Daily & Weekly Internship Reflections:
3/2/2015 Monday
Hours: 8am-4:45pm (8hrs 45min)
Today was my first day interning with Dr. Ron Ritz, overall I had a really great day. It was truly surreal to be able to see the profession of my dreams played out right in front of me. I can tell that this internship will be full of interesting cases, rigorous learning, and of course, fun. All day, Dr. Ritz and his staff made me feel very welcome at his office, upon arrival I was even given my own lab coat and an office to work in. Tina, Chris, Dana, and Dr. Ritz were great to work with, they were always willing to answer questions or give me direction, also over the course of the day they let me "see" 23 patients with varying medical needs. The most important thing I learned today is to treat patients as courteously as Dr. Ritz does. It is amazing to see the unique bond that he had with every single patient and the overall positive vibes it brings to his practice. Along with that I learned a ton of vocabulary and medical procedures, for example keratoacanthoma, and tarsorrhaphy. With such a great first day, I know that the next 3 weeks of my internship will be amazing and provide great learning.
3/3/2015 Tuesday
Hours: 9:30am-2:45pm (5hrs 15min) Running Total: 14hrs
My second day at the office was much more relaxed since Dr. Ritz was in surgery all day. I started out my day by meeting a couple new associates, then spent about 2 hours making patient literature packets. The rest of the day was free time to work on my notes from the previous day, study the blepharoplasty procedure by watching surgical tapes online(since I will be seeing one in person tomorrow), and reviewing patient charts. Overall today was much more relaxed than yesterday, this really gave me the chance to review my learning, and study for tomorrow.
3/4/2015 Wednesday
Hours: 8:30-4:30 (8 hrs) Running Total: 22 hrs
My third day interning was great, it was probably the best so far. Dr. Ritz was back at the office all day which gave me more time to pick his brain and learn about the art of plastic surgery. I watched my first two surgical procedures today, I watched a blepharoplasty and the excision of a basal cell carcinoma. It was truly amazing to witness Dr. Ritz in action. Today, I learned from Dr. Ritz that keeping patients comfortable with music and conversation throughout their procedures helped with providing them a positive experience, this taught me that surgery doesn't have to be 100% serious to be effective. Overall, today was amazing and I hope to see even more surgeries in the coming weeks.
3/5/2015 Thursday
Hours: 9-3 (7 hrs) Running Total: 29 hrs
Today Dr. Ritz was in surgery most of the day, therefore I spent most of my day reviewing notes and researching. Dr. Ritz came up to his office between surgeries to eat lunch today, this gave me time to ask questions and see 2 patients. Otherwise today was super mellow.
Weekly Reflection: This past week of interning for Dr. Ritz was truly amazing, I feel so privileged to have the opportunity to learn from him by observing him throughout his surgeries, consultations, and office work. Unfortunately I was not able to watch any major surgeries this week, but I will be completing OR orientation Tuesday of next week, so I will have the chance to throughout the rest of my internship. So far, I have observed two office procedures performed by Dr. Ritz, they consisted of an upper eyelid blepharoplasty, and the excision of a basal cell carcinoma. Dr. Ritz and his nurses did an amazing job talking me through each procedure as they were performed, while also giving me the chance to ask questions.Up to this point, my daily tasks have consisted of shadowing Dr. Ritz while he consults with new, or returning patients, watching him perform office procedures, and doing office work. Typically I've been working with Dr. Ritz, Kellie, Tina, Chris and Dana. Kellie and Tina are Dr. Ritz's nurses, I have observed them doing tasks such as removing stitches, filling breast expanders, and aiding Dr. Ritz in surgeries and patient consultations. Chris is Dr. Ritz's office manager, she has helped me coordinate OR orientation, and manage my overall internship. Over the past week, she has consistently been willing to answer my questions, give me direction, and even meet with Zoe my LINK coordinator. inclusively, Dr. Ritz and his entire staff have been overwhelmingly kind and gracious towards me this week, they have aided my learning through explanation, exposure, and including me whenever possible. By observing how Dr. Ritz's runs his practice, I have realized the true magnitude of lives he is saving, and positively effecting. It is admirable how much he opens up to his patients in order to create a trusting bond. As Dr. Ritz says, " Plastic Surgery is 1/2 art, 1/2 science", this really resignated with me because Plastic Surgery exists to rebuild and improve the human body. This task can truly only be achieved with the incorporation of both science and art, and enough skill to re-route details of the universe. Dr. Ritz also explained to me that the phrase "plastic surgery" came from the Greek word “plasticos” which means “to restore form”, this origin is fitting because plastic surgery is about restoration rather than destruction of the human body, and is often implemented to rebuild upon the work of bodily destruction. I have also learned from how Dr. Ritz has built himself an empire, as well as a strong reputation over the years. He has done this by treating his patients as people rather than just a business transaction, and providing them with the best and most reliable care possible. Dr. Ritz is truly an honorable surgeon in the way that he interacts with patients, and frequently performs life saving operations. Overall, this past week has been amazing, I am so grateful to people like my father and Zoe who helped coordinate my internship, as well as Dr. Ritz and his staff for their willingness to teach me, and allowing me to intern.
