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.

The occupational hazards of being a doctor are frightening

Kathryn A. Hughes, MD

Physician

February 13, 2015

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There isn’t any such thing as an ordinary life.
– Lucy Maud Montgomery

Heroes are ordinary people who make themselves extraordinary.
– Gerard Way

My colleague, Dr. Jesse Ehrenfeld, is currently on leave from his academic anesthesia practice as well as from his post as speaker of the house of delegates for the Massachusetts Medical Society to serve as Lt. Commander Jesse Ehrenfeld, combat anesthesiologist in Kandahar, …

How do patients really feel about students and residents?

Ergun Kocak, MD

Medical Education

February 10, 2015

During my residency training in plastic surgery, I remember spending time in the offices of some of our community faculty members. These were invaluable opportunities to gain exposure to the field outside of the academic university hospital, where things were quite different.

The university was a large organization where several residency programs and hundreds of trainees were not just seamlessly integrated into the workings of the hospital, but actually required to …

Touching a life on the other side of the world

Bhupesh Vasisht, MD

Physician

February 6, 2015

plastic surgery In 2012, in a remote town of San Jose, on the southern part of Occidental Mindoro province in the Philippines, I met a little boy and his desperate, but courageous mother. The boy was just a few months past his first birthday. He was born with a facial congenital defect known as bilateral cleft lip, so commonly seen in …

Survival pearls for surgical interns

Rajendra Sawh-Martinez, MD

Medical Education

February 5, 2015

Living in the trenches of a surgical internship can be a gut wrenching, lonely experience for many. The journey from medical student to resident to surgical attending is a notoriously steep trek, necessitating our long 6+ years of training. Surviving intern year remains as hard as ever despite the significantly greater resources and awareness that exists among residency programs today.

These burdens are felt by all specialties and have tragically led …

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Survival pearls for surgical interns

The best doctors expect the unexpected

Skeptical Scalpel, MD

Physician

January 30, 2015

The following is based on an actual case that occurred a long time ago in a galaxy far, far away.

A 65-year-old man arrived in the emergency department by ambulance after being found unresponsive. His respiratory rate was 40 per minute, heart rate was 170 per minute, and temperature was 102.2°. He did not respond to Narcan or an ampule of 50 percent dextrose. Blood sugar was 600 mg/dL. The diagnosis …

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The best doctors expect the unexpected

After a doctor’s murder: All you hear about is deflated footballs

Shirie Leng, MD

Physician

January 27, 2015

This week the local and national attention has been riveted on accusations that Bill Belichick and the Patriots football team deliberately deflated the footballs used in the division championship game. Football, remember, is a multi-billion dollar industry in which the commodity being sold is grown men throwing brown, oblong balls at each other and knocking each other down. Boston.com, a …

Truth in advertising: When is a doctor really a doctor?

Daniel Campos, MD, MPH

Physician

January 27, 2015

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

In an emergency, the first question people often ask is: “Is there a doctor in the house?” When you have a medical problem, the best advice is, “Ask your doctor.” Most people automatically assume that “doctor” in this context refers to a physician with a …

This is exactly why surgeons are so fragile. All of them.

Kathryn A. Hughes, MD

Physician

January 23, 2015

You are human and fallible.
– Charlotte Bronte, Jane Eyre

Alas, the frailty is to blame, not me — for such as we are made of, such we be …
– William Shakespeare, Twelfth Night

Sha-doo-bee, Shattered …
– Mick Jagger, “Shattered”, The Rolling Stones, Some Girls (1978)

The image of the surgeon is synonymous with strength. Surgeons are stereotypically charismatic, commanding, confident, even arrogant. Strong minds, strong bodies, strong wills. Leaders, especially …

The legacy of Dr. Michael Davidson

Miranda Fielding, MD

Physician

January 22, 2015

In 1994, I was working at my first radiation oncology job in San Diego at Grossmont Hospital when I came into work to hear disturbing news. One of my colleagues in medical oncology, a compassionate man known for his gentle nature, had stayed late at the cancer center the evening before to finish up paperwork. With his back to his ever …

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The legacy of Dr. Michael Davidson

The math and politics of organ transplantation

Christopher Johnson, MD

Conditions and Diseases

January 21, 2015

We have a problem in this country with how precious organs for transplant are allocated. The problem has been brewing for years, and is well recognized in the transplant community, the physicians and institutions that perform them. Two recent opinion pieces review the issue well: “Very Complicated Math — Reconfiguring Organ Allocation,” and, “Transplantation Traffic — Geography as Destiny for Transplant Candidates.” Since PICUs such as mine are …

Sexism in the OR: What’s a medical student to do?

