An excerpt from Off the Top of My Head: Stories from the Operating Room That Will Make You Laugh (or Cry).
“She has a size six head and a size four brain,” said my chief resident, Robert. “It saved her life.”
I was a junior resident at Shock Trauma and had called Robert in to see an 80ish-year-old patient named Hilda who had a large traumatic brain hemorrhage after a car …
Why a shrinking brain survived a deadly brain bleed
As someone who has spent decades peering into skulls and pondering the fragile machinery inside, I have seen firsthand how our gray matter can falter under the weight of time, stress, and poor habits. But here is the exciting part: Science is handing us tools to fight back. In this post, we will dive into brain biomarkers, those clever little signals in your blood that reveal what is happening upstairs. …
How blood-based brain biomarkers predict Alzheimer’s progression
An excerpt from The Clinical Research Handbook: A Practical Guide to Designing, Conducting and Publishing Clinical Research.
Research is a powerful force for change. Whether addressing global health care disparities, improving local community services, advancing technology, or exploring the frontiers of science, well-chosen research projects can solve practical problems and expand our understanding of the world. However, identifying the “right” question is often the hardest—and most critical—step in this journey.
This …
A step‑by‑step guide to crafting meaningful research questions
If you asked the third-grade version of most doctors what they wanted to be when they grew up, I bet most would have said, “I want to be a doctor!” I doubt many would have said “hospital administrator” or “life coach.” Yet, according to a recent Medscape survey, nearly one-quarter of physicians are considering a shift to non-clinical careers. They are burned out and want to work …
Never let a bad job or bad people convince you to quit medicine
Over coffee each morning, I quickly skim the headlines on my laptop before heading to work. It is Washington winter, it is dark outside, and the headlines in health care news are grim. Health care workers are burned out. Doctors are working hard all day and coming home to find scathing reviews on online rating sites. Some have their compensation tied to the results of patient surveys. Patients are trusting …
A neurosurgeon and patient satisfaction scores
Each day I am inundated with reminders of why doctors are leaving clinical practice. My peers are exhausted by pandemic patients and pandemic controversies. They feel unappreciated and overworked doing what was originally their passion. Many feel they are part of an industrial machine, turning out widgets in the form of patient visits or procedures. They want to leave. Should I? Wouldn’t it be easier to be a dog-walker, park …
A neurosurgeon finds another reason to stay in clinical practice
The headlines read “Why Healthcare Workers are Quitting in Droves,” “Docs are Leaving Practice,” and “Physician burnout declared a public health crisis.” The side-gig, financial independence retire early (FIRE), and non-clinical career posts pop up in my daily professional media feeds. Believing in the power of suggestion, I wonder if I should start looking for career number two.
Start. That’s a joke. …
I am not leaving medicine because I like the clinical practice part of my job
People who experience debilitating back pain come to their doctors with one pressing question: Do I need back surgery? Often, they are surprised to hear me, a neurosurgeon, answer, “No.” In many cases, physical therapy, pain management, weight loss management, and physiatry can help people to delay – and in some cases avoid – back surgery.
However, if those remedies don’t work well enough, a person might decide that spine surgery …
Expertise is the backbone of successful spine treatment
The transition from pumpkin spice to gingerbread lattes may conjure warm, cozy holiday feelings for some, but for those of us who treat trauma patients, it signals the beginning of Ladder Season. There is something in the crisp late Autumn air that is driving people to dust off their rickety ladders and climb onto the roof. Later they will line our ER hallways, a spinal fracture here, a pelvic fracture …
Testing gravity during Ladder Season
A message appeared in the chatbox. “Always trust the parents. If they think the shunt has failed, more likely than not, they’re right.” It was one of the two fifth-year neurosurgery residents, both present on the video platform for virtual clinic to moderate medical students through patient cases.
Prior to each virtual clinic session, the two residents would meet with me, fellow MS2 summer research students, and MS4 “visiting” interns, in …
How virtual learning enhanced my immersion and mentorship in neurosurgery
As a 4th-year neurosurgery resident, I’ve tried to sink my heels into every aspect of neurosurgical care in order to harness the skills, the knowledge, and the confidence to know that I’ll be ready to provide exceptional care to my own patients at the end of seven years of training. If you asked me before the COVID-19 pandemic, I would have never considered that telehealth and virtual care would not …
Virtual care for surgical subspecialties
Summer, 1998
Three Rivers Stadium
Pittsburgh, Pennsylvania
It was a typical Saturday morning on call. We’d finished rounds and I’d taken the sign-out from the resident who’d worked the night before. I headed to the library, planning to do some board prep before the inevitable beeper call to the ER or ICU. I was a PGY-4 neurosurgery resident, with many previous weekends on duty to my credit. No reason to think this one would be …
What a World Series MVP taught me about practicing medicine
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