3/9/2015 Monday
Hours: 9-3:45 (6hrs 45min) Running Total: 35hrs 45min
Today was a pretty great start to the week, Dr. Ritz was in the office all day so I was able to "see" 11 patients. Today was fairly vigorous, I was given a ton of time to ask Dr. Ritz questions and chat about the overall practice of plastic surgery. I was even given a couple research projects to work on while Dr. Ritz was in meetings. Overall today was great, I am really loving interning for Dr. Ritz, he is great.
3/10/2015 Tuesday
Hours: 7:30-3:30 (8hrs) Running Total: 43hrs 45min
Today has been kind of crazy so far, I had to wake up super early in order to make it to OR orientation at 7:30. OR orientation was at Mercy and lasted from about 7:30 to 8:45,during this time I was given the run down on surgical observation, and a tour of the surgical wing. While at Mercy, I happened to run into Aubree(another surgical intern from AHS) and Steve Smith, my chemistry teacher from AHS. After OR orientation, I headed over to Dr. Ritz's office. He was already in surgery when I got there, so I spent the morning filing patient charts and calling patients to confirm appointments for tomorrow. Steve also stopped by Animas Surgical to check out my internship, and meet my mentor. It was nice catching up, and reflecting on my experience as an intern with him. After, I spent the afternoon working on 2 research projects given to me by Dr. Ritz, and filing more patient charts. Inclusively,today started out busily but became more mellow as the day progressed.
3/11/2015 Wednesday
Hours: 8-3:45 (7hrs 45min) Running Total: 51hrs 30min
Today was pretty great, I had the chance to "see" a ton of patients, and witness two in-office procedures. The in-office procedures I observed today consisted of the excision of under-eye lesions(presumably calcium deposits), and the excision of a foreign body in the tip of the finger.
Dr. Ritz allowed me to learn hands-on today by letting me feel and asses a lipoma on a patients shoulder, and collect pathology specimens after they were excised. Dr. Ritz truly is an amazing teacher, he has taught me so much and allowed me to experience so many things I never would've been able to. Tomorrow is the day I get to watch my first major surgery, It is crazy to think that I am already getting the chance to attend surgery at the age of 16! Overall, this internship is going great for me, It is definitely the most productive and engaging way I have ever learned.
3/12/2015 Thursday
Hours: 9-7 (10 hours) Running Total: 61hrs 30min
When I first got to Dr. Ritz office this morning, I spent about an hour calling patients and confirming their appointments for this coming Monday. After that I spent my time improving my notes, researching, and reviewing patient charts while Dr. Ritz was in his first surgery. After he was finished, we headed over to Mercy so he could operate, and I could watch. This was the first major surgery I was able to observe, it was a a a a bilateral mastectomy & reconstruction(removing cancerous breast tissue & reconstructing breasts) for a lady with breast cancer. The surgery was expected to run about 3.5-4.5 hours, but in this case the procedure was not routine since the surgeons founds more cancer than expected. The surgery ended up running just under 5 hours, and I loved every minute of it. Mercy, its medical staff, and Dr. Ritz were amazing throughout the process. I was able to stand right near the patients head and observe the entire surgery from about 1 foot away. This allowed me to get a perfect view of the procedure and truly absorb any information I possibly could. The doctors present also were gracious enough to allow me to ask questions throughout the entire surgery, this really helped aid my learning because I was able to receive constant clarification. Overall, today was amazing, it was truly surreal being able to see Dr. Ritz, and Dr. Quayle save a lady's life just by changing her anatomy.
