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Thursday, July 31, 2008

Elias Joshua Simpson is born!

It has been a very rewarding day. I just got home, it's 1:15 AM. I started surgery this morning at about 7 AM and finished with the last surgery at about 12:20 AM. We had several emergency surgeries today. However, the reason for my post is not about me...

It's about a new baby boy, Elias, born to my dear friends Kavi and Taylor! CONGRATULATIONS guys! I can't wait to meet him. So, if you are interested, here is Elias' blog :) http://eliasjoshuasimpson.blogspot.com/

Welcome to Earth, Elias :) Happy Birthday!

Ok, I am off to bed. Nite nite.

Wednesday, July 23, 2008

My Readership

Hi everyone, I guess this is my first monthly report to all of you. This is a picture of where all of you are accessing and reading my blog within the last month. I just want to thank you for reading a piece of my thoughts :) You know, one of my love in life is to travel. I have visited and backpacked for several months over western Europe a few years ago. I lived in France for a few month and another few month in England. I also lived many years in a small island country in Asia... One day I would like to visit other places in the world. I have a long traveling list!

Some of my favorites about traveling are: FOOD! Learning a new language; immerse into a different culture; interact with people of different backgrounds (I really love different people in my travels, I think GOD created so many beautiful people with beautiful hearts around this world in which we live); taking photos of animals and living things and natural wonders; sight seeing; and, Getting LOST... yes, that's right, one of my favorite things to do in a new city is to get lost! I think that is the best way to experience the true sense of how people live away from all the tourism.

I know there are so many passions to pursue in life, but, life is really too short! I think we should realize our purpose and our passions, then set a goal to make it happen. "The best way to be spontaneous is to plan for it." - George ... yes, you can quote me on that.

Seeing all of you popping up on this map really puts the excitement in me. If you truly enjoy and love my thoughts, I wish I could come to your country and have a meal with you while we converse about the thoughts in our mental universe. Perhaps it will happen one day. Blessings to you. If you have a thought of encouragement, please feel free to leave it in the comment section by clicking on the underlined 'comments' at the end of the blog post. I always need some sweet encouragements :)

Monday, July 21, 2008

My brother is ENGAGED!

Yup, he popped the big question today!!! I am so excited for him and his fiance. I am so excited!

Guess what?! Da Vinci Surgical Robot!

So, I'm half way through my general surgery rotation. I have been doing a lot of exciting surgeries so far. Being the only student working with a group of 4 surgeons, I am treated as an surgical intern. I have to pre-round on all the patients and present them to the surgeons. I also have to do surgical consults in the hospital, the ICU, and the ER. So far, I have been first assist for all the surgeries and also being on call whenever the surgeons are on call. I'm also expected to research and know all the procedures, complications, treatments, managements, and pathophysiologies of all the cases we see and operate on. So, needless to say, I haven't got much free time. Daily we evaluate abdominal pain, obstructions, perforations, and we do surgeries when we need to. I've assisted in removal of cancers, stitching the bowels when they get perforated from ulcers, taking out appendix and gall bladders when they get inflammed, draining fluid out of every infected orfices and wounds, saving people's lives when they get critical, and assisting doctors of other specialties (such as OB/GYN) with surgical needs. I have gotten to do a lot and starting to get a feel of what internship is like and what being a doctor is like. I've got to admit that many times I do feel like I can't ever learn enough. The more I ask questions, the more I've been asked questions, the more I realize that I don't know enough. At times I do get satisfaction to be able to answer questions that are asked, but I still struggle to find ways to retain what I've learned and to keep learning more.

So, today, I met Da Vinci! I can't describe to you how excited I was. Da Vinci is a robotic system that allows doctors to do 'minimally invasive surgeries.' What that means is that this robot allows complicated surgeries to be done with the smallest possible incision sites. The robot has four arms that inserts instruments into the belly. It also has 2 cameras that goes into the belly and projects the images to a screen. The 2 camera system gives the surgeon a 3 dimensional view so they can do abdomenal surgeries with the highest degree of accuracy, also minimize risks and complications. Right now, we routinely do laproscopic abdomenal surgeries with instruments and cameras, but this robot take surgery to the next level. The surgeon is doing surgery in a console. The potential is that you can literally do operations on someone half way across from the globe. How about doing surgeries in the field on wounded soldiers or astronauts in space? The draw back is that the machine is several million dollars to purchase and costs more than $10,000 per month to maintain. I guess for the time being, the art of surgery still involves human touch.

