Will Lorion ’26: Boston Medical Center Orthopedic Surgery

If you had to lose one of your fingers, which one would you choose? Many people would automatically assume to discard the pinky, but everyone overlooks one crucial fact. The pinky actually contributes to around 50% of a person's grip strength, making it absolutely vital in hand function. Finding a new appreciation for the hand and its uses, especially as a piano player, is just one of the many things I learned working with orthopedic surgeon Dr. Stein this summer.

The campus of Boston Medical Center

Dr. Stein is an orthopedic surgeon at Boston Medical Center (BMC) specializing in the upper extremity, which refers to the arm, forearm, and hand. A common misconception about orthopedic surgeons is that they only work with bones, but much of what Dr. Stein does deals with the entire anatomy of the hand, not just its bones. In fact, two of his most common surgeries, carpal tunnel and trigger finger release, only occur because of problems with nerves and tendons, respectively.

Me with Dr Stein  Me with Dr Kim

On Mondays and Wednesdays, we would be in the clinic, where Dr. Stein and his chief resident, Dr. Ryan Kim, would see between 50 and 60 patients each day. There were four patient rooms that would constantly have patients cycling through them nonstop. A med student, physician’s assistant, or Dr. Kim would enter the room first to get a brief medical history to figure out what was going on with the patient, so they could brief Dr. Stein. Dr. Stein would then enter to make the final diagnosis. Each room visit could range from five to 30 minutes, and included first-time consults, cortisone injections, surgical discussions, and post-operative follow-ups. 

On Tuesdays and Thursdays, Dr. Stein is in the operating room (OR). Every operation is like clockwork. When a patient would get wheeled into the OR, the team would work to prep them for surgery and prepare the surgical field. I did my part by helping gown Dr. Stein and whoever else was scrubbing in and getting the patient set up and prepped for surgery. Dr Stein was incredibly thoughtful in explaining what he was doing in the middle of surgery, taking the time to make space for me to come close and see the cuts and stitches he was making. One of the nurses even showed me how to scrub in the proper way, which takes around five minutes, as well as how to gown and glove.

Learning how to scrub in

One interesting case I got to see in the OR involved a patient who ruptured all of the flexor tendons in their hand due to an infection. Dr. Stein harvested tendon grafts from his forearm and was able to repair each flexor tendon over a meticulous three hours. I was especially amazed by this procedure because Dr. Stein was only able to figure out the plan of how to fix the tendons after cutting the hand open and looking inside.  He had to figure it out as he went along.

  Harvesting graft Testing repaired tendon function

Another case I got to watch involved the repair of a severed nerve in the thumb, which required the use of a surgical microscope due to the incredibly small size of the nerve. Dr Stein used a special suture 10 times thinner than a human hair to expertly attach the two severed ends of the nerve back together so that the nerve could heal. After completing the suture, he even let me look through the microscope to see what it looked like.

Dr Stein using the surgical microscope

Dr. Stein was also kind enough to bring me to other ORs to watch surgeons of other ortho sub specialties. Sports medicine surgeon Dr. Xinning Li let me watch as he repaired a patient’s ACL tear. He took a graft from the patient’s patellar tendon, weaved it through tunnels in the knee, and secured it with screws to act as a new ACL. This was especially interesting to watch given the prominence of ACL tears with sports, and watching friends/teammates recover from a similar procedure. Over the course of my time at BMC, I ended up getting to see 66 surgeries in total, and spent around 45 hours in the operating room which proved to be an absolutely incredible experience, especially given that I am not even in med school yet.

Transposition of ulnar nerve at elbow

On Fridays, I was lucky enough to attend “bone school”, a morning conference where residents and med students hear lectures from other orthopedic surgeons and learn about different conditions or operations. One day, Dr Li presented Hill Sachs lesions, a bone defect on the head of the humerus, in the shoulder. After each lecture, every person in the room would go around and answer a question on orthobullets – an ortho themed kahoot like quizzing website. Bone school was where I met all of the other residents and med students, and I loved to hear each of their unique stories and aspirations. They all had great advice for entering the medical field, and were always eager to walk me through the steps of different hypothetical surgeries. One med student named Chris taught me how to wrap a patient’s hand in the same way they do in the OR, and let me practice on his hand. He also elevated my suturing skills by teaching me the figure eight stitch and the horizontal mattress stitch.

  Learning to wrap a hand Final product

After bone school, I was given the opportunity to follow around 2nd year resident Dr. Meghan Foos to see consults in the ER and post op. Seeing patients in the ER was completely different from seeing them in the clinic due to the wider variety of injuries and nature of causes. I even got to follow through with an ER patient, seeing them a few times after their operation. On some post op visits I even got to help redress healing incision scars.

The most meaningful part of interning at BMC was getting to see the continuation of care for specific patients. Since I was there for five weeks, I got to see many patients both pre surgery, in the operating room, and post op. I absolutely loved getting to see patients gain a much higher quality of life after Dr. Stein operated. My other favorite part of my time at BMC was just talking to Dr. Stein or residents in the hallway between seeing patients to learn about the nuances and importance of medical research, or getting lunch with med students to hear about what got each of them interested in medicine.

Dr. Stein's operating room

Thank you so much, Dr. Stein, for always taking extra time to teach me about each procedure and condition I saw – I feel as though I learned so much about orthopedics, but also about medicine in general and the healthcare system. Also, thank you Dr. Kim, Chris, and all of the nurses and staff at BMC that were so welcoming and caring (especially when I would get myself lost). Thank you, Mr Schlenker, and The Rivers School science internship program for setting me up with this opportunity.