Weekly Reflection: This week has been amazing, I am truly honored to be interning with Dr. Ritz and experiencing what he has to offer. The highlights of this week have been being able to do more in the office, as well as observing my first major surgery. On Tuesday, I was able to watch two in-office procedures, they consisted of the excision of under-eye lesions(presumably calcium deposits), the excision of a foreign body in the tip of the finger.The in-office procedures were both very interesting and allowed me to see how local anesthetic can be used for smaller operations rather than having to put the patient out. On Thursday I observed a bilateral mastectomy & reconstruction(removing cancerous breast tissue & reconstructing breasts), this surgery was incredible. During the surgery I was able to stand right near the patients head and observe from about a foot away, this allowed me to witness the surgery as closely as I could without interfering. The surgeons also allowed me to ask questions throughout the procedure, this enabled me to receive clarification and understand the procedure as well as possible. I'm quite glad I was able to watch this case, due to its non-routine nature. It was very interesting seeing how the surgeons reacted to finding more cancer than expected, and how they went about removing as much as they could. I was able to see them remove and assess both the sentinel and axillary lymph nodes(for malignancies) as they saw fit in order to provide the patient with the most thorough treatment possible. Dr. Ritz, and Dr. Quayle really showed their commitment to the patient through their meticulous surgical methods, and extra time devoted to her. Watching my mentor perform a life-saving operation was incredible, he truly is so smart and talented it is unbelievable I have the privilege to intern for him. Aside from this surgery, Dr. Ritz has aided my learning by graciously answering as many questions as I could possible come up with. At the beginning of my internship I felt as if I was burdening him, but he has really made me feel welcome and appreciated. As I spend more time interning I am also able to piece together information, and learn in a way that I can understand how everything in medicine is interconnected. Many procedures in plastic surgery share similarities in technique, precautionary measures, and aftercare procedures. Also most procedures involve materials of the body such as skin, blood, and soft tissue. Therefore being able to see and learn different procedures really aids my learning on those topics, as well as my overall understanding of plastic surgery and the human body. It is sad to think that I am finished with 2/3 of my internship and ill have to return to school in just two weeks. This internship has really made me realize that Plastic Surgery is what I want to do, It is really something worth devoting my life to. Overall, This week has been really great, It was amazing to have the opportunity to watch a major surgery as well as Intern for Dr. Ritz for another week. It is also nice that I've gotten to know and really like a lot of Dr. Ritz's patients.
3/16/2015 Monday
Hours: 8-3:30 (7hrs 30min) Running Total: 69 hours
Today was great, Dr. Ritz was around all day so we got a chance to see many patients who presented with varying issues. Dr. Ritz is such a busy man, and it is truly admirable how he takes the time to converse with each patient and address their questions and concerns. I also admire Dr. Ritz's commitment to his patients, he is on call 24/7 and is willing to bend over backwards in order to provide his patients with a safe and pleasant surgical experience. Inclusively today was pretty great, I have been learning so much from Dr. Ritz and am sad to see my internship come to an end.
3/17/2015 Tuesday
Hours: 9-4 (7 hrs) Running Total: 76 hours
Today was amazing! Animas Surgical cleared me as the the first AHS student to ever be allowed into their operating room. I was able to watch three surgeries today, they consisted of a blepharoplasty, removal of a malignant facial lesion, and removal of a precancerous facial lesion. The first surgery took about 45 minutes, I had seen a bleparoplasty before, but this procedure was different because the patient was put under and had high blood pressure that needed to be addressed during surgery to avoid excessive bleeding. The next surgery was quite simple, it was done with local anesthetic and was quite routine, Dr. Ritz had to remove the lesion with wide margins in order to eliminate the chance of continued growth or recurrence. The last surgery was especially interesting, the patient presented with a keratin "horn" on the tip of his nose. Initially, Dr. Ritz believed it was a squeamous cell carcinoma, In the case of this the patients would've had to have a large portion of his nose removed and reconstructed. To be sure, during surgery Dr. Ritz removed the lesion with clear margins, and sent it to pathology. I was able to head to pathology with the "horn" and witness the process in which it was prepared and analysed. Dr. Joy even allowed me to assess the specimen under the microscope, and drew diagrams of the cellular structure in order for me to understand exactly what I was seeing. The "horn" turned out to be precancerous and required a simple wound closure rather than excising and reconstructing a large portion of the patient's nose. As Dr. Ritz says, "when and doubt do a biopsy", in this case getting a biopsy saved a large portion of his patients face. After the surgeries we returned to Dr. Ritz's office and saw three more patients. Overall I am ecstatic that I was able to get into the OR at Animas Surgical today.
