An excerpt from PLAYING DOCTOR – Part One: Medical School: Stumbling through with amnesia.
As was her habit, she [the surgical chief resident] had called to check in with a surgical nurse to see how each of her patients was doing. They were discussing each patient when the nurse stopped to mention that there was a code team outside a room …
The most memorable books have twists, turns, and surprises. A plot twist is a literary technique involving a radical change in an expected outcome. It involves withholding critical information until the time is right, changing our perception of preceding or current events. There are often hints along the way, foreshadowing what is to come, but realization does not come until the twist happens, and often only appreciated in retrospect. Red …
Recently, I had a patient die unexpectedly in the operating room. I consider myself mentally tough, but this was the first time I’d ever experienced a situation like this, and the impact on me was far greater than I would have anticipated.
On its own, the patient dying was a terrible event, but after our futile and desperate attempts to save him failed, I still had to face the horror of …
My respected neurosurgery colleague just ended his career inauspiciously — having had an affair with a resident.
While I don’t know the details, I do know that many a male leader, like my friend, has fallen from his perch due to “zipper malfunction.” Had they stronger zippers, maybe they would have kept their sensitive parts in their proper homes and carried on to fulfill their important jobs.
Disappointed, but not terribly surprised, …
One of the most dramatic changes from my training to the present is the nearly complete disappearance of elective ulcer surgery. (Reminder: as I’ve said before, “elective” means non-emergent, as opposed to unnecessary.) The revolution began with the advent of drugs that effectively reduce gastric acid production and settled in for real when the relationship between ulcer formation and the bacterium known as H. pylori was worked out. I have to …
Most patients believe and trust a diagnosis and treatment plan their physician provides them. So why is a second opinion in medicine so important? The “practice of medicine” is a term used to imply a variety of diagnoses and treatments. Yes, there is a standard of care in every medical discipline, but there are also many physician-driven distinctions in getting to a definitive diagnosis with a treatment plan. These decisions …
It was a hot afternoon, but no dog day humidity yet. I was driving back from a satellite office when our nurse practitioner called. A patient with a condition we’d seen many times before, a brain hemorrhage, her consciousness waning. The CT scan showed blood in the ventricles obstructing the flow of cerebrospinal fluid.
The pressure was building and our patient was dying. She needed an external ventricular drain to relieve …
An excerpt from All Bleeding Stops.
42nd Surgical Hospital
Phu Bai
Republic of Vietnam
December 1967
Private Ira Stein has so many wounds, has lost so much blood, that the corpsmen nearly bring him straight to Graves. Steve Benson can’t get a pressure. He shakes his head. “Matthew, there’s no point taking this kid to the OR. He’s too far gone. He has no chance.”
“Bullshit!” …
Below are moments from my intern year of general surgery residency. They represent moments that occurred over three years ago, which I took home to my journal to process and work through. Back then, the moments left me speechless. And today, re-visiting them, the moments clearly demonstrate the fragility of the human spirit.
A silently sobbing 7-year-old the day after surgical repair of his broken femur. His face contorted. His pain …
“My mother, bless her ninety-year-old heart, is slowing down. The things that made her happiest — getting to church, visiting friends, taking walks, and wandering the aisles in the grocery store —are increasingly difficult. She worries that her lack of energy will soon make every activity impossible.
It is 2005 and …
Do you have any idea how beautiful you are? Well, OK; maybe for some it’s were. Before you got a little thick in the middle, smoked, or even just breathed city air for enough years, or drank a little, or did a few drugs, there was a time — and maybe it’s still true — when you were knock-down, take-your-breath-away gorgeous. While operating inside a belly, I’ve often stopped working …
I am a former chief of surgery and a scientific entrepreneur.
My practice consisted of patients who suffered from serious injuries and illnesses. Concerning the latter, a significant number had cancer, especially breast cancer. The issue all patient groups have in common to a certain degree is protein calorie malnutrition (PCM). The most dramatically affected are those stricken with a malignancy. PCM leads to increased morbidity, mortality, …
“Dehumanizing patients can lead to indifference in physicians. It is a privilege to be trusted to take care of every patient we encounter, yet we can lose sight of this and begin to see our patients as a burden, or as units of work, rather than as individuals. When individual …
ADVERTISEMENT
Four years ago, I was ready to throw in the towel. I practiced for 22 years in a large metropolitan hospital, became very involved in resident education, clinical program directorship, medical staff affairs, in addition to a busy hospital-based surgical practice. I watched as the environment of care for clinicians and the quality of the relationship between the medical staff and system administration steadily deteriorated.
My small, single-specialty surgical group merged …
As a practicing surgeon for 30 years in the super-specialized field of otology, neurotology and skull base surgery, I have been privy to some of the most disturbing realities of surgical care. Often, these realities are bleaker than most people expect. One thing physicians, and the general population, need to be more aware of is the very real racial disparity in surgical care.
Are the outcomes for Black and Hispanic patients …
“You will be asleep for your surgery,” anesthesiologists often reassure their patients. Just before the start of anesthesia, a patient may hear the nurse saying, “Think of a nice dream as you go off to sleep.”
While these statements are intended to soothe patients during a stressful time, they gloss over this critical fact: Anesthesia is not like normal sleep at all. That’s why you need medical doctors – anesthesiologists – to take …
While we’re not there yet, we may be approaching a point where we’re facing a significant skills shortage among surgeons. A 2017 study by Meritt Hawkins found that 52 percent of orthopedic surgeons were 55 and older, as were 48 percent of general surgeons. As many surgeons approach retirement age, there is a pressing need to up-skill and up-level the next generation of surgeons, especially with demand …
How is your ego serving you?
Medicine is a hierarchical entity. More so in surgery.
There is a linear line of command from the chief to the junior to the intern to the med student to the aspiring med student.
“Shit rolls downhill,” we said as interns while we powered through the 29th-hour on-call or the seven pending discharge summaries we had to finish, while a nurse was yelling or paging us 12 …
Due to COVID-19, hospitals were forced to reevaluate and rework systems and processes that had been around for decades. From managing the increasing demands for testing and treating patients with the coronavirus to acquiring necessary medical equipment to keeping beds available, hospital administrators, providers, and staff showed true heroism. At the same time, the constant ebb and flow of COVID-19 surges caused hospitals to experience significant financial challenges, and …
I began this journey in 2010. It began as a fresh-smelling breeze after a year and a half of anxiety, depression, and uncertainty. I did not think I would be a surgeon. I thought maybe family medicine, psychiatry — at worst, I would like gynecology. I outgrew the fear of the stereotypes and chose surgery for myself, despite what my now-husband warned me. He thought it would change me, depress …
Get free updates delivered free to your inbox.
