Friday, 29 January 2016

Offended

WARNING: THIS POST IS EXTREMELY SWEARY AND CONTAINS "FUCK" A LOT.  IF THIS BOTHERS YOU, FUCK OFF NOW.  I MEAN, TURN BACK NOW.  FUCK.  UNFORTUNATELY THIS IS ANOTHER LONG REBUTTAL OF BULLSHIT.  I APOLOGISE IN ADVANCE IF YOU CAN'T GET THROUGH IT ALL.  

If you know anything about me, you know that it takes a lot to offend me and that I don't get angry easily.  If you don't know anything about me, then you also know this because I just told you.  I realised long ago that getting angry at someone or something doesn't help anything, it just makes me do stupid things like bash my hand against a solid wood door (yes, I did this) or throw a glass against the wall so it discharges hundreds of shards of glass around the room including into a pot of simmering soup (yes, I did this too).  In other words, offending and angering me is difficult.

That said, I'm both offended and angry.  Really fucking offended and really fucking angry.

I was perusing the internet yesterday when I came across an article on Aeon.co entitled "There is no place for the surgeon myth in modern medicine."  Based on the title I assumed it was written by a surgeon-in-training who had encountered a prototypical "Asshole Surgeon" and was railing against his bad behaviour in the operating theatre.  Instead, I was chagrined to discover that the author, Alexis Sobel Fitts, is a freelance journalist who writes about science and medicine after studying science journalism for one year at Columbia University (and English at Yale) but seemingly has no actual science or medical training whatsoever (according to her website).

That bothered me a little bit.  How could this woman know anything about surgery? I thought.  Then I started reading the article, and by the second paragraph I wanted to reach through the computer and slap the living shit out of her.

I rarely give the punchline before the joke, but fuck it, here it is anyway: she claims that surgeons are essentially nothing more than thoughtless, crude barbarians with scalpels who descended from butchers and barbers and merely do, rather than think.

After reading that last paragraph back, I feel the anger rising again.

I'm going to take the liberty of quoting liberally from Ms. Fitts' heaping pile of bullshit, er, article.  No, sorry I was right the first time.  Heaping pile of bullshit.

She starts by describing a scene from The Knick, a show on Cinemax (that I've never seen) which focuses on a surgeon at the Knickerbock Hospital in New York in 1900.  Yes, 1900.  Dr. Thackery is about to perform a life-saving surgery in the era before antibiotics and anaesthesia, and he looks like "the perfect hero", according to Ms. Fitts.  But then she descends into the first bit of bullshit when she relates a joke her sister (who is in medical school) told her: "'An internist can figure out what’s wrong with you, but he can’t fix it,’ it goes. ‘A surgeon has no idea what’s wrong with you, but he’s happy to fix it.'"

Fucking hilarious, right?  Because surgeons don't ever think, and we have glorious cold hard steel to do the thinking for us!  Ha fucking ha!  It gets worse.  Much worse.

She then describes a cadre of medical students who appear to have self-selected as future surgeons as "the frat boys of medical school".  According to Alexis' sister these students are "the first to volunteer for dissection, and the last to answer basic science questions during drills," and that there was a difference "between surgeons, whose ability to solve problems was lauded by the public, and the rest of the medical establishment, whose ability to analyse data and diagnose was valued within."

If you aren't detecting Alexis' pattern of the surgeon being an unthinking idiot with a 10 blade, then you aren't paying attention.  First of all, many medical students don't decide on surgery until they are years into medical school.  I was in the middle of my third year (up until that point it had been a tossup between psychiatry and paediatrics), so this whole idea of a pack of surgical frat boys is ridiculous.  Second, the only people I knew in medical school who didn't want to dissect their cadaver intended on going into neurology or psychiatry.  Everyone else was more than eager to dissect.  Third, some of the biggest gunners (those students who raise their hands first and always seem to study most) were future surgeons, because they had to be (since surgical training is very competitive).  Fourth, since fucking when do surgeons not analyse data (more on that later)?