3/18/2015 Wednesday
Hours: 8-4 (8hrs) Running Total: 84 hours
Today was very interesting, I spent the day in the office and saw many patients. I am super exited for tomorrow, it will be my last day of internship and it will also be packed full of surgeries.
3/19/2015 Thursday
Hours: 7:30-6 (10hrs 30min) Runnign total: 94 hours 30 min
My last day interning for Dr. Ritz was truly amazing. I was able spend the entire day watching surgery, which was extremely cool. I watched removal of a fibrolipoma, release of dupytrens contracture, a bilateral mastectomy & reconstruction, and a blepharoplasty. The removal of the fibrolipoma was very interesting, the patient had their lipoma removed previously but it proceeded to recur. Dr. Ritz had to carefully carve out the lipoma due to the absence of its scar capsule in order to avoid recurrance. Next I watched the release of dupytrens contracture of the palm, it was amazing to see what the palm area looks like underneath the skin. Dr. Ritz even pointed out each tendon along with their sheaths, as well as the nerves and vessels. I learnhed from this that different "shaped incisions" such as a zig-zag incision enable a surgeon a flawless insicion closure as well as increased viewing of the surgical sight. The blepharoplasty was just like the many I had seen before, but was still very interesting.
Mentor Interview:
Me: How would you describe the essence of plastic surgery?
Dr. Ritz: "Plastic surgery is 2 art, 1/2 science"
Me: How do you manage your personal relations with patient?
Dr. Ritz: "[I treat my patients with respect and kindness, they are people not business. Most of them are very open to me and crave a doctor they can trust and get along with]"
Me: How is a facial sling structured?
Dr. Ritz: "[A facial sling is structured by placing a screw into the Zygoma(cheek bone) to create a Mytec anchor. Next a tunnel is created under the skin from the Zygoma to the corners of the mouth, the strattice(pig skin void of cells) is then fed through the tunnel and pulled tightly(must overcorrect to preserve sling).]"
Project Proposal: I will create a poster board that showcases my learning. It will incorporate photos, as well as personal recollection of my experience interning with Dr. Ritz
3/2/2015 Monday
Hours: 8am-4:45pm (8hrs 45min)
Today was my first day interning with Dr. Ron Ritz, overall I had a really great day. It was truly surreal to be able to see the profession of my dreams played out right in front of me. I can tell that this internship will be full of interesting cases, rigorous learning, and of course, fun. All day, Dr. Ritz and his staff made me feel very welcome at his office, upon arrival I was even given my own lab coat and an office to work in. Tina, Chris, Dana, and Dr. Ritz were great to work with, they were always willing to answer questions or give me direction, also over the course of the day they let me "see" 23 patients with varying medical needs. The most important thing I learned today is to treat patients as courteously as Dr. Ritz does. It is amazing to see the unique bond that he had with every single patient and the overall positive vibes it brings to his practice. Along with that I learned a ton of vocabulary and medical procedures, for example keratoacanthoma, and tarsorrhaphy. With such a great first day, I know that the next 3 weeks of my internship will be amazing and provide great learning.
3/3/2015 Tuesday
Hours: 9:30am-2:45pm (5hrs 15min) Running Total: 14hrs
My second day at the office was much more relaxed since Dr. Ritz was in surgery all day. I started out my day by meeting a couple new associates, then spent about 2 hours making patient literature packets. The rest of the day was free time to work on my notes from the previous day, study the blepharoplasty procedure by watching surgical tapes online(since I will be seeing one in person tomorrow), and reviewing patient charts. Overall today was much more relaxed than yesterday, this really gave me the chance to review my learning, and study for tomorrow.
3/4/2015 Wednesday
Hours: 8:30-4:30 (8 hrs) Running Total: 22 hrs
My third day interning was great, it was probably the best so far. Dr. Ritz was back at the office all day which gave me more time to pick his brain and learn about the art of plastic surgery. I watched my first two surgical procedures today, I watched a blepharoplasty and the excision of a basal cell carcinoma. It was truly amazing to witness Dr. Ritz in action. Today, I learned from Dr. Ritz that keeping patients comfortable with music and conversation throughout their procedures helped with providing them a positive experience, this taught me that surgery doesn't have to be 100% serious to be effective. Overall, today was amazing and I hope to see even more surgeries in the coming weeks.
