A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.
As an anesthesiologist and pain physician, I understand the complexity of pain management procedures required for chronic pain disease. Chronic pain is a disease like others such as hypertension and cardiac disease. Several interventional pain procedures can be dangerous, even in the hands of the most …
Unless you’ve lately returned from a retreat at a remote Cistercian abbey, if you’re interested at all in women’s issues you’ve probably read Anne-Marie Slaughter’s recent article in the Atlantic, “Why Women Still Can’t Have It All.” The author eloquently tells how she left her dream job in the State Department as the first woman director of policy planning in order to return to her husband, her two …
The patient had a large abscess surrounding his spleen. On a large screen in the middle of the operating room, I watched a surgeon drain the fluid collection and remove the organ with small metal tools.
I remember the surgeon navigating the complex anatomy with alacrity, handling the laparoscopic equipment with expert finesse, and quickly and confidently answering the battery of questions from the assisting medical student. To a young and …
All of us hate waiting in lines. Our society breeds a “me-first” attitude. Often the lines in which we wait are slow to move and, we become irritable and angry. Somehow there is always someone who is able to outsmart the system and get served ahead of their place in the queue. In the typical queue at the grocery store, (or at the apple store genius bar) we become impatient because …
One of the most memorable discussions regarding the cost of care was at 4:45AM during surgical morning rounds.
As usual, the interns would present the overnight events of their patients to the chief resident and a plan for the day would be agreed upon. These morning rounds were particularly intense: in addition to the 30 patients that an intern had to manage solo over night, the brutal hours that the surgical …
The end of my residency and beginning of my practice was the most wrenching experience of my life. I was woefully prepared for the transition. Full disclaimer: I was trained many years ago when residencies were acknowledged brutal demeaning processes. Things have changed considerably, but the psychological passage I endured still holds.
I think my process of becoming a surgeon was fairly typical, with the exception that there was no one …
Does muscle weakness improve after disc surgery?
For an NFL fan arguably the best thing that could happen to your team is to sign Peyton Manning and have him perform at or near his pre-injury level. The corollary is that one of the worst things to happen to your team would be to take a huge salary cap hit to get a Peyton Manning with such weak throwing arm that even …
There’s been a great divide between the medical and surgical specialties ever since I can remember. Surgeons believe internists perseverate too much when decisions need to be made. Internists consider themselves the true intellectuals of medicine. I suppose anesthesiologists like me fall somewhere in the middle–we work in surgery, but have to take care of all the medical problems the patient brings to the OR table. Does that make us …
Do ear surgeons perform facelifts? Absolutely!
And we perform nose surgery and throat surgery, too!
A recent article in the New York Times presented a scathing editorial on complications caused by poorly trained surgeons. However, the implication of the title “Ear surgeons performing facelifts,” is misleading and overlooks the fact that a large portion of training in the specialty of ear, nose and throat surgery includes plastic and reconstructive surgery of …
I’ve only had to declare death a couple of times. Once in a three-year-old and once in an adult. In each case the heart had stopped beating. Death was clear.
Brain death is tougher to cope with, both clinically and psychologically. I imagine it would make anyone want to say, at some point, “Are you sure? Are you really sure? How do you know? How can you be sure?” Some times …
I got home recently after a 14 hour day in the operating room with (predictably) a pair of really tired feet, which lead me to think about shoes, foot rubs, and the fact that no one ever talked to me about this in my training.
What kind of shoes should you wear in the hospital?
There’s a lot of walking in the hospital, but there’s even more standing. Running shoes don’t provide …
The principle of autonomy is one of the four guiding principles of medical ethics, the others being beneficence, nonmaleficence, and justice. It means that patients have the right to decide what is done to their own bodies. For children under eighteen, the age of majority, this means their parents decide for them. What happens when parents refuse a treatment that their child’s doctors recommend? (The right of a minor child …
What causes a doctor to commit suicide?
A story about a radiation oncologist from Springfield, IL brought this strange case to my attention. Dr. Thomas G. Shanahan committed suicide by cutting his throat in November of 2011. He was respected in his field, having published many research papers and traveled the world helping to set up brachytherapy clinics in several countries. He also had been an acting alderman in his …
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Let me start by saying that I love my father dearly. We have an excellent relationship, and talk regularly. So there’s no bitterness in this post, nor any desire to engage in armchair psychology.
My father, now retired, was a general and thoracic surgeon, who was triple-boarded in critical care, and ran a trauma unit in inner-city Philadelphia. He was in private …
No matter how quickly you tried to switch the television channel lately, you probably couldn’t escape the trial of Dr. Conrad Murray or avoid hearing about propofol, an anesthesia drug that can be fatally easy to use.
What you may not have heard is that the American people just dodged a serious threat to their anesthesia care, and most don’t know how near a miss it was.
The Centers for Medicare and …
Before going any further, the title to a Los Angeles Times story was “Adele to have surgery to treat vocal cord hemorrhage. What is it?”
I sincerely hope that whomever her surgeon is knows not to perform surgery when the vocal cord is in the middle of a hemorrhage. You do the surgery when the hemorrhage is gone and the culprit blood vessel is left behind which likely is the reason …
One of the saddest, but more treatable, causes of hair loss in patients is trichotillomania, the impulse control disorder in which a person repeatedly pulls out hair from their body for non-cosmetic reasons. While some people have never even heard of trichotillomania, according to the Trichotillomania Learning Center, as many as ten million Americans (or 4% of the U.S. population) suffer from the disorder.
According to the Diagnositic and Statistical Manual …
Every medical student goes though a process of elimination when deciding what kind of doctor they want to become. We hear the old saying, “Internists know everything and do nothing; Surgeons know nothing and do everything; Psychiatrists know nothing and do nothing; Pathologists know everything and do everything but it’s too late.” We hear that pediatricians wear bow ties, are short, and love to laugh and play; that surgeons …
This is a difficult story to tell but if I am to be true to the complete experience of a surgeon, I do need to tell it.
One of my seniors used to say that every surgeon has a graveyard hidden away somewhere in the dark recesses of his mind. He went on to say it was unfortunately normal, so long as you remember all the names engraved on the tombstones. …
People blame anesthesia personnel for everything. You name it, they blame us for it. They call us by the umbrella name “Anesthesia” and if there’s a problem, it’s always “Anesthesia’s” fault.
Got into the room late? Blame Anesthesia. (Even though the anesthetist’s been sitting at the bedside for twenty minutes waiting for the surgeon or the nurses to be ready.)
Patient craving ice cream when she woke up? Must be Anesthesia’s fault.
No …
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