It became clear to me at this point that Ms. Fitts had not spent one goddamned second with an actual surgeon and was basing her entire ludicrous hit piece on fictional early-20th century television surgeons and whatever lies her sister told her.  It became even more obvious that she had done exactly ZERO research (other than a 0.253-second search on YouTube) when she made several glaring errors in her next paragraph about an internal carotid endarterectomy:
On YouTube, anyone can watch a vascular surgeon remove a growth from the carotid artery, the passageway that transports blood to your face and brain. It is stunning: the skull, splayed open, revealing the thrumming sinewy flesh beneath. The procedure is as uncomfortably intimate as it is delicate. Any missteps might incite devastating consequences, as the surgeon navigates around the vagus nerve, which dictates facial response, and the hypoglossal nerve, which controls the tongue.
Good fucking grief.  Where do I even begin.
  1. It's not a growth, it's called a plaque.
  2. The internal carotid artery (which is being operated upon) doesn't supply blood to the face, the external carotid does.
  3. The carotid artery is accessed via an incision on the side of the neck, not by "splaying open" the skull.
  4. "Thrumming sinewy flesh"?  Seriously?
  5. The vagus nerve does not innervate the face, that would be the facial nerve.
At least she got the function of the hypoglossal nerve right.  But it would have taken her less than 5 minutes to correct any of these mistakes.  Other than "thrumming sinewy".  That's just farcical.

Anyway, Alexis continues her relentless assault on surgery:
But remove the glamour of labouring beneath the skin, and surgery can seem much duller. After all, fixing problems is corporeal, often removed from the more intellectually nimble task of diagnosis. It’s physical work, at its crudest achieved with simple steel tools and at at its most advanced using tiny, specialized cameras and computerized guides.
Later she adds this little gem:
Surgeons are valued for their ability to execute, not analyse.
Remove the glamour of . . . wait, what?!?  Of course it's duller if you remove the surgery from surgery!  Wouldn't cardiology be less glamorous if you remove the heart?  And surgery is never "removed" from diagnosis!  Does she honestly believe that surgeons simply walk into a room and fix something without knowing what they're fixing or why?  When I see a patient with a bowel obstruction, for example, I first must determine if there is an obstruction.  I do this by 1) interviewing the patient, 2) examining the patient, 3) reviewing labwork to see if there is any evidence of systemic illness (elevated white blood cell count, hyperglycemia, hyponatremia/hypochloremia, lactic acidosis, hypotension, etc), and 4) reviewing the X-rays and/or CT scans.  Once I've determined that an obstruction exists, I then have to determine the best course of action - a trial of non-operative management (since many obstructions will resolve on their own) versus surgery, and if the patient needs surgery, when.  If there is systemic sickness (ie sepsis or impending sepsis), the patient needs immediate surgery.  AND THEN I have to operate and actually fix the problem with my simple steel tools or my tiny, specialised camera (ie a laparoscope).

Does that sound like I'm removed from the more intellectually nimble task of diagnosis?  I have to do this for every single patient I see.  Granted with many patients it is easier and simpler.  But at no time am I ever not thinking.

Are we done yet?  Not remotely.
While medicine sprung from the academy, surgery originates with tradesmen. In the Middle Ages, ‘barber-surgeons’, who had knives and razors at the ready, performed bare-bones amputations and tooth extraction alongside haircuts. Becoming a doctor called for university training, but surgery – requiring less skill – was passed down by apprenticeship. Even women, barred from becoming physicians until the 20th century, could train as surgeons. Low rank is implicit even in the title, surgeon, which is derived from the combination of the Greek words for ‘hand’ and ‘work’.  Surgery's place at the bottom of the medical hierarchy can be attributed to the crude cruelty of early surgical procedures.
Wh . . . wha. . . what the fuck was she smoking?  Yes, barbers used to perform surgery, but that was ages ago.  What the fuck does it matter now?  Why even bring that up except to make surgeons look bad?  Surgeons attend the exact same schools, in the exact same classrooms, take the exact same tests . . . god damn it, you get the fucking point.  And "less skill" and "low rank"?  Bottom of the medical hierarchy?  According to whom, YOU?  Don't misunderstand me, I'm not saying that surgeons are at the top of the medical totem pole, because there is no top or bottom.  Every specialty is necessary and important.  But surgeons spend the most time after medical school of any specialty, often 8 years or more, learning their craft.  Less skill?  Are you fucking kidding me?