3/5/2015 Thursday
Hours: 9-3 (7 hrs) Running Total: 29 hrs
Today Dr. Ritz was in surgery most of the day, therefore I spent most of my day reviewing notes and researching. Dr. Ritz came up to his office between surgeries to eat lunch today, this gave me time to ask questions and see 2 patients. Otherwise today was super mellow.
Weekly Reflection: This past week of interning for Dr. Ritz was truly amazing, I feel so privileged to have the opportunity to learn from him by observing him throughout his surgeries, consultations, and office work. Unfortunately I was not able to watch any major surgeries this week, but I will be completing OR orientation Tuesday of next week, so I will have the chance to throughout the rest of my internship. So far, I have observed two office procedures performed by Dr. Ritz, they consisted of an upper eyelid blepharoplasty, and the excision of a basal cell carcinoma. Dr. Ritz and his nurses did an amazing job talking me through each procedure as they were performed, while also giving me the chance to ask questions.Up to this point, my daily tasks have consisted of shadowing Dr. Ritz while he consults with new, or returning patients, watching him perform office procedures, and doing office work. Typically I've been working with Dr. Ritz, Kellie, Tina, Chris and Dana. Kellie and Tina are Dr. Ritz's nurses, I have observed them doing tasks such as removing stitches, filling breast expanders, and aiding Dr. Ritz in surgeries and patient consultations. Chris is Dr. Ritz's office manager, she has helped me coordinate OR orientation, and manage my overall internship. Over the past week, she has consistently been willing to answer my questions, give me direction, and even meet with Zoe my LINK coordinator. inclusively, Dr. Ritz and his entire staff have been overwhelmingly kind and gracious towards me this week, they have aided my learning through explanation, exposure, and including me whenever possible. By observing how Dr. Ritz's runs his practice, I have realized the true magnitude of lives he is saving, and positively effecting. It is admirable how much he opens up to his patients in order to create a trusting bond. As Dr. Ritz says, " Plastic Surgery is 1/2 art, 1/2 science", this really resignated with me because Plastic Surgery exists to rebuild and improve the human body. This task can truly only be achieved with the incorporation of both science and art, and enough skill to re-route details of the universe. Dr. Ritz also explained to me that the phrase "plastic surgery" came from the Greek word “plasticos” which means “to restore form”, this origin is fitting because plastic surgery is about restoration rather than destruction of the human body, and is often implemented to rebuild upon the work of bodily destruction. I have also learned from how Dr. Ritz has built himself an empire, as well as a strong reputation over the years. He has done this by treating his patients as people rather than just a business transaction, and providing them with the best and most reliable care possible. Dr. Ritz is truly an honorable surgeon in the way that he interacts with patients, and frequently performs life saving operations. Overall, this past week has been amazing, I am so grateful to people like my father and Zoe who helped coordinate my internship, as well as Dr. Ritz and his staff for their willingness to teach me, and allowing me to intern.
3/9/2015 Monday
Hours: 9-3:45 (6hrs 45min) Running Total: 35hrs 45min
Today was a pretty great start to the week, Dr. Ritz was in the office all day so I was able to "see" 11 patients. Today was fairly vigorous, I was given a ton of time to ask Dr. Ritz questions and chat about the overall practice of plastic surgery. I was even given a couple research projects to work on while Dr. Ritz was in meetings. Overall today was great, I am really loving interning for Dr. Ritz, he is great.
3/10/2015 Tuesday
Hours: 7:30-3:30 (8hrs) Running Total: 43hrs 45min
Today has been kind of crazy so far, I had to wake up super early in order to make it to OR orientation at 7:30. OR orientation was at Mercy and lasted from about 7:30 to 8:45,during this time I was given the run down on surgical observation, and a tour of the surgical wing. While at Mercy, I happened to run into Aubree(another surgical intern from AHS) and Steve Smith, my chemistry teacher from AHS. After OR orientation, I headed over to Dr. Ritz's office. He was already in surgery when I got there, so I spent the morning filing patient charts and calling patients to confirm appointments for tomorrow. Steve also stopped by Animas Surgical to check out my internship, and meet my mentor. It was nice catching up, and reflecting on my experience as an intern with him. After, I spent the afternoon working on 2 research projects given to me by Dr. Ritz, and filing more patient charts. Inclusively,today started out busily but became more mellow as the day progressed.
