It is an emotional issue ...

“Feelings are not supposed to be logical. Dangerous is the man

who has rationalized his emotions.”
~David Borenstein

Every few months, the residents change services. Regardless of the sub-specialty or residency program, it is required that they get exposure to the different sub-specialty areas and/or patient types in order to have "general" understanding of their specialty of choice. My specialty is orthopaedics. To comply with the requirements of the RRC, residents must rotate on different services and/or physicians. It is this change of service that confuses many of the younger residents and even the more experienced resident. You may say, "Why?" Evey time the residents encounter a new physician, they must learn a whole new set of quirks. It is because we all have our own "Emotional Issues."

Now, my definition of Emotional Issue has nothing to do with the DSM-IV (or V or whatever number they are on now) diagnostic criteria. My definition pertains to a particular thing that you do that has no proven scientific benefit; but by doing it, it provides you a sense that everything will be better if it is done. Now, I am not talking about OCD. I am speaking of the little things that people do because of anecdotal experience but have no literature support.

Here are some examples:

• When I would press fit an acetabular component under reamed by 1 or 2, I would put in at least one screw. My rep said I didn't need it, but it made me sleep better. So, we termed it the "sleep better screw." (for all of you with dirty minds, that would be an orthopaedic device)
• When I use allograft bone, I put gentamicin in it. Why? I have no studies to support it, but it causes no harm and it makes me feel better.
• How about antibiotics in irrigation? I am sure we can find articles for both sides.
  
• Webril under the tourniquet or not?
• To ioban or not?
• Pre clean with alcohol or preop hibiclens shower?

I am sure there are a thousand more that we can list. These are what I term Emotional Issues (EI). Things we do because maybe we had a "bad experience" when we didn't do it or because it helps us sleep better. Every surgeon has them. Sometimes it is seems like OCD. This is what causes residents such anguish when they switch services. What they may do for one surgeon may be a no no for another surgeon and visa versa. It must seem like a moving target.

In the end, we all have these hangups. For me, I realize these EI's are the equivalent of an emotional security blanket. But, they help me sleep better.

“There are moments in life, when the heart is so full of emotion
That if by chance it be shaken, or into its depths like a pebble
Drops some careless word, it overflows, and its secret,
Spilt on the ground like water, can never be gathered together”
~Henry Wadsworth Longfellow

Check out my Guestbook!

Blog Rating

I found this interesting site that actually rates your blog. It's called, "what's my blog rated?" I was hoping for more of an R rating but no such luck.

The UHC

Check out the new post.

Please make comments on things you may feel are important to add in the hospital wars :).


Thanks

A sad day :(

“Censorship in any form is the enemy of creativity, since it

cuts off the life blood of creativity: ideas.”
~Allan Jenkins

Something happened today that I found very distressing. I was told that I might have to take down my blog. Let me step back.

A couple of weeks ago I wrote about an incident that happened between me and a radiologist. It was true. It did happen. It was my perspective on the situation. It was a rant or probably more of a vent of my frustrations. As pointed out by a number comments, it was obvious that I was in the right. (funny cheesy grin)

Some people commented about my bravado and that I was big man showing my clinical acumen:

both of you are such badasses. you guys are my heros! i can only hope to be a stud doctor like both of you by telling stories about how stupid other people are and how brave and clinically superior i am than everybody else.

Another posted how great my patient care was, how appropriately I title posts, and how well I read radiology reports:

or titling a post to teach an actual valuable lesson "not everyone will like you" and then describing how someone likes you so much they cry when you enter the room

"...but they will love me." is meant to be the rest of that post.

orthopods always go straight to the radiology reports when something is missed to make sure the radiologist missed it too... preparing to share/deflect the blame. If there is a lawsuit, do they tell the lawyers, though the radiologist also missed it, take it easy on them, they aren't that smart to begin with?

The last person commented on the my humbleness:

that one was a bit self-rewarding. Oh, well.

All of those comments were much appreciated. My skin is pretty thick, I can take the criticism. I do learn from those comments.

Also, in that blog entry, I used the curse words that I use on occasion. I have used them in some other blog entries, probably the most notable is FFT. For the most part, I swear in my head, as seen in a previous post about my head during a big case. I think my wife actually swears more than I do.

So, today I have received information that the above "said radiologist" came across my blog entry and had submitted a complaint about me for the "incident". He also brought up the "ADULT" language that was in my blog. Another concern that was brought up was HIPAA. The HIPAA thing threw me. Although I have referenced cases and disease disorders, I don't think I have ever mentioned a name, shown an xray, or placed patient information anywhere on my blog.

So, I will continue to post as long as I can. Some of the less dry, said in fun, tongue and cheek, and more personal posts may be gone, but at least my shell will be here. It is sad that in a country that has freedom of speech you are censored, your thoughts can be restricted, and you can't have a differing opinion. I am human. I make and have made mistakes. I have no problem saying when I am wrong or at fault. But, if I have a problem with a specific person, I first address that person directly. I welcome that dialog.

“Censorship reflects a society's lack of confidence in itself. It is a
hallmark of an authoritarian regime.”
~Potter Stewart