For the first time in my career I asked myself that question. Over the years, I’ve had more than my share of difficult cases. I’ve had patients with life threatening conditions whom I wished I could offer more than to just shake my head and speak empty words of encouragement. They stare back at me and I see their eyes full of hope. How many times have been forced to …
A new crop of medical students will begin a residency in plastic surgery this summer. They have worked long and hard to secure these coveted spots. As a service to them and the profession, I wanted to take this opportunity to help make their path a little easier by offering a bit of advice.
When asked what you do, simply say that …
Next in a continuing series.
There’s a reason for the cliche — surgeon barks out the name of an instrument, scrub nurse whacks it into the hand. The reason is this: when you are focused on a particular area — especially if it’s one in which danger lies — you don’t want to look away. If you need to change …
If you’ve read my reviews of the new medical TV show Monday Mornings, you’ll know I’ve been critical of many things about it. I was particularly disappointed with the way the show handled one of its central themes: the morbidity and mortality (M&M) conference.
I thought it might be useful to tell you how most real M&M conferences are run. M&M conferences generally take place at hospitals with residency training …
We were instructed not to knock, that the examiners would invite us in when they were ready. Even under the bright lights and unforgiving atmosphere of an operating room emergency, I couldn’t recall being this nervous. Yet today, in the dimly lit hallway of a three-star hotel, my hands trembled without a bleeding patient or sharp instrument anywhere nearby. I glanced left …
Next in a continuing series.
Inside the belly, everything is slippery. The peritoneum is a glistening layer of self-moistening plastic wrap, enveloping the surfaces of all the organs, and the inner aspect of the abdominal wall. Undisturbed, the intestines coil and slither, reptilian. Watching waves of peristalsis makes me smile: there’s something always entertaining about those moving contractions, following one upon another, gurgling, surprisingly tight bands of tension moving …
New research just out in the journal Psychology and Aging says pessimists live longer and healthier lives. If this is true, then contemplating the future of anesthesiology ought to make us immortal, because our professional prospects don’t look bright. As we teach residents to do what we’ve always done, shouldn’t we ask ourselves honestly if we’re training them for a future that doesn’t exist?
Especially here in California, it seems …
Next in a continuing series.
Traction and counter-traction: along with maintaining excellent exposure, that is one of the fundamental principles of operating. It’s Newtonian: equal and opposite. In nearly all forms of surgical dissection, there’s a need for some pull in the opposing direction: tissues that are a little stretched-out, that are under some tension, fall open more easily when dissected. Plus, it’s a form of stabilization, another obligatory …
Although I rarely get sick with the numerous strains of “bugs” that seem to go around our community this time of year, the week prior to my return to work for my next scheduled string of four shifts was spent mainly in bed, coughing and aching and whining about how miserable I felt. Fully recovered, though, I was excited to return to the emergency department to do my fair share …
In March 2008, prominent Denver business owner Leslie Fishbein suffered cardiac arrest and died after receiving trigger point injections with bupivacaine for chronic neck pain. Ms. Fishbein owned a chain of high-end furniture stores. She was well known within the community because of her starring role in television commercials promoting her business. Her death drew tremendous media attention and heavy scrutiny for …
Next in a continuing series.
The preliminaries are over. Sponges, needles, and instruments have been counted and checked, their number recorded on a whiteboard on the wall, as well as a clipboard. The checkoff is a comforting hum of words; the tuned machinery of the workplace. As the bottle of local is opened and poured into a sterile bowl on the …
As trauma surgeons we often have to disassociate ourselves from the stories that surround our patients so that we can focus on their life-threatening injuries. It’s also how I personally cope with the devastating injuries to the patient and the aftermath left for the family. Sometimes, though, I am caught off guard and my defenses aren’t strong enough.
A middle-aged man was brought in one evening after being hit while riding …
Christmas morning at 1:30 am the phone chimes away. What the … I’m not on call.
“Please call Dr. Dred for patient Selma, perforated colon at local ER,” read the text message.
Why are they calling me, I’m not on call. Dr. Young is. Maybe something’s happened and they can’t find him.
So, I called. It was just as reported. There was a fifty year old female with abdominal pain for three days, …
ADVERTISEMENT
The patient had arrived for a urology procedure with a blood glucose in the 400’s. He suffered from a recent stomach bug and had gotten off schedule with administration of his meds. While his GI symptoms had subsided, he was feeling crappy overall. I decided to cancel his case and went about initiating treatment to get his blood sugar under control. When I informed the urologist of my findings and …
In my hospital’s preoperative area, upright on her bed, sat an unhappy middle-aged lady who needed an operation to treat complications from her previous bariatric surgery. She hadn’t lost weight and clearly was feeling discouraged about practically everything. She was physically uncomfortable, couldn’t even keep down her own saliva because her lower esophagus was obstructed, and was in tears.
As her anesthesiologist, …
From the moment I first stepped into a restaurant kitchen, it felt like home; even though for the past eight years my real home has been an operating room, as I am a surgeon.
Though many on the outside may not realize it, the chef and the surgeon have much in common. Both profess modest beginnings. Cooks were slaves and surgeons were barbers. Those who did the cutting were not even …
When I clicked on the “View Your Exam Results” link on the American Board of Anesthesiology website, I thought something rashly exuberant would engulf me. I thought that everyone in the lunch room would turn suddenly, throw their reheated pasta and cafeteria sandwiches high aloft with glee and balloons would gush from the cracks between the fluorescent lights on the ceiling as the whole world burst into song.
But instead, there …
Doctors don’t like to go to doctors. I suppose we might see it as a failure or more likely it is pure intellectual arrogance. Whatever the reason, there can be no excuses when you need to get an insurance examination form filled out. One way of taking the edge off it is possibly to try to use your conversational skills to awe the poor general practitioner forced to see a …
Virtually every medical school graduate immediately enters at least three years of post-graduate medical training (internship-residency). The exceptions are those who:
1. combine the MD with a JD or PhD;
2. leverage the not-yet-dry diploma into a post as health policy advisor to a state or federal legislator, usually one of Dad’s chums;
3. are named Michael Crichton.
Commencement is in late spring, so post-graduate training begins on July 1. Every year my surgery …
We’re not going for sympathy here. Doctors as a whole enjoy less sympathy than many other professional groups (members of Congress enjoy the least, I would think), and that’s probably appropriate. They have high incomes and many prerogatives and rank highly in esteem polls as individuals, if not as a group. It’s not where they are that is causing the grieving, it is where they are coming from.
Let’s deal with …
Get free updates delivered free to your inbox.
