First Impressions: How Do You Introduce Yourself?

In this world of instant image management and quick intro snippets, your first impressions do last. As a doctor, you are patient-inundated, nurse-interrupted, time-limited, ego-conscious and sociably-challenged. Hence the way you introduce yourself may determine whether or not you start on the right footing with your patients. How do you introduce yourself?

Here are a few options you may consider. We have not yet run a fully randomised control trial, because these have not been put through the ethics committee, and no big pharmaceutical company is willing to sponsor the research. But some of these have been extensively studied and found to be quite effective in leaving a lasting impression:

If you are a Cardiologist:
“Hi. I am a doctor to the broken-hearted.”

If you are an Anaesthetist:
“Hi. I pass gas.”

If you’re a Neurologist:
“Hi. I’m your electrician.”

If you are a Urologist:
“Wee. I’m your plumber.”

If you are an Orthopod:
“You. Bone. Broke. Me. Fix”

If you are a Paediatrician:
“Peekaboo…”

If you are an ENT:
“Hi, I am your waxing specialist. I don’t do legs. I do ear wax.”
Or,
“Hi, people poke their tongues at me.”
Or,
“Hi, I am you otorhinolaryngologist. No, not automatic ventriloquist. Otorhinolaryngologist. Oops, sorry I sprayed some saliva there.”

If you are an Ophthalmologist:
“Hi, I’m your iDoctor. My iPhone app tells me you need an eyePad.”

If you are a Neonatologist:
“Hi, baby.”

If you are a Radiologist:
“Hi, please switch off the light.”

If you are a Colorectal Surgeon:
“Hi. I’m a shit magnet.”

If you are a Plastic Surgeon:
“Hi. I take cash, credit or cheque”

If you are a Psychiatrist:
“Hi. You can hear me. But you can’t see me.”

So how else would you introduce yourself to leave a lasting impression on your patients?

Thanks to Nick Bennett @peds_id_doc
If you are an Infectious Diseases Specialist:
“Hi, you’ve got the bugs, we’ve got the drugs”

7 Reasons Why You Should Be an Anaesthetist (or Anesthesiologist, if you don’t speak proper English)

WARNING: This post, like the rest of my blogposts, is best enjoyed with a glass of wine and a good sense of humour. THIS IS NOT A SERIOUS BLOGPOST! I love anaesthetists and have family members who are anaesthetists. We laugh at and with each other. So please have a read of my other blogposts and catch the humorous flavour in all of my posts before throwing egg at this one. If you still didn’t like it, feel free to leave your comments.

 

As surgeons, we work closely with anaesthetists every day. We get to love them, laugh with them and sometimes even look at them. They truly are the quiet heroes behind most of our surgeries. Without them, we wouldn’t be able to do what we surgeons do. Always undisturbed, and unfazed by the happenings, they hide behind their masks and machines. Often I wonder what goes through their mind (I found out it was always food or the stock market).

So, why does one want to become an anesthetist? After an exhaustive research involving multiple sessions of pondering about it while on the toilet, here are some reasons why (well, er… maybe):

1. You get to switch people off from talking by putting them to sleep.
Twitter limits talk to 140 characters. Anesthetist can do that to their patients too. They only need to ask enough pertinent questions, and in goes the milky solution and the tube to whiz them off to sleep. How cool is that? I sometimes wish I could do that to my patients, particularly the non-operative dizzy ones.

2. You are most up to date with the news.
The anaesthetist is always listening to the gossip around town. In one theatre they will hear about the general surgeons’ who’s who. In the next theatre, the orthopod’s who hates who. In the next they listen to the plastic’s who augmented who. Still in the next theatre they hear the neurosurgeon’s who buys who. The talks among the nurses, technicians, surgeons, trainees, etc. They are always up to date with gossip. Or ‘news’ as it is often called in the healthcare industry.

