My mind usually starts to wander around the third or fourth hour of retracting a fat flap or holding up a leg during a long operation. I start by guessing how many times the attending has done this particular procedure. Is it his hundredth time doing it? If he was one of the older attendings, perhaps it was his thousandth one. As a neophyte in the operating room, I still relish ...

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A few years ago, my colleagues and I started a non-profit called Women in Anesthesiology.  I started medical school late and had two children in residency (earning the delightful label of elderly primigravida or, if you prefer, geriatric pregnancy). My co-resident and I noticed few women in our department, and even fewer in leadership.  We charged forward, starting a local, then national group.  At the same time, a separate Facebook ...

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“Am I going to die?” There was a mixture of fear and pain in my patient’s eyes. He was a second grader but had already survived three major heart surgeries. Now he had pneumonia and was struggling to breathe. We were about to intubate him. “You’re a strong guy,” I whispered to him as his mother held his hand and sobbed. “We’ll get you through this.” He died two days later. I drove home ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Sometimes our best decisions as physician anesthesiologists are when we decide to call off a surgery or procedure. The “best anesthetic I never gave” was for 18-year-old Hunter Jones and her case really demonstrates the importance of talking with patients before surgery. Hunter was an active, ...

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Imagine while driving into work, you drive through a green light. When you look to the right, you see a car barreling through the intersection, and then everything goes black. You vaguely remember being taken into the emergency room of a prestigious hospital nearby. In the ED, you hear a doctor’s voice yelling at nurses to give you medications, and then everything goes black. You wake up in a hospital ...

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My husband and I, both anesthesiologists, enjoy our Sunday mornings together -- coffee, the New York Times, a leisurely breakfast. No rush to arrive in the operating room before many people are even awake. Today, though, seeing reporter Jan Hoffman’s front-page article in the Times -- “Staying Awake for Your Surgery?” -- was enough to take the sparkle out of the sugar. Her article on how much better it ...

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After writing my 21st post about appendicitis back in November, I swore I would not write about it again for the foreseeable future. Well, the future is now because investigators from the United Kingdom and Canada just published a meta-analysis including ten papers and 413 children about the efficacy and safety of nonoperative treatment for appendicitis in children. They concluded that nonoperative management is effective in 96 percent ...

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Telemedicine is often in the news and until recently I had only casually glossed over the latest articles. The details I paid little attention to, but the headlines I would remember. “Great for rural areas” I would read! “Extend physician reach!” “Get specialists to greater numbers of patients with unique conditions!” As a nearly graduated anesthesia resident in a large city with an abundance of doctors, I didn't think telemedicine would have ...

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As a medical student, I had nightmares about my first day in the OR: scrubbing incorrectly, contaminating a sterile field, forgetting the anatomy I had so carefully studied the night before. It seemed like the only thing I could do in that artificially lit room was mess up. After a few cases I came to love the routine and ceremony of each surgery: the timeout; the rhythmic pattern of suture, ...

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Among surgeons, it’s pretty common knowledge that residents and other providers may perform non-critical parts of a patient’s procedure. This not only helps residents and other trainees gain valuable surgical experience, it also gives patients better and faster access to high-demand surgical expertise. The question is this: How well are surgeons explaining these facts to their patients? Recent guideline updates by the American College of Surgeons (ACS) underscore the need ...

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