Tag Archives: trauma surgeon

What makes you a #bettermother?

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Nope, not a better mother than your neighbor, than your friend, or than the president of your local PTA…but what makes you the best mother you can be?  Going even further than that… What makes you successful as a person?  As a human being?

 

John C. Maxwell defines “success” as:

“knowing your purpose in life,

growing to reach your maximum potential, and

sowing seeds that benefit others”.

 

Very recently I was approached by www.inspiringwomeninsurgery.com to provide some words of advice or encouragement, and while my 4 year old was brushing his teeth at night I thought about work/life “balance”, envisioned a set of scales, and came up with this.

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Why am I a #bettermother because I am a surgeon?  Because I know my purpose in life, I am growing and I am sowing seeds.  I know that this mother may be sad that I miss my son’s soccer practices, but I also know there are lots of other mothers out there that are glad I did… because I was able to help their children in their time of need.  And although my children may miss me at times, I know they also gain valuable lessons from my career – independence and selflessness chief among them.  My children always know that I love them, and they are important to me… whether I am sitting at their bedside, or at the bedside of one of my patients.

And no, you don’t have to be a trauma surgeon or work outside the home to be successful, or a #bettermother.  Again, look at the definition.  Nowhere in that definition does it mention spending every moment of every waking day with your child(ren).  It doesn’t mention making your child’s first birthday cake by hand, or becoming Vice President of a company.  Nor does it mention “leaning in” to the point that you are about to fall over.

YOU are at the center of your success, and you have to give back to yourself in order to be in a position to give to others – whether that is your spouse or your children or your community.

An example for you.  The wife of one of my partners volunteers with her daughters’ Girl Scout troop.  This makes her a #bettermother – not because she spends time in an activity that involves her own children, but because she gives of her time to an activity that gives many children joy when other mothers can’t.  Another friend is a #bettermother because she is a Crossfit addict… She is teaching her daughter that strong is beautiful, and physical health helps build emotional health.

Taking time in activities, away from your family, work related or not, that develop your sense of self, fulfill your purpose in life, and replenish your soul is not selfish.  In fact, it is essential to being a #bettermother and a successful human being.

So what makes you a #bettermother?  Is it the 30 minutes you spent exercising this morning?  Or is it the 2 hours over the weekend you took to train for a marathon?  Is it the overnight business trip in another city that allowed you to present a project that will better your company?  Is it the hours you spend volunteering at your child’s school because other mothers can’t?  Is it that extra time you took at the hospital treating a patient who needed you?  Is it the time you spend organizing a book club giving women the opportunity to fellowship with other women, building their support system?

Success doesn’t require a title, or a degree, or a paycheck.  It requires YOU being the best YOU possible.

So take that time to develop yourself, replenish yourself, fulfill your purpose.

Enjoy it.  Own it.  And snap a photo of yourself doing it.  To keep as a reminder – when you are coming home late, or have 18 loads of laundry piled up, or serve Cheerios for dinner for the umpteenth time that week, or in any way feeling like you are “failing”…that you are, indeed, not.

I am a #bettermother, and so are you.

 

Who do you save? The emotional impact of mass casualties.

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A 6 year old boy with abnormal pupils and gasping for breath.

A 26 year old pregnant woman with a gunshot wound to her abdomen.

A 54 year old male with blood pouring from a wound in his thigh.

Now add 43 more patients.

Imagine you are the paramedic at this scene.  Who do you take to the hospital first?  Who do you have to choose to walk past and leave at the scene while you take your patient to the hospital?

Now imagine you are the surgeon.  You walk into an emergency room with blood everywhere – covering faces, limbs, the floors.  There is a cacophony of sound – screams, cries, gasps, whimpers.  Where do you start?  Which room and which patient gets your attention first?  How many patients, calling out to you for help, do you have to pass by?  What operation will you perform and how will you perform it knowing there are nearly 50 other patients needing your attention at that very same moment?  Will you be right?  Will you save everyone you could?

As a trauma surgeon, these are the real types of questions that we are given when training for mass casualty situations.  And although the patient specifics listed above are not from the shooting, these are still the same thoughts that every single healthcare worker and all six trauma surgeons in Orlando right now have had and will continue to have for months to come.