3. You become really, really good at Sudoku.
The anaesthetists have so much ‘leisure’ time sitting down during surgery (they call that ‘work’). Once the patient is asleep, out comes the Sudoku. The speed at which the endotracheal tube goes in is well correlated to the speed at which the Sudoku is extracted form the handbag. I’ve seen some really complex mind boggling sudokus done by anesthetists. Amazing. They get lots of practice at work.

4. You can handover the patient at the end of your shift.
This is one of the beauties of anaesthetics. While we surgeons have nightmares about our patients, anesthetists get to hand over the patient at the end of their shift. The good ones, bad ones, unstable ones, etc.

5. You get to finish reading a novel/newspaper/magazine/tabloids while getting paid.
See reason number 3. Actually, you also get to pay your bills, organise your holiday, bid on eBay, shop on Amazon, purchase a new car, do yoga, eat, drink, sleep, and sometimes even brush your teeth, all while the patient is asleep. Well, in short, you get to do what you do at home in the convenience of work.

6. If you don’t like the surgeon, you just have to lift up the sterile barrier.
It’s always interesting when that happens. I have the luxury of working elbow to elbow or face to face with all types of surgeons. I’ve got no blood/brain barrier I could lift. When they yell at me, well, they yell at me. I have to face the music. And that’s also often when the anaesthetic side suddenly lifts up their barrier and I can almost hear the muffled giggles behind.

7. And this is probably the main reason they do anaesthesia: You get to pass gas at work.
Now who wouldn’t want to be paid for passing gas all day?

And for the Famous Anaesthetists’ Hymn brilliantly done by Amateur Transplants:

[youtube=http://www.youtube.com/watch?v=c1JzCDqt3BM&w=480&h=390]

DISCLAIMER: I am a trainee surgeon. This may be a biased research. No anaesthetists were harmed in the writing of this “Piece of Work!”. In fact, no anaesthetists were present or awake enough to be bothered with this.

10 Things A Surgeon Can’t Say Out Loud

1. What is that?
2. Does that part go here?
3. Oops.
4. What happens if I cut here?
5. Hmmhh, not sure if I can fit it all back in again.
6. Could you please google up this procedure?
7. Where is my lawyer’s contact details?
8. Who is this and what did I do to him?
9. Sure I’ll be home for dinner, honey.
10. I love herbal tea, scented candles and bubble baths.

An Ode to the Mighty Bloody Surgeons

When erythrocytes are spilled
Many a surgeon would go “S%$IT!”
But not the Mighty Vascular Surgeon
Who smiles and says “Come on!”

Since young he dreams of balloons
Till old he plays with balloons
Poke, poke here, and pump, pump there
Let’s get those vessels flowing with flair

With a cheeky smile, and a twisted mind
With a thick wallet and a stent behind
The Mighty Vascular Surgeon walks the ward
Thinking everyone’s in awe

The smokers fear him
The diabetics adore him
The multi-toed worship him
And the toe-free pays him

Whether you are ischaemic, or haemorrhagic
Or just plain aneurysmic
Whatever the bloody specific
Fear not, The Vascular Surgeon is here to fix

Aaah… The Mighty Vascular Surgeon
Once they get you, they ain’t letting you go
They start from them toes
And up to those groins, going, going, goes

From A to Z they wield their control
Abdominal Aneurysm to Zenith Endovascular control
They have the power
They have the money

They love to strip
Veins, that is
They love to disimpact
Arteries, that is

The Mighty Vascular Surgeons
No vessels they can’t unblock
If they can’t, they’ll divert
Or to open they’ll convert

The Mighty Vascular Surgeons
Their lives are simple red and blue
If it’s white, they’ll turn them pink
If it’s black, they’ll amputate to nothing

This ‘piece of work!’ is dedicated to my Vascular Surgery friends both tangible and virtual.
No vascular surgeons were harmed in the making of this masterpiece.
Image thanks to Cook Medical,
With whom I am not associated.

