“My mother, bless her ninety-year-old heart, is slowing down. The things that made her happiest — getting to church, visiting friends, taking walks, and wandering the aisles in the grocery store —are increasingly difficult. She worries that her lack of energy will soon make every activity impossible.
It is 2005 and …
Stories of surgery, clarity, and grace [PODCAST]
Do you have any idea how beautiful you are? Well, OK; maybe for some it’s were. Before you got a little thick in the middle, smoked, or even just breathed city air for enough years, or drank a little, or did a few drugs, there was a time — and maybe it’s still true — when you were knock-down, take-your-breath-away gorgeous. While operating inside a belly, I’ve often stopped working …
Do you have any idea how beautiful you are on the inside?
I am a former chief of surgery and a scientific entrepreneur.
My practice consisted of patients who suffered from serious injuries and illnesses. Concerning the latter, a significant number had cancer, especially breast cancer. The issue all patient groups have in common to a certain degree is protein calorie malnutrition (PCM). The most dramatically affected are those stricken with a malignancy. PCM leads to increased morbidity, mortality, …
Protein calorie malnutrition is devastating for patients
“Dehumanizing patients can lead to indifference in physicians. It is a privilege to be trusted to take care of every patient we encounter, yet we can lose sight of this and begin to see our patients as a burden, or as units of work, rather than as individuals. When individual …
A neurosurgeon’s lessons on love, loss, and compassion [PODCAST]
Four years ago, I was ready to throw in the towel. I practiced for 22 years in a large metropolitan hospital, became very involved in resident education, clinical program directorship, medical staff affairs, in addition to a busy hospital-based surgical practice. I watched as the environment of care for clinicians and the quality of the relationship between the medical staff and system administration steadily deteriorated.
My small, single-specialty surgical group merged …
Ageism and the mid-career physician
As a practicing surgeon for 30 years in the super-specialized field of otology, neurotology and skull base surgery, I have been privy to some of the most disturbing realities of surgical care. Often, these realities are bleaker than most people expect. One thing physicians, and the general population, need to be more aware of is the very real racial disparity in surgical care.
Are the outcomes for Black and Hispanic patients …
The bleak reality of racial disparity in surgical care
“You will be asleep for your surgery,” anesthesiologists often reassure their patients. Just before the start of anesthesia, a patient may hear the nurse saying, “Think of a nice dream as you go off to sleep.”
While these statements are intended to soothe patients during a stressful time, they gloss over this critical fact: Anesthesia is not like normal sleep at all. That’s why you need medical doctors – anesthesiologists – to take …
You are not “asleep” under anesthesia
While we’re not there yet, we may be approaching a point where we’re facing a significant skills shortage among surgeons. A 2017 study by Meritt Hawkins found that 52 percent of orthopedic surgeons were 55 and older, as were 48 percent of general surgeons. As many surgeons approach retirement age, there is a pressing need to up-skill and up-level the next generation of surgeons, especially with demand …
Robotic surgery’s impact on training the next generation of surgeons
How is your ego serving you?
Medicine is a hierarchical entity. More so in surgery.
There is a linear line of command from the chief to the junior to the intern to the med student to the aspiring med student.
“Shit rolls downhill,” we said as interns while we powered through the 29th-hour on-call or the seven pending discharge summaries we had to finish, while a nurse was yelling or paging us 12 …
Due to COVID-19, hospitals were forced to reevaluate and rework systems and processes that had been around for decades. From managing the increasing demands for testing and treating patients with the coronavirus to acquiring necessary medical equipment to keeping beds available, hospital administrators, providers, and staff showed true heroism. At the same time, the constant ebb and flow of COVID-19 surges caused hospitals to experience significant financial challenges, and …
Surgical volumes are still down. A data-first strategy is the key to recovery.
I began this journey in 2010. It began as a fresh-smelling breeze after a year and a half of anxiety, depression, and uncertainty. I did not think I would be a surgeon. I thought maybe family medicine, psychiatry — at worst, I would like gynecology. I outgrew the fear of the stereotypes and chose surgery for myself, despite what my now-husband warned me. He thought it would change me, depress …
Lessons learned from a general surgery chief resident
My friends and I spent Thanksgiving 2018 attending surf school in Jacó, Costa Rica. We spent that week fully immersed in twice-daily surf sessions interspersed with conditioning, balance exercises, and of course, downtime to explore the town and rainforests of Jacó. Having been on a surfboard only a handful of times previously, this was a new experience for me. Our surf instructors quickly got us out on the water, and …
Feel the musicality: A surgeon explores how he learns
In his 1862 novel, Fathers and Sons, Ivan Turgenev describes (spoiler alert) a death from sepsis in excruciating detail. There is nothing to do but comfort the man in the throes of mortality, his parents, and unrequited love at his bedside.
Today, thankfully, modern technology and processes can deliver a quick diagnosis and treatment, often saving the patient’s life and about two weeks of brutal suffering. Technology is essential, but attention …
When new technology is no match for old-school medical tests
An excerpt from You What?!: Humorous Stories, Cautionary Tales, and Unexpected Insights About A Career in Medicine.
The relationship between physicians and nurses is a complicated one. We are both there to “Take care of the patient.” Each has their own role. Doctors are undeniably in charge of ‘their patient’s care.” Particularly in an operating room. Somebody has …
Be nice to the nurses. Respect the nurses.
“We need to shampoo the patients’ hair,” said Kristen, a physician assistant with a two-foot flaxen rope of her own. She’s an authority. Operating room nurse Jess seconded the idea. Between the two of them advocating, it needed to happen.
Somehow for the last 23 years, as a man with short hair, I’d always considered a rinse with water or peroxide to be sufficient to clean a patient’s scalp and hair …
How washing hair taught me to be a better doctor
As I embark on my chief year in general surgery, I look forward to most is taking junior residents through operations. I am grateful to have had excellent teachers over the past five years, and I appreciate the opportunity to pay forward this mentorship. But taking what you have learned and teaching someone else turns out to be a very different challenge than learning itself! Suddenly, you realize your attendings …
“Use the force”: How do we teach in the operating room?
In his novel Buddhism Without Beliefs, Stephen Batchelor observed that “death alone is certain and the time of death is uncertain.” This knowledge should guide us in one of our most important decisions: How should we spend our limited amount of time on earth?
Why do you work so hard?
There are many different reasons why people might work too hard. Often they toil out of necessity. …
Put down the knife: A neurosurgeon explains the importance of a work-life balance
If you’ve been diagnosed with a condition and the recommended treatment is surgery, there are proactive steps you can take to lower the risk of post-surgical complications and improve the likelihood of a good outcome. First, before deciding to undergo surgery, which always carries some risk, seek a second opinion from a physician who has experience treating the specific diagnosed condition. In most non-emergency cases, undergoing surgery immediately after diagnosis …
Choosing an experienced surgeon and high-volume hospital can impact your outcome
As an aspiring surgeon, I at times contemplate whether being creative has any effect on my future career. On one hand, if you see surgery as an “art,” then possibly a creative personality is beneficial. On the other hand, surgery often seems objective and clear-cut, qualities often deemed uncreative. Perhaps even my goals of surgery and my interests in artistic creation are independent, noncommunicating personality features that are unrelated and …
Why creative endeavors are important for the future surgeon
A moment in medical school that left a huge impression on me was when we had chairman’s rounds with the department of medicine’s chair. He was a renowned breast oncologist and researcher and described a bit of his process when interacting with a patient. The process he had developed over his years of experience was so fine-tuned that there was not a single movement, action, word, or breath that was …
I’m the best anesthesiologist there is
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