Surgery

Surgeons writing on KevinMD about the craft and the culture of surgery: training and who holds the knife, the operating room and its checklists, outcomes and whether the public should see them, the robot and now AI, women surgeons, and what it is like to be sued over an outcome rather than a decision. Three maintained records draw on this archive: Surgeons and surgery: what surgeons say, in their own words, Residency: what residents and attendings say, in their own words, and Medical malpractice: what physicians say, in their own words.

Financial freedom goes a long way towards addressing physician burnout

Nisha Mehta, MD

Physician Finance

April 5, 2018

I’m coming off a string of talks about physician finances and physician empowerment, and despite knowing that physicians are stereotypically financially naive, every once in a while I’ll hear a question that really makes me pause and drives home the need for a better financial education. The latest came up when I was discussing negotiation techniques, and somebody interrupted me to ask, “When you’re earning a six figure …

Is surgical training stuck in the past?

Justin Barad, MD

Physician

April 4, 2018

When we look back on the last century, the pace and number of advances in our ability to treat disease and injury is truly astonishing. The exponential growth of technology has contributed to this greatly, as we see new advances often come in the form of new technologies. Amazing innovations in the fields of endoscopy, catheterization, robotics, imaging, navigation, 3D printing and more allow us to do things that were …

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Is surgical training stuck in the past?

What this medical student learned from running a marathon

Shoshana Weiner

Medical Education

March 29, 2018

“4 ounces water every mile, half an electrolyte ‘gu’ pack over 2.5 miles, ¼ energy bar every 6 miles” — a.k.a. how did you manage training for a marathon while in medical school? The simple truth: I decided to run a marathon, so I did. Longer story: months of rigorous training, more moments of doubt than I care to recall, and insights already positively impacting my medical training.

Training for and …

Reading about resident wellness and physician burnout failed me

Joshua Goldman, MD

Physician

March 26, 2018

I leaned back against the wall, breathed into my palms and brushed beads of sweat from my forehead. I wondered if I wasn’t crying because I lacked the emotional capacity, was too exhausted to expend the energy or maybe simple dehydration. Sounds from the preceding hours played on repeat: congratulations on a clean dissection, a panicking anesthesiologist unable to ventilate, the sad songs of bradycardia and hypoxia playing on the …

A physician is often the only person that sets the tone of hope, or despair

Joshua S. Jolissaint, MD

Physician

March 24, 2018

It was mid-afternoon in the ever-bustling surgical intensive care unit (ICU). The nurse, one of those experienced, battle-hardened savants of human symptoms, called me into one of the patient rooms. He was tachypneic on the ventilator with labored breathing and declining oxygen saturations; with each inspiration, his diaphragm would paradoxically elevate, his stomach bulge and the ventilator alarm with the dyssynchrony. Intubated, sedated and unaware, he was fighting for his …

The truth about plastic surgery chains

Jennifer Greer, MD

Physician

March 17, 2018

Over 17 million cosmetic surgery and minimally invasive procedures were performed in the U.S. in 2016. With the increasing popularity of cosmetic procedures, it seems nearly everyone is out to get a bite of the apple.

Cosmetic surgery chains are growing in size and popularity in an attempt to cash in on this market. Examples include: LifeStyle Lift in the U.S., which declared bankruptcy in 2015 …

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The truth about plastic surgery chains

Intern year is still universally hard. Intern year is also universally great.

Grace Faith Chao, MD

Physician

March 17, 2018

4:00 p.m. Right on time.

I am walking down the street with my brother on his first visit to me in residency; I’m only two weeks in.

I turn to him: “Wait a second.”

I place my hand on the cement wall next to us, and I start to heave.

“Um … are you OK?”

“Yeah. No worries. My body’s just adjusting.”

I go on to describe how every day at 4 p.m. after a 24-hour …

My calling includes recognizing and responding to the separation between worlds

Bruce Campbell, MD

Physician

March 11, 2018

“They may forget what you said, but they will never forget how you made them feel.”
– Carl W. Buechner

I draw back the curtain and look within. My patient, Mr. Buchanan, is on the cart. His daughter, Jessica, whom I met during his office visit, sits in a chair with her preschool-aged daughter. He wears a hospital-issue gown and has an IV taped in place. The little girl looks intently at …

The #MeToo movement in medicine can’t come too soon

Heather Hansen, JD

Health Policy

March 7, 2018

I’m a trial attorney, and I’m a woman. Since 76 percent of all lead trial counsel are men, I know what it’s like to be a woman in a traditionally male profession. I also give workshops to women in the medical profession, and I listen to their stories of harassment. I’ve been following the #MeToo movement with interest. It started in Hollywood, and has expanded to Silicon Valley, to …

