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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The warm rays of the sun serenade me as I drive to work eager to begin another shift. I find a parking spot on the first floor of the garage don my N95 mask and walk towards the hospital. First, I must stop by at the neighboring building and have my temperature checked. Today it is 97.3. I am awarded the sticker for the day; my boarding pass into the ...

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An excerpt from The Surgeon's Obol. July 1, 8 p.m. "Isabella Isaksen," I said with an arm extended. "Most people call me 'Izzie'." "Mike Gunderson," came the reply. Most people called him Gundy, but he didn't feel the need to let me, the goddamn intern, in on this. And ...

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I have been an academic surgeon in a large medical center in New York City for the past 20 years.  The current climate of scrutiny to systemic racism and bias (including prejudice against all “different” populations) coupled with our own struggles with growth and equitable distribution of resources has highlighted a disturbing trend. It is and has been customary for as long as I’ve been practicing medicine to relegate patients with ...

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Yeah. I said it. As an anesthesiologist, especially as a cardiothoracic anesthesiologist, there are few things I am more interested in than how well or how poorly your heart functions and why.  And a cardiologist can help me obtain a lot of vital information in that regard.  But there several things a cardiologist cannot, and I argue, should not do, when it comes to the perioperative care of patients. First, a cardiologist's assessment ...

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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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When I was in Sweden, I heard this phrase several times: “There is no such thing as bad weather, just bad preparation.” They said this when we asked them what they did with their children in dead of winter. The proud parents made it very clear that no matter what the weather, when it is time to go outside for recess at school, or to get out of the house ...

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I never expected to have a friend from Alabama. My upbringing in Brooklyn, New York, didn’t include anyone from the South, and this was a time in American history when the South was in turmoil. I recall black and white images on our family’s TV showing federally enforced integration of schools and communities, swelling civil rights marches, and disturbing scenes of riots and attack dogs used to intimidate ...

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Recently surfing the far reaches of Netflix for a program on World War II that I hadn’t yet seen, I found a low budget serial documentary dealing with air power in war and in peace. The producers profiled individuals who had contributed to the eventualities of the airplane as a weapon of war or, conversely, as a beacon of man’s progressive evolution from terrestrial prisoner to celestial astronaut.


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Many states are beginning to reopen, and hospitals are once again scheduling elective surgeries. The question on many patients’ minds is, “Should I undergo elective surgery right now?” Although 31 percent of people have chosen to delay care and 50 percent of people over 65 have decided to wait to receive care during COVID-19, according to a Kaiser Health News roundup, making this decision will depend ...

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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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I am a female surgical resident. I signed up for this. I chose four years of medical school, five years of residency, two years of research, a year of fellowship, and finally attending surgeon life. I’d choose it again. And I want this road to be hard. I want my training so tough that I don’t wonder while a patient’s on the table if I’m good enough. I want to know ...

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I am a newly minted surgical specialist, less than one year into practice. Residency was no walk in the park, but the clinical experience, along with hours of studying, reading papers, and reviewing practice guidelines, undoubtedly gave me the tools to practice modern, evidence-based medicine. As residency came to a close and the light at the end of the tunnel grew bigger and brighter, my excitement to move on to ...

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The United States has some of the most advanced medical technology in the world, yet COVID-19 has exposed significant deficiencies in our health care system. As nothing will be the same after coronavirus, our health care system must also change as we move forward.  Now is the time to work towards improving the current system and begin to develop an infrastructure that delivers medical ...

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A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. It is the ultimate irony that health care professionals on the front lines of the COVID-19 pandemic are among the highest risk, not only for exposure to the deadly virus, but economically. Whether they are inundated with COVID-19 patients or still awaiting ...

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I am a surgeon, mother, daughter, researcher, and ethicist. These multiple roles dancing together to a more discordant tune amid this unprecedented time. The "daughter" has managed to convince her ageing parents that they really ought to not leave the house and that she will step in to accommodate their needs. Simultaneously, the "surgeon" is surprised when her 80-year-old mother, Layla, relays that she received a phone call telling her ...

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Elise loves this book. The protagonist is a girl who, due to a desire to fit in with her friends, denies her love of lima beans. Camilla awakens with stripes on her skin, and no one can explain it. The doctors are called in, then the specialists. The scientists and experts come next, but all are stumped. ...

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I walk into my fifth operating room of the morning. “Good morning, Mr. Jacobs. My name is Dr. Michaelis. I will be the anesthesiologist helping to safely get your breathing tube in as we get your surgery started today.”  He nods and closes his eyes. That’s all he can see of me. My eyes. I am wearing my PAPR (powered air purifying respirator) and mask. For the second day this week, ...

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I hugged her for the last time on March 15, waving goodbye as she drove away from my apartment complex. On April 15, I got a call that my friend was dead. She had unceremoniously taken her own life, unable to overcome the crippling feeling of hopelessness that plagued her after repeatedly being prevented from fulfilling her dream. The details of her death are devastating and tragic. Imagine being in ...

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The COVID-19 pandemic is fundamentally changing medical practice across the country by allowing telemedicine reimbursement, where it was previously limited, and by leveraging video conferencing technology to conduct business and educational meetings in order to comply with social distancing guidance. Necessity is resulting in innovative ways to interact with patients, colleagues, and now with prospective trainees as residency and fellowship interview season begins. While in-person interviews are a trademark of ...

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