Thursday, March 22, 2007
Can TV make you a better doctor?
I sleep well when I go to bed on Sunday nights. I close my eyes knowing I will be in the operating room on Monday morning. The O.R. at Grady Memorial Hospital in Atlanta, Georgia, is where I feel at home, content and focused. I know the patients need me to bring my "A-game." I know the residents in neurosurgery need me to teach, demonstrate, explain and encourage. I am confident that I will deliver on both.

My day begins with orange juice and a scrambled egg - vitamin C and protein - no caffeine. Never any caffeine on Mondays. It is early, very early and during my 10-minute commute to the hospital, there is no one else on the road. It is surgeon time. From the car, I call my chief resident. This month it is Lou Tumialan. He's already at the hospital and gives me the latest updates on the patient who will be our first case.

At the hospital, it may appear that Lou and I are joined at the hip, in a never-ending, quiet, unemotional conversation. We run through scenarios, we discuss options and possible outcomes for the patient. We hope for the best and we are prepared for just about anything. We emerge from the doctor's locker room energized, unshaven, and dressed in our uniforms of green. A small wooden box containing our magnifying glasses is tucked like a football in our right hands. We scrub in together, both up to our elbows in the harsh yellow iodine soap and we become quieter, more inwardly focused. It's almost as if I can actually feel every cell in my body working to bring years of information, education and experience to the starting blocks of my mind. I am ready for the race. I feel fully prepared to start the case.

Today, I get to return function to a broken and damaged body. On the very best days, I get to save a life. A resident doesn't have that same sense of confidence and calm. I tell my residents it's fine to have butterflies, just make sure they're flying in formation. There may be surprises, there is certainly a sense of urgency, but chaos is not an option. It is never an option.

Maybe I feel so comfortable at this particular hospital because, like me, it has a history of combining health care and journalism. Henry W. Grady, editor of the Atlanta Constitution newspaper in the 1800s, worried that Atlanta's poor couldn't get good medical care. His dream of providing quality basic health care for Atlanta's less fortunate came true when Grady hospital opened in 1892. Although he chose journalism as a career, he felt drawn to health care. I, on the other hand, chose medicine as my career, but felt drawn by the power of journalism. Now, six years into a life with dueling careers, I have a clear appreciation for both. Each job makes me better at the other.

Today, because of what I've learned from being a journalist, I will not only try to educate Lou on a particularly complicated maneuver to correct a spinal injury, but I also will explain what can be gained from getting to know the patient's story. Accuracy, the cornerstone of good journalism, is also critical to the neurosurgeon, as Lou will learn during today's intense six-hour procedure.

As more than a dozen medical professionals move around a music-filled operating room, negotiating sharp instruments, multimillion dollar machines and lifesaving, yet dangerous, chemicals, the residents will also hear my lesson on clear communication. These lessons are as important for a doctor as they are for a journalist. It's my hope that my experiences as a journalist will allow me to more fully prepare and equip our next generation of doctors.

So far, so good.

To learn more about Dr. Sanjay Gupta's work at Grady Memorial Hospital, watch "Grady's Anatomy" on CNN this weekend. It airs Saturday and Sunday at 8 p.m. and 11 p.m. ET.
Sanjay--