Next, Ms. Fitts laments the lack of women in surgery, stating that "surgical specialties remain segregated":
An operation is performed within a distinctly macho context: a showdown between disease and individual doctor, leading a team through authoritative decision-making. 
How is that macho?  What does that even mean?  Do women not solve problems in Alexis' universe?  Regardless of that bit of inanity, it took me all of about 13 seconds (admittedly a bit longer than usual) to find out that while the number of women in surgery is still relatively low, the trend is the exact opposite:
Percentage of women in surgical specialties

I thought enough must be enough.  Her attack on surgeons has to be over, right?  HA!  No.  Somehow in her mind there is something wrong with the fact that only 10% of articles in the prestigious New England Journal of Medicine have to do with surgical innovation:
As evidence-based medicine has become increasingly the standard of discovery, surgeons have not risen to the top of scientific enquiry. Since the 1950s, laboratory science has increasingly been the origin of medical innovation. Which is why, over the past four decades, merely a 10th of the articles published in The New England Journal of Medicine have covered surgical innovation.
Apparently Alexis didn't get the memo that we surgeons have our own journals.  Hundreds of them.  And guess what percentage of their articles are about surgery and surgical innovation?  ONE HUNDRED FUCKING PERCENT.

But Ms. Fitts still isn't finished with her all-out assault on surgeons, now claiming that we don't know how to play nicely in the sandbox with the other kids:
And the future of medicine is forcing surgeons to adapt. While surgical achievement fixates on the craft of the individual, advances in medicine are forcing physicians to adapt a team-based approach. Increasingly, a surgical procedure is only a part of an overall treatment plan – forcing surgeons to work alongside their peers in internal medicine. This is coupled with a technological revolution that is creating intelligent tools, requiring the contemporary surgeon to guide their actions by data, rather than instinct.
All this does is demonstrate that Ms. Fitts has no fucking clue how medicine works.  As technology has improved, surgeons have had access to more and more data.  Thus we haven't had to act "by instinct" for decades.  Plus, I consult my internal medicine colleagues regularly to assist in management of medical problems.  For those patients of mine with kidney disease, do I do my own dialysis?  Of course not, I call a nephrologist.  I don't read 2-D echocardiograms, I let my cardiology experts do their job.  I'm not "forced" to work alongside these people, rather my colleagues and I know how the cogs in the medical system all turn.  Ms. Fitts obviously does not.

But she wasn't done yet.  I could almost hear the "plop" as Alexis dumped her concluding steaming pile of excrement:
Atul Gawande, a surgeon and staff writer for The New Yorker implored his peers to place increasing emphasis on diagnostics rather than skill, in a lecture delivered to the Association for Surgical Education in 2001. ‘We are doctors, not technicians,’ urged Gawande, even though for the rest of the world, being a technician might be glamorous enough.
Not that it matters much, but Dr. Gawande was still in his residency when this speech was given, which is surprising considering he was asked to talk about how to improve surgical training when he had not finished his own.  Irrespective of that, Ms. Fitts completely misinterpreted the point of Dr. Gawande's excellent speech.  He wasn't talking about surgeons becoming mere thoughtless automatons, but rather about expanding surgeons' training on surgical diseases and improving communication between 1) surgeons and patients, and 2) surgeons and the rest of the surgical team.

