Dr. Brian Cameron is a retired pediatric surgeon who has spent much of his life dedicated to global surgery. In this conversation, we discuss his new book Ripples from the Rupununi: Dr. Aidun’s Healing Journey. We talk about what it takes to write a book and also discuss the book itself. 

Let us know in the comments or via email: Have you ever thought about writing a book? 

Links:

1. E78 Brian Cameron On Global Surgery: https://www.youtube.com/watch?v=bdetQSXBRMQ
2. Ripples from the Rupununi. https://books.friesenpress.com/store/title/119734000491425890/Brian-H.-Cameron-Ripples-from-the-Rupununi
3.  Surgical training in Guyana: the next generation. Cameron BH, Martin C, Rambaran M. Can J Surg. 2015 Feb;58(1):7-9. doi: 10.1503/cjs.010414. PMID: 25621909 Free PMC article. 
4. Evaluating the long-term impact of the Trauma Team Training course in Guyana: an explanatory mixed-methods approach. Pemberton J, Rambaran M, Cameron BH. Am J Surg. 2013 Feb;205(2):119-24. doi:  10.1016/j.amjsurg.2012.08.004. Epub 2012 Dec 13. PMID: 23246285 
5. International surgery: the development of postgraduate surgical training in Guyana. Cameron BH, Rambaran M, Sharma DP, Taylor RH. Can J Surg. 2010 Feb;53(1):11-6. PMID: 20100407 Free PMC article.
6.  Teaching in Fiji: practising medicine, coping with coups. Cameron BH. CMAJ. 1989 Apr 1;140(7):833-5. PMID: 2924235 Free PMC article. No abstract available.

Dr. Michael Leveridge is a urologist at Queen’s University. He specializes in urologic oncology and is the editor in chief of the Canadian Urological Association Journal. We spoke to him about his career, his role as editor in chief, and how he creates mental models in his practice. In addition, Dr. Leveridge did a masterclass with us on ureteric injuries. We also watch videos together and get his thoughts on how to avoid these injuries.

Check out the YouTube masterclass here: https://youtu.be/izHOSh38J7U

Links:

1. https://cuaj.ca/index.php/journal/index
2. Cancel half of your clinic visits* (a Halloween hot take). https://cuaj.ca/index.php/journal/article/view/8996
3. Mental models in practice: Calculus and the future self. https://pubmed.ncbi.nlm.nih.gov/35623001/

Campbell Roxburgh is a consultant colorectal surgeon and Professor of Colorectal Surgical Oncology at University of Glasgow in Scotland. Mr. Roxburgh is a multi-faceted researcher, surgeon and academic. He has a large body of research in systemic inflammation and tumor response, as well as clinical trials. We were lucky enough to have him join us at Queen’s University for a week.  In this talk he gave to the general surgery division, he talked about the development of robotic surgery in Scotland. What stood out for us from his talk was the deliberate, systematic approach to introducing a new technology adopted by the NHS, as opposed to the way that technology is often rolled out in North America. We also had a great time asking Campbell questions at the end of his talk, and we particularly liked his response to how to find work-life balance as a surgeon and an academic.

What do you think? How should something like robotics be rolled out in Canada? Email us at [email protected]. Feel free to leave us a voicemail, and we might play your response on our next episode. 

Campbell Roxburgh on X: @C_Roxburgh

Links:

1. https://www.gla.ac.uk/schools/cancersciences/staff/campbellroxburgh/
2. Ingham AR, McSorley ST, McMillan DC, Mansouri D, Chong D, MacKay GJ, Wrobel A, Kong CY, Alani A, Nicholson G, Roxburgh CSD. Does robotic assisted surgery mitigate obesity related systemic inflammatory response and clinical outcomes in left sided colorectal cancer resections? J Robot Surg. 2025 Mar 5;19(1):98. doi: 10.1007/s11701-025-02261-0. PMID: 40042780; PMCID: PMC11882609.
3. Ingham AR, Kong CY, Wong TN, McSorley ST, McMillan DC, Nicholson GA, Alani A, Mansouri D, Chong D, MacKay GJ, Roxburgh CSD. Robotic-assisted surgery for left-sided colon and rectal resections is associated with reduction in the postoperative surgical stress response and improved short-term outcomes: a cohort study. Surg Endosc. 2024 May;38(5):2577-2592. doi: 10.1007/s00464-024-10749-3. Epub 2024 Mar 18. PMID: 38498212; PMCID: PMC11078791.

