Published onChildren's View
Some would call it the most rigorous training experience in medicine. Senior Surgical Fellow Katie Russell, MD, calls her two-year fellowship at CHOP “the coolest job in the Hospital.” Join us for a typical high-energy (and very long) day in her life.
Up and at ‘em. Commutes to CHOP by running the 3.5 miles from her home.
Meets her team (another fellow, residents, medical students, nurses and a visiting surgeon from South Africa) for morning rounds in the Pediatric Intensive Care Unit. The group walks briskly from room to room, engaging in quick but thorough discussion of each patient: what happened overnight, what’s the plan for today.
Team moves to the Evelyn and Daniel M. Tabas Cardiac Intensive Care Unit to see a baby boy who has had two major surgeries. The tiny infant is almost invisible amid wires and dressings. Russell listens attentively as the baby’s father, who has spent the night at the bedside, reports his observations. “Parents know their children best,” she says.
Rounds continue on the fourth-floor surgical unit. All told, the team is responsible for 105 patients on this day.
Quick stop in the cafeteria for a breakfast burrito and coffee.
Heads to the OR for the day’s first surgery: a fetal repair of spina bifida. Scrubs in and joins three attending surgeons at the table, including Surgeon-in-Chief N. Scott Adzick, MD, as well as a neurosurgeon, anesthesiologist, maternal-fetal medicine specialist, fetal cardiologist and several nurses. Russell assists as the mother’s womb is opened, the fetus exposed and the spina bifida defect repaired.
Surgery finished, Russell goes to the Harriet and Ronald Lassin Newborn/Infant Intensive Care Unit (N/IICU) to check on more patients, including a baby operated on nine days ago: ”Awww, she’s doing awesome!”
Heads to her private call room — a tiny dorm-like space containing a bed and desk — to prepare for the next surgery. Consults her notebook in which she has created detailed entries with notes and diagrams for each operation. Stenciled on the wall above her bed: “Do or do not. There is no try.”
Reports to OR 8. Russell is operating with Adzick on an 18-year-old with pectus excavatum, a condition that causes the chest wall to cave in. They perform a Nuss procedure, implanting a metal bar to support the chest. Russell will soon leave Adzick’s tutelage, so he takes every opportunity to reinforce key lessons: “I will be on your shoulder at 3 a.m. when you’re tired and you think, ‘Maybe this is OK.’” Russell nods: “OK is never good enough.”
Between surgeries, goes to the N/IICU to perform a rectal biopsy on a newborn with bowel issues. Dashes up three flights (“Always take the stairs”) to deliver specimens to Pathology.
Back to OR 8 for a thyroidectomy on an 11-year-old with Graves’ disease. Russell and Adzick work painstakingly to reveal the thyroid gland and remove it. She has performed more than 1,600 surgeries during her two-year fellowship.
Russell’s in-laws drop off a stock of food for her call room: “They are a constant source of support for me.” Her husband, a flight paramedic, is on assignment in Alaska for the summer.
Next up in OR 8: another Nuss procedure. As the team finishes, Adzick bestows high praise: “That chest looks good, Katie Russell.” Scheduled surgeries are done for today, but, Russell says, “if I had to bet, I’d bet I’ll do another case tonight.” She is on call and will stay overnight at the Hospital.
Visits the N/IICU again to examine a 20-day-old baby she’ll operate on tomorrow for gastroschisis, an opening in the abdomen that allows organs to protrude outside the body. She gently reassures the newborn’s mother: “These little ones — they’re feisty!”
Meets with one of her surgical residents to review the status of several patients. She asks about his day, offering advice and encouragement. Russell wears a silver whistle around her neck, a gift from the OR staff, who have dubbed her Coach Katie: “I pump everyone up!”
Catches up on paperwork; consults on several newly admitted patients.
Russell bet correctly: The day ends with one more surgery, an emergency appendectomy — the 236th she has performed at CHOP.
What is a surgical fellow?
A pediatric surgical fellow has completed medical school, five years of adult general surgery residency training and two years of surgical research, and is now in the final stage of preparation to become an attending pediatric general and thoracic surgeon. Many fellows are funded by philanthropy, making it possible for CHOP to train the next generation of pediatric healthcare leaders.