Seriously, the surgeon let me sit in the console and see through the 3D camera... it was so cool! If you want to experience and see what it does, click on this site:

I am thoroughly impressed! I want one. I want one NOW!!!

Thursday, July 17, 2008

Be a surgeon!

Hey guys, I'm exhausted! I am pretty busy working at the hospital with several surgeons. My typical day consists of doing surgeries all day, assessing patients in the ER, talking to patients before and after the operations, and having to read up on surgical techniques and anatomy. I am studying hard, but very much enjoying myself. A surgeon is the El Capitan of the ship! An operating theatre functions as a well-oiled machine. The parts of this machine consist of an anesthesiologist, a scrub tech, an OR nurse, pre-op and post-op care team, and of course the surgeon and the asistant. The anesthesiologist give the magic cocktail that gives the patient a deep sweet dream; the scrub tech hands the surgeon all the instruments and keeps count on everything that is used; the OR nurse takes care of all the processes of the operation and gets necessary materials during the surgery and also record the timing of all the process; the surgeon and the assistant do the operation. When you enter the operating theatre, the surgeon is the 'chief.' It is quite a rush to be treated as one. A tyical operation for a general surgeon include taking out gall bladders and appendix, fixing all sorts of different hernias, taking out cancer from the breast/thyroid/bowel/skin, doing endoscopies .....

So, the surgical operative procedure has evolved to having to master the 'sterile technique.' Everything from 'scrub' (a special way of scrubing and washing hands from finger nail to 2 inches above the elbow), to putting on gown and gloves, and keeping the operative fields sterile. We owe much of the low rates of post-op infections to this obsessive/compulsive technique.

The surgical patient often is acutely ill. To be able to think and act on your toes makes a well trained surgeon stand out from the other medical specialists. What is unique about being a surgeon is that, when a ill person presents with a surgical problem, a surgeon is often the only one to offer a curative solution.

I have found myself to be extremely fascinated by this field, even though my eyes are constantly red from keeping them open all the time (don't want to miss anything), and my legs are stiff from having to stand hours on end. It is amazing that when we are so focused on something, we can actually ignore our regular bodily functions. I often have to remind myself to move my legs and blink my eyes... I'm glad God made us 'automatic' in many ways, otherwise, I wouldn't be talking with you right now. Ok, it's bed time for me. Talk to you soon.

Saturday, July 12, 2008

"Better" by Atul Gawande MD, a general surgeon's notes on Performance

This book is the second book written by a general surgeon, Atul Gawande MD, from Harvard. The theme of this book is about performance in medicine. “As a doctor, you go into this work thinking it is all a matter of canny diagnosis, technical prowess, and some ability to empathize with people. But it is not, you soon find out. In medicine, as in any profession, we must grapple with systems, resources, circumstances, people, and our own shortcomings, as well. We face obstacles of seemingly unending variety. Yet somehow we must advance, we must refine, we must improve.” The picture to the left is from http://www.amazon.com/ you can also buy the book there.

In medicine, there are three core requirements for success: Diligence, Doing Right, and Ingenuity.
  • Diligence is “the necessity of giving sufficient attention to detail to avoid error and prevail against obstacles. It is central to performance and fiendishly hard.”
  • Doing Right is dealing with and puzzling “over how we know when we should keep fighting for a sick patient and when we should stop.”
  • Ingenuity is “thinking anew. It is often misunderstood. It is not a matter of superior intelligence but of character. It demands more than anything a willingness to recognize failure, to not paper over the cracks, and to change. It arises from deliberate, even obsessive, reflection on failure and a constant searching for new solutions.”