And with that last heave of excreta, Alexis was finally finished.  I counted 17 new dents in my desk where I bashed my head while reading her bullshit article bullshit, and 21 more after I wrote this.  The editors and publishers at Aeon should be embarrassed for publishing this toxic heap of manure, and Alexis Fitts owes every surgeon in the world a huge apology for writing this article of pure ignorance.

I would apologise for the number of "fucks" and the ridiculous length of this post, but I don't think I have any more fucks to give.

79 comments:

  1. Someone is wrong on the internet. https://xkcd.com/386/

    Unfortunately a lot of content must be produced to fill the internet, both on that trashy blog and on here. I do wonder if the author's sister is suffering a bit of both envy and annoyance at the gunners in her medical school class. First year med students more closely resemble high school students than doctors. And it appears that the author's sister isn't part of whatever jock clique populated that high school.

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    1. Yep, all that content to "feed the beast" and little or no copyediting. Publications don't seem to care that stupid errors hurt their credibility and cost them readers.

      Delete
  2. she is to writers what she imagines surgeons are to the medical profession.

    bet her sister flunks out.

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    1. We know she's already pissed off at that menacing gang that she thinks *might* become surgeons.

      "Doctors don’t begin to specialise until their fourth year but, according to my sister, those who intended to pursue a surgical career had already begun to stick out in their first year of medical school. They travelled in a pack, attending optional surgical rotations in the morning and leaving their white coats on for afternoon class."

      A gang of sociopaths, for sure! LMAO!

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    2. wearing white after labor day? the HORROR!

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    3. Sooooo, the pre-surgeons who are only interested in cutting and have no interest in learning are going to OPTIONAL sessions to, wait, learn more? What a bunch of jerks!
      I am curious about the med school her sister is attending. I recall no cliquish behavior relating to future specialities at the med school I attended. There was a bunch of people who were the " life of the party" type, but they were interested in all manor of specialities. And many of them were total gunners. It is a bit like high school in that regard, but since I got over not being a cool kid in Jr. High School, I did not find them to be offensive. And they were fun to party with.
      The only speciality related activities we had the first 2 years were "interest groups" for various specialities that gave us free lunches with lectures several times each month. And EVERYONE went to them, 'cuz Free Lunch!

      Delete
  3. IMHO, just another example of the phenomenon that we see so often in this "age of information." "Doing research on the internet" doesn't necessarily result in a writer's having an actual informed opinion, or even one that makes ANY sense at ALL, depending on what that person actually *read* or *viewed.*

    I don't know what the hell she saw on YouTube, but apparently she knows nothing about basic human anatomy. I actually had to laugh at her account of having to "splay open the skull" to reach the carotid artery. There was no *need* to read much further to dismiss her entire article as totally clueless.

    Doc, I totally understand why this article was offensive to you. Still, we need to remember that students sometimes say and do some really dumb stuff as part of the learning process. My guess about this student's "real life" experience is that it hasn't yet presented the occasion to actually *have* an illness or injury that was positively addressed by a surgeon's involvement, or to see that happen in the life of a family member or friend. I don't wish misfortune on anyone, but am pretty confident that if these things *do* happen, her attitude will change too :)

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    1. If she runs across an arrogant surgeon even though he may perform excellent work, she doesn't seem like the type who will be able to learn much from it.

      I wrote this as someone who had an orthopedic surgeon with the bedside matter of a jerk but whose placement of a plate, pins and tightrope was about as perfect as you can get. I am sure you can guess what really mattered to me in the end.

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    2. the first half of your first sentence is probably unnecessary.

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    3. Scarab - The only problem with your last sentence is that she isn't the med student - her sister is.

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    4. I know...but Alexis *herself* is still a student too. By her own admission, she's only completed one year of her journalism studies, and her "job," in addition to freelance writing, is editing and writing for the Columbia Journalism Review, which is published by the University's Graduate School of Journalism. So, she's still got lots to learn too :)

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  4. Someone has seen too much "Grey's Anatomy" I suspect. And I don't mean the text-book.