When you learn about a person’s story, you can’t ignore it

Julia Cartledge

Medical Education

March 4, 2018

I had the honor and privilege of rotating for three weeks on the transplant service where I experienced a lot of great medicine, surgery and the ethics that intertwines them. One late night on service I had the opportunity to travel to a different hospital and help the team harvest a liver and kidneys from a donor. Never had I seen anything more amazing than what I witnessed that night …

For medical school graduates, the entrance strategy is more important than the exit strategy

Tom Ellis

Physician

March 2, 2018

Two years ago I fielded a call from a surgeon I knew of but had not met. Raised locally, she had left the state for undergraduate school, returning to Texas for medical school and North Texas for her fellowship. Heavily recruited, she wanted to stay close to home and her family, and accepted a position with a group of surgeons practicing at one of the area’s stellar hospitals.

But she wasn’t …

Is apathy needed to survive medical school?

Anonymous

Medical Education

March 2, 2018

I’m about two-thirds of the way through my 3rd year of medical school, and I have hit my wall. I have become so fed up with the set up of medical school. I think a decent amount of this comes from the fact I am on my 6th week of an eight-week surgery clerkship (an area of medicine that I literally have zero interest in). I’m tired of waking up …

A code, a trauma, and our fragile humanity

Amy Blake

Medical Education

March 1, 2018

Somehow, I made it to my 4th year of medical school before I saw my first code blue.

I had no experience in emergency medicine before medical school, and my chosen specialty is about as far from critical care as you can get. It wasn’t until my rotation in the emergency department that I got the chance to absorb what it means to care for an emergently sick patient.

I was on …

A doctor to a patient: Please call me when you get home

Aalap Shah, MD

Physician

February 21, 2018

It is 3:30 p.m. on a Wednesday, and I am bringing my last patient out of the operating room. Everyone is in great spirits: a smooth case and an early finish at our surgical center. The patient has already awakened, stretching his arms, and clearly comfortable.

“Everything went alright, doc?”

I smile, knowing that I will be repeating what I am about to say a few more times as the anesthesia wears …

The dark side of negativity bias in medical school

Jay Thetford

Medical Education

February 15, 2018

As a third-year medical student, fresh and green on my clerkship rotations, I was determined to stand out on my general surgery team. I knew this was not going to be easy; I was often the last item on many surgeons’ minds as they rush through morning pre-rounds at the hospital, flying around corners, their Nike sneakers squeaking on the polished white floors.

In the OR, I observed from the corner, …

Is residency an exercise in futility?

Brian Radvansky, MD

Physician

February 12, 2018

It was Saturday. My first day off in the last 14, which included three 26-hour calls. My wife was left home alone for these stretches to care for our 2-week-old son. I’m sitting on the couch, reading a book to my little man, enjoying a much-needed breather, and making up for lost time in seeing him grow into a person.

And the phone rings. Concurrent emergent cardiac surgeries: the only way that …

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Is residency an exercise in futility?

Lifelong lessons from a medical student’s first rotation

Ezinwanneamaka Morayo Ejiofor

Medical Education

February 10, 2018

“How long have you been doing this?” he asked, eyes gleaming with admiration. I was unsure whether he was asking how long I had been conducting patient interviews or how long I had been a medical student. I decided on the latter.

“2 years,” I replied with a confident smile across my chin.

“Well, you’re very good!”

“Thank you,” I replied, almost a whisper. It was a compliment that I was definitely not …

Harassment of women in medicine: We are all in this together

Rita Agarwal, MD

Physician

February 7, 2018

Almost every day there is a new revelation about men committing horrible, criminal, bizarre, or nauseating acts of sexual misconduct. Harassment and assault seem to be rampant. The #MeToo and #TimesUp movements have illuminated the vast scope of the problem. Most stories have focused on famous men in politics, business, sports, and entertainment, but this type of behavior is pervasive. Lately, the lay press, medical blogs, and social media have …

Stop opioid addiction where it starts: in the hospital

Blake Farmer

Conditions and Diseases

January 29, 2018

Doctors at some of the largest U.S. hospital chains admit they went overboard with opioids to make people as pain-free as possible, and now they shoulder part of the blame for the nation’s opioid crisis. In an effort to be part of the cure, they’ve begun to issue an uncomfortable warning to patients: You’re going to feel some pain.

Even for people who’ve never struggled with drug abuse, studies …

What inspires this medical student

Jamie Katuna

Medical Education

January 28, 2018

Someone who I care about deeply messaged me today: “I think I’m done with surgery.”

This person, a surgeon, feels like his potential is elsewhere. There are more opportunities, different challenges, and fulfilling experiences in other places and he is ready to explore.

I told him that he inspires me.

But I am in medical school. So how could someone leaving the medical field be inspiring to me?

Because inspiration does not come from a job description or a fancy …

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What inspires this medical student