26 operations in 12 hours.  I wish I could adequately describe the inhuman and superhuman effort that this represents from the trauma surgeons at Orlando Health, one of whom has been a friend of mine since high school.  When I first heard the news I immediately contacted him, letting him know I was thinking of him and his team, knowing exactly that this day will never leave him, or any of them.  I have written before describing the multitude of feelings involved when losing a patient… but this is just the tip of the iceberg when discussing a situation of this magnitude.

After the adrenaline surge, after the floors are mopped, the scrubs are changed, and the patients sorted through, they will pick apart this day – every last detail, decision, and action will be analyzed, examined, and questioned – and never forgotten by a single person who touched a patient on June 12th, 2016.

These six trauma surgeons have made a thousand decisions in the past 24 hours – the types of decisions that no one should ever have to make, but are unfortunately faced more and more by those of us in this field.

To the surgeons at Orlando Health – I know you haven’t slept.  I know you haven’t eaten.  I know you haven’t sat down in close to 30 hours.  I know you are mad, I know you are sad.  Stay strong my friends, we are all with you.

My thoughts and prayers go out to the victims, their families, the first responders and healthcare workers in Orlando – #lovewins.

 

 

 

A Surgeon’s Survivor’s Guilt

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My heart tells me I lost them.  My brain tells me I never had them to lose.

One of my mentors has said that all trauma surgeons have their own personal graveyard, filled with patients we couldn’t save, and families’ hearts left broken.  A truer statement has never been said, and this weekend, this trauma surgeon’s graveyard has increased yet again.

The feelings that accompany this increase are always varying and deep.

There is anger.  True wrath.  When the hell are we going to figure this out?  When are we going to stop shooting one another?!  When are we going to learn that drinking and driving can be deadly?!  When are we going to start respecting ourselves, our bodies, and one another?!  When are people going to stop paving a path of destruction for themselves and others that is wide and immeasurable?!

There is sadness.  Sadness over the pain and the fear that my patients surely felt.  Sadness over the waste of life that we witness.  Sadness for the families left behind, in a new world they never anticipated.

And yes, guilt.  Guilt over being able to go home, when our patient couldn’t.  Guilt for leaving the hospital to enjoy my family knowing another family has just been destroyed.

This weekend was a particularly rough one for myself, and the hospital at which I work.  Although to most people around the country, it was just another act of violence, to myself and our community, it was felt deeply.  Every person in our hospital was stung, upset, and shocked.  Everyone knew what happened – I received touches on the arm, knowing hugs, and reassuring smiles.  They knew I did everything humanly possible even when the inhuman was needed, but that knowledge is a poor salve against this type of wound.

So please, if you know someone who works in healthcare – give them a hug, a high five, or even a thank you.  I have said before how we all take you, our patients and communities, home with us at night, but please also know that our lives are never the same either.  Every patient encounter alters us – sometimes subtly, and sometimes drastically.  We are changed, and we never forget.

Stay safe.

Today Nearly 300 of Us Will be Killed or Injured with a Gun

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My heart is heavy this week due to gun violence. Today, it is a mass shooting that happened afar. Most days it is something that happened in my own trauma center’s catchment area.

Some people ask why I only speak up about our nation’s epidemic of gun violence when there is yet another mass shooting. After all, as a trauma surgeon I am all too familiar with the daily toll of gun violence one person at a time.

Whether it is the young urban dweller who lacking hope for a good future, in the absence of socioeconomic security and educational opportunities, turns to a life in gangs armed with illegal guns and ends up in a crime fueled shootout…

Or the depressed middle-aged suburbanite who under the oppression of dark feelings related to job loss or divorce or perhaps seemingly no obvious stressor attempts to take their own life with a hand gun…

Or the believer in concealed carry who, in a state of inebriation, engages in what might have otherwise been a simple fisticuffs that instead turns out to be a deadly bar fight…

Or the curious child who, due to the momentary carelessness of an adult who would swear they are an educated legal gun owner compliant with best practices for firearms safety, pulls the trigger with a devastating outcome…

Or the bereaved, yet obviously mentally unstable, individual who acts on his grievances against his mother’s surgeon by gunning him down in the clinic…

Or any of the 297 Americans killed or injured daily due to firearms, as trauma surgeons, my colleagues and I bear witness the death and destruction caused by our nation’s obsession with the right to bear arms first hand each and every day.

