Surgery and surgeons

1,981 articles · Since 2004

Articles, page 52

The initial cut of the surgeon is a leap of faith

August 25, 2013Aug 25, 20135

When Tiger Woods addresses the ball, he's focused like a cat that heard a rustle in the leaves. He takes a few practice swings, moves up to position, adjusts his feet, steadies his shoulders, locks his eyes onto the target.…

When Tiger Woods addresses the ball, he’s focused like a cat that heard a rustle in the leaves. He takes a few practice swings, moves up to position, adjusts his feet, steadies his shoulders, locks his eyes onto the target. He waits until there’s absolute silence, brings his breathing under control, funnels all his energy into the impending swing; takes the club back, and explodes in an immensely balletic movement. …

Medical education

We need to start a revolution in surgical education

Leo Gordon, MD

August 21, 2013Aug 21, 201316

A few months ago I read an essay by Dr. Herbert Fred of Houston, Texas. After reading his essay, "Medical Education on the Brink," I was inspired to start a revolution in surgical education. His essay ends with the following…

A few months ago I read an essay by Dr. Herbert Fred of Houston, Texas. After reading his essay, “Medical Education on the Brink,” I was inspired to start a revolution in surgical education.

His essay ends with the following recommendation:

“…raise the bar of performance in all training programs to a distinctly higher level, with excellence as the perpetual goal.”

As the Fourth of July approached, I began to …

Physician voices

This was not a congenital deformity, but a preventable crime

Bhupesh Vasisht, MD

August 9, 2013Aug 9, 20138

I started seeing patients the moment we arrived at Apollo Hospital in the small rural town of Bilaspur. There was no time to rest. These patients had been waiting for us for weeks to arrive. It was during this clinic time, on this day, that I realized something that really struck me to the core. I have been to India to do these missions many times. Heck, I have been …

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Patient voices

Good doctors are those who genuinely care about patients

Robert Spencer, MD

August 7, 2013Aug 7, 201368

Helpless. That is how I felt when my mother found out she had a fibroid the size of a cantaloupe living in her uterus. In my role as a medical student I might have dismissed the finding as nothing serious, telling my patient, “Don’t worry, it could be much worse.” But as a loving son I was not quite as cavalier. At first my mother resolved to ignore the fibroid, …

Health technology

Disruptive technology in medicine has the ability to heal or harm

Kunmi Sobowale, MD

August 2, 2013Aug 2, 2013

Disruptive technology is a term used to describe new technology that disrupts the status quo. These technologies displace existing technology—dramatically changing the production, delivery, or use of a product or service. For example, 3D printing is an innovative method of producing three dimensional objects using digital prototypes and will change manufacturing as we know it. Although the term is traditionally used in a positive light, this technology, as its name …

Conditions and diseases

Anesthesiology and obstructive sleep apnea: A patient safety challenge

American Society of Anesthesiologists & Jeffrey S. Jacobs, MD

August 1, 2013Aug 1, 20134

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Obstructive sleep apnea (OSA) has been diagnosed in more than 18 million American adults, but there are likely millions of others who suffer with OSA, but are undiagnosed.…

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

Obstructive sleep apnea (OSA) has been diagnosed in more than 18 million American adults, but there are likely millions of others who suffer with OSA, but are undiagnosed. While OSA is frustrating to the patient and the patient’s family, it is crucial to remember OSA is a significant disease that can affect the patient’s safety during and after medical and …

Physician voices

Bigger is not necessarily better when it comes to medicine

Angelo Falcone, MD

July 30, 2013Jul 30, 2013

Two recent articles highlight the challenges we will face as our healthcare system changes with regard to how care is delivered and reimbursed. The first article from the New York Times, Medicare Panel Urges Cuts to Hospital Payments for Services…

Two recent articles highlight the challenges we will face as our healthcare system changes with regard to how care is delivered and reimbursed. The first article from the New York Times, Medicare Panel Urges Cuts to Hospital Payments for Services Doctors Offer for Less, notes that large hospital-centric systems of care do not necessarily serve patients well in terms of cost and sustainability.

The second on the front page of …

Physician voices

In medicine, trust needs to be built in a matter of minutes

Scott Finkelstein, MD

July 27, 2013Jul 27, 20136

I was a very shy child. I never felt comfortable speaking up, especially in groups or in new situations. When asked a question in class, my heart raced, my eyes teared up, and I felt sweaty. As I grew up, these physical reactions subsided as I learned to internalize and manage this fear. But at that time, I could not have imagined that my professional career would depend upon my …

Physician voices

Cockpit culture and using the two challenge rule in the OR

Marjorie Stiegler, MD

July 25, 2013Jul 25, 20132

With the crash of the Asiana 777, we're hearing a lot about cockpit culture and how communication across a hierarchy sometimes fails, even when the very lives of the folks communicating (or failing to do so) are on the line.…

With the crash of the Asiana 777, we’re hearing a lot about cockpit culture and how communication across a hierarchy sometimes fails, even when the very lives of the folks communicating (or failing to do so) are on the line. This isn’t a new concept, and isn’t unique to aviation. Many parallels have been drawn between aviation communication and healthcare team communications, …

Physician voices

Behind the scenes of a total colectomy

Sid Schwab, MD

July 23, 2013Jul 23, 2013

Next in a continuing series. Would you know what I mean if I describe whistling without whistling? Barely pursing the lips, making little quasi-audible windy sounds while inhaling and exhaling, in tune yet nearly silent? Unless there's music playing, that's…

Next in a continuing series.

