Women who lose part or all of one or both breasts due to breast cancer surgery may choose to have new breasts created with their own tissue -- a process that also may or may not involve breast implants. A wide range of reconstruction procedures is available, including a variety of flaps and options to use either implants or what is known as autologous fat transfer. Each surgery has its own ...

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Recently, I was challenged by the mother of a trauma patient. She had read about traumatic spleen injuries online and was concerned about the risk a hematoma presented and wanted the ultrasound to look at the hematoma. I found myself floundering around trying to explain how this study was unnecessary. In frustration, I turned to my nurse practitioner and said, “Heather, can you translate for me?” This is a common problem. ...

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In the movie Malice, Alec Baldwin plays Dr. Jed Hill, a surgeon who gives a famous speech during a deposition in a medical malpractice case. “”If you’re looking for God, he was in operating room #2 on November 17th, and he doesn’t like to be second-guessed ... I am God.” No one wants a doctor like that. And yet, maybe we do. We yearn for someone capable of healing all of our ...

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After about the first week of anesthesia residency, I was told, “Don’t get pregnant, you are going to ruin the call schedule.”  Initially, I took it as a joke because I was getting married that year and I wasn’t thinking of having children yet, but I did think, “what if it happened accidentally?” After it’s told to you over and over again by your male co-residents and even some of my ...

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Earlier this week, one of the residents and I saw a new patient who apparently had been sent in to see us for a pre-op visit, an evaluation to make sure that her medical conditions were well controlled and that the surgery was safe for the surgeons to proceed with. She reported that she forgot the paperwork they gave her. All she knew was that whatever we wrote had to ...

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As a cardiac anesthesiologist, there are times I care for patients who are faced with a tough decision: to take their chance on a very high-risk surgery, or let nature take its course.  It is in these times I feel most humble and most human, as I may be the last one to hear the last words they speak. Recently I was at a social event and introducing myself to some ...

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Phnom Penh is changing at an incalculable rate. It is evolving so quickly that even from my last visit four years ago, I barely recognize the streets I once shuffled my well-worn sandals through. Now, the streets of my old neighborhood are proudly adorned with a new facade of artistic, stylish restaurants and a collection of boutique coffee shops. Bigger buildings and prime real estate positions are now occupied by ...

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A friend of mine recently underwent a total knee replacement. Although he did well and was pain-free, he did say that he felt he was on an assembly line. I asked him what he meant. As he was talking, I flashed back 30 years, back to a time when by today's standards I would be considered a “good old country orthopedist.” Thirty years ago, I moved to a small community to ...

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It’s a tale of two health systems: the VA and Kaiser Permanente. The U.S. Department of Veterans Affairs, Veterans Health Administration (VA) is a mission-driven health organization, serving our nation’s veterans. A patient population of 8.9 million, led by David Shulkin, MD. An early leader in health technology adoption. The VA has faced serious issues; however: long patient wait times (deadly long in some cases) and high physician turnover rates. Kaiser Permanente ...

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“How far you go in life depends on your being tender with the young, compassionate with the aged, sympathetic with the striving and tolerant of the weak and strong. Because someday in your life you will have been all of these.” —George Washington Carver Earlier this week, I walked into the exam room and introduced myself to a 48-year-old male.  As I generally do, I sat in front of him and asked, ...

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