3/11/2015 Wednesday
Hours: 8-3:45 (7hrs 45min) Running Total: 51hrs 30min
Today was pretty great, I had the chance to "see" a ton of patients, and witness two in-office procedures. The in-office procedures I observed today consisted of the excision of under-eye lesions(presumably calcium deposits), and the excision of a foreign body in the tip of the finger.
Dr. Ritz allowed me to learn hands-on today by letting me feel and asses a lipoma on a patients shoulder, and collect pathology specimens after they were excised. Dr. Ritz truly is an amazing teacher, he has taught me so much and allowed me to experience so many things I never would've been able to. Tomorrow is the day I get to watch my first major surgery, It is crazy to think that I am already getting the chance to attend surgery at the age of 16! Overall, this internship is going great for me, It is definitely the most productive and engaging way I have ever learned.
3/12/2015 Thursday
Hours: 9-7 (10 hours) Running Total: 61hrs 30min
When I first got to Dr. Ritz office this morning, I spent about an hour calling patients and confirming their appointments for this coming Monday. After that I spent my time improving my notes, researching, and reviewing patient charts while Dr. Ritz was in his first surgery. After he was finished, we headed over to Mercy so he could operate, and I could watch. This was the first major surgery I was able to observe, it was a a a a bilateral mastectomy & reconstruction(removing cancerous breast tissue & reconstructing breasts) for a lady with breast cancer. The surgery was expected to run about 3.5-4.5 hours, but in this case the procedure was not routine since the surgeons founds more cancer than expected. The surgery ended up running just under 5 hours, and I loved every minute of it. Mercy, its medical staff, and Dr. Ritz were amazing throughout the process. I was able to stand right near the patients head and observe the entire surgery from about 1 foot away. This allowed me to get a perfect view of the procedure and truly absorb any information I possibly could. The doctors present also were gracious enough to allow me to ask questions throughout the entire surgery, this really helped aid my learning because I was able to receive constant clarification. Overall, today was amazing, it was truly surreal being able to see Dr. Ritz, and Dr. Quayle save a lady's life just by changing her anatomy.
Weekly Reflection: This week has been amazing, I am truly honored to be interning with Dr. Ritz and experiencing what he has to offer. The highlights of this week have been being able to do more in the office, as well as observing my first major surgery. On Tuesday, I was able to watch two in-office procedures, they consisted of the excision of under-eye lesions(presumably calcium deposits), the excision of a foreign body in the tip of the finger.The in-office procedures were both very interesting and allowed me to see how local anesthetic can be used for smaller operations rather than having to put the patient out. On Thursday I observed a bilateral mastectomy & reconstruction(removing cancerous breast tissue & reconstructing breasts), this surgery was incredible. During the surgery I was able to stand right near the patients head and observe from about a foot away, this allowed me to witness the surgery as closely as I could without interfering. The surgeons also allowed me to ask questions throughout the procedure, this enabled me to receive clarification and understand the procedure as well as possible. I'm quite glad I was able to watch this case, due to its non-routine nature. It was very interesting seeing how the surgeons reacted to finding more cancer than expected, and how they went about removing as much as they could. I was able to see them remove and assess both the sentinel and axillary lymph nodes(for malignancies) as they saw fit in order to provide the patient with the most thorough treatment possible. Dr. Ritz, and Dr. Quayle really showed their commitment to the patient through their meticulous surgical methods, and extra time devoted to her. Watching my mentor perform a life-saving operation was incredible, he truly is so smart and talented it is unbelievable I have the privilege to intern for him. Aside from this surgery, Dr. Ritz has aided my learning by graciously answering as many questions as I could possible come up with. At the beginning of my internship I felt as if I was burdening him, but he has really made me feel welcome and appreciated. As I spend more time interning I am also able to piece together information, and learn in a way that I can understand how everything in medicine is interconnected. Many procedures in plastic surgery share similarities in technique, precautionary measures, and aftercare procedures. Also most procedures involve materials of the body such as skin, blood, and soft tissue. Therefore being able to see and learn different procedures really aids my learning on those topics, as well as my overall understanding of plastic surgery and the human body. It is sad to think that I am finished with 2/3 of my internship and ill have to return to school in just two weeks. This internship has really made me realize that Plastic Surgery is what I want to do, It is really something worth devoting my life to. Overall, This week has been really great, It was amazing to have the opportunity to watch a major surgery as well as Intern for Dr. Ritz for another week. It is also nice that I've gotten to know and really like a lot of Dr. Ritz's patients.
