Ava Russo ’26: Lahey Hospital & Medical Center Anesthesiology

I have always admired people who dedicate themselves to helping others, and I’ve always been interested in science, specifically physiology. I’ve had many visits myself to the doctors with sports injuries and chronic pain, which led to me having two knee surgeries. It wasn’t the best feeling being the patient going into surgery, but I put that aside and found it so fascinating how each person I met played a significant role in the process. My summer internship at Lahey Hospital and Medical Center (LHMC) helped solidify my interest in going into clinical medicine, as I was exposed to and gained experience in an environment that people ordinarily don’t see until medical school. 

Dr. Kaufman and I in the office

Throughout my six-week internship shadowing Dr. Michael Kaufman, the chair of anesthesiology, I got to closely observe anesthesiology as well as surgeons in different specialties, and I learned just how important a role anesthesiologists play in the operating room. Even though every day looked a little different, it always consisted of something new and exciting for me to learn and observe. At the beginning of a case, we would typically start by seeing the patient in pre-op to ask about medical history, allergies, past anesthesia experiences, and other relevant information. Once the patient was moved to the operating room, everything sped up very quickly. I was amazed the first time I witnessed the meticulously organized chaos involved in prepping the patient for surgery. Early on, Dr. Kaufman taught me the three key components to general anesthesia: analgesia (loss of pain), amnesia (loss of memory), and paralysis (loss of movement). Each of the three is essential for ensuring the surgery is performed safely. While each component is not necessary for all forms of anesthesia, general anesthesia was used in most of the more invasive surgeries I saw.

Dr. Kaufman worked frequently in transplant anesthesia, specifically with liver transplants. I was able to sit in on several transplant meetings and witness the amount of collaboration and thoughtful discussion that went into the process, which showed why LHMC is one of the best in New England for transplant and hepatobiliary care. I was surprised when I saw just how many medical specialists played a role: anesthesia, surgery, infectious disease, nutrition, cardiology, psychiatry, social services, etc. I was fortunate enough to observe seven liver transplants in my six weeks at LHMC. I saw just how much went into organ transplants compared to other procedures from the anesthesia and surgical standpoint.

Cirrhotic liver Donor liver

I also had the opportunity to have a window into the research side of transplant medicine during this internship. I worked with Dr. Ryan Nazemian, one of the anesthesiologists at LHMC, on a research project analyzing liver transplant interventions and outcomes using the SATA (Society for the Advancement of Transplant Anesthesia) and Tufts REDCap databases. I learned how to interpret the data for each patient, which changed the way I experienced the operating room.  It gave me context for what I was seeing and helped me understand why certain choices were made during surgery. Liver transplants are highly complex, requiring close coordination between anesthesia, surgical, and post-operative teams. Witnessing the data and surgical perspectives showed me how each decision impacts patient care. Experiencing both the research and surgical perspectives gave me a more complete understanding of how individual cases fit into larger patterns in medicine and left me with a deeper appreciation for how research and hands-on medicine work together.

Entering data into the SATA database

Dr. Kaufman worked on a variety of cases, ranging from joint replacements, to vascular repairs, to cholecystectomies and pancreatectomies (removal of the gallbladder and pancreas), to open heart surgery, and much more. I was amazed by his in-depth knowledge of the surgical steps for not only his cases, but also cases we would observe. I also had the opportunity to shadow many other anesthesiologists and CRNAs (certified registered nurse anesthetists) in an effort to expose me to different cases when Dr. Kaufman attended meetings or had gaps in his schedule.

Me observing a lateral hip replacement

I got the chance to observe multiple open-heart surgeries performed by Dr. Shekar, where I shadowed Dr. Swanson as the anesthesiologist. One of Dr. Shekar’s patients had endocarditis (cardiac bacterial infection) on the prosthetic mitral valve; the patient previously had a bovine (cow) mitral valve replacement. The patient contracted a staph infection that traveled through the bloodstream to the heart, infecting the bovine valve. The case was emergent because the infected leaflet (moving part of the valve) could throw a fragment into the left atrium at any time, which could then travel to the brain, creating a high risk for a stroke. During open-heart surgery, the anesthesiologist or cardiologist monitors the surgical intervention and heart function with a constant TEE (transesophageal echocardiogram), a tube with an ultrasound tip that's guided down the esophagus, giving a full view of the heart. Dr. Swanson took the time to explain to me how it works and how valuable it is of a tool for the surgeons, while also walking me through the steps of the surgery as it progressed. Dr. Shekar was able to remove the infected valve and replace it with a mechanical valve, which he explained to me was the better option for the patient because it lasts longer than the tissue valves. I felt incredibly grateful for the time and patience each physician took to share their knowledge with me, making it one of my most memorable learning experiences of my internship.

      Valve with endocarditis       Mechanical valve

Dr. Meade, Transplant surgeon (left), showing me the anatomy of a spleen and a pancreatic mass

I am beyond grateful for my experience at LHMC based on all I learned and the positive environment I walked into as an intern. Everyone at LHMC was incredibly welcoming and went out of their way to ensure I had the best experience and learned as much as possible. The experience of shadowing Dr. Kaufman was truly incredible, whether observing the way he immediately made patients feel comfortable, seeing him work in the OR, teaching the residents, and hearing how positively his colleagues viewed him as a mentor and a boss. Dr. Kaufman taught me what it looks like to truly love one’s job and that when you are deeply passionate about something, you can do amazing things and make a positive impact not only in your field but also on the people around you. I am so grateful to Dr. Kaufman and the entire anesthesia team at Lahey Hospital and Medical Center. Thank you also to Mr. Schlenker for providing me with this very meaningful and life-changing experience.