Andrea Merrill is a surgical oncologist in Charlottesville, Virginia. She is the creator of Scrubbed Out, a website dedicated to highlighting the talents and passions of surgeons and trainees outside of the operating room. As listeners will know, Chad and I have been obsessed with exploring how to be the best surgeons we can be without losing our humanity in the process. Dr. Merrill had some really important insights on how we might walk the line between being completely immersed in surgery, but also staying grounded. We also talked about several of her superb pieces of writing, including “Free Solo” and “Taylor Swift in the Operating Room”.  We’d love to hear from you – what hobbies or side hustles do you have? How do you balance them with a life in surgery? Email us at [email protected].

Links:

1. https://www.scrubbedoutsurgeon.com/
2. Merrill AL. Free Solo Surgery. Ann Surg. 2022 Aug 1;276(2):e77-e78. doi: 10.1097/SLA.0000000000005499. Epub 2022 Jul 6. PMID: 36036994.
3. https://kevinmd.com/2024/02/taylor-swift-in-the-operating-room-the-surgeon-who-found-strength-in-song.html
4. https://kevinmd.com/2015/06/why-are-women-so-underrepresented-in-surgery-leadership.html
   
   

Dr. Mohammed Bellal is a consultant urologist based out of Birmingham, UK. He specializes in complex functional reconstructive surgery. He’s also the UK’s first paralyzed surgeon. Dr. Bellal has probably one of the most powerful talks we’ve ever heard called “The Gift of Adversity”. During our conversation with him, we explore the power of fate, and how letting go of the outcomes is such a difficult but powerful life lesson we all need to learn. We also delved deeply into how Dr. Bellal has adapted to his paralysis and has come back to practice as a surgeon, and his insights on how we might design the operating rooms of the future. 

Links:

1. The Gift of Adversity: https://youtu.be/uTPVvPMod2Q?si=VTn616zCI8M7oF71
2. https://www.bbc.com/news/uk-england-birmingham-63586045

In this second episode of our mini-series with the Canadian Medical Protective Association (CMPA), Richard Mimeault and Liisa Honey talk about the “Anatomy of a Lawsuit”. They talk about what you can expect if you are served with a College complaint or a lawsuit, what the process looks like, and how you can psychologically survive through it all.

Links:

1. https://www.cmpa-acpm.ca/en/education-events/elearning/anatomy-of-a-lawsuit

It’s hard to describe exactly what Dr. Stephen Foster is. Dr. Foster is a general surgeon, urologist, infectious disease doctor, entrepreneur, and missionary who has spent his career working in Angola. We caught up with Dr. Foster to talk about his life working in Angola and really to explore his thoughts on empowering non-MD providers to provide life-saving care. Dr. Foster has a fascinating biography called “The Benefit of Steel: The Life and Times of Steve Foster.” For us, the conversation with Dr. Foster has reminded us of the huge inequities that exist in the world, but also the tremendous effort of folks like Dr. Foster to make the world a better, more humane place.

If you want to get in contact with Dr. Foster to support his foundation, you can find his email in our show notes.

Links:

Stephen Foster Email: [email protected] 

1. https://www.amazon.ca/Benefit-Steel-Times-Steve-Foster/dp/B07Y4K7CM4
2. https://www.nytimes.com/2015/03/29/opinion/sunday/nicholas-kristof-a-little-respect-for-dr-foster.html
   
   

Clip of Senate hearing with Robert F. Kennedy Jr.