While it’s a thrill for a trauma surgeon to get a great case—it might be the adrenaline surge of doing an ED thoracotomy on a coding patient with a hole in the heart or the exhilaration of the exploratory laparotomy requiring 4 or 5 lacerated organs to be repaired—but as a human, each and every time I am called upon to care for someone who was shot, no matter what the circumstances, I feel sick to my stomach. My soul grieves for those who I can’t save, for those who will be left permanently disabled, and for everyone—patients, families, and caregivers alike—who will share the post-traumatic stress of having gone through the shooting and its aftermath.

This should not be happening in a civilized society.

To be sure, there are myriad other issues that contribute to gun violence in our country ranging from economic insecurity to mental illness to extremist beliefs to the ubiquitous violence we see in our LED lit world today. And, let’s not be naive; many objects can be weaponized to intentionally or unintentionally injure, maim, and kill others. As we have come to know from the fertilizer used in Oklahoma City to the ball bearings used in the Boston Marathon to the box cutters and airplanes used on 9-11, to the beer bottles, lead pipes, knives, bats, and automotive vehicles that we surgeons see as causes of trauma every day, it’s not just guns that are the problem. But it is foolish to think that these other issues contributing violence in all of its forms trump that of essentially unfettered access objects that, in any form—shotgun, handgun, semi-automatic—have a singular purpose: to injure, to maim, or to kill. The original purchaser’s intent may have been different—perhaps for target practice or for hunting animals or for self-defense borne out of paranoia of threat to personal property that is seemingly rampant in our society—but it’s just too easy, no matter how the gun was acquired and by whom, for guns to be used to cause harm whether by murder, or suicide, or terrorism, or accident.

And so, when there is a mass shooting that attracts the social media outcry of those around me—those known to me from near and far and those unknown to me who simply come across my news feed—I do speak up more vociferously than I do in my everyday life as a trauma surgeon because, in the deepest depths of my heart, I am hoping that this increased attention might galvanize WE THE PEOPLE to find it in our collective consciousness to finally take steps to re-envision what the right to bear arms means in a civilized society. No other country accepts this as an inalienable right; and, as a result they don’t see nearly as many deaths and injuries due to firearms as we do. But we hang on to this 18th century notion as a point of American pride. It’s time for 21st century Americans to figure this out because today nearly 300 more of us will be injured or killed by gun violence.

Dear Drunk Driver, “Tonight”.

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Dear Drunk Driver,

Tonight, I am tired.

Tired from lack of sleep, tired from the long hours, and tired from bearing witness to your destruction.

Tonight, you caused an accident while under the influence of alcohol.  And, you are badly injured, requiring emergency surgery.  Your liver is hard, cirrhotic, and unforgiving.  Although I can get you through this first surgery, I know you will not survive.  I know over the next few days, your broken and beaten liver will begin to fail, your kidneys will stop working, you will start bleeding from every orifice of your body, and you will die.

Tonight, I met your family.  They thought you had quit drinking, but they asked, and I answered, “Yes.”  “Yes” you had been drinking and “yes” your liver carries the scars of your addiction.  “Yes”, it is likely you will not make it.  I saw the hurt cross their eyes, the anger, the embarrassment.  And then, the part that I dread the most, the part I was hoping wouldn’t happen – but it always does… They asked about the accident.  They asked if someone else was injured.  They asked if the other person was okay.

And a fresh, new, searing pain begins, because…

Tonight, you killed someone.  Someone’s husband, wife, father, son, mother or daughter isn’t coming home.

I see a shadow cross your daughter’s soul as her mascara weeps down her face and stains her arms.  I see your son’s image of you crumble upon the impact of my words.  I see their shame, their sorrow, with no outlet other than tears.  Their heartbreak reaches out and stabs at me, their confusion begs my sympathy.

Tonight, another family is being informed of their loved one’s death…  Their souls, and hopes, and dreams are extinguished with the two words, “I’m sorry”.

Tonight, you are blissfully unaware and asleep…disoriented, medicated and sedated because of your own injuries.  But while you sleep, perchance you dream… of all the wreckage you have caused.

Tonight, you have blazed a trail of tears.

Tonight, I am angry.

Angry you didn’t know better, angry at all the hurt you have caused.

Tonight, I am angry.

Because I know this will happen again.

When does this end?  When will you stop assaulting your body, your family and your friends?  When will you stop tearing through lives, ripping out the hearts of people you know and of people you don’t?

