What do you think of the Making of a Surgeon so far? Do you think this is an effective way to train surgeons? What would you do differently if you were in charge of medical school education?
We're having a blood drive on campus next Wednesday. In MOAS, the residents fiercely guard their blood supply...and often had interesting means of keeping their blood bank full. Why was it so important to get people to donate blood? Have you ever donated blood before? How might you encourage your classmates to donate on Wednesday?
Post your response by Tuesday, May 18th.
I am actually really enjoying this book so far. After reading the first few chapters, I definitely thought that this book would be worthless and would simply be about a guy with a hard life in a hard hospital. However, each chapter now goes deeper into the actually medical procedures Bill is performing, and I find it SOOO interesting to learn about surgical procedures. Bill always uses these fancy names to describes the surgerical procedures, but then he puts a simple explanation of what the procedure is right after it so that any normal reader can understand. This makes the book so useful as a learning device. A week ago, I would have had no idea what a tracheotomy was, but now I have a basic understanding of the procedure simply from reading the book. I certainly think that this is an effective way to train surgeons. Obviously one could not completely rely on this book for a surgical education, but on top of medical school and an actual textbook this would be an awesome guide with both life pointers and good surgical instruction. Hmmmm....well, there is not much I would do differently. Bob seems to be adapting quite well, and he seems to be learning a lot. This question seems to go back to an earlier question about whether or not Bob should be thrown straight in to his medical career. I think that as long as the patient is not harmed, this a great way to learn.
ReplyDeleteIt is so important to get people to donate blood because blood is such a vital aspect of life. Many of the injuries Bill is treating have to do with dangerous levels of blood loss, and many of the surgeries cause the patients to lose blood. Without an extra supply of the specific type of blood needed by a patient, many of the patients would die. It is as simple as that, when blood is lacking, people will die. No I have never donated blood, I am still not old enough. Some of my classmates are scared of needles, which makes it difficult to convince them. Also, some students who have previously given blood tease about how "painful" it is. We know that is not true, but it still deters people. Anyway, reading this book would be a great way to convince them to donate because it shows the extreme importance of blood availability. If we simply inform people that their blood helps save lives, I am sure it would sway them!
Sorry about the typos in my previous post, I forgot to proofread it!!!!! :( My apologies!!! :)
ReplyDeleteAlthough gruesome, The Making of a Surgeon has proved to be a captivating read. It's really nice to be able to read a book solely for its plot and information rather than its themes, imagery, and metaphors. Nolen divides each chapter into its own anecdote within the story of his career which keeps the book fresh. His writing style is direct and this too makes the book a breeze to pick up and enjoy.
ReplyDeleteThe techniques Nolen describes in the book to train the surgeons seem reasonable and effective. Much of the training comes with the assumption that the resident has learned the material in med school and simply needs practical appliance of their knowledge. Although at times risky, this method seems to work well for the staff at Bellvue. It also makes sense that the residents spend time at all the different wards of the hospital. Not only does this provide them with different teachers and mentors, who can show them new ways to tackle medical problems, but it also ensures that the resident has a basic knowledge of how the entire hospital runs. Much like a conductor must have a general understanding of all the instrumental sections of his orchestra, a doctor or surgeon must know something about all parts of the hospital.
To improve the medical school education, the curriculum would simply need to include more hands on experiments and procedures. Potential lives could be saved if med students could operate on dead bodies to practice for real surgeries.
Blood is our bodies life source, and although there are many parts of the body that are vital to survival, blood may play the most important role of them all. During surgeries and while in the hospital, patients often need blood transfusions to keep their blood levels normal. Without donations from outside sources these people would perish even as the doctors were trying to save them.
I have never donated blood.
To encourage my classmates to donate blood on Wednesday I would probably rely on basic forms of propaganda. Several circulars posted around campus stating: Not giving blood is like not helping an elderly woman with her groceries" and "Replenish someone's life force is as easy as sitting in a chair for 5 minutes" would get the job done and really show students that giving blood is simple and life-saving.
Hey, so I really enjoyed the making of a surgeon book. It was enlightening, yet entertaining and often gruesomely realistic, but comic. I was expecting a didactic and technical read, but instead i found myself reading far beyond the assigned reading.
ReplyDeleteAs far as an effective way to train surgeons, the process may seem very risky and un-academic, but I feel that the only way to learn surgery is through experience. I can read every book on human anatomy on the planet, but still have no idea how to preform a simple operation such as an appendectomy. I think perhaps I would try to prepare surgeons a little more in medical school geared towards reality and not the academic.
The reason blood is in such demand is because people loose a lot of blood during surgery and there is no artificial substitute for blood. I have indeed donated blood. I would very much encourage my friends to donate blood by asking them to think about how they would feel if they were the ones who were sick or injured and needed blood.
