I’ve worked at a few VA medical centers, including four years at the Phoenix VA. I’d like to report something missed in the media storm. Before spilling secrets, though, I’ll dispense with the non-secrets. Everyone who has entered a VA hospital knows: 1. The system is overwhelmed. While we might have planned for the increasing needs of aging Vietnam-era vets, I doubt anyone predicted two long wars or the number of ...

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Is a board certified surgeon a safer one? Am I safe surgeon, or merely a board certified one? I usually spend Tuesdays fixing elective hernias. But the other day I was asked to clear a c-spine, handle an unexpected gynecologic finding, manage a pediatric trauma, resuscitate a septic ICU patient, and opine on a neck dissection. No, I wasn’t in Africa or 1985; I was sitting in front of a computer ...

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"How are residents supposed to prepare for real life as a surgeon if they can’t even work twenty-four hours straight now?" I hear this complaint about once a month from a someone trained in the Golden Age of hazing. Outside of anecdote, we’ll never know if surgeons are better trained now or twenty years ago, or fifty. But it’s too painful to imagine every-other-night-call wasn’t of critical importance. Residency resembles the ...

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Spent a sweaty week operating in a hilltop Hospital Nacional in Guatemala a while back. A patient gave me a hat in thanks for her surgery.  It’s a full-brimmed canvas safari number – I’m sure Hemingway shot a rhino in one.  I’m just mature enough now to value sun protection and always grateful, sometimes to the point of pain, for gifts from those who have almost nothing.  I was also ...

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