Kitty Holbrooke: Medicine, Week One

My name is Kathryn (Kitty) Holbrooke, and I am originally from New York City, but I now have the pleasure of calling the tiny town of Telluride, Colorado, my home. I have interned the last five days at Gov Juan F. Luis Hospital & Medical Center, as well as the Moorman Aesthetic Clinic, under the mentorship of Doctor Gregory Moorman.

We began our adventure at the break of dawn on Wednesday morning at Grand Junction Airport. By we, I mean myself, and my fellow Pintern, Alexis (Lexi) Boots from Olathe, Colorado. We said goodbye to our family members, went through security for Alexis’s first time, and boarded the plane excited, nervous, and exhausted, expecting to be in bed that night in a tropical paradise under the roof of a wonderful host family. Our wishes were granted except for the detail “that night” as we didn’t end up arriving at the St. Croix airport until almost 1 a.m. (intended 9 p.m. arrival) as a result of spending three hours on the tarmac in Miami because of the worst lightening storm I had ever seen. We walked through the door at 2 a.m., dripping with fatigue, expecting to be sent to bed with a granola bar, but were greeted with a three-course meal, ending in homemade cheesecake with whipped-cream, prepared by our 13-year-old host-brother Stefan.

In the later hours of Thursday morning we were up and out the door by 7 a.m., driving the winding island roads in the backseat of Dr. Moorman’s suburban, headed for Gov. Juan F. Luis Hospital, where Dr. Moorman takes the patients he cannot treat in his office. There, we met the staff: other surgeons, nurses, anesthesiologists, scrub techs, and the two PA (Physician’s Assistant) students that would also become our much revered and respected teachers, Megan and Tyler.

Our first task was to head to HR to receive a HIPPA orientation (Health Insurance Portability and Accountability Act) to learn the rules and regulations of patient privacy and information- a truly riveting video if I do say so myself. And from there our day really began when we were plunged into the operating room, OR, to observe a breast reduction by the inferior pedicle technique. I have never stepped foot in a hospital outside of the maternity ward and have never been exposed to serious trauma, gore, or blood in real life or on the screen. As a result I was absolutely terrified for this first day, and had assured myself that there was no way to avoid fainting or nausea. Luckily, both Alexis and I watched the entire case with bursting curiosity instead of uncontrolled vomiting. Dr. Moorman was an incredible teacher, explaining every step he took and answering our often naive questions. What was supposed to be a 4.5-5 hour case ended up taking over 5.5 hours because the patient was young, and thus had stronger, more difficult to cut through breast tissue. By the end of the case Dr. Moorman and his team had removed upwards of six pounds of breast tissue and had completed a truly life-altering surgery. 

Day two we began at Dr. Moorman’s office at Gallows Bay where he sees his patients pre and post-operation as well as carries out smaller procedures that do not require the high tech instruments and staff of the more chaotic hospital. Here we observed multiple Botox and Juvederm injections. Botox, a toxin “freezes” the Frontalis and Procerus muscles temporarily, eliminating wrinkles around the forehead and brow. Juvederm is a filler, and fills-in the wrinkles surrounding the mouth, temporarily removing them, until the substance dissolves. After our cosmetic cases at the clinic were complete, we returned to the hospital to do another breast reduction, but due to a case that went overtime and a staff in need of a lunch break, we didn’t get into the OR until almost 5 p.m., much later than Dr. Moorman usually prefers to begin large cases such as this one. We still carried it out, and this time, had the opportunity to “scrub-in,” meaning we used an iodine soaked scrub sponge to meticulously clean our hands, and then were dressed in sterile gowns and gloves as well as our already donned hair nets, shoe covers, and face masks. This made the five-hour surgery infinitely more exciting as we were allowed to hold the breast tissue, vacuum the smoke from the Bovie (electrosurgical cutter), and cut stitches. We finished the procedure at the ripe hour of 9-o’clock with our bucket filled with 3,800 grams of breast tissue ready to be sent to pathology. 

Our weekend had arrived after two long days and we were ready to hit the beach. We brought Alexis on her first ever snorkel where we saw an abundance of vibrant fish as well as a sea turtle, apparently a rare find. We ended the day with frisbee on the beach with Gabriella, our incredibly gracious host-mom, Stefan, and Ava our exuberant 10-year-old host-sister. Sunday was another relaxing and beautiful beach day with a little bit of flare as we had the opportunity to go jet-skiing, a first for both Alexis and I. It was thrilling, as was just watching Andreas, our 16-year-old host-brother, and his friend speed past us and get flung into the water at every sharp turn. Our final weekend adventure was pier-jumping off the Frederiksted Pier into warm, but slightly dark and ominous waters.

We began our week this morning with a fairly simple excision of intra-oral hardware in the mandible, from a man who had broken his jaw in a car crash. We assisted slightly in situating him but primarily observed. In our second case of the day, using local anesthetics (lower risk as the patient was elderly), we took a skin graft from a man’s thigh and transferred it his forehead to cover a wound that had been created from the excision of a melanoma. The procedure was successful and I was left in awe of the technology; the precision, the thinness (for lack of a better word) and the ease with which the machine worked was astounding. Our final case was a panniculectomy, similar to an abdominoplasty or “tummy-tuck,” where we removed excess skin in the belly region that had been left after the patient underwent massive weight loss, a gastric bypass surgery, and a breast reduction. We were allowed to scrub in to this case as well and even had the privilege of using the Bovie for a minute to cut through the abdominal wall. After carrying out some liposuction from the side belly we finished the case successfully and had over 2,000 grams of abdominal fat tissue which Dr. Moorman insisted we hold (pictured here). 

So far we’ve had nothing but great experiences and have loved our time with Dr. Moorman and his family, both as his students, and as his guests. We cannot wait to see what the remainder of our time here brings.