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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You may already be aware of what a tummy tuck is and who should get one. One thing, perhaps, you’re confused about is what kind of tummy tuck would work best for you. If that is correct, worry not. We’ve got you covered. There are several different types of tummy tucks, each designed to address particular areas of the ‘tummy’ in a specific manner. Considering each of us has a different ...

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How are two-career households with children — let alone single-parent households — going to manage with daycare centers and schools closed, perhaps for a long time to come? What damage will this do to career progression and earning potential if one parent must cut back on work? Will childcare demands inevitably delay or derail partnership or academic promotion? When I was a young mother — my two youngest children are only ...

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Our obstetric anesthesia team sat down to debrief after a particularly harrowing case. We had just replaced our patient's blood volume twice over after she went into labor with a placenta previa accompanied by a placenta accreta. The operating room had been the usual controlled chaotic scene of multiple teams intensely focused on their responsibilities. It was noisy. Too noisy. I had to remind everyone to restrict themselves to essential ...

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There is nothing more indelible than the words of an unhappy patient. In fact, in the past ten years, I can count on one hand the number of patients who have expressed dissatisfaction either in person, online, or on patient portals.  Even though negative patient interactions are so rare, unfortunately, I’m consumed by them.  I ask myself the same question that other physicians ask themselves every time something goes wrong: ...

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Explore why this general surgeon wrote a novel, and how writing helps with the stresses that accompany a surgery career. What is his #1 tip for those interested in surgery? What are the challenges facing the profession today? How can surgeons find that elusive work-play balance? And why should aspiring doctors start a journal? Arthur Williams is a ...

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It had been a long day. Our progress notes were done. The last scheduled case in the operating room was done, and it was time to wrap up loose ends and sign out my patients to the night team. But that's when Room 4 died. I walked onto the Burn Unit. The nurses were frantic. Can you page the Intensive Care Resident? He's bradying down. The patient's heart rate was steadily declining ...

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The most persistent problem I encounter is not nerve pain or slipped discs. It’s the tenacious misconception that someone can be “too old” for spine surgery when it’s truly needed. Many years ago, it was true that age played a significant factor in a person’s ability to tolerate and recover from surgery. Surgeries were once highly invasive, and recovery could take months. But over the decades, spinal surgery techniques have improved ...

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Recently on Twitter, I asked this question above. The 130 (2.5 percent) of 5,213 respondents who said they would allow a CEO to make a skin incision highlight the unscientific nature of Twitter polls. Restricting voting to surgeons only is not possible. Many people asked me why I asked the question because surely no surgeon would ever have allowed it. Here is ...

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This was the first time that I was unsure of how to respond when a patient cried.  Usually, as a medical student, compassion and understanding helped make up for obvious gaps in our knowledge.  It just comes with the territory.  But this time was different: I could not understand why the patient was crying, because it was a reason I had yet to consider in my short medical journey. The patient ...

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Many physicians would like to use their skills on the mission field, but have a hard time finding an option that fits into their busy schedules. Several years ago, I looked for a medical mission, but I couldn’t find one that would work for me, so I came up with the idea of setting up a medical mission experience in my own town. A local mission meant I wouldn’t need to ...

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Setting: An impersonal, windowless conference room within a hospital Characters: A nurse in charge (NIC), a department chair (DC) and me (ME) *** NIC: Thank you for joining us to discuss the report you made of unprofessional behavior in the operating room. We’d like to start by letting you know that in this institution, we have a culture of informality. When I first got here, I found it unsettling that doctors were called ...

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"Billroth spent long hours dissecting cadavers and planning on surgical interventions. He was able to pioneer abdominal surgery with careful preparation and strict adherence to meticulous antiseptic technique. Animal experimentation and cadaveric-rehearsed surgery emboldened the Viennese professor; perhaps the abdomen could be entered. Nothing short of a 'godlike creative spirit,' as Mukherjee calls it, would suffice when it came to intestinal ...

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After many years of training, I have graduated from residency and am now a board-eligible general surgeon.  I was one of more than 1,000 candidates who attempted to take the American Board of Surgery (ABS) Qualifying Examination on July 16, 2020. What should have been a major milestone rapidly devolved into a nightmare, as examinees were locked out of sessions, falsely accused of violations, and unable to attain certification due ...

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Papa was a seasonal farmworker. This job was noted to be “slave work” by the American locals. Still, he traveled from Jamaica to Florida and toiled in fields to send money home to his wife and eleven children for several years. Unable to read and write, he required assistance with letters that expressed gratitude for the barrel of food and the need for school fees and uniform fabric. Eventually, Papa ...

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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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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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