Finishing Up in the Lab

As my internship with the Irving Medical Center at Columbia University comes to a close, I have many positive reflections to look back on. In a very tangible way, I can see how much I learned. In a short time, I was able to begin to understand the details of Kidney transplant rejection research, when prior to this summer, I had extremely limited knowledge in the field. My goals for the summer were to take advantage of the opportunity and to learn as much as possible. I understood and did the procedure of staining tissue biopsies with antibodies to analyze the tissue. I learned the intricate anatomy of the kidney, the glomeruli, tubules, interstitium, nephrons, cytokeratin, and was able to recognize them under a microscope. I went to different conferences and seminars to learn about cutting edge biotechnology machines. I went to a seminar about the history and current regulations within medical research morality and standards (which was fascinating). I also heard the department head of the Harvard nephrology department give a talk on kidney function.

One thing that I am most proud of is that I developed the skill of being quite fearless about asking questions. In my work environment, I could have easily been embarrassed by the fact that I didn’t know a lot of things. I could have been bashful in asking questions, knowing that the doctors I was surrounded by have delved into their specialized sections of pathological study for years, and felt way out of my league. I certainly did recognize my newness to the field of study. It was very humbling, and I actually saw it as a perfect opportunity to be completely unembarrassed, ask any question I wanted, even knowing if they were more introductory questions in an expert’s eyes. There was always more I could ask and more I could learn, so I tried to take advantage of that in the best way possible. One day in the last few weeks, I actually sat in my supervisor’s office for a few hours, just me and her, and we got into a long detailed discussion about her research, writing all over her whiteboard, discussing it (as you can see in the picture here). It was totally wonderful.

I learned something about my medical aspirations and desires this summer as well. I had a very positive experience in the pathology department and learned so much, but I did discover that I am drawn to patient interaction. I kept finding myself going from the science (cross sections of tissue) and asking ‘how exactly does this translate to the patient’? ‘How can we best treat the patient?’ and ‘How did the patient respond?’. I am a ‘people’ person and I think that my career in medicine will somehow be intricately connected to seeing patients throughout the day, rather than only doing research or only looking at the tissues of patients.

Along with my internship work experience, I also had a nice time on evenings and weekends, seeing friends and family and exploring NYC. This summer internship has been a wonderful experience of learning and fun, and I am so grateful to the World of Work (WOW) Brandeis internship fellowship for making the experience possible.

Learning in the Lab

Over the last few weeks I have become comfortable and familiar with my work environment in the Columbia Irving Medical Center. It is now a routine each morning to walk 20 blocks from my apartment in New York, go into the Vagelos College of Physicians and Surgeons building, go up to the 15th floor and begin with my work, looking at kidney transplant rejection in the department of pathology and cell biology. My mentor is kind and helpful and wants very much for me to learn as much as I can while being helpful to her. This has created a very positive experience for me in the lab, and has enabled me to explore many opportunities to learn more.

In the pathology lab, I have learned a great deal about tissue staining and cellular imaging, both of which I knew very little about prior to my internship. While preparing for my internship, I read about kidney anatomy and function, but I now understand the microscopic level of biopsy samples and how to properly decipher cellular images. Just recently, my week was spent doing a multi-day staining lab procedure. The lab process was a three day process of intubation, buffer washings, and rinsing of different chemicals. The goal of the process was to do a multiplex “stain” where antibodies were used to stain particular cell tissue, so that the different dyes could identify different cell types clearly under a microscope. For example, if there can be 6 different dyes on one kidney biopsy tissue cross section, then we stained with an antibody for different types of T-cells, B-cells (both lymphocyte immune cells), macrophages, nuclear stain (DAPI). In simple terms: we want to see if the kidney was attacked by the immune system. When having the antibody bind to the antigen on different immune cells, it allows us to see under a microscope if immune cells are all over a kidney.