7 Reasons Why You Should be a Surgeon

I’ve been asked many times why I chose the path of surgery. The esoteric, philosophical, mightier-than-thou answer would be “Well, I didn’t choose surgery. Surgery CHOSE me.” Somehow the conversation falls flat after I say things like that. So for practical reasons people can understand, here are some reasons why:

1. No traffic jams.
Yes. That’s right. With surgery, your day begins with 6am (or so) ward rounds, and ends sometime between 8pm and midnight, or you may not even make it home. Which means that you get the joy of driving to work when everyone is still asleep or watching Glee on TV. No traffic jams. No honking. No stressed out road rage. No queues at MacDonald’s drive through. Isn’t that great?

2. No public holiday shopping nightmares.
As a surgical trainee, you get to kiss all your holidays good bye for the duration of your training. That’s great, cause this way you get to avoid the silly seasons of buying things for yourself, or worse, for others. Now who wants to do that?

3. You get to wear pajamas all day and still get paid.
Surgical scrubs are great! There are several good excuses here. Certainly you save a lot of money cause you don’t really need to buy too many shirts, pants, ties or any of those things. Also you save yourself a lot of laundry time. The down side, however, is that you will have to have on at all times a good pair of underwear. It has been noted many times that wardrobe malfunctions do happen with surgical scrubs. An incidental showing of the undergarment occurs not too infrequently around major hospitals, either through a thin scrub material, a slit on the side, a hole on the back, or just because of a poorly tied scrub pants. Depending on the undergarment incidentally revealed, one may end up with a job promotion, or a trip to see the disciplinary board.

4. You get to spend a lot of time with your patient, asleep.
It is a myth that surgeons spend little time with patients. They say physicians and internists spend massive amounts of time really talking to patients, while we surgeon “swing by the bed” (like as if we were chimpanzees or something) and not even talk to patients. They say: “don’t blink, or you’ll miss the surgeon”. Well, I’m here to abolish that myth. We clock up more time with our patients compared to physicians. But our patients are anesthetized when we’re with them, for good reasons. Apparently anesthetists put the patients to sleep for the patients’ benefit so they won’t be exposed to the surgeon too much. Hmm…

5. You get to cut people open and stuff.
Isn’t that the coolest thing in the world? In any other business it’s called ‘assault’. In my cut-throat industry (pardon the pun), it is called ‘craftsmanship’.

6. You’ll always have an excuse to stop a job, a conversation or an article if you’re getting bored (or can’t find reason number 7).

Sorry, gotta go. Hospital called.

Duty, Discipline and Delight

Surgery should be built on a bedrock of duty and discipline. Otherwise one will not enjoy the delight it offers.

As a trainee surgeon, doing long hours in the hospital is a necessary evil I wil have to endure. There has been many a times when I’ve not been able to reach home at night, or that I hit the doorsteps of the home, only to be called back to the hospital. I’m getting very familiar with the old cranky bed we have in the residents’ quarters.

Particularly in ENT, when our emergencies are true life or death emergencies (such as a potential airway disaster), there are many times when I have had to stay in the hospital to be within 5 minutes of the patient.

We are doing it better than our bosses, who literally used to live in the hospital for weeks. I get to go home every couple of days or so. Still, its not a nice idea to think that I’ll be missing much of my wife and son.

As a trainee surgeon, I need to develop a habit of discipline and a sense of duty. I don’t choose to work hard. I am expected to. It is a minimum standard that a trainee surgeon trains his/her mind, heart, emotion and body to endure tough times.

But this is not unique to surgery. Training hard is a feature of many demanding jobs. Most successful people get to where they are by training hard. We often only see the results broadcast, but not see the gruesome training that leads up to the results. World class athletes, musicians, and leaders, if they’re worth their weight in gold, would have put in years of unseen training and preparation time to get to where they are.

In my pursuit to be a great surgeon, I need to do years of unseen hard work. I need to delay the delight of surgery, because I need to work hard on the discipline and duty of surgery. I need to do it with humility, respect and honor, knowing that if I really want to be useful to my patients in the future, I need to put in the hard work today.

