"The COVID-19 pandemic has exacerbated factors that cause violence in the workplace. At no time in recent history will you find clinical health care workers under this degree of stress. Physicians and nurses are operating under high alert in hospitals and clinics while facing COVID deniers and abusive treatment (name-calling such ...

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"Early in the pandemic, in thinking of and discussing possible solutions to help protect health care workers, two of my former colleagues and I recalled a device called the Surgical Smoke Evacuator (SSE), which we used extensively since the 1990s when we worked together at the University of Pittsburgh to collect and ...

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To say that I grieved in the months following the unexpected death of my husband is an understatement. I couldn’t sleep. I couldn’t eat. Thirty pounds evaporated from my 5’ 4”, 130-pound frame. Incessant crying left me dehydrated with cracked, bloody lips. Too soon, financial and professional pressure forced a return to my anesthesia practice. To the outside observer, I appeared functional; I was, in reality, suicidal. Between cases, I’d cry in ...

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So there's this 60-year-old African American physician, and she is fed up. She’s working at a local hospital because she wants to sleep in her own bed rather than continue the life of a locum tenens. After a weekend call where she’s on her 29th hour in the OR in two days with only three hours of sleep, she refuses to do another case. “I’m tired,” She says, “I’m sleepy. ...

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You were a twenty-one-year-old Black man. When we received you, your eyes were open I asked if you could hear me You whispered a phone number and “Mom.” To the green sterile operating room With your breaths of anesthesia, Your final conscious moments Your pain ceased. We worked on you for hours, Terrell. I swear we tried With fourteen units of O negative Surgeons explored your wounds. They clamped your major arteries. Until your heart failed And we watched you leave us. I was a ...

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As an anesthesiologist, I fully understand that providers in my specialty, along with emergency room and intensive care providers, must care for patients with COVID-19 at close physical range during aerosol-generating procedures (AGPs) such as tracheal intubation and extubation, without the option of “social distancing.”  Consequently, we currently rely on personal protective equipment (PPE), operating room ventilation systems, preoperative COVID testing, and hopefully, in the future, on vaccination and herd ...

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I recently met a student and aspiring surgeon who asked me if I was happy with anesthesiology and a career in medicine in general. I told him that aspiring to medicine is wonderful and that while I am indeed happy with my career choice, it does come with daily challenges, both professional and personal. This led to a discussion of work-life balance, particularly with regard to family life, in which ...

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The practice of anesthesiology is the practice of medicine. People who go to medical school and do a residency in anesthesiology are best equipped to deal with anesthetic delivery because they are qualified physicians before starting four years of specialty training in anesthesia. Many also have a fifth year of subspecialty training before entering their practice.  With all this training, why is it that we cannot figure out how to ...

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An excerpt from The Diamond Rose: A Sentinel 10 novel. Amanda waited until evening before dressing in her scrubs and heading to the hospital to visit Mr. Khananian, partner to the second victim, Martin Campbell. She rationalized that by going late, there’d be less chance of running ...

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"I suppose those of us between zero and ninety-three are blessed in our own way as well. We are here, swirling in a jumble of the inconsequential and consequential. We’ve enjoyed some of the world’s beauty and reserve the potential to experience more. Some of us will have longer than others, but perhaps we should focus on savoring rather than quantitating ...

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Two of the biggest hitters in the physician finance online world are both anesthesiologists (Physician on Fire and Passive Income MD).  Both of them are masters of side income by approaching money in completely different directions.  Is it sheer randomness that out of dozens of possible medical fields, both of these successful ...

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I am a voyeur of human anatomy. Not in a perverse sense, but rather as part of my profession. In a single day, I can watch a heart beating in its chest cavity in one operating room, walk two doors down to view an exposed brain, and then cross the hallway to an abdomen incised down the middle to expose the organs and viscera inside. I see joints replaced with ...

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"This pandemic presents a unique opportunity for senior anesthesiologists to see the benefit of accommodating the health care needs of our workforce. Just as I tried to avoid the teratogenic effects of certain cases when pregnant, we should consider the most effective ways to protect senior anesthesiologists from a life-threatening infection. When the pandemic has passed, anesthesiologists of all ages can ...

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The annual meeting of my profession’s national society last fall may have been the last old-school, convention-size, professional meeting I will ever attend. I could be wrong, but it may mark the end of an era. Disruptive change to the convention business model was inevitable, though hastened by COVID-19. This year, the leadership of many medical associations announced that their upcoming annual meetings would be virtual – if ...

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1. Change is slow. In fact, it's much slower than I ever imagined. Part of the issue is that people don't like change; another is that workplace culture often doesn't support new ideas. Tackling this issue: Shift your focus. Get to know people first. Be present. Changing perceptions and convincing people to change first requires that you know them, and they know you. 2. Patience is a virtue. ...

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I was listening to a podcast the other day about this woman who kayaked the inner passage from Puget Sound to Juneau, Alaska. She was describing the end of her journey, the day she paddled into Juneau, and she noted that it was so anticlimactic. She paddled in, after 66 days and there was no one to celebrate the end of the journey with, the harbormaster was badgering her to ...

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I have a major issue with MAC. To be more specific, I have a major issue with how we communicate the concept of MAC to our patients, anesthesia care team members, and proceduralist colleagues. MAC stands for "monitored anesthesia care," and we tend to throw it around and use it interchangeably with a lot of other terms:

  • Sedation
  • Procedural sedation
  • Conscious sedation
  • Twilight anesthesia
  • Light anesthesia
The fact is, these entities are not ...

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"As a physician anesthesiologist who has previously been on assignment for Doctors Without Borders in a resource-depleted region fraught with conflict, I’d like to say there’s little I haven’t seen. But now, after four weeks of staffing COVID intensive care units and emergency response teams throughout New York City, I struggle to distinguish between the exhaustion of a distant war-zone and ...

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1. Anesthesiologists are your protector Think about this: An anesthesiologist's job is to protect you from the harm your surgeon is causing.  Seriously. A surgeon's job, at its very essence, is to damage your body. Now undeniably, it is with the intention of causing greater good and/or fixing something that is already broken.  But in order for a surgeon to help a patient, they take a knife, saw, drill, or hammer, ...

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As a fourth-year anesthesiology resident, I opened up my email eagerly, awaiting the results of the pain fellowship match. It was official; I was heading to a major academic program in New York City. First came excitement and relief immediately followed by a rush of all-encompassing fear. I had grown up in Arizona my entire life, and the idea of living and training in New York City was daunting, to ...

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