Going to Greece and maybe Mexico

Good news, Jane and I are going to Greece, Athens and Santorini in 2 weeks! whoo hoo

http://millhouses.gr/Photos.asp

Now arranging a Mexico trip with my parents

Gorham pics

Of course, a couple months late, pics of northern NH. Beautiful place . . . considering its in the boonies

So boonies here, they can’t even spell Hillbilly right

On the border with Maine at sunset, its not the ocean but ain’t it beautiful?

Mt Washington . . . I climbed that sucker . . . in my car :)

Gorham, not much there but at least its green and pretty.

Judgement

Just woke up from a fun night on Thursday my last call night on Surgery. Had a full day in the OR, still working on tying those knots under Dr. Liu’s watchful eye. Made it to Dr Z’s guest lecturer talk by Ross Jaffe, another one of those guys that one could perceive to “have it all”. He’s an MD/MBA, was an internist and founded Versant Ventures which now has $1B under management (with 11 other GPs, this means he probably pulls in $1mil a year in salary plus 2% carry so probably gets a payday of $50-70mil every 10 yrs). Dr. Jaffe said something that really resonated with me. He said that people ultimately get paid for 3 things 1) Skills 2) Analysis 3) Judgement of which judgement is the most important thing (and what he iterated to me that should be a reason for me to pursue residency instead of stopping at the intern year.

As I left with those words for my last call night at DHMC, I saw again how judgement makes a big difference in the ED. A 30yo guy who was partially ejected in an MVC came in with what turned out to be a really bad laceration in his spleen and was bleeding to death in his belly. We took him to the OR and as soon as we opened his fascia, he started gushing blood out of his abdomen. We ended up sucking 4L of blood out but fortunately found the lac in his splenic and short gastric arteries and tied them off (I hope he makes it). The other fortunate thing was that Dr. Burchard (one of the best teachers I’ve met here incidentally) was on call and was able to make the right judgement to take him to the OR immediately after the FAST scan (ultrasound) of his belly showed fluid for immediate exlap. In this age of testing and data overload, another physician may have wanted to waste precious minutes by taking him to CT scan risking the possibility that he would bleed out.

I guess the moral of the story is really that in an age where “evidence based medicine”, hard sciences and technology seem to rule the day, the truth is that the soft squishy qualities like good judgement, common sense and deciphering what is important and relevant are MORE not less important.