The OR Team

Every Memory Has Value

Memories - kMITRA

Have you ever noticed that when an experience ends in a sour note, our first instinct is to try to erase it’s memory as if it never existed in the first place? We attempt to block any recollection of the event as if to protect ourselves from the pain. Sometimes we go as far as to rewrite history to attempt to make ourselves feel better about the whole thing or to justify our decision in the end. I think that we do this in order to regain control and shield ourselves from the bad experience, thus taking away it’s power and impact. This is what we tell ourselves at least. However, I feel like the exact opposite is true. Every experience, good or bad, has value and a take away point. Most experiences that end badly were not truly 100% bad, or we wouldn’t have engaged with that experience to begin with. Nobody is that masochistic. I think that by expending the mental energy to rewrite history or deny any good memories that were also associated with it, we are actually granting more power to the bad part of the experience than it deserves. We are actually chaining ourselves to that negativity and becoming an essential part of the bad experience. We are discounting our own credibility in our judgement regarding what we chose to participate in. By allowing ourselves to acknowledge any positive aspects as well, we truly begin to free ourselves from that negativity and realize that, whatever the experience was, it wasn’t just a waste of our time to begin with. Have a fantastic day everybody!

Dr. Katz

Please tell your doctor everything…at your actual visit and while you are still in the room if you could.

Hello everyone. This is just a quick public service announcement on behalf of physicians everywhere. Everyone knows that it is our sacred responsibility to care for other human beings to the best of our ability. OK great. What seems to elude everyone is that our ability to be able to care for someone is highly dependent upon the information that we receive from the patient….at the time of their actual visit. I am always talking about the doctor patient team relationship and the communication between the patient and the physician is the absolute pillar and foundation of that relationship. There is no way that I can do my best to take care of you without knowing EVERYTHING there is to know about your health history and the details of the concern that you have. You are master and commander of your own ship. I am just the first mate. I help steer but I am not actually in charge of the course. I cannot act on anything that I don’t actually know about. I need you to tell me all of your symptoms and all of your history in order to help you. Every detail is potentially life or death important. Something you may think is trivial could be the absolute key to your health and survival. It is not safe to think of all the physicians that care for you as separate individuals. We are all on one team and we all need to be on the same page with the same knowledge base so that we don’t do anything that could cause you harm. We may be several different physicians, but we are all working with the same individual and everything that we recommend affects you. You can’t assume that everyone has access to the same information. Most of the time, we are getting our information from you so you need to be an active participant in letting all your team members know what is going on with you. The bottom line is: there is no such thing as too much information. Leave it to me to filter out what I need and what I don’t. Don’t self censor. It could cost you your health. And please, try to mention it while we are still talking in the room if you could. Have a great day.

Dr. Katz

I’m Here to Cancel My Monthly Subscription

I heard this this morning from one of my hysterectomy patients in pre op. She came in wearing a sweatshirt with this quippy saying ironed on the front of it. She wanted to make sure that I could see it. It literally made my day and we both laughed out loud. I truly treasure these moments when a patient and I are able to laugh and joke right before major surgery. I applaud her for her sense of humor. On top of that, this particular patient has been going through some major life stuff lately. In my mind, the fact that she stayed on track with taking care of herself and following through with surgery makes her even more bad ass. I completely respect that. Also, her facility for humor tells me that I have been able to achieve a level of comfort for this patient that actually allows her to make jokes before saying goodbye to one of her main organs. She is able to balance her nervousness with the necessity of her decision. That can only be achieved with extensive counselling, back and forth discussion, establishment of comfortable rapport, and making it a priority to allow the patient to take an active role in the decision-making process regarding her own body. There is nothing that engenders feelings of hopeless and loss of control like someone telling you that you need to be put to sleep and have things done to you that will change you forever. That is huge in my book. Think about the trust that you need to have in your doctor to relinquish that ultimate level of control! It’s hard to fathom really. I think we as physicians need to embrace that humbling fact at the beginning of each and every case that we do. It’s a way to appreciate the patient’s trust, keep yourself in check and remind yourself of your responsibility as a physician and a surgeon. Have a fantastic day everyone!

Dr. Katz

What is it about the last weekend of vacation?

What is it about the bittersweet last weekend of vacation? I find that it seems to drive most of us crazy. Instead of soaking it up and metaphorically holding on with both hands, we begin to think forward about all the things we put on the back burner, fretting about what’s ahead. Insidiously conversations get more tense and work creeps back in before the deadline. That last bit of precious time becomes wasted. The cellphones turn back on, the computers get fired up? Why? How can we avoid it? This phenomenon is so common that even the Today Show has done segments on the end-of-vacation-blues and the Sunday Scaries.

