Harry Zou Week 4

 This was a busy week filled with both clinical experiences as well as research experiences. On the clinical side, I started shadowing rounds in one wing of the medical ICU (MICU) with Dr. Lindsay Lief as the attending physician. It was very interesting to see throughout the week how the conditions of patients changed with some getting worse, some staying the same and some even recovering enough to leave the hospital. One notable patient had acute respiratory failure and pneumonia and the physicians were unable to determine the cause of these symptoms. I found it interesting that this patient was not ruled out for having tuberculosis even though they tested negative and did not have granulomas (a characteristic of Tb). When I asked about this, the residents said that in these severe cases, it is better to hedge your bets when there is no clear benefit. Another patient also had HLH and a fungal infection with other patients also having various respiratory or cardiac conditions. I was also able to observe a bronchoscopy for a blood clot removal which was very cool! Despite working on lung-related research previously, I had never seen actual lung airways and it was clear to see the particular issues with that patients lung. Shadowing the ICU was very different than the outpatient work I had previously shadowed as the risk/benefit relationship heavily favored higher risk but higher benefit treatments. As a side note, all of the physicians were very patient in answering my questions which I really appreciated!

On the research side of things, I finally have Mtb samples to work with and sequence. I did an organic extraction of Mtb genomic DNA which was different than the kit-based methods I typically use in Ithaca. I then ran a gradient PCR under various cycling conditions for some control samples as a first pass at PCR optimization for downstream sequencing.