What about you? Duty and discipline will ultimately lead to delight. What unseen work are you doing today in preparation for the delight of results in the future?

What’s your IQ?

Mine is pretty low.

I’ve been thinking about my work as an ENT registrar at a busy tertiary referral hospital here in Australia. I receive patients from all over the state as we have a fully serviced ENT department with Trauma, Hyperbaric¬† Oxygen, and other superspecialised services under one roof. So we see patients with complex presentations requiring high level care that only this hospital can provide, which means that my day is often inundated with phone call interruptions. Doctors from other hospitals, including interstate, may refer patients to our service. Some call for advice, others request urgent assistance and transfer. Patients too, interrupt my day with various queries ranging from “When will I next come to clinic?” to “My father’s tracheostomy tube is dislodged, and he’s coughing up blood. What do I do?” One day I looked at my iPhone and calculated that I received 43 phone calls between 7am to 6pm. And this is on top of the ward round, clinic, face to face consults with upwards of 20-30 patients and the operating session.

Busy, busy, busy. I hate interruptions. I’m sure you do too. But interruptions, particularly for a surgeon, is a necessary part of our job. When I come to work, or be on call, there’s a huge element of unpredictability as to what will actually happen. My ideal day will be when I get to operate all day uninterrupted. But that rarely happens.

It’s obvious that the more interruptions I get, the more annoyed/irritated/frustrated I become. The poor doctor who was caller number 35 that day received the unfortunate end of my annoyance stick. He was unlucky. But to him and his patient, that call was important because they needed my assistance. But to me, it was an interruption.

At home, when I’m trying to immerse myself in the anatomy of the pterygopalatine fossa and it’s contents, my son may run up to me and shout “daddy, daddy”. That’s an interruption as well. Or is it really? To Little E, he was simply expressing his love and desire to play. To me, he was an interruption.

So I have a very low IQ, indeed.

Interruptibility Quotient, that is.

And it’s not good. People don’t interrupt other people for the sake of interrupting. Most of the interruptions in my life as a trainee surgeon comes from true requests for assistance. Patients need specialty help and advice. And I’m here to provide them. My son is not an interruption. He is a gift from above, given to me so both he and I can grow.

When is something or someone an interruption? I suppose when I expect my day to go a certain way according to my plan, and there are unexpected intrusions to my day. That’s an interruption. Dictionary says “something that breaks continuity or uniformity.” I want my day to be uniform and continuous, but something breaks or intrudes into it.

There are 2 personal issues here: 1. I want to control my day, 2. I do not want anyone or anything to interrupt my day.

I know what you’re thinking: “Hmm… that’s pretty unrealistic and childish.” Well I think so too. I’ve been challenged to think that perhaps maturity may also include the ability to accept interruptions, and that I do not have full control over my day. They say maturity involves accepting responsibilities. I say that maturity also involves accepting interruptions as part of life. Throwing tantrums whenever I get interrupted doesn’t seem quite a mature thing to do.

As a trainee surgeon, a father and a husband, I need to accept interruptions as a normal part of life. Interruptions are to be opportunities to help, assist, care, grow, encourage. Accepting interruptions as normal will lower my annoyance level and help me mature quicker. I need to respond to each interruption with grace and humility. Noah was interrupted by a flood. Abra(ha)m was interrupted by a call to leave his home. Moses by a burning bush. David by a Goliath. Jonah by a storm and a mighty big fish. And Jesus interrupted the engagement plans for teenage kids Mary and Joseph with His arrival. I’m glad Mary saw Jesus not as an interruption but as a gift.

Interruptions are opportunities to practice grace and humility. Interruptions are gifts. Interruptions are a normal part of life.

What about you? What’s your IQ: Interruptibility Quotient? What are the interruptions in your life that you need to see as gifts and opportunities for grace and humility? How can you turn interruptions into a tool to help you mature in your life?