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.

Guts on the bed: A surgeon talks postoperative evisceration

Hope Amantine, MD

Physician

May 16, 2015

We spend a lot of time in medicine in education. Pursuing medicine as a career requires embracing learning for a lifetime, because there is always something new, always something different, new approaches, new medications, new discoveries — we want what’s best for our patients, and you can’t deliver on that promise unless you know what’s out there.

As a consequence, we spend time trying to organize information, categorize it, study it, …

Tests in medicine and public schools: What do they really measure?

Shirie Leng, MD

Physician

May 10, 2015

Humans are social creatures who naturally evaluate where they stand in relation to those around them. I have no idea how this evaluation process evolved, but at some point we noticed that some cavemen brought more food to the cave than others. The idea was born that some people are better hunters than others. We’ve been trying to decide who is “better” ever since.

The origin of the word “test” comes …

It ain’t bleeding until you can hear it bleeding

Hope Amantine, MD

Physician

May 8, 2015

Bleeding is upsetting. At least, that’s what I’ve been told. I mean, I have noticed that many people have visceral reactions to the sight of bleeding, or even just blood. People who pursue a career in surgery generally do not have this kind of reaction, and I find it interesting that it can distress some individuals while others are not at all bothered by it.

This might lead you to assume …

A surgeon who wasn’t God in the OR after all

Hope Amantine, MD

Physician

May 4, 2015

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Do you know the difference between a surgeon and God? God doesn’t think he’s a surgeon.

Everyone who goes into the study of surgery has ideas about what they’re going to be. I would imagine that each individual has different expectations of what the future holds, though few find their future at all resembles those expectations.

I recall when I started my surgery …

A physician anesthesiologist reports in from Afghanistan

Jesse M. Ehrenfeld, MD, MPH

Physician

May 4, 2015

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

As a physician, you never quite get used to being paged in the middle of the night. The shrill tones emitted via a radio frequency device that seems squarely stuck in the 1980s are almost always …

Dear drunk driver: From your trauma surgeon

Jamie Coleman, MD

Physician

May 4, 2015

Dear drunk driver,

Tonight, I am tired.

Tired from lack of sleep, tired from the long hours, and tired from bearing witness to your destruction.

Tonight, you caused an accident while under the influence of alcohol. And you are badly injured, requiring emergency surgery. Your liver is hard, cirrhotic, and unforgiving. Although I can get you through this first surgery, I know you will …

The downsides of automating health care

Skeptical Scalpel, MD

Physician

May 2, 2015

If you are a doctor, nurse, patient, or just someone interested in patient safety, you should read a five-part story called “The Overdose: Harm in a Wired Hospital” excerpted from a book The Digital Doctor by Dr. Robert Wachter.

Dr. Wachter and the hospital are to be commended for publicizing this incident so others may learn from it. The hospital staff, the patient, and his mother, also deserve credit for allowing their …

Read more…

The downsides of automating health care

When is it OK to secretly record your doctor?

Jeffrey Parks, MD

Physician

May 1, 2015

JAMA published an opinion piece about the controversial issue of patients secretly recording their physicians during encounters. We live in the era of the smartphone. Everyone has one — soccer moms, teenagers, young kids who can’t even read yet, elderly nursing home patients who can’t safely feed themselves. Everyone. And these devices have amazing powers of audiovisual capability. We all know this. …

IMGs matching into surgery: What are the chances?

Skeptical Scalpel, MD

Medical Education

April 25, 2015

Anyone considering attending a Caribbean or any foreign medical school should do due diligence. An Internet search is step one. If the school does not list residency match statistics, that could be a red flag. It would not be easy to accomplish, but try to speak with some current students or recent graduates of any schools you are thinking about.

If the school won’t give you any names, use caution, and …

So you want to be a female surgeon. Here are 10 tips to make it.

Dr. Nikki Stamp

Physician

April 24, 2015

I am lucky enough, from time to time, to be invited to speak to young women who want to be surgeons when they “grow up.” I always have a hard time striking a balance between what I should share that is positive and inspirational and what I should share that is a little harsh and uncomfortable. Once, I turned to my …

How Murphy’s law applies to medical students

Bradley Lander

Medical Education

April 23, 2015

If the analogy between medical training and a fraternity is true, then medical students are the pledges.

For many, the most grueling part of this pledge process is the third year surgery rotation where the modified Murphy’s Law is applicable almost daily: Anything a medical student can do wrong, a medical student will do wrong.

In a fraternity, pledges can do no right. …

I am a general surgeon. There is no shame in that.

Jeffrey Parks, MD

Physician

April 22, 2015

A few months ago, I was seeing an elderly man in the hospital with a sigmoid mass seen on his colonoscopy that day. He had presented to the hospital with fatigue and anemia, and the long meandering workup eventually zeroed in on this malignant appearing mass as the source. His daughter was in the room while I discussed the results, the …

Mental illness: Is it organ dysfunction like any other?

Hope Amantine, MD

Physician

April 19, 2015

I often get referrals from the town’s free clinic. As you would imagine, the patients often have a unique set of problems, coming as they do from the underserved segment of society.

One such patient, Julia, was a fiftyish-year-old woman who had recently moved to town from California. She went to the free clinic (not really sure what the original complaint was) and ended up getting a physical exam that revealed …

A tale of two surgeons: Which would you choose?

Thomas D. Guastavino, MD

Physician

April 17, 2015

Let’s face it, residency is no picnic. A combination of on the job training and trial by fire, no physician who has gone through it and survived will ever forget the experience. The emotions run from jubilation to sheer terror. It is inevitable that some of the people you interact with will leave a lasting impression. In the case of the …

Crisis averted after a tense moment in the operating room

Starla Fitch, MD

Physician

April 15, 2015

How many times do we start out our day with the best of intentions? It’s probably most days, if you’re at all like me.

Even when we’re going through a spell of negativity, we all try to pull it together for the sake of our patients, our staff, our families.

A couple weeks ago, I was tempted to throw in the towel.

It was one of those days when the last straw was …

So you want to be a surgeon? Here are 10 tips to help you.

Dr. Nikki Stamp

Physician

April 12, 2015

My interns started the term with mixed career aspirations. One wanted to do interventional radiology, the other, “not sure.” Now, in their last few weeks of our term, they’re thinking about a surgical career. Which I think is great. I’ve been lucky enough to have had some great advice over the years, and I’ve nutted a few things out myself along the …

What does it mean to be a health care leader?

James D. Grant, MD

Physician

April 10, 2015

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Clearly, physicians are the leaders of the health care team. We were educated and trained for that role.

But on the business and political sides of health care, maybe not so much.

One reason is that the word “leadership” has a lot of different meanings. A leader in one …

10 secrets to success as an academic surgeon

Sarah Bryczkowski, MD

Physician

March 30, 2015

1. Be yourself and learn to be flexible. Don’t ever change who you are as a person. It’s OK to have a personality of your own. If you secretly listen to Taylor Swift’s Shake it Off on the way to work, it’s OK. As a junior member of the team it’s very unlikely your iPhone playlist will make the cut for the operating room …

Ground rules for the aspiring surgeon

Matt McCarthy, MD

Physician

March 29, 2015

An excerpt from The Real Doctor Will See You Shortly. Warning: Contains explicit language.

It started with a banana peel.

After years of quiet study in the libraries, laboratories, and lecture halls of Harvard Medical School, I finally made the tectonic shift to hospital life in the summer of 2006. The third year of medical school marks a …

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Ground rules for the aspiring surgeon

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