Would you know what I mean if I describe whistling without whistling? Barely pursing the lips, making little quasi-audible windy sounds while inhaling and exhaling, in tune yet nearly silent? Unless there’s music playing, that’s what I do when I operate. And for reasons about which I have absolutely no clue, I nearly always “whistle” The Caisson Song. I’ve always wondered if anyone …

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Behind the scenes of a total colectomy

Physician voices

Sedasys for anesthesia: Can a machine guide sedation?

Karen S. Sibert, MD

July 16, 2013Jul 16, 20132

Movie buffs and science fiction fans certainly remember HAL, the computer in 1968’s hit movie “2001: A Space Odyssey”. Considered one of the greatest villains in film history, HAL was capable of reasoning and language processing to assist the astronauts on their space mission. Ultimately, however, HAL decided that its best course of action was to kill all the astronauts. “I am …

Physician voices

An ovary removed instead of an inflamed appendix: What happened?

Skeptical Scalpel, MD

July 13, 2013Jul 13, 201319

On June 10, 2013 a 32-year-old pregnant woman was reported to have died after having an ovary removed instead of her inflamed appendix. As the infected appendix festered, she became septic and succumbed to multiple organ failure. This tragedy occurred…

How could this have happened?

Let me count the ways.

The surgery was performed by two trainee surgeons. Their …

Conditions and diseases

A surgeon deconstructs bowel surgery

Sid Schwab, MD

June 29, 2013Jun 29, 2013

Next in a continuing series. Let's make it easy on ourselves. I haven't yet established why -- other than liking the particular operation -- we're removing this nice person's colon. So since our patient has agreed to remain exposed and…

Next in a continuing series.

Let’s make it easy on ourselves. I haven’t yet established why — other than liking the particular operation — we’re removing this nice person’s colon. So since our patient has agreed to remain exposed and to do so for all to see, I declare s/he has diverticulitis. (Were it cancer, the operation would be largely the same, taking a bit more out.) Most likely …

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A surgeon deconstructs bowel surgery

Physician voices

Consoling a family whom I’d never met

Jason McKeown, MD

June 18, 2013Jun 18, 2013

It’s painful enough to lose a patient. But I found it even more painful to try to console a family whom I’d never met. Depending on your point of view, the limited patient contact afforded the anesthesiologist is a disappointment…

It’s painful enough to lose a patient. But I found it even more painful to try to console a family whom I’d never met.

Depending on your point of view, the limited patient contact afforded the anesthesiologist is a disappointment or a perk of the specialty. Anesthesiologists are steadily branching out into other areas of perioperative care where lengthier patient/family contact is necessitated but the preop encounter with the anesthesiologist is …

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Consoling a family whom I’d never met

Physician voices

What should a surgeon do with an impossible case?

David Gelber, MD

June 12, 2013Jun 12, 20132

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 …

Physician voices

Have a safer hospital stay: Use a checklist

American Society of Anesthesiologists & Anita Gupta, DO, PharmD

June 12, 2013Jun 12, 2013

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Thousands of patients undergo surgery every day, but many are unaware how to better ensure a safe and comfortable experience. Too often patients feel like they’re in the…

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

Thousands of patients undergo surgery every day, but many are unaware how to better ensure a safe and comfortable experience. Too often patients feel like they’re in the passenger’s seat when entering the hospital, even under the best circumstances. When planning to undergo a surgical procedure, with or without subsequent hospitalization, I always encourage patients to use a …

Physician voices

Being a plastic surgeon requires a lot of explaining

Peter Neligan, MD

June 11, 2013Jun 11, 20136

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…

When asked what you do, simply say that …

Physician voices

Why surgical instruments are the way they are

Sid Schwab, MD

June 10, 2013Jun 10, 20133

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…

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 …

Physician voices

What I’ve learned from saving physicians from suicide

Pamela Wible, MD

May 27, 2013May 27, 2013492

A psychiatrist in Seattle had picked out the bridge. At 3 a.m. he would swerve across his lane and plunge into the water. Everyone would assume he fell asleep. A surgeon in Oregon was lying on the floor of her…

A psychiatrist in Seattle had picked out the bridge. At 3 a.m. he would swerve across his lane and plunge into the water. Everyone would assume he fell asleep.

A surgeon in Oregon was lying on the floor of her office with a scalpel. Nobody would find her until it was too late.

An internal medicine resident in Atlanta heard an anesthesiologist joking about …

Conditions and diseases

Should you choose to have a robotic hysterectomy?

Jennifer Gunter, MD

May 20, 2013May 20, 201313

In a word, no (unless you have cancer). So, let’s take cancer out of the picture and discuss hysterectomy for non-cancerous (benign) reasons. First of all. A hysterectomy (removing the uterus) can be done via one of the 4 methods:…

In a word, no (unless you have cancer). So, let’s take cancer out of the picture and discuss hysterectomy for non-cancerous (benign) reasons.

First of all. A hysterectomy (removing the uterus) can be done via one of the 4 methods:

1. Vaginal, a small incision at the top of the vagina and the uterus is removed entirely through the vagina without any incision on the abdomen.

2. Laparoscopic surgery, where incisions are made …

Surgery and surgeons

Articles, page 52

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