Normally, if the body has a foreign body, it is great for the immune system to attack the pathogen or cancerous cell and try to destroy it, but in the case of a kidney transplant, it is actually terrible. We want a patient’s body to accept the kidney transplant as something that’s trying to help. After the staining, the slide can then be looked at under a microscope, images are taken and then these images are analyzed further on advanced biotechnological software to count cell types electronically. By looking at the types of immune cells, their spatial orientation and the quantitative amount in certain areas, it is possible to determine how to better prevent kidney transplant rejection.

My work at the Irving Medical Center with the help of “World of Work”, is different from university life in an exciting way. In my course study at school, it’s easy to get lost in a book and lose sight of the larger purpose and real benefit to serving the medical field. In other words, potentially lose sight of how you can impact the health of people in the real world. This experience is making the connection of scientific study to improving the health of patients very clear. It is strengthening my motivation to work in the medical field and to continue to pursue studies in science. I have now seen the direct impact that medical professions have on individual people’s lives. Our analysis is directly helping current patients as well as helping to further the study of successful kidney transplantation.

My work at Columbia is certainly going to help to improve my skills and confidence in the laboratories at Brandeis. It has also helped to strengthen my analytical and reasoning skills over the summer. So far, I’ve had a lot of fun and learning along the way!

Arielle Leeman, 2022

Kidneys at Columbia

This summer I am doing kidney transplant rejection research at the Columbia University Irving Medical center. The start to my internship has been wonderful! On my first day, I was filled with excitement and nervousness.  As I arrived at the Starbucks on the corner of Broadway and 168th in NYC, I was greeted by my supervisor and by my lab partner. Each morning and afternoon I take a brisk walk from my apartment on 186th, just 18 blocks away. Arriving at the Starbucks, that first morning, I was shown the route to the lab. My lab partner is from Finland, and as the first person that I have met from Finland, it will be great to do research together and also learn a bit about Finish culture.

Within the Columbia Irving Medical center there are many different departments, along with the Columbia Presbyterian Hospital. You can see in the photo here the entrance to my building, titled the “College of Physicians and Surgeons – School of Medicine”. On some of the floors of the building the labs are specifically for medical and surgical medicine students. The floor that I am on however, is a part of the Department of Pathology and Cell Biology. Within this department, there are dozens of doctors doing both clinical work, as well as conducting research.

The doctor that I am working for specializes in

renal pathology, looking at the kidneys and the urinary system. She has patients who she often does not see face to face. As a pathologist, she will usually get the tissue samples on a slide for those patients needing medical attention. She will then look at the tissue sample under a microscope and, with a high level of expertise, she can withdraw critical information from looking at the cells and make diagnosis or predictions. The research looks specifically at kidney transplants and when they are rejected. After a person has kidney failure in both of their kidneys, they can either go on dialysis (this involves getting their blood filtered once, twice or even three times a week), or go on the transplant waiting list. 
The waiting list can take a long time. When someone finally receives a new kidney, there is a shockingly high percentage of people that reject the new kidney. In America, 21% of patients reject a kidney within 5 years of getting a transplant. A kidney transplant would be rejected when the immune system does not see the new kidney as trying to help the body, but rather as a pathogen (a foreign substance) trying to harm the body, thus causing the immune system to attack and reject the kidney transplant. In an attempt to avoid this problem, patients that have a kidney transplant are put onto anti-rejection medication (immunosuppressants) that suppress the immune system and prevent it from attacking the newly acquired kidney. I am helping do research which attempts to determine why the kidney transplant rejection is taking place in order to prevent it. To do this, we must analyze the spatial quantitative distribution of T cells (immune cells) in human kidneys that are rejected. Over the past two weeks, I have been learning the intricacies of kidney anatomy, working in the lab to do immunohistochemical slide staining, to then have had the opportunity to analyze the cellular tissue on advanced computer software. I also went to a seminar downtown near Penn Station to learn about an imaging software, to help me better use it in the lab. My goal is to learn a ton more, and to make an impact on the research in the lab. Stay tuned for next time where I will share more scientific detail about work in the lab and explanations of the kidney anatomy and cellular immune response reasons for rejection. Hope you are having a good start to the summer!