“It looks like it’s healing well.” I told her. I didn’t know if it would be appropriate or not, but I decided to say it anyway. “Your scar is a story. I hope you can own it. Don’t ever be ashamed by it. It’s a testament to your strength, a mark of your courage.”
…….some time after this the neurosurgeon got a call from the family doctor from their home country. he was indignant. he wanted to know why the gallbladder had been removed in such a young male, a group that usually does not have gallbladder problems and that in the absence of gallstones. he felt it was totally unnecessary and demanded an explanation……..
I called the family to thank them for their generous gift. The son answered the phone. When I identified myself he said that I had done a poor job because he didn't see the James Bond movie. I apologized and assured him that it was much more important to be healthy again.He then passed the phone to his father. I thanked him for the gift. He said it was only a small token of appreciation. I assured him that it was much more than that.
T, Notes of an Anesthesoboist, back from her vacation in France tells us about a call to the ER -- “you know it’s bad when”
One day I was giving someone a lunch break and wheeling her patient to the O.R. with the circulating nurse when we heard over the P.A. system,"Any available surgeon stat to the emergency room. Any available surgeon to E.R. stat."That stopped us in our tracks for a second. The nurse and I exchanged a look."Sounds pretty bad," I said.
The other day I picked up the chart of a lady who needed a port and the first thing I noticed was that she was 92 years old. I must admit, my first thought was: what the hell are we doing here? She had metastatic breast cancer with lesions seen in her lungs and liver. I was all ready to march into the room and have an honest, heart to heart talk with the patient and the family about futile care and cost effectiveness etc etc.But I composed myself. Every situation is different. I asked questions. I listened.
"now why did i just walk away?" he asked. we all gave the usual blank stares. "because there is nothing we can do for her." he said with a chuckle. those of us who needed to be in his good books gave the obligatory half hearted laugh. i could just manage a smile that i think came out more as a grimace.
The other day, Sid Schwab, surgeon blogger extraordinaire, brought up a question that, I'm guessing, most nonsurgeons wonder about from time to time when contemplating how it is that we surgeons do what we do.What about bathroom breaks?
…………….It happened to me only once, but it provided a serious dilemma. What do I do? I'm captain of the ship of the O.R., so to speak. The entire team depends on me. The patient depends on me.And that's the key to making the correct decision……..
A small mental exercise for medical bloggers.
See the following three portable (bedside) chest radiographs that were taken in an ICU setting. They are in sequence.See if you can guess the story that they tell.
Adult intraosseous needles are coming more into favor in the United States, although they have been part of standard practice in the military and Europe. Various commercial devices exist. The one we have at SF General is the EZ IO Needle. (I have no financial ties with the company.) Needle placement is surprisingly easy and takes less than 10 seconds, especially if you channel your inner Home Depot self in using the power drill.
Surgeon hands intern trochar. Intern, stepping up on small stool puts all her weight behind it and hubs it. Descending aorta pierced, Surgeon apoplectic, blood fills abdomen, patient's legs get blue, Vascular Surgeon scared shitless, knows it's a hopeless case, tries to punt, no one receiving, then finally gets an accepting somewhere else. Rest of story plays out.
I've been having some unpleasant pressure in my right ear and a couple of episodes of vertigo over the last six days. Today I had an appointment with my ENT Dr. He entered the exam room, we shook hands, he looked at my throat, looked up my nose (but doc, it's my ear that troubles me!) looked in my right ear and while rolling across to look in my left ear, he said "We're gonna have to get that hair out of there."
Answering to one attending is difficult enough. Answering to three or four at the same time, about the same patients, is extremely tricky (I’m not going to try to explain the structure of this group of attendings……..
- medpiano RT @jonmikel: HUGE TUMOR: Radical right nephrectomy http://is.gd/1IjLH <<ENORME! (CT is image before and on wall behind)
- jeffreyleow RT @jonmikel: GIANT inguinal hernia: http://www.flickr.com/photo...
- jeffreyleow RT @ColumbiaSurgery: What You Must Know about Flesh Eating Bacteria and Superbugs from Dr. Oz. http://bit.ly/C7eRB
- DrCris I'm blue. Non-surgeons get to guess what procedure I have just done. http://twitpic.com/bavlb
- DrCris I like "smurf appendicectomy" but @twelveeyes hit the winner with sentinel node biopsy (for breast cancer)
And on that note, I wish you a wonderful day! Enjoy the reading. Remember if you would like to be the host in the future, please contact Jeffrey who runs the show here.