Month: May 2018
Mental Health Awareness Month- Beyond Resilience
Across the United States, organizations and individuals are recognizing Mental Health Awareness month, shedding much needed light on an issue that affects nearly 1 in 5 US adults every year. Rates of mental health distress among healthcare professionals are even higher, with a 2015 meta-analysis demonstrating a prevalence rate of nearly 30% among residents and 300-400 physicians committing suicide every year in America. Yet despite the attention the crisis has received, both within the medical community and in the general population, it persists. Much of the current discussion and wellness programming responding to this issue has focused on increasing resilience among trainees. Suggested strategies for improving resilience include promoting recognition of stressors, stress reduction through mindfulness training, and improving self-regulation of stress responses. But at what point is asking trainees and physicians to become more resilient simply adding another task to what seems to be at times an endless to-do...
Dear Pat Responds to Surgeon-Mother-to-Be
Dear Pat, I’m a second-year surgery resident and somewhat older than my co-residents. I am considering getting pregnant during residency, but I am unsure if my co-residents will be supportive. I don’t want them to be mad at me. What should I do? Sincerely, Surgeon-Mother-to-Be For this month’s “Dear Pat”, AWS Council Member Dr. Simone Betchen shares her strategies in response to “Surgeon-Mother-to-Be”. Dear Surgeon-Mother-to-Be, How exciting! No one can tell you when is the best time to start a family, but since you asked, here’s what I think. The best time to start a family is when the timing is right for YOU and your family. While it is kind of you to think of your co-residents, your co-residents will step up and survive without you during maternity leave because no one is indispensable. And it goes both ways, If any one of them had an issue in future,...
Is taking time to do research right for me?
Is a professional development year right for me? Should I do research? What is the benefit? These were some of the questions raised during the last “hang-out” session hosted by the Resident and Associate Society of the American College of Surgeons (RAS ACS) on May 7th. “Hang-outs” are informal conference calls designed to help medical students navigate various aspects of surgery such as work-life integration, academic development years, residency interviewing tips and more. Our last discussion with the medical students got me thinking about the reasons I am spending (two or maybe three) years in the middle of general surgery residency dedicated to research: 1) a desire for an in-depth understanding of basic science research, and 2) to increase my probability of matching into the fellowship of my choice. I’ve always had a passion for basic science research. As a chemistry major in college, I made Cisplatin, a cancer drug,...
The Transition: Adding to the Picture of Surgical Care in India
My fourth trip to Nanakpur but my first in a hospital setting. We had five cases posted for the day: open inguinal hernia repair; open cholecystectomy; renal stone removal; bladder stone removal; and diagnostic cystoscopy. The surgeon arrived at 9 AM, asked for the list of patients and began to order the cases based on complexity and tool requirements. This was different from the U.S. where elective cases were scheduled for a time slot. The first patient was already in the OR getting prepped but the anesthetist was unable to gain access. Instead of using an ultrasound to find the vessel, the anesthetist told the patient to to return after two of the other cases. The surgeon had to complete all 5 cases before the staff left at 2 PM and did not have the luxury of time. We moved on. The next patient walked himself to the table and...
“How do you envision your family looking?”
My face crumpled up and tears erupted from my eyes as soon as the young doctor in front of me asked this question. I reflexively reached for a Kleenex to cover up my face and erase the signs of weakness. My cheeks turned bright red in embarrassment. But she took it in stride and gave me a moment to sob out, “I don't know. I just want to be able to have a family someday.” I was in a fertility clinic. From the second I walked in, I felt out of place. There were a few couples in the waiting room. I was the odd one out—a single woman in this stark place for couples struggling to have children. I wondered what they thought of me—what was this single woman doing at a fertility clinic? Maybe they imagined a partner somewhere in my life who just wasn’t present today. Or...
Balancing Act: Not Letting The #GymGrind Grind You Down
The Santa Hustle Half Marathon on a chilly, windy Galveston day in December 2016 “Everything in moderation” is one of those phrases we all toss around when it comes to nutrition and wellness. For me, it was one of my mother’s broken-record-phrases that she applied to everything from exercise to broccoli to peanut butter (gasp, I know). Long before mind-body wellness and balance were hip themes for marketing fitness products, they were core values that my parents prioritized in our family. As I considered our blog themes for this month-Mental Health Awareness and National Physical Fitness & Sports Month- I began to realize the intricate relationship the two have, especially in my life. I’ve always been an athlete, from tee ball to high school track & cross country, to college intramurals (with just a few championships along the way). Sports have always been an outlet for...
What is Private Practice Anyway?
Private Practice. Academic Practice. It used to be a straightforward decision as the end of training loomed in the distance. It is a common enough query, a conversation starter as you scrub with your attendings through training—will you pursue an academic career, or are you heading in to private practice? How to decide? What to consider? What does it mean? What used to be a simple fork in the road of a surgical career, with the occasional chance to jump the track from one path to the other, is now much more complex and nuanced than ever. Lines have blurred, the business of medicine has evolved, and this just isn’t so simple any more. Academic practices are increasingly aware and mindful of the business side of medicine; and fewer private practice surgeons are working in the traditional independent solo or small group setting, instead are joining large multispecialty groups or...
“Cure Sometimes, Treat Often, Comfort Always”
Six years ago, I was attending a Pain and Palliative Care Symposium when I heard a medical oncologist say, “We treat disease. We do not treat emotion.” She was an outspoken advocate for palliation in all aspects of care, be they spiritual, mental, or corporeal, and during all stages of illness ranging from curative treatment to terminal care. Initially, her words struck me as false, almost antithetical to the entire profession of medicine. Today, they resonate as precise if not true. In understanding what palliative medicine is, it is imperative to know what it is not, and what it could be. Coincidentally, the recent death of our former first lady, Barbara Bush, known to be receiving “comfort care” in her final days, prompted the National Hospice and Palliative Care Organization (NHPCO) to release a statement clarifying the nomenclature and respective roles of palliative care, comfort care, and hospice. According to...