These surgeons don't have to worry about lawsuits if they make mistakes
BY ALISSA POH
High school students practice physical examinations and surgery on mannequins at the Goodman Simulation Center in one of the sessions at Med School 101, designed to invite interest in medical careers.
More than 150 teenagers from California high schools flocked to the Clark Center on Feb. 29 to spend the day imagining themselves as Stanford medical students.
They came for "Med School 101," an all-day feast of experiences and information on what it's like to be studying or working in the field of medicine. Participants had the opportunity to perform virtual CPR, touch and feel animal hearts and see embryonic stem cells that had given rise to heart cells beating in a lab dish.
The 160 participants came from nearly a dozen schools, from Palo Alto to San Diego, to attend sessions with School of Medicine researchers, designed to get them thinking about careers in medicine and science.
One session that sparked considerable interest was "Mind control—for better living," led by Sean Mackey, MD, PhD, associate professor of anesthesia. He showed the students, for example, that the brain has similar circuits for processing both empathy to pain and the experience of pain. He illustrated this point effectively by showing a series of "painful videos"—a tennis player turning his ankle, a boxer getting badly beaten up—drawing horrified, empathetic moans from his enthralled audience. Sociopaths, Mackey informed them, are incapable of engaging such empathy-related areas, as their brains are "miswired" that way.
Mackey also introduced the students to "real-time brain control"—patients using a technique called functional magnetic resonance imaging, or fMRI. With fMRI, they watch their own brain on a screen to observe the activity in its pain-processing areas, as the processing takes place. They're also taught mental strategies for taking control of and reducing the whole pain experience.
"Did we just design the world's most expensive placebo?" Mackey asked of this promising approach to treating chronic pain. Still, he was enthusiastic about this "concept of self-empowerment," describing the use of mental training to increase activity in the brain's "happy center" (the subgenual anterior cingular cortex), along with fMRI, as a potential treatment for intractable depression.
"It sounds kind of sci-fi, but it isn't entirely, because we're getting there," he told the group.
Dekel Sherman, a freshman at Gunn High School, was drawn to this session because he's an athlete who regularly faces the issue of injury-related pain. Rather than medicine, however, he's thinking more about a future in biotechnology.
Another student was so interested he may come back to learn more about Mackey's work. "It's really cool, those images he showed and his ideas about controlling pain," Scott Kidd enthused. The sophomore at Summit Preparatory High School has definite plans for medical school, and will take up Mackey's invitation to the high-schoolers to apply for a summer position in his laboratory.
Others flocked to a session on surgery. There's nothing like performing virtual surgery without worrying that you might wind up with a corpse and a lawsuit on your hands. Fourteen eager students were taken to the Goodman Simulation Center and allowed to "do" a laparoscopic procedure on one of the simulators there.
"It's like a video game," Jessica Reyes of Sequoia High School said, keeping her eyes fixed on the computer screen. Keeping her eyes focused, she maneuvered the laparoscope like a joystick in search of target areas as instructed by the simulation program.
"Oops, he bled to death," joked Sandra Feaster, program director at the simulation center, as the screen turned bright red—a sign that the virtual laparoscope had accidentally penetrated a blood vessel. Reyes exclaimed, "Oh, I killed him again!" as fresh "blood" filled the screen.
The students also got acquainted with "Mr. Jones," one of the mannequins that surgical interns practice on at Stanford before being turned loose in the operating room. They were shown the perils of dealing with dropped oxygen levels in the midst of surgery, as well as changes in heart rate and blood pressure. Awed whispers like, "His jaw's really moving," and, "His tongue's swelling up" were heard as the mannequin responded, in a very real fashion, to various manipulations.
"We use our ears here, too," Feaster explained to the group. "The deeper the monitor's beeping tone, the lower the oxygen level—it's not something you want to hear in the OR."
Alissa Poh is a science-writing intern in the Office of Communication & Public Affairs in the School of Medicine.