Anonymous

Medical Education

January 18, 2015

We recently had a session hosted by the medical education staff at our school where we were encouraged to share any difficult situations encountered in clerkship (submitted anonymously beforehand if that was preferred) and discussed them as a class. Issues regarding ageism, sexism and racism were brought up and addressed with the group. While I have not encountered any of the …

MDs and CRNAs: Highlighting each other’s expertise

Shirie Leng, MD

Physician

January 15, 2015

A front page entry in a recent issue of Anesthesiology News: “Physicians Versus CRNAs: Redefining Roles in the Changing Landscape of Health Care.” Sounds like a prize fight or a gang war: Crips vs. Bloods. I immediately got my boxing gloves on, readying myself for another bout of vitriol and dislike thinly disguised as concerns for patient safety. But the author, Michael DeCicca, a second-year anesthesia resident, surprised me.

He writes: “Logically the number …

Want to know what Atul Gawande thinks? Read this interview.

Robert Wachter, MD

Physician

January 15, 2015

Atul Gawande is the preeminent physician-writer of this generation. His new book, Being Mortal, is a runaway bestseller, as have been his three prior books, Complications, Better, and The Checklist Manifesto.

One of the joys of my recent sabbatical in Boston was the opportunity to spend some time with Atul, getting to see what an inspirational leader and superb mentor he is, along with being a warm and menschy human being. In my continued series of …

The American Society of Anesthesiologists: Deep roots in patient safety

John P. Abenstein, MD

Physician

January 10, 2015

In a hushed surgical theater in Boston in 1846, anesthesia changed medicine forever. The first successful public demonstration of ether anesthesia allowed patients to undergo surgery they would otherwise not have been able to tolerate. Previously, patients who had been subjected to biting down on cloth or looking into a blue light could finally undergo surgery …

Joan Rivers: What should the anesthesiologist have done?

Karen S. Sibert, MD

Physician

January 8, 2015

New York Post reporter Susan Edelman revealed the name of the unfortunate anesthesiologist allegedly present on August 28 at Yorkville Endoscopy, during the throat procedure that led to the death of comedian Joan Rivers. She is reported to be Renuka Reddy Bankulla, MD, 47, a board-certified anesthesiologist from New Rochelle, NY.

Having her name made public will be a nightmare for Dr. Bankulla, as …

How to keep a medical marriage strong

Kim Blackham

Physician

January 4, 2015

Question:

We are currently in the last year of med school, and I’m wondering; what are some practical, everyday things we can do to keep our marriage strong? Especially with intern year coming up.

Answer:

Don’t confuse character with situation. When the demands of life become overwhelming, it is easy to attack your spouse’s personality when in reality it is the situation you are angry …

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How to keep a medical marriage strong

Physician burnout: Medicine fails us

Starla Fitch, MD

Physician

December 22, 2014

We are often our own worst critics.

Whenever doctors feel down, or burned out in our roles as health care providers and healers, we look inward. We wonder what is wrong with us. What could we do differently? We wonder why other doctors don’t have this problem.

The truth is, we do. We all do.

And yes, sometimes the problem is within us.

But other times, the problem is outside of us. Sometimes, it’s …

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Physician burnout: Medicine fails us

Tongue cancer in an elderly patient: Thinking of my grandmother

Bruce Campbell, MD

Conditions and Diseases

December 17, 2014

Old age is no place for sissies.
-Bette Davis

“I want the surgery today!” She started to cry. “I’m ninety-four years old. I’ll accept any risk. Just take this thing out!”

She looked back and forth between the anesthesiologist and me. Her golf-ball sized tongue cancer had been growing over the past six months. It wasn’t changing from day-to-day, but it had increased over the course of the three weeks since we had …

A cardiologist undergoes knee surgery. Read what he learned.

Wes Fisher, MD

Physician

December 10, 2014

The phone rang one evening and a pleasant voice was on the other end. “Hi, my name is nurse so-and-so and I’m the educational coordinator for your upcoming knee surgery. Do you want to go to the patient orientation session?” she asked. “It’s very helpful to go over things before and after your surgery and to answer any questions you might …

Surgery

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