    Ugi

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    1. gray's anatomy = General hospital, the next generation.

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    2. Gray's Anatomy = useful.
      Grey's Anatomy = jumped the shark about 10 seasons ago and has nothing to do with real life. I still watch it for shits n' giggles... I can't help it, it's hilarious!

      Delete
  5. Wow, what surgeon pissed in her Cheerios?

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  6. high praise for a diagnostician = someone watches too much House

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  7. Bitch has never been sick. All of the specialists that I have ever seen are board certified both in Internal Medicine and what ever specialty they are in. God help her if she ever gets cancer.

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  8. Perhaps she's had a problem with a surgeon before--say, one that performed a double hemispherectomy on her.

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    1. Haha, nice one.
      Admittedly I had to Google it to get it however.

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    2. More likely, she is suffering from a case of cranial rectal inversion, which is fairly common among teens and very young adults. Fortunately, many of these cases DO resolve spontaneously, with age and life experience. Sadly, some of those afflicted never completely recover.

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    3. Scarab, best comment ever. "Cranial rectal inversion". (^-^) hahaha, oh that is awesome.

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    4. Hahaha that is fantastic. Don't bash your head in, though. There is so much idiocy on the Internet. As a woman in surgery, I cringe at the thought that some female med student (the writer's sister) is being such a moron. Hopefully she'll end up in derm. ;) (found you via Twitter!) ~YB

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  9. Hi, a little OT but I'd appreciate some good thoughts on the 3rd, I'm going in for an angiogram. I saw my GP 1-6, saw the cardiologist on the 14th and in on the 3rd. Doc 2 said that if it was just 1 or 2 symptoms, he wouldn't be concerned but because I have 4 symptoms they got the referral in record time. I'm trying to stay positive but because both sides of my family have heart issues, my BP is higher than normal. Thanks!

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  10. May she find herself in need of a real surgeon but opt for a barber.

    Wednesday

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  11. Thank god for Dr. Lorenzo F. Munoz, MD in Chicago; the surgeon who did the surgery on my husband who had a GBM tumor.
    He was a very knowledgeable man and also the kindest. He is truly a gentleman. My husband was able to live far beyond the average 9 months past diagnosis with quality of life because of his skilled hands.

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  12. Me surgeon. Me cut here.

    Soooooo not what I do. I talk to people, I look over labs and scans, I review FHT strips, I talk about alternatives. Yes, I do surgery. But I also do so much more. I can help people nonoperatively - and that may be more in line with their values. I can remove a uterus...or fit a pessary instead.
    Choosing not to operate is the mark of a thoughtful surgeon. We do exist. Fuck this chick.

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    1. Nailed it.
      I avoided surgery (rotator cuff) with PT and one cortisone shot (which I had been against... I was all for surgery) after seeing a very kind, and world renowned surgeon at a very good hospital I had to travel to. You wouldn't think "kind" and "world renowned" go together, but oh man, this guy was excellent. From what I've read about him, he's surgically done things that many doctor's could not, but for me, he helped me decide that surgery was the lesser option, to go for a more conservative approach, and I avoided up to 9 months of (more, and more painful) PT (and yes, my insurance covers it) and, from what I've heard, a terribly painful surgery with a pretty crappy first 6 weeks after.

      If only I had found him after the initial damage was done! Good on you. Much respect. Surgery is necessary, but not always, and in my experience (with a few injuries - I ride horses) the doctor's have carefully guided me to the correct approach. (Yes, I have had surgery, I broke my jaw badly at 18. It's fine now. I also had ECT, electroconvulsive therapy, while not technically surgery, many consider it "barbaric", but it saved my life, and now I'm a certified welder and computer engineer)

      And I'm Canadian.

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  13. Has she thanked you for the readers and exposure you generated?

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    1. No, she blocked me without a word. I was wholly unsurprised.