When will you stop?

Please, let it be-

“tonight”.

Sincerely,

Your trauma surgeon

** This writing does not describe one particular patient or event, but is the unfortunate result of many patients and experiences I have had over the years. **

Driving tips from your friendly neighborhood trauma surgeon

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No one ever wants to meet me…Well, at least inside of a hospital.  If you are meeting me in a hospital, it is likely because you have been stabbed, shot, assaulted, or in a car accident.  Although the only advice I have about avoiding the first three mechanisms of injury is to stay away from “two dudes” and not try to sell Bibles on the street at 2 am, I do have some more specific advice when it comes to car accidents.  In my non-scientifically proven experience, the majority of my patients are in the hospital due to someone’s bad decisions – either their own or someone else’s.  And don’t get me wrong, I make bad decisions all the time.  For example, I ate a chocolate doughnut this morning for breakfast. However, no one ever expects their seemingly small bad decision to text their husband, or try and beat that red light on the way to work to result in their meeting me at the hospital.  But it happens.  Every.  Single.  Day.  So, stay safe America, and here are some trusty driving tips from your friendly, neighborhood trauma surgeon.

1.  Seatbelts are good, especially if you are pregnant.

I am not going to go into how many pregnant women (just in the last year alone) I have seen ejected from vehicles during car accidents and try to describe the tragedy that ensues.  However, no matter who you are – old, young, short, tall, overweight, or what trimester of pregnancy you are in, wear your dang seatbelt.  It saves lives, and there is absolutely no excuse whatsoever to NOT wear one.  So, can you please just wear it?  Tire marks across your belly are just not a good look.

2.  Texting is bad.

I know it is hard for some of you young grasshoppers to imagine, but back in “the day”, phones needed to have wires.  Therefore, they were only located in places with walls and telephone jacks.  Meaning, somehow, I was successfully able to be a teenager and not communicate with anyone for the 15-20 minute drive between my house and my destination.  And, believe it or not, my social life did not suffer.  There is nothing in this world so important to make you pick up your phone at all while driving.  Life seemed to go on just fine before this capability, and you have a much higher chance of your life continuing to go on if you forget that this capability exists.

3.  Let’s talk about alcohol.

I get it, alcohol seems to have some pretty magical powers.  It will give the average Joe the comedic powers of Jerry Seinfeld.  It can even make your 60 year old neighbor look like Heidi Klum.  But it will not make you a long-lost member of the Andretti family.  In fact, it won’t make you a better driver of any vehicle in any way, shape, or form.  It will make your reaction times slower, and your likelihood of being involved in or causing an accident exponentially higher.  This is true for driving cars, mopeds, motorcycles and yes, even golf carts.  Let me also tell you, from my non scientifically-proven experience: You will probably be fine. But, your friends riding with you, or the person that you hit with your car will not be.  And living with the guilt of confining your best friend to a wheelchair for the rest of his or her life is probably something you don’t want.  With so many designated driver services out there right now, there is just no reason to drive yourself after you have morphed into your Jerry Seinfeld alter ego.

4.  Speaking of the Andrettis…

Speeding really will not get you there any faster.  And I can prove this mathematically.  The average commuter travels 15 miles one way, with an average trip lasting almost 26 minutes. Increasing speed by 5 – 10 miles per hour for short periods of time is not going to shave your commute off by half.  So, if you truly are running late, driving faster is not going to make up any considerable amount of time.  You, in fact, will still be late.  And let me tell you, being 10 minutes late to work is waaaaay better than not showing up at all.

5.  And on the topic of work…

If yet another Snowmageddon has arrived at your doorstep and your job doesn’t involve saving lives or ensuring public safety, you have many viable options.  Sleeping in late, watching an omnipresent Law and Order marathon, climbing the walls because your children are at home (yet again) – all acceptable activities.  However, driving to work with your car functioning as a bobsled is NOT one of them!  Stay at home peeps.  Just lock yourself in the closet with some wine and cookies if the kids start giving you homicidal tendencies.

Think I am exaggerating?  Don’t want to follow any of the above advice? Don’t worry.  I will still be here… at the hospital… waiting to cut off all your clothes, see you naked, and then charge YOU for the experience.  Oh, that doesn’t sound like fun?  Oh, well in that case, re-read the above, and we can meet for coffee instead.

Stay safe!