A day in the life of Pediatric Surgeon/Scientist Richard Keijzer
Published by: michadmin on October 18th, 2011
Every morning the alarm clock wakes me up around 6.15 am to walk our new dog. I am always a bit afraid to tell people about the breed, because it is one of these new designer hybrid dogs: a Double Doodle, which is a mix between a Labradoodle and a
Goldendoodle. For those of you not familiar with this phenomenon, they have mixed a Poodle with a Labrador and a Poodle with a Golden Retriever and mixed the offspring again and then you get in our case a black Golden Retriever-like dog that does not shed, is hypoallergenic, is smart and has a very friendly character. I think it is coming pretty close to the transgenic mice that we use in the laboratory, so I would not be surprised if the next generation of dogs will light up in the dark like those green fluorescent protein transgenic mice do.
Anyway, I start the morning with a walk in the park and breakfast with my family. This is one of the big advantages of living and working in Winnipeg: there is no morning traffic jam. In The Netherlands it would normally take me 45-60 minutes to get to work because of traffic, whereas here it is only 10-15 minutes so it gives me some extra family time in the morning.
Today I have to start a little earlier, because I have three cases in the operating room. I start with a laparoscopic interval appendectomy in a patient who had a perforated appendicitis a few months ago. This is treated with antibiotics in the acute phase and patients are brought back after three months for removal of the appendix. To illustrate the differences between practicing in Europe and North America, here, it is general practice to remove the appendix to prevent future complications. However, in Europe removal of the appendix is not advocated to prevent complications from the surgery. I do not know what is better, but I offer patients and their parents a choice based on this information. Next is the excision of a branchial cleft remnant in a baby. This is a leftover from an embryonic structure in the neck that was not properly removed during embryonic development. It can drain fluid and get infected, so we try to remove them in total. And finally I perform an esophagogastroduodenoscopy to search for an explanation for upper abdominal pain.=
After completion of these surgeries at noon, I rush over to the Manitoba Institute of Child Health (MICH) to meet with the Child Health Research Day Committee to discuss and review the abstracts submitted for presentation during this day. We pick the 11 best abstracts for oral presentation in ‘Dr. Goodbear’s Den’ during the research day and the rest of the abstracts will be presented as posters.
After this meeting I go back to my office in the laboratory at 1 pm. I answer some e-mails and meet with the people in my laboratory. Barb Iwasiow is the senior technician who has been instrumental in establishing my laboratory in a surprisingly short period and getting things up and running in the past year. She is pretty much directing the lab when I am working in the hospital. Ramin Kholdebarin is a general surgery resident doing a Master of Surgery with me and he has already shown that he has talent for doing basic science since he was able to successfully set up the microRNA in situ hybridization technique in my lab in just a few months. Naghmeh Khosgoo just arrived from Iran to do a Master of Science in Physiology. She is busy getting her life organized after a big move from one side of the world to the other, something I am very familiar with myself.
Around 2.30 pm we begin our weekly laboratory meeting. Normally this is at 10 o’clock in the morning, but because I was in the operating room we postponed it to the afternoon. During these meetings, everybody presents the results from their experiments from the past week and discusses what they will do in the coming week. Any problems or good new ideas are discussed between the different members of the lab.
After the meeting I read some more e-mails and work on finishing some manuscripts that I am preparing for submission until I am paged to check on a patient with abdominal pain in the Children’s Emergency Room, since I am on call this week. Together with the resident I evaluate the patient’s history and perform a physical examination and we come to the conclusion that this patient most likely does not have appendicitis as an explanation for the abdominal pain.
Back in the lab, Ramin shows me the first results of his in situ hybridization experiments. Together we look at the slides under the microscope and conclude that this experiment was successful in working out the conditions for the next experiment and bringing us a small step closer to learning why the lungs in newborns with congenital diaphragmatic hernia (a developmental hole in the diaphragm) have abnormal lung development.
Even though I am on call today, I can go home around 6 pm to have dinner with my family. Again, the beauty of living in Winnipeg, I am home in 10 minutes and can be back in the hospital in 10 minutes, so this gives me the opportunity to spend some extra time with my family. I only get a few calls from the resident and I do not have to go back to the hospital, so it is a good night to be on call. After putting our children (an eight year old son and a five year old daughter) in bed, I have some time with my wife to go over our day with a cup of tea. We both finish some work on the computer and do some reading before going to bed around 10.30 pm. Not before I walk the dog again of course. Anyway it has been another nice day in my life as a pediatric surgeon-scientist with many diverse activities. I love the combination of clinical work and basic science research and if I would have had to write the job description of my perfect job a few years ago, it would have come pretty close to what I am doing these days in Winnipeg.
