Reflections in a Head Mirror

Welcome to the Aug. 9, 2009 edition of surgeXperiences! I'm happy to be hosting again. Here in the Northern Hemisphere, these are the "Dog Days of Summer," so in honor of dogs everywhere, lets chew into the best of the surgical blogosphere. Along the way, we will sniff around a few categories and search for the "Best of Show."


Candidates for the "THAT'S REALLY AMAZING" Trophy:

MedGadget posts about a remarkable chain of kidney transplants. Sixteen people in four states received organs! The chain was started at Johns Hopkins where one of their administrators donated her kidney for a co-worker. She has kept a blog about the experience including a nice post on the therapeutic benefit of staying in your pajamas. Amazing!

Dr. Wes has a post that links to a video of a 34-year-old man who was born with his heart outside of his ribcage. 

In a post entitled weighty issues, South African surgeon and blogger bongi tells about treating a substantial woman who was mauled by a hippopotamus. 


Candidates for the "I NEED A BREAK IN THE ROUTINE" Trophy:

T., who crafts the blog Notes of an Anesthesioboist, reflects on the healing moments. In a post entitled Detour, she writes "Sometimes it's the moments between procedures, the tucked-away opportunities to participate in healing (even if it can't be completely achieved), that remind us why were called to medicine in the first place..." 

Here's a post by someone who needs a different kind of break. Gizabeth Shyder, a pathologist, in her blog Methodical Madness tells how the odor of  Tuna Salad affected her day.


Candidates for "THE LIFE OF A SURGEON" Trophy:

Ramona Bates at Suture for a Living provides some great links this week! Here's a discussion and photo of macrodactyly that would set any hand surgeon to planning a series of procedures. She also provided a link  to a patient blog with photos of his ulnar nerve transposition. And here she provides a link to a blog with a photo of a cute young man showing off his Colles Fracture.

Kevin, MD, in a post entitled, Are Female Surgeons Happier than their Male Counterparts? provides a link to a MedPage Today report. Happiness is hard to quantify, but female surgeons are significantly more enthusiastic in recommending surgery as a specialty to students. The study also confirms the huge impact that specialty choice has on lifestyle and family. 

The New York Times Health Blog, Well, has a post and a link to a wonderful essay by surgeon Pauline Chen, MD. Dr. Chen tells the story of a woman who pursued alternative breast cancer treatment for two years before presenting with a large, painful mass. She writes, "I find myself wondering when it comes to patients like Marla or others whose diagnoses are delayed for various personal, social and economic reasons, how responsible am I as the physician and are they as the patients?" I have had several similar experiences.

Dr. Jon at Unbounded Medicine presents some amazing (and a bit  disturbing) photos of Rectal Prolapse. Thank goodness for colorectal surgeons! 

In my own blog, Reflections in a Head Mirror, I describe how, in the operating room, not everything the patient tries to hide stays hidden.

Sometimes, the life of the surgeon has unpleasant challenges. Jeffrey Leow provided a link to a story about plastic surgeons in Australasia being stalked by unhappy customers.

A medical student, MedZag, writes a moving post about the loss of a patient in The Bee Gees, Storage Closets, and Medical Education. It is another essay that resonated with me. (His current post is about his initiation on the surgical service. Hang in there!)


Candidates for the "THIS MAKES IT ALL WORTHWHILE" Trophy:

QuietusLeo, an Israeli anesthesiologist who writes The Sandman, has a beautiful essay entitled The Gift where he reflects on the gratitude of a young patient and his family. "He who saves one soul - saves an entire world."

Sid Schwab at Surgeonsblog writes about how a patient and a gift had a long-term effect on him in a post entitled Kung Fu Surgeon. 

South African surgeon and blogger bongi writes about his surprise when he learns that Americans are not all the same in a post entitled "gracious." 

In a post entitled "difficulties," bongi writes about how hard, yet rewarding, it is to keep visiting patients for which we have little to offer. He remarks, "i just kept on visiting her, usually just to say hello so that she would know she was not totally alone."

In another great piece, bongi reflects on the concept that "Only the Good Die Young" in a post entitled, "who actually wants to live forever?"

SeaSpray, an eloquent patient-blogger, writes about the final moments before surgery. She writes, "I do believe it ... but there is always that ... last glance around the room or up to the ceiling, knowing that I am right then ... at that moment in time ... surrendering my mind and body to them." Powerful stuff. 


Candidate for the "BAD DOG!" Trophy:

In a story entitled Plastic Surgeon Botches 28 Operations, we learn that there is value in checking to see if your physician is board-certified. Tragic outcome.





Candidates for the "GET READY FOR THE FUTURE" Trophy:

Surgery in the future will have new tools. MedGadget tells of research at MIT that will lead to the development of tissue-specific adhesives.  

Is social networking coming the the operating room? Kevin, MD reviews some of the potential uses for Twitter in medical practice. Two of our local hospitals recently used social networking for surgical procedures. One live-twittered a bilateral knee replacement with 250 tweets. (Can you sterilize your BlackBerry???) Another local hospital used Twitter, Facebook, and YouTube to follow a patient through prostate surgery. A bioethicist and colleague, Art Derse, MD, JD was interviewed on our local NPR affiliate about the Twittering Dilemma in the operating room. (Spoiler: Social networking has potential pitfalls, but is not inherently unethical.)

Can we afford the future? Buckeye Surgeon discusses the future of medical innovation in the midst of healthcare and world financial crises. He notes, "At some point in time (like when health care in America isn't in full crisis mode) it may be advisable, even desirable, to see innovation...gather momentum as acceptable alternatives to the standard of care. But we aren't there yet." MedGadget includes a post with a photo of President Obama at the controls of a DaVinci Surgical Robot, one of the world's most expensive medical innovations at $1.75 million apiece. Paul Levy, at Running a Hospital explains why every medical center feels pressured to spend the millions of dollars the devices cost just to stay competitive.  

AND FINALLY ...

The winner of the "BEST IN SHOW" Trophy:

Rusty, who lives at Suture for a Living, is one of the medical blogosphere's beloved mascots (along with a certain lobster and some llamas). Rusty is a contestant in the Top Dog in Arkansas Contest! You can vote for him (registration required) at the Arkansas Democrat-Gazette's website from now until August 26. Go, Rusty!




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