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    2. thereby tacitly admitting that she cannot defend her drivel.

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    3. Or, just pissed off that she's *already* gotten more unsupportive comments on her article than she expected...

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    4. Or she just reached her annoyance quota. I think that most people can understand that.

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    5. If by "annoyance quota" you mean a realization she cannot defend her drivel.

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    6. Ken, though I disagree with her I also disagree with your conclusion. Most of us have ignored or blocked someone(s) simply out of annoyance and the fact that we don't want to get entangled in some brouhaha.

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    7. you are correct that some people are so convinced that they are right that they automatically disregard any evidence presented to the contrary. most of those will respond at least once, though.

      and a person who writes the sort of outlandish screed she did do not strike me as the sort of people who want to avoid a brouhaha.

      Delete
    8. Ken, "do not strike me" is your opinion. Again: I disagree with her but I also disagree with you re: reasons for her nonresponse.

      If everyone who posted disagreeable or inflammatory things online had to respond to critics or have the last word, most of the U.S. would be too busy posting to hold a job.

      Delete
    9. Anon - of course everyone understands that. I've gotten several comments regarding my Daily Beast articles ("WORST ARTICLE EVER!"), but I respond to them. If they have a valid criticism, I would like to know. I have never blocked anybody merely for questioning something I've written. In fact, I've only blocked a handful of people, all of whom are for trolls and/or have nothing useful to add (in my opinion). But that has always been after we have had a conversation, never preemptively.

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    10. Doc, I understand that. I don't know exactly what you mean by blocked, but there are a few very critical comments in the poll section following her essay and - last time I looked - the comments weren't closed.

      My sole point was that no matter how nuts someone is, lack of response doesn't necessarily mean s/he can't defend something. S/he might be a rare responder, have a lousy personality, view that piece as a "B-job" blat or whatever. The most that I could conclude is that she doesn't give much of a s**t.

      Delete
    11. I meant on Twitter. I called her out specifically, and she blocked me.

      By the way, you can say "shit" here. No one gives a shit.

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    12. Tnx Doc. I and you don't give a shit but some sites do, and if I get into a shit habit I might forget the asterisks elsewhere.

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    13. Doc, *almost* everyone who's viewed your internet postings, whether on this blog, Twitter, FML, or Daily Beast, thinks you are actually a surgeon. (Had to qualify with *almost* because of one known exception). There's no reason for someone who's already passed judgment on a profession about which she apparently knows very little would want to risk possibly confusing herself with actual *facts*.

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  14. @Timethyfx Don't feel bad--I had to use Google to figure out the name.

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  15. If you click through some of the links you come upon a question/article that the editor to this piece (Pam Weintraub) wrote about chronic lyme disease and how it does exist. I think that's helpful to contextualize how this site approaches modern medicine.

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  16. Way to put that idiot in her place, this rebuttal was amazing.

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  17. My surgeon was one of the most compassionate physicians I ever met. We compared tattoos in pre-op, after the nurse couldn't start the IV he actually ran to get the anesthesiologist, I was asleep when he did rounds, so he waited, on his own time, until I woke up, and consulted with an oncologist because I couldn't take the pain medication he prescribed. When I went for a follow up, he went above and beyond getting me samples of new medication for my migraines, because I happened to have one at that visit, he was an ENT surgeon.

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  18. Let's not speak about her inherent lack of writing skills. She obviously doesn't read any "to the trade" books, nor does she put much effort into developing her own writing skills. Oh where do I begin? And I'm a business major.

    She obviously has so little to do but disparage others who spend countless hours honing their skills and actually contribute to society. I certainly hope she never has to rely on one of these "frat boys" to save her life, but I'm certain they will still operate despite her abuse. As for her sister, the world doesn't need any more poor quality doctor hacks on the Medicaid rolls. Those unfortunate patients are better off continuing to rely on their shamans (or Dr. Google).

