Content from the Journal of the American Neurological Surgeons.
From November 2000 until November 2001, I served as president of the BACTS, The Belgian Association of Cardio-Thoracic Surgery. Our sixth General Assembly was held on November 10, 2001 and for my Presidential Address I chose this quotation from Winston Churchill: “This is not the end. It is not even the beginning of the end.…
The following represents my views and experiences as a cardiovascular and thoracic surgeon. It is my hope that the reader will gain some insight into a specialty that has undergone major changes in the last decades. When Gruntzig introduced angioplasty, I was just beginning my career in cardiovascular and thoracic surgery. I attended one of…
A few weeks ago I took a weekend trip to Denver from my home in Billings, Montana. I arrived at the airport 90 minutes early as directed. Three minutes later I was ready to board, as things are a little slow in Billings at 0600 on Saturday morning. Two baby faced National Guard conscripts patrolled…
“Who Moved My Cheese? is a simple parable that reveals profound truths about change.”(1) It describes four characters, two mice named Sniff and Scurry and two ‘little people’ Hem and Haw, who are the same size as mice but act and appear like people. Sniff and Scurry possess simple rodent brains, but have good instincts.…
This is a strange, brave new world indeed. As I surf the Net for updates in post-operative mediastinal infection management, my computer server is being infected by cyber worms and viruses. The Nobel Peace prize is announced as a new “world war” commences. Scholars talk of “Globalization” and “Conflicts of Civilization” in the same breath.…
The relationship between the attending physician and the treated patient is of a very high order and is best described by the French definition “Le Colloque Singulier.” The “Colloque” suggests an equality between the two partners of the relationship and also conversation as the most intense force of interaction. The inequality in medical expertise and…
Years ago I used to write. Usually late at night. Usually focused on the college student’s search for meaning, for purpose. Usually struggling with the reconciliation of idealism with reality. I still have a small package of those writings. One of those musings poses an unfinished task: Must I grow up? How it hurts to…
Changes that are currently sweeping over the world are having a great effect on the professional lives of doctors and especially cardio-thoracic surgeons. Perhaps the most important of these trends are the everyday use of Information Technology (IT). Also important changes are demands for better cost-efficiency in medicine, a declining respect for the medical profession,…
During the past year, we have been inundated by stories about the massive changes that are taking place in our lives as a result of the application of electronic technology. Even those infatuated by the absorbing nature of this new world must have reservations about the extent of the unimaginable permeation of our lives by…
CARDIAC SURGERYIntern “Survival” Guide Kirk J. Fleischer, M.D. POSTOPERATIVE MANAGEMENTOF THE CARDIAC SURGERY PATIENT Discharges Review all meds for discharge with fellow the morning of discharge Give the MAR with the final discharge medication list to the case managers ** If wires have not been removed, do so early » patient must be observed for 4 hours!! Make…
CARDIAC SURGERYIntern “Survival” Guide Kirk J. Fleischer, M.D. POSTOPERATIVE MANAGEMENTOF THE CARDIAC SURGERY PATIENT Anticoagulation [Table of Contents] Coumadin dosed QAM » No running orders INR drawn routinely QPM. Depending on fellow preference and/or the patient’s condition, an additional AM INR may be drawn prior to daily dose. Case managers are a useful resource for dose conformation if…
CARDIAC SURGERYIntern “Survival” Guide Kirk J. Fleischer, M.D. ROUNDS [Table of Contents] Meet with fellow between 5:15AM and 5:45AM (Monday through Saturday)6:00AM and 6:30AM (Sunday) » Depending on fellow and patient census Preround for:vital signs and fluid balance (from data board) Rhythms (from telemetry at RN station) CSICU rounds begin at 6:15AM (Mon through Sat) and 8:00AM (Sun) CSICU…
CARDIAC SURGERYIntern “Survival” Guide Kirk J. Fleischer, M.D. At most teaching institutions, there are junior surgical housestaff on the cardiac surgery service. Because they are often unfamiliar with the “routine” of the cardiac surgery service, we developed an “Intern Survival Guide” which outlines the responsibilities of the junior housestaff and provides guidance on how best…
W. Gerald Rainer interviews Clarence Dennis on May 5, 1974. This is the fifth interview in the Pioneers of Cardiac Surgery series. Dr. Dennis discusses his role in the development of heart-lung bypass.
Theodore R. Sadler interviews Clarence Crafoord on April 26, 1974. This is the fourth interview in the Pioneers of Cardiac Surgery series. Dr. Crafoord discusses his career and the early days of cardiovascular surgery.
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