SurgeXperiences 124: Season Finale

Welcome to the last edition of this season's SurgeXperiences blog carnival!

The loose theme for the collection was "Secrets and Surprises" - what season finale would be complete without a few of those?

Yet there's another ingredient that no real season finale would be complete without. It's The Unanswered Question. The Unsolved Mystery. Unfinished Business. Arguably it's why any of us keeps returning to any realm of inquiry or learning.

The world of medicine abounds with unanswered questions. While they might not show up here in the form of a conventional "cliffhanger ending," they're here all right...lurking behind the answers to other questions, the often-untidy "resolutions" to stories, and in situations that remain unresolved altogether and that keep us wondering about doctors, nurses, patients, the O.R., the characters in the vast series of episodes that comprise life in medicine today.

So without further ado I give you Secrets, Deep Dark Secrets, and Surprises.

Secrets

Aggravated Doc Surg has written several truly enjoyable posts about hospital life behind-the-scenes. Read here about the five people you DON'T meet in the hospital, usually, but should still appreciate, and here and here about how doctors REALLY feel about JCAHO, the folks that go around making surprise visits to hospitals and subsequently determine what should be changed about them and whether they should even stay accredited. I confess to enjoying Doc Surg's satirical and sardonic bent in the latter.

In this post, Dr. Bates at Suture for a Living navigates the sometimes-tricky situation of meeting a patient outside the expected setting.

And speaking of the expected setting, what goes on, exactly, in the O.R.? Katy at her engaging blog Funny Girl once invited folks to go ahead and ask, through her comments section, and graciously, she answered.

She also writes of a recurring anxiety dream that materializes in her sleeping mind once in a while in response to her work as an O.R. nurse. We all know about those recurring dreams. Being late for class, or showing up without your homework, getting lost on a familiar route, or teeth or hair falling out in public, or missing some other crucial necessity at the most inopportune moment. Dr. Bates shares a very interesting dream one of her patients had regarding her upcoming surgery. It doesn't matter which side of the surgical drapery we're on. Those secret concerns come out at night for our brains to play with and puzzle over.

That is, if we care enough to take responsibility for the work. Buckeye Surgeon describes the issues involved in being the kind of surgeon who takes this "You operate, you own it" type of resonsibility for patients. The discussion generated in the comments section is enlightening.

On a lighter note, if you missed my recent post on the yuckiest things I can think of from hospital life, here it is in all its repugnant glory. I pair it here with a post by Oystein Horgmo, our Sterile Eye, about "Inner Scents." Enjoy.

In a well-written post I consider one of the most important in this collection, Dr. Bruce Campbell, ENT surgeon and author of the blog Reflections in a Head Mirror, discusses the perils of losing the capacity for empathy during one's medical training, while in his beautiful and bittersweet post on empathy, Dr. Sid Schwab reflects with both hope and perhaps a hint of sadness, "If empathy can be learned, I'm not sure it can be unlearned."

Deep, Dark Secrets

Photo: Premier secret confié à Vénus by François Jouffroy, photographed by Christophe Moustier

If you haven't visited Respiratory Therapy 101, please do - it's a wonderfully-written window into the world of respiratory therapy and critical care medicine. And while you're there, check out this post about little human touches in the ICU, and what a mixed blessing they can sometimes be, along with the thought-provoking comment from RogueMedic that follows it.

The Sterile Eye gets a pretty intimate view of some patients who often end up in surgical ICU's. He shares his work with us in this post containing sarcoma videos.

If a life in medicine shows us anything it's that there is just so much pain in the world. We could all probably make a list of the worst stories we've ever heard / seen / been involved with, and I even wrote a post once entitled "The Worst Story I've Ever Heard." But there's never only one such story, and certainly not just within the confines of our hospitals, as Bongi painfully recounts.

There's less dramatic, silent suffering too - amorphous, almost like a vapor you can smell but not see. Elusive pains like those fomented by doubt, distrust, suspicion, ill-repute, as Sheepish describes in The Paper Mask.

When bad things, really bad things, happen to good people on both sides of the drape - the caregivers and the patients - there are several ways to respond. Denial. Rage. Hiding or giving in to despair. Or you can do what this outstanding individual did, generously and courageously and with consummate integrity, and try not only to become a better person and physician but also to transform the systems around oneself for the better.

And groups can do the same. Here Paul Levy writes about M&M, morbidity and mortality conference, during which docs discuss adverse events behind closed doors and try to establish ways to prevent future errors or disasters. Far from being a dismaying and dismal post, this narrative leaves us with a sense of hope that we can and will do better.

Surprises

This surprised me: a patient writes, "Interestingly...I owe my blogging hobby to being stented," referring to the placement of a stent into an obstructed ureter. Glad to have a patient's input in SurgeXperiences!

I was also surprised to see some insider info and an entreaty from a Beverly Hills plastic surgery blog about how the stars should just quit trying to make their lips bigger!

The Repository for Bottled Monsters highlights the "clearest pictures ever taken" of human ovulation as it is occurring.

Next, some stories that I found both refreshing and refreshingly well-written. Quietus Leo describes how one of his patients finally came to give herself a much-needed rest, even from the preparations for the highest holy day she traditionally honored. Sid Schwab writes about fainting. TBTAM who writes The Blog that Ate Manhattan relates a lesson from Italy about caring for aging parents.

A Little Summer Reading

I'd like to close the carnival with some posts to keep us thinking for the summer. Dr. Bates at Suture for a Living gives us useful information about dog bite prevention here. For practicalities involving medical practice, visit Ian Furst's writings about a simulation regarding wait times, and Sid Schwab's (and many other doctors') concerns about appropriate reimbursement. Dr. Schwab also offers a sampler of great posts from his blog for our ongoing perusal as we look forward to the season premiere of SurgeXperiences Season 2, to be hosted by our very own carnival founder, Monash Medical Student Jeffrey Leow.

To be continued...