Saving a life must be the ultimate rush as far as lifetime experiences. For 12 years I worked for Dr. Lloyd Duncan the only surgeon in a small rural town in the northwest corner of Tennessee. It was most rewarding being in his office and watching him work. He was a general surgeon so as you can imagine we saw a bit of everything on a daily basis. I still see Dr. Duncan quite often and he has recently published an autobiography that highlights his life. I am now a first grade teacher and it is most rewarding being in the classroom each day---the opportunity to open the door of the world for 6 year olds is a true blessing however those days working side by side with a surgeon are quite memorable. There was always drama of some kind. The emotional rollercoaster of life and death, illness and recovery were bittersweet experiences. No doubt the job you do in both professions is most noble. We all depend on the information we gather from television to make educated decisions about our health. Keep up the excellent work and may the opportunities for you to combine your professions only increase. We all stand to benefit from your excellent reporting. You do a great job keeping us healthy!
Sanjay,
I myself am going thru Medical schol and find this field of medicine so energizing to be able to see sick patients and to be avle to make them whole again, I see what you mean by clear communication in the medical field for I am taking a speech communication class this semester.I have two friends that are cardiologists and have seen the work they do and I have learned so much as I have learned so much from you and television that this has helped in my skills as I graduate in Sept and go forward with my career in pediatrics. Keep up the good work Sanjay and good luck in the future.
How interesting to have two careers that are so different from each other. I will look forward to seeing you in action at the hospital.
I am a Physician's Assistant in Neurosurgery in Houston, TX for a solo practice. Your description of a "day in the life" on OR days is excellent. Like you, the doctor I work with knows that chaos is not an option, and our butterflies are always in formation. I thank the Lord for stable, steady influences like him and you for our future neurosurgeons. Some patients come to the office wanting a good technician in their surgeon, others want good bedside manner, some need both. You personify the latter. If it is journalism that has led you to that, then, yes, TV can make you a better doctor!
Dr. Gupta,

I always enjoy seeing/reading your health reports on CNN. I�ve worked in the healthcare field in mental health and substance abuse research for the past 8 years. I sometimes have difficulty reading the way medical research is presented on news websites (not this site in particular, by any means). I often feel that so much is unexplained or only one side of the available information is presented that a story can become misleading, producing to a wide range of reactions in the public � from panic to delight. I understand this is part of what drives ratings and gets people to email the story to all their loved ones, so it could be considered a success from some perspectives.

I�m curious how you balance the dueling pressures of being a good health care worker with being a good journalist. I wonder if your entrance into the world of journalism has changed the way you read or process medical research findings. Is your immediate response one of a provider or one of a reporter? Do you feel any need or pressure to report the findings with more emotion or bias to make it an interesting piece, even if a study has limitations or the topic is equivocal? Does the power of journalism drive your medical inquiries, or does the power of medicine drive your journal? If I were in this position, I�m not sure how I would stay sane.

I wish you the very best always in your career and personal life.
Dr.Gupta,

I liked your blog because in some way, I too am in the same position. I graduated with a Communications degree but am currently working in healthcare. I used to be a Pre-med student, but I dropped it for Communications. Although I love the degree that I graduated with, I miss medicine, especially now that I work in a hospital, filled with Medical professionals, patients, etc...

Maybe someday I will pursue Medicine once again and be able to apply what I have learned in Communications. Thank you!
Dear Dr. Gupta,
You amaze and encourage me so much. I am a second year medical student and watching you conquer your endeavors leaves me speechless. You are a great role model and a wonderful professional. The best part is that not only are you great at your jobs, you love to share knowledge and educate others. I look forward to meeting you in the future! Take care and good luck!
The power of the pen as some say it is becoming almost as powerful as the power of the vaccination needles. From my work in the public health field especially as I get my MPH in health promotion and communication, I have seen people desparate for accurate knowledge in this media driven age. In fact as a local correspondent for my communiity access TV station I have seen the positive response from viewers. Although there is no thrill comparable to being there on the frontlines of medicine with patients in the clinic, there is still something to be said about the positive impact on public health that medical journalism has.
Dear Dr. Gupta,

First of all let me tell you that you inspire me.

Next, I wanted to share with you a story. One of my friend lost her 3 year old daugher. She was healthy and happy, got a fever and within a week she was gone, it seems she got a rare condition called HLH, which nobody at hospital could diagonose. Her father wrote this very touching blog. You can read it at:

http://www.dailykos.com/story/2007/3/18/121556/908

Thanks for being so dedicated to the cause of saving lives.