So again I ask, how can we avoid the blues? There are some tips out there. For example, travel psychologist Scott Haas says that we need to step back and consider ourselves lucky that we got to take a vacation in the first place. Did you know that half of Americams don’t even use all their vacation days, if they even get some in the first place?

In the Personal and Social Psychology Bulletin, University of Chicago psychology fellow Amit Kumar and Cornell professor Thomas Gilovich recommend that you focus on experiential purchases rather than souvenirs while on vacation. By purchase they don’t necessarily mean spend physical money but rather the investment of time in doing something unique that gives you something with interesting details to share. You will probably have a lot more to talk about after a hiking trip in the mountains as opposed to a pendant or t shirt that you bought.

Another tip is to start planning your next trip. That doesn’t mean discount everything that you just did on vacation. It just means start making a straight forward list for your next trip to help it become a reality and something else to look forward to. There is something called the Zeigarnik Effect that refers to our tendency to remember incomplete tasks more clearly than ones we have finished. Translate that to trip planning and if you have thoroughly planned your next trip it may free your mind from the intrusive “what’s left undone” thoughts that can plague you toward the end of vacation and actually help allow you to enjoy the last few days. That can even apply to tackling your untouched email inbox without guilt while you are on the flight home so you can relax when you get there before work the next day.

USA Today suggests that you nurse that post vacation culture shock. Instead of asking yourself why am I in boring old (insert hometown here) instead of exciting ( insert exotic vacation local here), remind yourself why you moved to your hometown in the first place. Remember why you love it. Reminisce over good memories.

There are a few things you just have to get off your butt and do when you get home: unpack your bags, do your laundry and grocery shop for heaven’s sake. Those suitcases and mountains of dirty laundry will only serve as monkeys on your back and feed your longing to be somewhere else. Grocery shop for healthy food to detox your body from vacation food. It will thank you for it and leave you with more energy to face your new old schedule.

Currently I find myself facing the end of a vacation. I am following my own advice by writing of this blog as an example of finishing a to do list to free my mind to enjoy my last bit of time. I am also reminding myself how much I love my family, my animals and my memories. So far, it’s working. I hope these tips help you too. Have a fantastic day.

Dr. Katz

I have a hard time turning it off

Word Writing Text Private Practice. Business Concept For Work ...

So, I am sitting here right now, trying to relax. I am supposed to be on vacation and yet my mind is spinning with thoughts about my business. Are my patients going to be okay? Will my colleagues care for them like I would? Are any bills going to be late? Did we tie up all the loose ends before we left? Will there be any money in the bank when we come back? Is there anything I forgot? Will all my followers move on when I don’t post for a week? Will I miss any job applications? Will I miss a deadline I didn’t know I had while I am gone? It just goes on and on.

I guess that that is the life I signed up for. You are never truly “off” … least, not if you are really in it to win it. It is the compromise that you strike the second you sign on the dotted line to commit to a private practice sans safety net type of scenario. I have no set hours or guaranteed salary. However, I am at least philosophically the master of my own destiny. In reality, my success also depends on a number of third parties like insurances, reimbursements, billing companies, vendors, and employee work ethics. So, I am kidding myself if I think that I alone can guarantee or swamp my career.

I am not a 9 to 5 type of physician and I never wanted to be. I look all around me and see the significant disincentive to starting private practice. Medical school graduates now seemed to be groomed to think that private practice is impossible and that they NEED the backing of a large conglomerate, set hours, employed practice in order to even entertain the possibility of being a physician. It’s a shame really. What these new docs have traded for this implied security is stamina, work ethic, commitment, and dedication. To be 100% transparent, this is only my opinion based upon what I have observed all around me with the newest generation of doctors. I am not trying to be some hard core, stone age dinosaur, but I have literally seen resident physicians turn away mid conversation about a patient if that conversation was occurring when their shift was over. That is just not what I want, nor do I feel that that is appropriate. That is going too far in the 9 to 5 direction. We are not office workers. We are responsible for lives.

The private physician is slowly but surely going the way of the dodo and being replaced by shift workers with set hours and volume driven goals at the expense of quality. For me, the world does not stop the second that the office phones get turned off. My responsibilities are not just handed off to the next guy. That is not my reality and that is OK. I am not saying that I never need a break because, in fact, I do. I really do sometimes. It’s just that I am not going to spend time whining about the inconvenience when I chose to have it this way. It would be kind of ridiculous. Now, having said that, I am sure that my family would not agree that I should always be on. It definitely goes against that eternal quest for balance that I am always talking about. Yes, yes, I do actually listen to myself when I am attempting to espouse wisdom to the masses. I guess what I really saying is that I still just need to work on it.

Dr. Katz