3/16/2015 Monday
Hours: 8-3:30 (7hrs 30min) Running Total: 69 hours
Today was great, Dr. Ritz was around all day so we got a chance to see many patients who presented with varying issues. Dr. Ritz is such a busy man, and it is truly admirable how he takes the time to converse with each patient and address their questions and concerns. I also admire Dr. Ritz's commitment to his patients, he is on call 24/7 and is willing to bend over backwards in order to provide his patients with a safe and pleasant surgical experience. Inclusively today was pretty great, I have been learning so much from Dr. Ritz and am sad to see my internship come to an end.
3/17/2015 Tuesday
Hours: 9-4 (7 hrs) Running Total: 76 hours
Today was amazing! Animas Surgical cleared me as the the first AHS student to ever be allowed into their operating room. I was able to watch three surgeries today, they consisted of a blepharoplasty, removal of a malignant facial lesion, and removal of a precancerous facial lesion. The first surgery took about 45 minutes, I had seen a bleparoplasty before, but this procedure was different because the patient was put under and had high blood pressure that needed to be addressed during surgery to avoid excessive bleeding. The next surgery was quite simple, it was done with local anesthetic and was quite routine, Dr. Ritz had to remove the lesion with wide margins in order to eliminate the chance of continued growth or recurrence. The last surgery was especially interesting, the patient presented with a keratin "horn" on the tip of his nose. Initially, Dr. Ritz believed it was a squeamous cell carcinoma, In the case of this the patients would've had to have a large portion of his nose removed and reconstructed. To be sure, during surgery Dr. Ritz removed the lesion with clear margins, and sent it to pathology. I was able to head to pathology with the "horn" and witness the process in which it was prepared and analysed. Dr. Joy even allowed me to assess the specimen under the microscope, and drew diagrams of the cellular structure in order for me to understand exactly what I was seeing. The "horn" turned out to be precancerous and required a simple wound closure rather than excising and reconstructing a large portion of the patient's nose. As Dr. Ritz says, "when and doubt do a biopsy", in this case getting a biopsy saved a large portion of his patients face. After the surgeries we returned to Dr. Ritz's office and saw three more patients. Overall I am ecstatic that I was able to get into the OR at Animas Surgical today.
3/18/2015 Wednesday
Hours: 8-4 (8hrs) Running Total: 84 hours
Today was very interesting, I spent the day in the office and saw many patients. I am super exited for tomorrow, it will be my last day of internship and it will also be packed full of surgeries.
3/19/2015 Thursday
Hours: 7:30-6 (10hrs 30min) Runnign total: 94 hours 30 min
My last day interning for Dr. Ritz was truly amazing. I was able spend the entire day watching surgery, which was extremely cool. I watched removal of a fibrolipoma, release of dupytrens contracture, a bilateral mastectomy & reconstruction, and a blepharoplasty. The removal of the fibrolipoma was very interesting, the patient had their lipoma removed previously but it proceeded to recur. Dr. Ritz had to carefully carve out the lipoma due to the absence of its scar capsule in order to avoid recurrance. Next I watched the release of dupytrens contracture of the palm, it was amazing to see what the palm area looks like underneath the skin. Dr. Ritz even pointed out each tendon along with their sheaths, as well as the nerves and vessels. I learnhed from this that different "shaped incisions" such as a zig-zag incision enable a surgeon a flawless insicion closure as well as increased viewing of the surgical sight. The blepharoplasty was just like the many I had seen before, but was still very interesting.
Mentor Interview:
Me: How would you describe the essence of plastic surgery?
Dr. Ritz: "Plastic surgery is 2 art, 1/2 science"
Me: How do you manage your personal relations with patient?
Dr. Ritz: "[I treat my patients with respect and kindness, they are people not business. Most of them are very open to me and crave a doctor they can trust and get along with]"
Me: How is a facial sling structured?
Dr. Ritz: "[A facial sling is structured by placing a screw into the Zygoma(cheek bone) to create a Mytec anchor. Next a tunnel is created under the skin from the Zygoma to the corners of the mouth, the strattice(pig skin void of cells) is then fed through the tunnel and pulled tightly(must overcorrect to preserve sling).]"
Project Proposal: I will create a poster board that showcases my learning. It will incorporate photos, as well as personal recollection of my experience interning with Dr. Ritz