Betterment is a perpetual labor. Dr Gawande gave some illustrations in the book regarding each of these three principles. For Diligence, he gave stories of the “efforts to ensure doctors and nurses simple wash their hands; one about the care of the wounded soldiers in Iraq and Afghanistan; and one about the Herculean effort to eradicate polio from the globe.” For Doing Right, he gave examples to address some uncomfortable questions about “how much should doctors get paid; what we owe patients when we make mistakes; and participation in executions of prisoners. For Ingenuity, he gave examples of people who have transformed everyday medicine by improving “the way babies are delivered; the way an incurable disease like cystic fibrosis is fought; and exam how much more of us can do the same.”

Those people who can successfully attempt and accomplish these three principles, Dr Gawande calls them the “Positive Deviant.” Here he gave 5 suggestions on how to become one:

  1. Ask an unscripted question – our job is to talk to strangers, why not learn something about them?
  2. Don’t complaint – “nothing in medicine is more dispiriting than hearing doctors complain. Medicine is a trying profession, but less because of the difficulties of disease than because of the difficulty of having to work with other human beigns under circumstances only partly in one’s control. Ours is a team sport, but with 2 key differences from the kinds with lighted scoreboards: the stakes are people’s lives and we have no coaches. Doctors are expected to coach themselves. We have no one but ourselves to lift us through the struggles. But, we are not good at it. Wherever doctors gather, the natural pull of conversational gravity is toward the litany of woes all around us. But, resist it. It’s boring, it doesn’t solve anything and it will get you down.”
  3. Count Something – do a study of your success and failures, count how often mistakes happen of certain sort that interests you.
  4. Write Something – put in words your experiences to add some small observation about your world. Don’t underestimate the effect of your contribution, however modest it may be.
  5. Change – people respond to new ideas in one of three ways, “A few become early adopters, most become late adopters, and some remain persistent skeptics who never stop resisting. Make yourselves early adopters and look for opportunity to change. Be willing to recognize the inadequacies in what you do and to seek out solutions. The choices a doctor makes are necessarily imperfect but they alter people’s lives. Because of that reality, it often seems safest to do what everyone else is doing. But a doctor must not let that happen.”

Once you become a physician, the question is not whether you have to accept the responsibility. By doing your job well, you have accepted responsibility. Then the question becomes, “having already accepted responsibility, how does one do such work well.”

Monday, July 7, 2008

Ahhh...

Just an update from me. I am now done with both of Step 2s' of medical board exams. It feels so good. I am now packing up and getting ready to move to AZ for 6 weeks starting tommorrow. As I begin my fourth year in medical school, I am very excited again for another year of rotations (working/learning under specialist-physicians in different fields every 2 to 4 weeks). My year is starting off with General Surgery and will end with 6 weeks in foreign lands. I am going to be on the road most of the year... So, stay tuned in, I will try to bring you on all my adventures :)

Thursday, July 3, 2008

(*) Have you ever wonder what life would be like without arms and legs?

Let me introduce you to a man name Nick Vujicic! He was a native of Australia and he was born without any extremities! Have you ever been angry at God? Have you ever wish that your life would be more complete? Have you ever bargain with God... "God if you just give me ____, I will _____ !" Well, Nick has an awesome testimony to share with you. Please watch the video by clicking on his name
--> NICK VUJICIC <-- Or, you can visit Highland Church's website and go to the 'Sermon' tab: http://www.highlandschurch.org/

I was very much encouraged by his story and also entertained... you'll see, he is a character! He also has a website that is the main resource of his ministry: http://www.lifewithoutlimbs.org/

Why don't you pray for opportunities to tell your story?! If you think about it, we are all beautiful and unique. No one else is created like you, individually. The journey that we all walk is not an easy one. We all have different experiences and see things from different perspective. I think it is valuable for us to share with one another our triumphs and failures. Do not underestimate the power of God in your lives. As I was pondering about our frailty, I am reminded of God's Sovereignty. Have your heart every 'condemn' you for happenings of the past or shamefulness of present thoughts? Well, in 1 John 3:20 says, "Whenever our hearts condemn us, God is greater than our hearts, and He knows everything." Whenever you meet a challenge or discouragement in life, know that
GOD IS GREATER THAN ________.

Our Struggle & Our Savior