Kerry was only 28-years-old. He showed up in the ER one night complaining of upper abdominal pain which started suddenly that day. The emergency physician did the usual workup and found two things which led to an urgent call: a large intrabdominal mass and free intraperitoneal air. The large mass was not necessarily an emergency, but free air, that is, air outside its usual place inside the bowel, almost always represents ...

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Halsted once described plastic surgeons as “the surgeon’s surgeons.” Yet in today’s era of media hype about cosmetic surgery, this turn of phrase feels long-forgotten. Despite what reality television may have you believe, the specialty remains at its core about reconstructive surgery, and collaboration is still a key element. Here, a few points that show those words are as true now as they ever were: We manage a patient’s expectations. Patients may have ...

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You cannot connect the dots looking forward; you can only connect them looking backwards. -Steve Jobs "Doesn't that window open any wider? Bring in another fan!" the surgeon demands. Beads of sweat gather at the edge of his cloth cap and the circulating nurse steps up periodically to wipe them away. Heat and city noise roll through the open windows and into the operating room. The brief morning rain shower has left the ...

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About eight years ago I was desperate to improve my golf game. I just couldn’t straighten out my drives or hit my irons crisply. (Yes, I’m fully aware that this is a first world problem). I decided to try golf camp in Palm Springs for a few days. My sensei, a crusty ex-touring pro named Artie McNickle, watched me hit several dozen balls on the driving range, video recorder running. “So, ...

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On a hot afternoon in July Harold “Junior” Bray walked around his small farmhouse one last time before it was time to leave for the hospital. Everything was in order -- the coffee maker was unplugged, the windows secure and the message on his brand new answering machine informed callers that he would return their call as soon as his health permitted. Every step was deliberate, slow and painful. Whenever he ...

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A new study confirms what previous studies tell us. That a robotic hysterectomy is not a safer or a more efficient way to remove a uterus for non-cancerous (benign) surgery than a traditional laparoscopic approach. This study indicates that there is little difference between the two types of surgery with one glaring exception, a robotic hysterectomy was $2,489 more expensive than a laparoscopic hysterectomy. Several months ago the American Congress of ...

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From MedPage Today:

  1. Budget Deal Muddles SGR Fix. As the dust settled following yesterday's last-minute budget deal to avert a federal government's default, a frightening fact emerged for the nation's doctors.
  2. A Better Way to Rate Bariatric Surgery Quality? A composite measure that includes procedure complications, patient and surgeon volume, and other outcomes provided a more objective scale to rate sites that provide bariatric surgery.

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Medical errors are a real problem. I won't deny that. It was bad enough when the often-quoted Institute of Medicine figure that 98,000 deaths per year in the US are caused by medical errors was in vogue, but now a paper in the Journal of Patient Safety states that adverse medical events result in 210,000 to 400,000 deaths per year and 10 to 20 times those numbers of serious ...

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It was a battle. Looking back I don't think we ever had a chance, but you don't just give up on a young man in the prime of his life. We had to try. He was my patient. He was a foreigner, on a gap year in Africa where he was going to learn all sorts of things about conservation and African wildlife. Up until the accident, all had apparently gone ...

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I have been a loyal patron of the Karma Hair Salon in New Haven, Conn. for at least the past 15 years. Whenever my hair looks good, it is thanks to Karma and owner Cheryl McMahon's expert attention to my unruly head (the thickness of my hair -- a good problem, I know! -- could give a yak envy; and I have more cowlicks than several small countries). If ever my hair doesn't look ...

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