I used to toss sensitive documents in the hospital shredder bin. The bin is usually a locked cabinet that is emptied occasionally by a professional shredding company.

Several weeks ago, I noticed that a few of the hospital maintenance workers were digging around the “locked” bin. Since then, I’ve acquired a cheap-o-shredder for shredding purposes.

What I’ve discovered is that the standard 6-8 page vertical shredders are junk. You can’t aggressively shred anything thicker than 5 pages without jamming the grinder. In addition, the papers shreds could actually be reconstructed without too much difficulty if all the pieces were available.

I guess I have two alternatives:

1. Buy a nicer, cross cutting shredder with larger blade.
2. Burn my documents.

Or shred AND burn them. That would be entertaining and most effective.

misc humor, work

I’ve performed about ten pterygium excisions in the operating room so far, and the biggest challenge I’ve encountered is operating on the LEFT eye. I’d imagine that any experienced surgeon would scoff at this hurdle, but the patient’s nose seems to impede my suturing abilities significantly (I use my right hand for needling driving).  The suturing in pterygia operations involves the medial bulbar conjunctiva, which is adjacent to the nose.

On my first few cases, I used a traction suture on the cornea to help rotate the globe for access. To minimize trauma on the cornea, I now ask my assistant/attending to help rotate the globe with a muscle hook. This is impractical, since most surgeons operate solo in practice. To remedy this problem, I’ve come up with three solutions:

1. Practice more–the obvious solution, but not elegant.
2. Use my LEFT hand to drive the sutures when operating on the LEFT eye. Use my RIGHT hand to drive sutures when operating on the RIGHT eye. Switch hitters in baseball do it, right? While I am not completely ambidextrous, I’m sure that my triple-digit hours playing Quake III and other FPS’s might have helped my dexterity.
3. Operate only on RIGHT eyes. After all, there are already too many subspecializations in ophthalmology. Why not specialize on just one eye?

Which one is your favorite?

medicine humor, ophthalmology

The further I progress in specializing in medicine, the more I realize how much my daily abilities deteriorate.

Take language, for example. Aside from the broken Spanish I acquire from my Hispanic patients, I rarely invoke English dictum beyond the eighth grade. Our vocabulary in the office is limited to a defined collection of complex medical terms strung together with linking verbs and qualifiers describing outcomes (hemorrhage, blindness, infection, inflammation). Outside of  the office, I’ve struggled to identify common objects like “spoon” and “basket” without using hand gestures.

Is this shift simply a result of natural selection (adaptation on steroids!)? French naturalist Jean Lamarck coined terms like “use” and “disuse” for adaptation spanning generations. Are professionals contributing to their own extinction by being good at their job?

It would be interesting to measure cortical function throughout the course of medical school. This could be followed with serial PET scans to localize metabolic activity in the brain. Areas that fail to sustain signal can be used to correlate with mapped cortical regions. Indeed, a spatial correlation in such an experiment would be damming to future physicians-to-be…

misc euphemisms, humor, life

I know little about non-western medicine (ie acupuncture, herbal medicine), but the moment I saw this jar of powder in a local store, I knew I needed a photo of it. Unfortunately, the photo came out fuzzy as the pharmacist shooed me away from the aisle. The jar reads:

“Stomachin: Chang Kuo Chou Strong Stomachic Powder”

I found an online store that sold an equivalent concoction of health. It appears that this medicine is intended to remedy gastritis, given that licorice and sodium bicarbonate account for the bulk of the powder. I assume that this medicine may actually be effective, given that almost a billion people have probably taken it at one point in their lives (This is a Chinese medicine).

*Note: I am not affiliated with this product. I do not endorse the use of this product either. I have neither prescribed this product nor used it myself. *

medicine humor, medicine

When I told one of my friends that many ophthalmologists operated without wearing shoes, she responded with an insightful remark: “Isn’t that dangerous?”

In medical school, we were forbidden to wear open toed shoes while in the hospital. After all, who wants to have ascites or a bloody mess on your feet? The potential consequences of walking barefoot in the operating room are even more severe. Imagine delivering a C-section without proper gowns! With needles and other dangerously sharp equipment lingering around the OR, who wouldn’t be wearing shoes?

Indeed, I was uneasy the first time my attending told me to take off my shoes when I was operating as primary surgeon. Since then, I’ve realized that it’s nearly impossible to control the microscope and the Infiniti (I’ve only used the cautery mode) while wearing shoes. The pedals for the operating microscope control the focus and zoom on the operating field. A four-way joystick is situated above the pedals. An additional four buttons are also on the platform surrounding the pedals. All of this is controlled using ONLY your LEFT foot. A similar configuration to control the phacoemulsification machine is  located on a separate platform for your RIGHT foot. Having tactile sensation on the pedals eases the difficulty of learning the machine, especially for newbies like me.

Still, I cringe every time we lose a needle (or #57 blade) on the ground.

medicine humor, ophthalmology