GMI Student Perspectives | Erik Wu: Observations, Descriptions, and Other Interpretations

Reflections from Global Medical Innovation MBE students.

Experiences in Hospital Nacional de Niños. Petting therapy “dogs” – this one is fake (left), and posing in scrubs right before entering the operating room (right)

When thinking about healthcare, for a majority of my childhood I had held a very simplistic view. After all, my only exposure to medicine was my pediatrician’s private practice and I had a relatively healthy upbringing. A check up to me consisted of a hearing exam, a blood draw, maybe some small talk here and there, and then a pat on the back before I left. Growing up, I rarely stepped foot in a hospital, so I assumed that it was just a scaled up version of what I experienced. Just a bunch of identical rooms all filled with doctors giving patients hearing exams, blood draws, etc. However, working in an Emergency Department my senior year of high school was when I first began to grasp how complex medicine can be. I saw firsthand what a Patient Care Assistant (PCA) did, how triage was implemented, even what happens during a code blue. My first foray into surgery occurred during my junior year of high school, where I was able to shadow an orthopedic surgeon for a semester, experiencing how teams work together, from the device rep to the scrub nurse to the physician assistant.

Now in Costa Rica, I have been able to expand on these experiences through the Friday clinical observations at Hospital Nacional de Niños, or the National Children’s Hospital for my fellow English speakers. While I first started off watching endoscopic (briefly mentioned in the first post) and ENT procedures, by just circumstance (or maybe fate) I have somehow found my way back to watching orthopedic procedures, observing two intramedullary (IM) rod placements in children with bone disorders. In procedures like this, rods are placed down the long bones either to stabilize the leg, lending support, or to straighten the leg. While I am there officially in an engineering capacity to look for ways I can improve the tools during the operation, after all this is an engineering masters program, the pre-med in me marvels at the technique and communication between all the parties involved in order to successfully complete the surgery. Overall watching these procedures have since come to change what healthcare means to me. Rather than a self-contained endeavor, a solitary doctor caring for a solitary patient, these latter medical experiences show me that medicine is best when it is team based, with each member playing their own, but similarly important, role to achieve optimal outcomes. If the x-ray tech struggles to position the device, the scrub nurse misidentifies the tools, or if the surgeon places the rod incorrectly, time is added on to operations and the patient suffers. Most of the needs I have identified have been designed to target these inefficiencies, albeit from an engineering point of view. Later in the summer we will transition to observe at another national hospital, Hospital México, where I can see more examples of team based care with a different patient population.

Besides observations at the hospital on Fridays, I am now 4 weeks in to my internship at Establishment Labs, the first Costa Rican Company to go public on a United States Stock Exchange. Focusing on silicone implants, E-Labs as the cool kids call it (idk I just made that up) has been developing ergonomic implants to provide a more natural look for breast reconstruction and enhancement. I have signed an NDA and I don’t want to go to jail so I can’t reveal too much about what I am working on, but most of my projects revolve around how to make these implants better for patients in a variety of different ways. Learning about design, manufacturing, and even regulatory in this setting has been extremely interesting to say the least, and it is illuminating to see the different perspectives that are brought to projects, since many teams are interdisciplinary in nature. Hopefully these links to their website and other publicly disclosed sources can help illustrate a little bit more about how E-Labs works and for the next post I will check to see what I can and cannot say.

So after balancing the spirit of HIPAA on one hand and my NDA on the other, here comes the part of the blog post where I can talk about things in excruciating detail: weekend trips and other fun activities! On the weekend of July 4th, several GMI students and myself traveled to Monteverde where went ziplining over some gorgeous gorges, got some great coffee, and walked across a series of hanging bridges suspended in the cloud forest. Interestingly enough the hotel we stayed at for the night had a Rice University poster hanging on the wall! Who would have guessed? The previous weekend we went to Irazú, the tallest active volcano in Costa Rica. Crossing a greyish-black landscape, there is a beautiful greenish blue lake. On the way there we also passed by a “haunted” asylum, but due to time constraints we weren’t able to visit. Maybe we will visit that place in the future and see who would be the first to disappear horror movie style (my money’s on Genevieve). Finally some other random updates, Lamiya and I got granizados (Snow Cones) at work on Thursday, we watched Costa Rica almost upset Mexico in the Copa Oro at a food market called Amor de barrio (would highly recommend), and not to brag or anything, but now I have almost three times as much XP on Duolingo compared to Luc.

Erik Wu, 2019-20 Cohort, MBE in Global Medical Innovation