Tiger Country - Episode Eleven: Damage Control Surgery and the Open Abdomen, or, You Knew We Were Going To Need An Abthera From The Start of The Case, Kyle!
In this episode, your intrepid podsurgeons talk to the venerable and famed Martin Zielinski, lately of the Mayo Clinic and currently Chief of Trauma and Acute Care Surgery at Baylor. Dr. Zielinski talks with us about damage control surgery. For something so widely practiced and studied, there are few better examples of the art of surgery than DCS. When does one know that a patient is in a damage control state? It is physiologic derangement or the severity of the injuries? When does one know the patient's ready to go back to the OR? How has the shift away from crystalloid altered thinking and practice? That leads to a discussion about direct peritoneal resuscitation and management of the open abdomen before Dr. Zielinski talks about what it's like to move from the paradise that is the northern Midwest to Houston, where the average temperature is approximately a hundred and thirty degrees. In December.
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32:53
Tiger Country - Episode Ten: Surgical Treatment of Gastric and Duodenal Ulcers, or, That’s A Spicy Meatball
In this episode, DuBose and Milos are sadly deprived of my companionship and commentary, but that's perfectly fine because they're talking to David Feliciano and who's a better guest than that? The three of them discuss the operative treatment of gastric and duodenal ulcer disease, which was once a mainstay of emergency general surgery and is now something rarer than hen's teeth. In addition to proton pumps, those pills inhibit trainee experience. When we started eradicating H. pylori, we started eradicating familiarity with the Kelling-Madlener and Pauchet procedures. I can't think of a third one. Anyway, I'm not there for this episode because I was off on my bachelor weekend, which is apt because Dr. Feliciano talks about what it's like when your spouse is as much a surgical heavyweight as you are. He also talks about his fondness of powerboating and what it was like to train with Michael DeBakey. DuBose and Milos do not ask Dr. Feliciano if Debakey would tell the scrub to, "hand me the me clamp," or snap, "these me forceps are off-center, damn it all!" If I had been there I would have asked that.
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48:38
Tiger Country - Episode Nine: The Sickest Gallbladder I Ever Did See
In this episode, which is the second in a row that was recorded without me, Milos and DuBose interview Dr. Kevin Schuster, a Professor of General Surgery, Trauma, and Surgical Critical Care at Yale. I am reminded, as I listen, to my very first question in my very first room of my general surgery oral boards. A cardiac surgery patient with sepsis, likely intraabdominal. Was it acalculous cholecystitis? It was. Did I completely blank out? I did indeed. Did I say, "I'm going to get a CT scan," and was I met with an abrupt transition to the next patient? Yes and yes. Did my realization of my error lead to my conviction that I had irrevocably failed my oral exam? Yes. Did that conviction relax me for the remainder of the day and make me think more clearly and speak more fluidly? Also yes.
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49:40
Tiger Country - Episode Eight: Whole Blood, or, Meet Doctor Acula
In this episode, Milos and DuBose talk to Martin Schreiber, the Division Head of Trauma, Critical Care and Acute Care Surgery at the Oregon Health Sciences University. Professor Schreiber discusses the finer points of resuscitation with whole blood, including how to get a whole blood program started. He also goes on to discuss how to have two weddings at once, and why John Holcomb has used 'tonic-clonic' to describe Dr. Schreiber's dance style. The most notable thing about this episode, of course, is that I am absent.
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52:11
Tiger Country - Episode Seven: Subspecialty Trauma & Acute Care Surgeons, or, How Many Fellowships Would A Wood Chuck Do If A Wood Chuck Could Even Be Board-Eligible
Like me and DuBose, Dr. Chad Ball is an expert in BDSM - Boards in Diverse Surgical Majors. He's as associate professor of surgery and oncology at the University of Calgary, where he practices hepatobiliary, pancreatic, acute care, and trauma surgery. We discuss how the desire to master surgical subspecialties is rooted in masochism, really, and how that training affects practice.
Quick bites of trauma: spend a half hour or less with trauma surgeons from around the world, discussing interesting cases, pearls of wisdom, lessons learned, whether or not a hot dog is a sandwich and whether brushing one’s teeth in the shower is economy of motion or a waste of water.
UK