lifestyle

Patients Are NOT Like Airplanes

As promised in my post “Surgeons Are Not Pilots,” I will address the issue of whether patients can be compared to airplanes. Honestly, I cannot think of even one thing that patients have in common with airplanes. Unlike an airplane, each patient is unique. If a pilot sits at the controls of any Airbus A320 aircraft, he can be reasonably sure that pulling back the stick a certain amount will result in a very consistent response from the plane. Therefore, practicing on a simulator will enable the pilot to prepare for any emergency with the knowledge that what he did on the simulator will in fact be reproducible in a real emergency. Contrast that with a patient. Often patients with similar illnesses will behave very differently because human beings are not engineered like airplanes. For example, let’s say I am performing a difficult laparoscopic cholecystectomy (removal of the gallbladder) and I am having trouble locating the cystic artery (artery to the gallbladder). I know that the anatomy of the cystic artery is highly variable. This link illustrates 11 of the most common anatomic variations in the location of that vessel. This means that there is not a simple maneuver that will help me find the artery in every case. A pilot can be confident that a 5% increase in power will result in a very predictable response in airspeed....

Cute Baby is a CPR Pro

When I took my CPR class this past spring, I realized I was a bit behind the curve. Most of my classmates were just renewing their licenses that they had had for years, and we were all the same age. Someone vaguely taught me CPR back in that Red Cross Babysitting Training Class back in 2007, but something like that apparently doesn’t fulfill the CPR certification for an EMT. Apparently, I’m even more behind the curve than I thought… Post by HCH Fans Club. *A big thanks to Rohan Jotwani for discovering this precious...

Surgeons Are Not Pilots

I am sick of hearing that surgeons can be compared to pilots. Yes, there are some similarities and some things can be learned from the aviation industry. For example, I am a big fan of checklists, having used them in both the operating room and intensive care settings. Both a general surgeon and a fighter pilot will have occasions to multitask and both need to have what is termed “situational awareness” or an understanding of where he is and what is going on around him. But let’s look at some of the differences between specifically, general surgeons (GS) and fighter pilots (FP). The training of surgeons and pilots is remarkably different. Both spend 4 years in college, but there is no pilot equivalent to medical school. General surgery residency takes 5 years. Flight school is 2 years.   Total hours of training for a GS after medical school can be broken down as follows. Five years of residency training at 80 hours/week equals 20,800 hours. Allowing for 6 hours of sleep/night (Ha!) over five years would reduce the actual training time to 15,600 hours of which some 2000 hours would be spent in the operating room (about 1000 cases performed by the average graduating chief resident at about 2 hours/case). Total hours of training for an FP entering the US Air Force are as follows. Once accepted to flight...

Spreading Awareness or Avoiding Charity? The ALS Ice Bucket Challenge

Amytrophic lateral sclerosis has been in the news and on your newsfeed a ton lately, thanks to Julie and Pete Frates. Major national news outlets like NBC and CBS News praise the efforts of those who have taken part in the viral “Ice Bucket Challenge.” However, in this now famous (or infamous) challenge, some question along the lines of: Why are we celebrating people dumping ice on their heads to avoid giving away $100 to a cause they likely don’t know much of anything about?    Before we get into the actual ice bucket challenge, I’d like to talk about ALS. The bad news: ALS is a terminal illness with no known cause or cure. It is also known by the name of Lou Gehrig’s Disease in honor of the famous New York Yankee who was diagnosed with the disease in 1939 and died just two years later. While ALS does not affect mental awareness, it is characterized by aggressive paralysis which often leads to difficulty in communication. According to the ALS Association, the degenerative disease breaks down the motor neurons until they die. Once the neurons die, the brain loses all ability to trigger or control any muscle movement.     The good news: Though there is no definitive cure, there is one FDA approved treatment on the market that helps to slow the progression of ALS. There...

Resident Work Hours: The Solution

I don’t know why I didn’t think of it sooner, or like many great ideas, why someone else didn’t come up with it already. As I lay awake one morning at 4:30, having just received a consult from internal medicine for an elderly lady being admitted with gallstones, atrial fibrillation and acute dehydration, (which could have waited until 7:00 a.m. today or even tomorrow) it hit me. I had the solution to the resident work hour controversy. Many years ago, I was in the Navy and served on a ship. Crew members “stood watch,” which consisted of four-hour rotations on duty followed by eight hours off duty. Thus, each crewmember worked eight hours per day, but the work time was divided into two four-hour shifts. To me, this seemed to be the perfect solution to the resident work hour dilemma. I know, you are saying, “but Skeptical Scalpel, wouldn’t that mean six patient hand-offs per day?” Yes, of course it would. But according to the proponents of reduced work hours for residents, hand-offs are not a problem for continuity of care or patient safety. It’s better to have discontinuity instead of tired residents. So if two or three hand-offs per day are OK, why not six? Still, there are a few issues that need to be worked out. For example, surgical residency training would have to be increased to...

How to Stop Worrying On A Late Night Out

In the “Wild West” of college partying, there are many risks to take into account. Sure, there are the normal ones such as drinking too much or spending all of your money at the club, but my least favorite is losing someone late at night. I’m fortunate enough to have some friends who are girls (that’s right, actual platonic girlfriends) that I sometimes go out with, and it’s a huge drag on a great night when we realize someone is lost and they’re not answering their phone. We have to halt the festivities, get in touch with everyone, and confirm that the person is alive and safe. That’s why I was very relieved when I saw this article about a new service called Kitestring. Kitestring is designed to check in on you at predetermined times of the night, and messages your emergency contacts if it receives no response. The interface is easy to manage, and it can easily be turned off or pushed back with a simple text if you’re busy.  While it might not necessarily keep you out of trouble, it at the very least can be a reassurance (or warning) to your worried friends. That way, you’ll hopefully end up like this: Source: giphy.com And not like this: Source: giphy.com So stay safe, and have fun tonight, and don’t forget to study...

Why Being a Patient in the Hospital is Awesome

Being admitted to the hospital generally means that there’s a problem with your health. But that doesn’t mean that you have to be a pessimist about your ailments! Here are six reasons why staying in a hospital is one sweet deal. 1. Breakfast in bed. All the time. Mmmm, tasty hospital food! 2. For men, hot nurses As the famous Animaniacs once said…. hello, nurse! 3. For women, your chances of landing a sexy, rich doctor-husband are exponentially higher! Aim high, ladies! 4. Drugs…yay!* (The Almost Doctor’s Channel does not endorse the inappropriate or illegal use of any drugs) Hey, modern pharmaceutical innovations, right? 5. Those cool bracelets You Can’t Wait to Show Off to Your Friends (Applicable Until 8th Grade) A surefire way to say, “I did more things than you today, and here’s proof.” 6. It’s like your birthday every day—everyone’s nice to you, people come visit with cards, flowers, and presents, and you get to be the center of attention! Nothing better than being in the spotlight!   Anyway, next time you’re in the hospital, stay optimistic and keep your head held high! Unless you’re in a neckbrace, in which case keep it right where it...