That was a clip from a Senate hearing with  Robert F Kennedy Jr, who, as many listeners will know, is the current US Secretary of Health and Human Services. In 2025, many folks around the world have become interested in the way that science currently works, particularly around the process of peer review. Peer review is a process where scientific journals ask experts in the field to evaluate the validity and accuracy of articles that are submitted to the journal. There are many challenges around peer review in the modern era, and one particularly thorny one is finding reviewers who have the time and expertise to provide high-quality reviews.

David Maslove is a Clinician Scientist in the Departments of Medicine and Critical Care Medicine at Queen’s University. He, along with economist Chris Cotton and a team of other researchers, recently published an article in the Journal of Critical Care Medicine entitled “Effect of Monetary Incentives on Peer Review Acceptance and Completion: A Quasi-Randomized Interventional Trial”. Dr. Maslove performed what is, in some ways, a very simple study conceptually – does paying reviewers increase the rate at which reviewers complete their reviews? We delve into this study in depth and hear Dr. Maslove’s thoughts on this really important topic.

What do you think? Do you think peer reviewers should be paid? Send us your thoughts via email at [email protected] or on X @coldsteelpod.

Links:

1. Cotton CS, Alam A, Tosta S, Buchman TG, Maslove DM. Effect of Monetary Incentives on Peer Review Acceptance and Completion: A Quasi-Randomized Interventional Trial. Crit Care Med. 2025 Mar 6. doi: 10.1097/CCM.0000000000006637. Epub ahead of print. PMID: 40047491.
2. Maslove DM, Tang B, Shankar-Hari M, Lawler PR, Angus DC, Baillie JK, Baron RM, Bauer M, Buchman TG, Calfee CS, Dos Santos CC, Giamarellos-Bourboulis EJ, Gordon AC, Kellum JA, Knight JC, Leligdowicz A, McAuley DF, McLean AS, Menon DK, Meyer NJ, Moldawer LL, Reddy K, Reilly JP, Russell JA, Sevransky JE, Seymour CW, Shapiro NI, Singer M, Summers C, Sweeney TE, Thompson BT, van der Poll T, Venkatesh B, Walley KR, Walsh TS, Ware LB, Wong HR, Zador ZE, Marshall JC. Redefining critical illness. Nat Med. 2022 Jun;28(6):1141-1148. doi: 10.1038/s41591-022-01843-x. Epub 2022 Jun 17. PMID: 35715504.
3. Maslove DM, Badawi O. The Many Faces of Prediction Modeling in Critical Care. Crit Care Med. 2022 Apr 1;50(4):687-689. doi: 10.1097/CCM.0000000000005409. PMID: 35311775.
4. https://med.stanford.edu/master-clinical-informatics-management/stanford-clinical-informatics/ms-phd-in-biomedical-informatics.html
   
   

The only thing that can save us from our irascibly self-centered existence is to make sure that our existence is in the service of others

Mark Shrime, ENT surgeon, global surgery researcher and now career coach is our guest on this episode. The quote I read was from his wonderful book, “Solving for Why: A Surgeon’s Journey to Discover the Transformative Power of Purpose”. It’s important to understand just how much of a fascinating person Mark Shrime is to get a context for this conversation. Dr. Shrime was the International Chief Medical Officer at Mercy Ships, an international NGO that operates hospital ships. Mark is also one of the major figures in the global surgery space, and was part of the 2015 Lancet Commission on Global Surgery. If that were not enough, he is also an American Ninja Warrior! We explored why Mark felt the need to write a book on purpose as well as his insights on global surgery, amongst many other topics. This was such an important conversation not just for surgeons but for anyone trying discover meaning and purpose in their life. 