One of the things that strikes me most in reading The Making of a Surgeon is the relevance of the medical practices in the 1950's and 60's even compared to medical practices today. Although the language used in the book is a little dated, the different surgeries and procedures described in the book are for the most part still common practices today. Every time Dr. Nolen has to operate on a hernia or get a red cell count, I know that what I'm reading is solid documentation of life in a hospital. One of the most interesting medical tools that I read about, at least for me, was the vibrating saw used for taking off casts. I've had to have two casts taken off in my lifetime, and I always wondered how the saw never even managed to scratch my skin while decimating the cast shell.
ReplyDeleteThere are both good and bad things about medical school's method of training surgeons like Dr. Nolen. For example, I think real-world case work is an extremely effective way of teaching rookie doctors and pulling them out from the world of theory into the world of practical. That said, I dislike the abusive nature of being a hospital intern, such as going for 3 days straight with no sleep. Being a doctor doesn't mean you have to sacrifice your own health to impart health to others, and what's more, lack of sleep accounts for a hefty chunk of mistakes made in surgery for first-year medical interns. I think if I could change anything about medical school, I would arrange it so that interns had a rotating hospital plan, and could experience in fairly equal parts the white-tower hospitals and gritty freecare hospitals like Bellevue.
As many before me have commented, donating blood is absolutely essential for doctors. Having blood on hand is necessary to keep patients alive and healthy, and it is often lack of blood that fails to save an otherwise curable patient. With that in mind, I would encourage my classmates to donate blood this Wednesday if it is in their ability to do so. Giving away blood is not self-sacrifice...it's a gift that someone in need will receive, and it is probably the greatest gift they will have ever been given.
I am unfortunately unable to donate blood this Wednesday, and have never donated in the past, but wish that I could. I plan to do so in the future, and strongly encourage my friends to do so. Your blood will save someone from an otherwise unnecessary death.
Training a surgeon at the Bellevue Hospital was much more different than what I expected at first. Beforehand, I thought that interns were given books and different theories about how surgery should be performed. After this initial stage of understanding how one should go about operating, they would perform possibly on a corpse or a dummy, in order to not make a fatal mistake. Maybe not, they'd probably start on the easiest case, but still, much more different than what I thought. Bellevue offers an immediate entry into the surgery, and I feel as if this method of pushing one suddenly into the field will help them adapt better in the future to surprises and thus help them become more successful. However, as Matt stated correctly, there is a huge cause of concern for the lack of sleep.
ReplyDeleteWithout sleeping for consecutive days, a doctor's performance can drop to hazardous levels, where a seemingly easy surgery takes much longer than necessary and superfluous mistakes are made consistently. Especially for interns, sleep should become a priority because they do not yet have the routine of not sleeping down like the doctors or nurses. Mistakes are what causes deaths, and if they can be prevented by one or maybe two hours more of sleep, then those precautions should be taken and made into a critical priority. Having interns who are well-rested and eager to learn is something I, as a doctor, would much rather have than groggy, lifeless interns. Their active engagement in surgery is what is going to help them memorize, and memory is what serves doctors the best for surgery or any other procedures. A structured schedule that allows consistent rest for doctors should be implemented in hospitals around the country, and maybe then will the mortality rates go down for deaths caused by ridiculous mistakes, because of the lack of sleep.
I have already finished reading this book because of how clearly and succinctly Dr. Nolen writes, yet is simple enough for non-surgeons to understand even the most complex of surgeries. Although our class has yet to extensively cover the human body and its many functions and purposes, Dr. Nolen makes it seem to easy to understand surgery. This book is fascinating and offers a view into the world of a surgeon without actually getting our hands dirty.
Without blood, a patient can go into cardiac arrest during surgery and die as a result. Blood loss is a constant problem that Dr. Nolen faced at Bellevue, as patients would roll into emergency rooms with a massive losses of blood. At a hospital like Bellevue, blood is absolutely critical in saving lives, and thus a blood supply was needed; basically, without donations the hospitals wouldn't have any blood for surgeries and the mortality rates would be sky-high. By having a mass amount of people donate blood, Bellevue was able to save lives they wouldn't have been able to save without donations.
Donate blood. It's scary as hell though because you see your hard-worked blood going into a tube and... UGH. Even though it may be disgusting and the sight of the needle may turn you off, just think about the lives you may be saving with the blood you donate. It might even be your favorite actor, athlete or anyone famous.
This comment has been removed by the author.
ReplyDeleteI am really enjoying this book so far. It has a kind of wry humor, but still remains informative. I believe the methods within are the most effective way to train surgeon. How else can a surgeon learn but by doing? In matters of life or death, can anyone really trust to something they read in a book instead of something they've done time and time again, motions that they have trained the very muscles in their hands to remember? People have said before that they feel that this method is too harsh, that people can't function with such sleep deprivation or such constant stress. But I've talked to quite a few doctors about training recently (this book piqued my interest) and they told me that new laws and regulations actually do make training easier. There's a limit on the amount of time a surgeon or any other doctor can spend working. So, if a patient bleeding out is rolled in the door and an intern is trying desperately to save his life, if that doctor is at the time limit, he's forced by law to leave the hospital.
