The Making of a Surgeon by Stanley MD Ashley

Author:Stanley, MD Ashley
Language: eng
Format: epub
Publisher: RosettaBooks
Published: 2012-10-15T00:00:00+00:00

At 6:40 a.m. on a weekday, the streets around The Brigham are alive with people.

Wander out on to, say, Copley Square in Boston at this time, and it’s like a ghost town. That’s the heart of the Back Bay area, home to many students and people with 9–5 jobs in insurance, or retailing or education. Things get busy there later in the day.

The area in which The Brigham is located—the so-called Longwood Medical Area—operates on a different clock. Here, a half-dozen, world-renowned medical centers are located within a roughly 20-square block area, as well as a half dozen colleges and universities. Besides The Brigham, Harvard Medical School, Boston Children’s Hospital, Dana-Farber Cancer Institute, Beth Israel Deaconess Medical Center and the Joslin Diabetes Center are all a stone’s throw apart.

Almost everyone out and about in the early hours is related somehow to one of these or other major local medical facilities, which together employ roughly 43,000 people. Out on the streets, surgical scrubs are as common as jeans; the swing of lanyards and official hospital IDs draped around necks provide a silent rhythm to the movements of passers-by; dispensers of antibacterial hand lotion are ubiquitous on walls and by doorways. So are the anxious faces of patients, often accompanied by loved ones and families, on their way for procedures and tests.

The entire area is geared towards the healthcare industry. As the 24/7 hospital world is fueled by caffeine, there are coffee-shops at every corner and one suspects the Longwood Dunkin Donuts and Starbucks outlets must be gold-mines. Even the local gym knows exactly who it’s catering to. Its advertising slogan: “Where Surgeons Get Cut.”

At 7 a.m., a trickle of people is making their way into the Bornstein Amphitheater at the Brigham. Most are clad in the white coat uniform of the physician; most are young; many sipping on coffee and juice, nibbling on bagels and rolls laid out on a table near the entrance. “Care for some carbs?” a visitor is asked by one of the organizers of the session—the glamorous, dark-haired instructor Dr. Jen Irani.

As the associate program director for general surgery residency (as well as a surgeon herself), part of Irani’s job involves organizing the weekly sessions called “M & M’s.” That stands for Morbidity and Mortality. Despite the grim sounding title, it’s actually a coming-together of residents and senior staff who examine recent cases, and the complications and mistakes that might have been made, with a view towards avoiding them in the future.

Although the format is believed to have been developed at Johns Hopkins a century ago, it has become a cornerstone of a surgeon’s education at The Brigham. Here, M & M’s are designed to help residents understand what went right, what went wrong, and what could have been prevented, in even the most commonplace procedures they might have performed.

But when mistakes are identified, no punishment is meted out, no points deducted from some imaginary report card.

“It’s very collegial,” Irani says.

“The goal is to raise the level

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