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    1. To be fair, and speaking of disparaging those who hone skills and contribute:

      I'm a teacher and my wife is a lawyer. We have a surfeit of degrees and skills-honing between us and make a point of giving back. We also are used to having our professions routinely disparaged by opinionists of all sorts. Sometimes you just have to roll your eyes and move on.

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  19. Speaking of offended, Wally World won't let me access your site on their public wireless connection. Notice says your blog site is not secure but I expect it is the profanity in your URL.

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  20. Hi Honeys, i suspect she has had a bad experience with a surgeon or perhaps her sister has.
    I wonder if her sister failed some part of her course, was rebuffed by a surgeon she had her eye on or decided she hates surgeons because she doesn't have the skills or intellect required to be one.

    It would explain her vitriol.

    I wonder what she would say if she needed surgery and it was a male performing it?

    have a great day and keep up the good work, we all appreciate all you do, even if some numpties don't.

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    1. Hi, Tania! I had the same thought about the "sour grapes" dynamic, regarding the author's sister's disdain for surgeons.

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  21. I recently had surgery. Performed by an orthopedic surgeon. Over 15 years my pain was ignored by numerous doctors. I was treated like I wanted narcotic pain relievers. I wasn't, that was the last thing I wanted.

    Funny enough, after year of seeing podiatrists, general practitioners, physical therapists, etc., it was a surgeon who ordered an MRI of my ankle. Which showed a 1.3 cm tear in one of my tendons. After a year of trying non-invasive techniques for a pain free life we went with surgery. I'm 12 weeks out, weaning out of a walking boot.

    I am incredibly thankful to my surgeon for me hopefully living pain free. Even if the pain is just less than it was I'll be thrilled.

    I also think of the numerous surgeons who saved my mom's life. Including the one who was on call the day we found the staph infection in her knee. He had just worked an 8 day week & was swimming with his kids when he got the call. He was in shorts, a t-shirt, & flip flops when he came in to do a fluid draw on her knee. He was amazing. As were all the surgeons that summer.

    Some people are just idiots.

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  22. I'd like to send a thank you out to the surgeon who seven days ago performed a right hemicolectomy on my father. ten days ago my father had a routine colonoscopy, during which they found a tumour. the surgeon very kindly fit us in to his schedule that afternoon and booked dad in for surgery three days later. dad was up and walking the day after his surgery. a week later and he's on to solid food. the surgeon came in to the hospital multiple times at odd hours to attend to my father, including a visit at 6PM Friday. this surgeon is one of the best doctors I've ever met. my father is recovering well and it is all thanks to the skill and knowledge of a surgeon.

    on the other hand, two weeks ago I had the misfortune of seeing an endocrinologist who was the rudest, most hidebound, excuse for a human being I've ever had the misfortune of meeting. he completely discounted my knowledge of my own body in favour of what he thinks is right. telling me to discontinue a medication because "I only had one abnormal lab result". ignoring the fact that my symptoms have been alleviated since taking this medication. ignoring the fact that every individual is unique and what could be a normal lab value for one person can be an abnormal value for another.

    if we're using anecdotes for evidence this 'writer' would have written about endocrinologists instead!

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    1. Best wishes to your dad for a continued successful recovery. My mom had a similar situation, biopsy of the tumor revealed cancer, and her surgery was done a few days later. She has now been cancer-free for ten years, thanks to...guess what...the actions of a caring and competent surgeon! :)

      Regarding the behavior of the endocrinologist, this just points to the reality that *any* individual human being, in *any* profession, can be rude and inconsiderate. Sometimes these are persistent personality traits. Sometimes it happens because that person just isn't presenting the "best self" at a particular moment due to other stresses of which we're not aware. In any case, as you stated, one anecdote of a bad experience isn't "evidence" that *everyone* in the profession is a jerk.

      Delete
  23. I just had emergency surgery to remove a ruptured fallopian tube and the surgeon and his team were amazing... They explained everything to me, even though I was pretty out of it due to the pain medication, and they took great care of me.

