Waiting for the Light

I wait for the light to change. Every time. I hit the scuffed but still reflective silvery button and then stare at the other traffic light waiting for it to go from green to yellow to red and then for the hand to turn into the little walking avatar. Every morning. Every evening. Every time I’m walking across the street from the parking garage to the hospital or back.

This is not really a normal thing to do in Baltimore. I’m in no way accustomed to seeing, well, anyone else do this. I occasionally get little looks while I’m standing there on the corner and others are crossing the street. “I guess he’s waiting for someone,” I imagine they’re thinking. In most cases, I doubt it even occurs to them that I’m standing there waiting for the proper crossing signal before I step into the street.
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Indispensable Medical Texts

Amazon has made it much harder over the last few years to find “Listmania!” lists, and there was one I made long ago to which I keep trying to refer students and residents. Therefore, I’ve reincarnated (or at least resuscitated) below my list of “indispensable medical texts”. I’ve only updated to newer versions of books where available, and otherwise just copied my prior content from Amazon. [Edit: I’ve now added more!] It also still links to the Amazon listing for the books, but I don’t receive any affiliate credit for your using the links. Hope it helps!

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ABSITE Statistics: The Absolute Basics

The Behind the Knife team put together a great last-minute ABSITE review podcast to cover those annoying issues asked every year which require memorization. However, they noted that statistics wasn’t their strong point; I’m happy (and only mildly embarrassed) that it’s one of mine.

Long, long ago, I put together a brief “concepts” review for ABSITE statistics. It includes no calculations, tables, or graphs, and is a set of the absolute basics. If you just want to remember what a few of the important terms mean, feel free to download. It’s available as a PDF or the original PowerPoint

In My Day

When I was in training, attending surgeons regularly complained about the low quality of the residents they were teaching. Most didn’t recognize the changing landscape of medicine which, to be brutally honest, had been far from an abrupt shift and much more of a gradual evolution that they didn’t feel the need to accept or even acknowledge. Those attendings dedicated to medical education frequently tried to explain the changes and encourage open-mindedness about alterations to the status quo, but this has never been a strong point among the stereotypical surgeon, who would commonly instead complain about how things were different when they were in training.

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Socrates Wasn’t a Pimp

Kost A, Chen FM. Socrates Was Not a Pimp: Changing the Paradigm of Questioning in Medical Education. Academic Medicine, January 2015 90(1):20-24.

Yes, I wish the article were open access, but it’s still worth a read. And, you know, it gives me the inspiration for this picture.

Legalities: Image modified from “Socrates” by Ben Crowe (https://www.flickr.com/photos/croweb/2836991287) and “pimp hat” by Beth Kanter (https://www.flickr.com/photos/cambodia4kidsorg/2274922356), used per Creative Commons-Attribution-2.0 License.

One Sheet Surgery: Surgical Emergencies

[Last updated 30 June 2016]

Just a reminder of the steps to take in any surgical emergency. These are not evidence-based.

The attached files are nicely formatted, and additionally include contact info and a reading list. Share and enjoy.

  1. Call for help
  2. Airway
  3. Breathing
  4. Circulation
  5. Disability
  6. Exposure
  7. Foley
  8. Gastric decompression
  9. Hertz
  10. Imaging

PDF: OSS – Surgical Emergencies

Microsoft Word: OSS – Surgical Emergencies

As always, these files that are the sole work of Christian Jones are hereby released into the public domain, with no rights reserved.

To Complain is Human

If you feel obliged to criticize, be fair-warned you are also open for ridicule. — Mark Reid, MD (@medicalaxioms) via Twitter on 14 July 2015

ProPublica has released the Surgeon Scorecard, their study (with accompanying app and news report) on complications in surgery. There have been many such national studies of Medicare and other administrative databases; this one is novel in that it evaluates the complication rate of individual surgeons, rather than grouping the complication rate by hospital. When ProPublica announced last week that they’d be releasing these reports, there was much gnashing of teeth regarding the interpretation of data, correction factors for operating on more complex patients, and public response to the findings. This is likely to become a pretty big story this week (at least); USA Today has already picked it up, and it’s right up NPR’s alley as well.
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Behold, Data!

Data are good. Data we can share are better.

It’s easy to hold onto data we’re using for research. Despite the “security breaches” which fill news outlets with repetitive stories and warning, the data we tend to use in academics can typically be kept, quite securely, on a password-protected desktop in our locked offices, with little fear they’ll make it into the hands of ne’er-do-wells. Certainly this safety is still important—so much so that most institutional review boards require a specific statement regarding how we’ll handle our data to ensure it remains safe. “Protected health information” needs to be kept confidential, with hefty fines and public shaming for those who fail to adequately protect it.
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Subjunctive Complaints

Let me start by saying this isn’t a cry for help.

Physician burnout has been getting some press lately. Physician satisfaction, or the lack thereof, a bit less so, but it’s at least present. A few years ago, there were more articles supporting the high risk (if not prevalence) of more serious psychiatric disorders among physicians, with results similar to those we’re finding in the satisfaction and burnout studies: that certain specialties are more strongly associated with problems, that pay matters a little but not as much as one might think, and that they’re major problems that certainly need to be addressed.
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