran and I faced some adversity spending the entire day today on our feet, moving from room to room with Dr. McElveen and his patients and always standing in the corner, observing. It was fantastic listening to each patients story, every one of them had known Dr. McElveen personally, because he had worked with them for so many years.

We didn’t learn many logistical aspects of ear surgery or even the anatomy of the ear. We were taught that the ear consisted of three central bones, the malleus, the incus, and the stapes, but that was it for the most part. We watched Dr. McElveen remove a hearing aid from a patient under a microscope that was enhanced on a television screen in the corner, which was fascinating. Another patient was a young child who couldn’t work their hearing aid so that was interesting.

For the most part we focused on treating and handling patients today, and meeting the other doctors and learning about their individual specialties.