ReplyDeleteThis hypothetical situation aside (this happens more often than you'd think) there are other objections to these rules. These new limits substantially decrease the amount of time a doctor spends learning his trade, by as much as two-fifths of the old time. It was almost universally the opinion of the doctors I talked to that this later generation of doctors was not as experienced as the newer one. In addition, in Malcolm Gladwell's book Outliers, he found that true "genius" as it were in any area was only achieved after someone had spent 10000 hours practicing or doing. For interns of previous decades, with their hundred hour or more weeks, this was an easy number to surpass. But nowadays, with restrictions cutting down weeks to about sixty hours, that finish line is much more difficult to pass.
In addition, it is said that the hardest part of being a doctor is over the second you finish internship and residency. After those initial one hundred hour weeks, with little sleep and constant stress, everything afterwards is much easier. If a surgeon can routinely perform surgery after having been awake for the last 35 hours, he is ready for anything post-intern years will throw at him.
When I first started reading this book, I did not like it at all. It did not fit with what we were learning, Dr. Nolan didn’t make a lot of decisions I agreed with and it just felt pointless because I knew I had no interest in becoming a surgeon. That being said, I think that the book has really turned around and now that what we are learning about in class is somewhat relevant to what he is saying; I don’t feel like I am just wasting my time while I am reading it. As Brett has mentioned, I really like how he gives the simple definitions along with the very fancy surgical names in the book. I do think that this is a fairly effective way to train medical students, but at the same time there are many flaws. As Matt pointed out, the staff is often mistreated and sleep deprived and this can cause a lot of issues that shouldn’t be necessary. I would also think that students in med school should have more opportunities to actually practice procedure so as not to have to risk an actual human’s life when they first arrive and are thrown in to something they have only study and never actually experienced.
ReplyDeleteAs other people have mentioned, blood is essential for survival and there are many ways that people lose their blood and need more. Without an extra blood supply, there is no way the doctors would be able to save many of their patients who would then die of blood loss. I have never given blood, but I have tried to every year they come to our school. I know that personally I travel over the summer and the blood donor checker people are not fond of that. I also know that many of the coaches on the sports team tell their athletes not to donate blood because they have a game (and sometime just a practice) that day. I would it if the students and coaches could all understand how important giving blood is and that it is more important than a game. Maybe we should set it up on a day where there aren’t any games or some other compromise so that more people will be “allowed to donate”. I also think they shouldn’t be as picky with whose blood they take, but I understand why they are so there is really no way they will change that.
This book seems to have grown on me over my time reading it. I approached as I would our typical bio textbook - as a source of knowledge but nothing more; but as I've read through chapter after chapter I would say that I have begun to enjoy the read. Although it is not my favorite book of all time, it is an interesting book to read. I find it produces and sort of counter-point to the bio textbook. The making of a Surgeon provides piratical applications for all of the things we have been learning. It shows the use of biology on a larger scale. It is easy to get caught up in the plot, but along the way we are inevitably taught something - about medical science and what it means to be a medical professional.
ReplyDeleteI singed up to donate blood on Wednesday. I have never given blood in the past, but I feel that giving blood is very worthwhile. Although blood drives may be physically draining for participants (no pun intended), they can actually save lives. A few minutes of pain on one persons part is inevitably worth the life of another. I feel that giving blood is a personal choice, and it would not by my or the school's job to trey and convince people to go. I would alert people of the drive but in no way try to coarse them. everyone has the right to do what they want with their own blood. No one should be pressured into giving blood.
Though I am not entirely fond of Dr. Nolen's style of writing, I have to admit that I have enjoyed reading the book. I like the format, and by that I mean that I like the fact that he gives a little background about the topic of each chapter before delving into a number of anecdotes related to the subject, all the while nonchalantly slipping in some medical vocabulary to assure us that yes, he is a real doctor. He also tries, and you can definitely tell he is trying, to introduce humor into the book which is refreshing after hearing stories about botched surgeries. It is a nice mix of humor and more serious topics and I think that it is a good way to learn about human physiology in general.
ReplyDeleteAs for Bellevue's method of training surgeons, or lack thereof, I think that using scare tactics to prevent surgeons from making future mistakes and their total hands-off approach to "teaching" new surgeons what to do in certain situations is a wee bit dangerous. I am sure that the doctors get the point that an error during a surgery is extremely costly but I fear for the patients. I know that I certainly would not want to be treated at Bellevue, not after seeing the less than admirable job that the staff does about not only maintaining their work facility but their patients as well.
I can not say that I have ever given blood but I know for a fact that my sister has, mainly because she has gone to great lengths to ensure that I am aware of her donations. She is type O negative so she gives blood pretty often and I am sure she gets treated very nicely by the doctors at the hospital. As for myself, I was strongly considering giving blood this time around but sadly, I was unable to. The day for giving blood was during the week of NCS finals for volleyball and my coach, understandably, thought that it might not be the best idea to be doing rigorous physical activity with a significantly lowered amount of blood in our systems. But if it were not for that, I probably would have donated blood, even if only for one of those stickers that say "I gave blood!". Those are pretty cool.