On Writing: Marking the Anniversary of a Blog

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“I admire anyone who has the guts to write anything at all.” – E. B. White

“All you have to do is write one true sentence. Write the truest sentence that you know.” – Ernest Hemingway

“Writing is easy. All you have to do is cross out the wrong words.” – Mark Twain

“There is no greater agony than bearing an untold story inside you.” – Maya Angelou

“There is nothing to writing. All you do is sit down at a typewriter and bleed.” – Ernest Hemingway

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Dr. Kathy Hughes, Behind the Mask

This is the anniversary of my very first blog post, that day a year ago when I summoned up my courage, took a deep breath and clicked on the “publish” button that first time. I crossed a threshold of sorts in that moment, the start of my transformation into a writer.

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Pretty in Pink (Rethinking Pink)

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“Isn’t she…isn’t she pretty in pink?” – Psychedelic Furs, Pretty in Pink

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October in New England. The sky is a brilliant blue, the leaves on the trees are turning impossible shades of orange, yellow, and red.

October is Breast Cancer Awareness Month, so in addition to the brilliant fall colors all around, people are wearing pink clothing and pink ribbons, and products on store shelves has been packaged in pink wrappers. Professional sports teams wear pink. Hospital, civic, and community organizations sponsor special Breast Cancer programs and often have pink treats and pink giveaways to reinforce the message.

One’s inner cynic can easily rise to the surface, and it’s easy to unleash a bit of snark at this pink-splashed world every October. From the little annoyances like markups and surcharges on items because they are repackaged in pink, to the big scandals and exposes on breast cancer organizations who support exorbitant CEO salaries or only spend pennies-on-the-dollar on research, support, prevention, or treatment. And really, who isn’t aware of breast cancer already? (Final person has been made aware of Breast Cancer, from this recent satiric post). I’m really not a “pink” kind of girl, studiously avoiding it for most of my life, so I appreciate those who find pink cringe-worthy.

Not that long ago as a young surgeon in-training and later as a young attending, when I wore my pink ribbon pin people would ask me what it meant. Specifically, doctors asked me about it, and more specifically, other surgeons asked about it.  Mostly male surgeons, but then, surgeons were and are still mostly men. Women patients, women physicians, and women surgeons had started to wear the ribbons to raise awareness and show support, but it was relatively small number of people. Breast Cancer was felt to be a women’s disease (although it affects men too), and there were not a lot of options or even challenges to the surgery or for the treatment. Surgeries were deforming, medications made patients quite ill, and outcomes could be depressing and disheartening.

How times have changed.

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I Look Like a Surgeon, and #ILookLikeASurgeon

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“A good surgeon has the eye of an eagle, the heart of a lion, and the hand of a woman…”– 15th Century English Proverb

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#ILookLikeASurgeon, operating

#ILookLikeASurgeon, a new hashtag on Twitter and the movement it has inspired, has resonated deeply with me.

I look like a Surgeon. There is so much more behind this seemingly simple statement of fact. I am not just stating that I have excelled and I have achieved and I am accomplished by being a surgeon. In saying I look like a surgeon, I am saying that it is normal for me to be a surgeon; that it is normal for me to be seen as a surgeon; that it is normal for me to command the respect and authority of a surgeon; and ultimately, that it is normal for others who look like me to aspire to be surgeons.

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The Ultimate Patient Advocate

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Posting my piece written for Sermo, as a guest blogger on the Sermo Blog, April 13, 2015. Click on the link here (The Ultimate Patient Advocate)to see the original post. 

Adding the quotes to set the tone, though, as I usually do. The graphic is also my own photography, as with all of the pictures on this blog. Enjoy!

“Only one rule in medical ethics need concern you — that action on your part which best conserves the interests of your patient.” – Dr. Martin H. Fischer, German-American Physician and Author

“A physician shall, while caring for a patient, regard responsibility to the patient as paramount.” – Principles of Medical Ethics, American Medical Association

“I pledge to pursue the practice of surgery with honesty and to place the welfare and the rights of my patient above all else.” – Fellowship Pledge, The American College of Surgeons

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Laurel, North Andover, MA

Advocating for patients is a core value in medicine, in patient care. Our legacy as patient advocates dates back to Hippocrates in 500 B.C.E., codified in the oath and teachings that have provided the moral and ethical foundation on which the profession has been built. Even the Code of Conduct for the American College of Surgeons includes as its first principle, “Serve as effective advocates of our patients’ needs.”

Physicians fundamentally care for patients, their families, our communities. We advocate on the small, individual scale for each patient, and we advocate on the large scale for the entire population of patients and society.

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A Different Kind of Mentor

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This is my “mentor piece” that was written for the Association of Women Surgeons, and published on their blog April 22. 2015. Click here to link to the original post. The quotes and picture on this version are my own addition, like I always do. Enjoy!

“The greatest good you can do for another is not just to share your riches but to reveal to him his own.” –Benjamin Disraeli

“Have a little faith in me…” – John Hiatt

“If you’re lucky enough to do well, it’s your responsibility to send the elevator back down” – Kevin Spacey

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Swans, Rockport, MA

Mentorship in medicine and surgery was not always formally acknowledged and promoted. Today not only is it acknowledged and promoted, but also the importance of mentorship for professional development through the arc of a career is stressed. However, for many women, the one-to-one relationship of the classic mentor-protégé remains elusive, complicated by gender and generational differences. This has been especially true for the groundbreaking women before me, and for some remains true even today.