with best regards,
Abdul
You are my hero...I TiVo your 5:30am show each weekend and thoroughly enjoy your reporting. Was thrilled to see that this show will be aired, as I am an ICU nurse in San Jose, CA. So, my one request is that I'd love to see you acknowledge RN's, RT's, PT's, OT's and ST's as part of the team. The Grey's Anatomy and House shows, are favorites of mine, but mostly because they're so pathetically inaccurate. It would be GREAT to hear from a REAL M.D., who has a huge following from a journalism standpoint of the realities of the TEAM! Thanks for all you do and I"m so excited you were in Iraq for that soldier's neurosurgery! You're one of my heroes!
Linda
Dear Dr. Gupta,
I am a 59 year old Viet Nam vet. After the Viet Nam war, I became a Product Quality Analyst for the National Industries For The Blind Technical Center in Saint Louis, Mo. I helped develop the nylon webbing suspension unit that goes in the new Kevlar army helmet. I need your input on an idea I had for lessening the severity of brain trauma from IEDs. The idea is sence cold reduces swelling, then could a cold pack reduce brain swelling if it was cold enough to penitrate the scull and applied immediately after injury. A scull cap with an indothermic chemical could be designed to fit inside the kevlar helmet between the suspension unit and helmet. Upon impact the chemical reaction would start the cooling process. The thing is we need to find the optimal tempreture to do the trick without harming brain cells or function. You know about brains, is this a feasible idea or has this already been thought through and it just doesn't work?
Outstanding special!! As a high school student aspiring to be a physician, I really enjoyed seeing the realistic part of life as a resident! Hope you will do more like it.
This show is the best, it was wonderful to show the doctors and their lives as they work hard in Atl Grady hospital.. Make it a weely special.. it's a must!!! 4 thumbs up
Doctor Gupta:

Fortunately, the medical community is making a very large effort to keep residents from working for more than 30 hours continuously and 80 hours per week. This is an initiative of the Accreditation Council for Graduate Medical Education (ACGME). This change represents a significant improvement in working hours for medical trainees. Unfortunately, this change was reactive instead of proactive. This means, the reduction of working hours for residents were a response to the high profile Libby Zion Case. In this case a young lady died as a result of medical errors committed by a sleepy resident. This is only the tip of the iceberg. Charles Czeisler and colleagues, out of Harvard Medical School, published studies showing reduction of medical errors in the ICU and reduction of car accidents in medical residents by reducing the amount of continuous working hours.

Sadly, many people within the medical community, especially surgeons, oppose the reduction of working hours for medical residents. The proposed counterarguments are it adversely affects continuity of care for the patients (patient-physician relationship), it decreases the trainees’ experience, and “physicians have been training this way for ever”. With this mentality, some studies have been published in the surgical literature showing that sleepiness does not affect the ability of surgeons to perform procedures. However, these studies are methodologically flawed, contaminated by a lack of adequate (well rested) controls.

Sanjay Gupta glamorizes the fact that Emory Medical School breaks the ACGME mandates by overworking medical residents. His comments show a bias towards “breaking the rules”. Research also shows that a sleepy individual is more likely to take unnecessary risks. Pilots and truck drivers working hour limitations are stricter than those available for resident physicians. Most people would not feel comfortable being the passenger of a plane piloted by someone who has been awake for 30 hours. The state of New Jersey addressed the dangers of reckless drowsy driving by sanctioning “Maggie’s law”. Therefore, why should we allow someone who is legally impaired to drive to do surgery on someone you love? Let’s call for some common sense.

Sincerely,

Alexander Villareal, MD
Sleep Medicine Fellow
Henry Ford Hospital
Dear Dr. Gupta,
i've only watched grady's anatomy once (earlier). i graduated college (bachelor of science in nursing) last year and i am now a registered nurse here in the Philippines but i haven't practiced yet. because i wanted to pursue my dream which is to practice and be a registered nurse in the US. i was very inspired with your show and i admire all of you doctors. i have similar experiences with the residents and by watching your show i got really inspired. i am hoping that someday, i will be able to see you at Grady's me as your applicant. keep up the good work and continue saving lives!
Dear Doctor Gupta,
this is a continuation of my previous comment.
having been graduated from school has kept me away in providing care to the patients and going to the hospital. that's why when i saw grady's anatomy, i felt the thrill and the rush once again. your program is a big help in explaining and making people realize and understand that you doctors are also human just like them. people will be able to see the dedication, hardwork, perseverance and enthusiasm that you all have. most especially, on how you take good care of your patients. thru your show, it is as if that i am one your team! i hope that there will be many more doctors in the future like all of you who are very sincere and very much dedicated to your chosen craft which is saving lives. more power to you, to the program and to the other residents. i must say that you're many people's hero and so is my idol! may God bless you all always!
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