    Her article is insulting, not just to the surgeons, but to the lives surgeons have saved. Without that surgery, I would have bled out into my abdomen. Without the nurses helping, I would have been terrified and woefully confused about what I would be going through. The surgeon and the nurses working under him were a lot more helpful than the ER doctors who misdiagnosed me with a simple miscarriage...

    Thank you, surgeons.

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  24. That's weird : I seem to remember a very negative "opinion" of ER Physicians (as a crass generalisation) being espoused on this blog ?

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    1. You do indeed. I said every specialty is necessary and important. I said nothing about the people within those specialties being competent.

      For any emergency doc reading this, yes I give you a hard time here. It's part jest, part good fun, part exaggeration, and part brutal honesty about what I see.

      Delete
    2. Not much different in my field, really. We all have our jokes, teasing, pet peeves about each other's disciplines, and such. But everyone's specialties...architects, engineers of all types, construction managers, and all the trades...are necessary and essential to the team. And, despite our differences, and occasional dumb mistakes on the part of one individual, most humans still find *buildings* a convenient place to live, work, and conduct business :)

      Delete
  25. Fuck fuck fuck, ye Bastard ! And I've met (and assisted in OR) barbers I wouldn't let within 20 yards of my carcass with a scalpel blade :-) Hahaha, all in jest, all in jest. Yep, we all have our bad apples : no argument. They're both unforgiving environments, and competence matters. Rating sites and Press Ganey ? Hahahaha, give me a break. I wish that patients would understand. The question to ask an MD : who would YOU refer your family to ? Refer me there too, please. It's not rocket science.

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  26. Well, it's true. There are surgeons who can't even interpret a simple lab result. Especially in general surgery.

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    1. There are bad surgeons, just like there are bad anythings. But I think it's safe to say that 99.9% of surgeons can interpret basic labs. I've never met one who can't.

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  27. A general surgeon asked me one time why his hypothermic patient went into V-Fib during his exam. I referred him to one of my ER nurse to educate him about cold blood and V-Fib.

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    Replies
    1. And next on "Things That Never Happened..."

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    2. why was a surgeon examining a hypothermic patient?

      wait - don't bother answering - ER docs send them, right?

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    3. Keep in mind it's the ER Docs that keeps you in business. At least that's how it is in the U.S. Be an A-hole and and you won't get the ER doc's referral. They'll be happy to get someone else. So there goes your practice. That's IF you even have one.

      Delete
    4. Ken Brown, way to go trying to be a doctor. Fail.

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    5. I have never claimed to be a doctor. and yet, I suspect I have seen more, and had more training about, hypothermic patients than you have. (anon)

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    6. Ken Brown - I'm impressed. I really am. sigh.

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    7. Ken, different anonymous. You do know that trauma patients can be hypothermic, right ? And septic patients with perfs ? And massive transfusion protocol patients ? And... The kinds of things Surgeons and ER Docs share care on. If I'm missing something. my apologies, otherwise your question and experience with hypothermia just don't make sense ?

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  28. oh, anyone can be hypothermic, and certainly hypothermia can accompany trauma. the original and follow up comment was to imply, as doc did, the anon that started this thread was making the whole thing up.

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    Replies
    1. Good segue Ken Brown.

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  29. This is the kind of stupid that makes me hear my own heartbeat... Surgeons are the end-all specialists in their given field, hence, why THEY are consulted BY the internist/FP physician..

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  30. What is this prejudice of mental work being superior to physical work or craftmanship? Thats some bourgoise BS.. working with your hands ,or really anything, takes talent + work to be good at. it also takes mental skill. Just different skills than a philosopher, lawyer, etc. People who make and do things are totally crucial.

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  31. This comment has been removed by the author.

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  32. That woman is crazy!!! I needed my appendix out. I was bleeding internally as well. Surgeons are very much needed or a lot of ppl would be dead. What an idiot

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