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Little Miracles

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“There are only two ways to live your life. One is as though nothing is a miracle. The other is as though everything is a miracle.” ― Albert Einstein

“Miracles happen everyday; change your perception of what a miracle is, and you’ll see them all around you.” — Jon Bon Jovi

“The miracle is this: The more we share the more we have.” — Leonard Nimoy

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Sand and Sky, Summer, Ocean Park Beach, Maine

It is amazing when things in medicine work just the way they are supposed to —  it’s like a miracle.

When I take an antihistamine, I can breathe, and all the itching and sneezing stops. When I get an injection of local anesthetic, I can touch and poke and pinch to test that it is working — and it is. When I had an operation on my knee, an ACL repair, my knee stability was noticeably restored almost immediately, despite the post-op pain and swelling. I know these things work on patients, because books, observations, and experiences have shown me so. As a surgeon I get a kick out of operating on acute appendicitis, where often even in the recovery room immediately after surgery, the patient already feels better.

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Muted

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Smitty greets Sully as they meet to head to work, “Hey there, Sully! How’s your wife?” Sully answers, “Oh, geez. She’s up in bed with laryngitis.” Then Smitty says, “Laryngitis?! That damned Greek!”

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First cone of the season, West Boxford, MA

As you may have guessed, I am nursing a case of laryngitis, my voice muted and strained. This time, it has not stopped me from attending to my work responsibilities or other activities. It has required some adjustments though, as I squeak and growl and cough and sputter, my voice robbed of inflection and tone, and even volume control. It is an irony to have to strain my voice to repeat myself because of my strained voice.

I have had more severe laryngitis twice, one time a couple of months ago, another time several years ago. These were so bad, my voice so completely silenced, that I had to change both my operative and office schedules, not just to recover, but because it made my job impossible. We wear masks in the operating room which obscure our expressions and hide our mouths, muffling our voices just a bit; it can be difficult to hear and be heard even with functioning vocal cords. It is impossible if you can’t even manage a whisper.

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A Matter of Faith

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“Have a little Faith in Me” – Have a Little Faith in Me, John Hiatt

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Russian painted wooden Easter eggs

Spring ushers in major holidays in many faiths and religions. Western Easter has just passed, we are in the midst of Passover, and coming to the close of Holy Week with Good Friday for Eastern Orthodox Christians, making final preparations for their own Easter celebration.

The rites of spring and the vernal equinox, new life and rebirth are springtime themes and touchstones across many cultures. Faith is important to many people and across many cultures and religions. I would assert faith is even important to atheists and agnostics, and those without a formal religious tradition.

Faith is important in medicine, too. Continue reading →

Thoughts on Doctor’s Day

“Clowns to the left of me, jokers to the right. Here I am, stuck in the middle with you!” – Stuck in the Middle with You, Steeler’s Wheel

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Daffodil between the rocks, Spring 2014, North Andover, MA

Today is Doctor’s Day, established to take a moment to recognize and honor the work and contributions of doctors.

The first thing I read today was a message from current Massachusetts Medical Society President, Dr. Richard Pieters, who in speaking about Doctor’s Day reminds us all that the focus of the day is not just physicians, but the physician-patient relationship. The physicians of the Massachusetts Medical Society have declared that this Doctor’s Day we recognize “the basic principles that the doctor-patient relationship is confidential and sacrosanct.”

In his piece, which discusses this in the context of gag laws preventing physicians from asking about gun ownership and gun safety in the home, he emphasizes the efforts of physicians to focus on the patients and have unencumbered and protected conversations. It is impotent to protect both directions of these conversations—patient to physician as well as physician to patient. He further stresses the importance, and danger, of government laws, rules, and regulations that would insert themselves between physician and patient, silencing physicians or compelling them to include specific proscribed content.

I could not agree more. I would in fact go even further. Continue reading →

Friday Afternoon Rituals—Here Comes the Weekend!

“Party Weekend” – Joe “King” Carrasco

“Fight for Your Right (To Party)!” – Beastie Boys

“We Just Wanna Dance” – The Flirts

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Mom & Dad’s dog Sophia, too pooped to party…

My favorite radio station, WHFS, had a ritual every Friday afternoon to start off the weekend, back in the day. DJs Weasel and Bob Here would exchange pleasantries as they exchanged shifts, and would launch in to the same set of songs at the same time every Friday (with occasional additions). The songs above, as a matter of fact. These were selected to get your spirits up and blood pumping as the work week morphed into the weekend. It was a ritual which became a tradition for ‘HFS and loyal listeners, fondly recalled to this day, even though the radio station itself is long gone and the DJs dispersed. Every Friday I seemed to be in my car at just the right time, cranking up the volume, celebrating the end of my week and the coming weekend.

Doctors also prepare for Friday afternoons, bracing for a ritual of sorts. Any time after 3:00 it starts, lasting until well after the offices close and the weekday schedule transitions to the after-hours weekend routine. It is observed by most physicians, regardless of specialty, whether they practice in the hospital or in an outpatient office.

Suddenly on Friday afternoons, it occurs to people that the weekend will be starting, and the availability of the doctors and their offices, labs, imaging, testing and what-have-you will be limited. So all of the problems languishing in and out of the hospital take on a renewed sense of urgency, and must be taken care of Right Now, before the weekend hits. Nothing can wait another hour or day, and certainly not until Next Week (Monday)! Continue reading →