Tuesday, November 24, 2009

In-Flight airway obstruction - what would you do?

Had an interesting discussion today in Anatomy dry lab. We were examining pictures of the larynx and describing how someone would do a crichothyrotomy. We discussed how that is done quickly on the street to open an emergency airway vs. the tracheotomy that is typically done in the hospital and can be a more time consuming procedure...
During this, one of the fellow students gave an anecdote (I couldn't find it online) about a physician on an in-flight airplane that performed a crichothyrotomy and saved the passenger's life. After this, the patient turned around and sued the physician for scarring their neck/larynx by doing the procedure that saved his/her life! The student then went on to say with the way malpractice suits are in the US, that he would not do the same thing.
I was shocked by this and argued that I would do the same thing and that it is our responsibility as physicians to help in an emergency. He said if he is not working in the hospital then he is not responsible for what happens. I countered that society has invested great resources to train us as physicians, to which he retorted that he is paying for his education and that he would not run the risk of being sued. As this was during lab, I only got partway through explaining that the government (society) sponsors our loans and didn't get to mention medicare funding for residency positions. Nevermind the ethical implications.

Now, both of our positions are based on our very limited understandings of lawsuits, mainly anecdotally or research, and our lack of having been in a similar situation with the ability to do something about it. But, it made me wonder: has the malpractice industry gotten that out of control - or at least the perception of it - that those with the power to save a life would just look the other way?

What would you do?

Wednesday, November 18, 2009


I have been trying to stick to a morning schedule this semester, with spotty success. I've aimed to get up by 8 most days, only to roll out of bed in the 9-9:30 range most days. Lately, I've found that giving myself some deadline or something to do in the morning helps. Today that was getting my ID card at 8 (got there at 8:15 for it) and printing out a lecture to listen before histo lab.

As I was walking back after getting my ID I saw my first hummingbird in Grenada! I think it was a Copper-rumped hummingbird, looked like this guy. It flew around in its insect like manner and was off before I realized I brought my Nokia with its phone with me! A nice treat that may entice me to take some morning walks early in the morning...

Monday, November 16, 2009


Just thinking about how it's been 2 weeks of head and neck and aside from cranial nerves and some vessels, we haven't really touched the brain. Just feels odd. I guess there is a lot of other stuff going on in your head and neck, like ear and eye and random ganglions and the nasal cavity and glands and muscles. So lot's of anatomy... but I feel that brain just sitting there. Waiting.

Monday, November 9, 2009

Toon Docs

Nice collection of cartoons from the Golden Age of Comic Book Stories via Neil Gaiman's journal. A few of the medical oriented ones are copied below, enjoy.