Links:

1. https://www.markshrime.com/ 
2. https://www.hachettebookgroup.com/titles/dr-mark-shrime/solving-for-why/9781538734162/?lens=twelve
3. https://www.thelancet.com/commissions/global-surgery
4. Shrime MG, Alkire BC, Grimes C, Chao TE, Poenaru D, Verguet S. Cost-Effectiveness in Global Surgery: Pearls, Pitfalls, and a Checklist. World J Surg. 2017 Jun;41(6):1401-1413. doi: 10.1007/s00268-017-3875-0. PMID: 28105528.
5. Smith ER, Kapoor P, Concepcion T, Ramirez T, Mohamed M, Dahir S, Cotache-Condor C, Adan Ismail E, Rice HE, Shrime MG. Does reducing out-of-pocket costs for children's surgical care protect families from poverty in Somaliland? A cross-sectional, national, economic evaluation modelling study. BMJ Open. 2023 May 2;13(5):e069572. doi: 10.1136/bmjopen-2022-069572. PMID: 37130683; PMCID: PMC10163539

Tsuyoshi Konishi

Dr. Tsuyoshi Konishi is an associate professor of Colon and Rectal Surgery at the University of Texas M.D. Anderson Cancer Center, in Houston, USA. We again got a chance to hear several of his talks at the COLOSOS conference in Toronto in Oct 2024. 

Dr. Konishi is really helping to bridge the gap between “Eastern” and “Western” approaches to colorectal cancer. In this episode, Dr. Konishi really broke down the sometimes nebulous concept of complete mesocolic excision in right sided colon cancers. We’d really encourage you to head over to our YouTube channel www.youtube.com/@coldsteelsurgery to check out the accompanying video and slides. One of the really enjoyable parts of this conversation was discussing some of the differences between Japanese and North American training – there’s lots we can learn! 

Maybe we should incorporate the Japanese system of having everyone upload their operative video prior to board certification?? What do you think? Send us an email at [email protected].

Check out YouTube version with Dr. Konishi's slides here: https://youtu.be/PGIBtYyBAxU 

Bio:

After completion of advanced training in the field of Surgical Oncology and Colorectal Minimally Invasive Surgery at top institutions including the University of Tokyo, Cancer Institute Hospital of the JFCR and Memorial Sloan-Kettering Cancer Center, Dr. Konishi served as an attending colorectal surgeons since 2010, and Head Attending since 2017, at Cancer Institute Hospital of the Japanese Foundation for Cancer Research in Tokyo, Japan. He took a leadership in advancing a minimally invasive surgery program for complex colorectal cancer.

Dr. Konishi’s research interest includes combining multidisciplinary approaches for complex colorectal cancer, including neoadjuvant therapy, extended surgical resection and a minimally invasive surgery. Particularly, he has been taking an international leadership in studying lateral pelvic lymph node dissection for rectal cancer.

Dr. Tsuyoshi Konishi is currently an associate professor of Colon and Rectal Surgery at the University of Texas M.D. Anderson Cancer Center, in Houston, USA. 

Links:

1. Hohenberger W, Weber K, Matzel K, Papadopoulos T, Merkel S. Standardized surgery for colonic cancer: complete mesocolic excision and central ligation--technical notes and outcome. Colorectal Dis. 2009 May;11(4):354-64; discussion 364-5. doi: 10.1111/j.1463-1318.2008.01735.x. Epub 2009 Nov 5. PMID: 19016817.
2. Konishi T, You YN. Complete Mesocolic Excision and Extent of Lymphadenectomy for the Treatment of Colon Cancer. Surg Oncol Clin N Am. 2022 Apr;31(2):293-306. doi: 10.1016/j.soc.2021.11.009. Epub 2022 Mar 5. PMID: 35351279.
3. RELARC trial: Lu J, Xing J, Zang L, Zhang C, Xu L, Zhang G, He Z, Sun Y, Feng Y, Du X, Hu S, Chi P, Huang Y, Wang Z, Zhong M, Wu A, Zhu A, Li F, Xu J, Kang L, Suo J, Deng H, Ye Y, Ding K, Xu T, Zhang Y, Zhang Z, Zheng M, Su X, Xiao Y; RELARC study group. Extent of Lymphadenectomy for Surgical Management of Right-Sided Colon Cancer: The Randomized Phase III RELARC Trial. J Clin Oncol. 2024 Nov 20;42(33):3957-3966. doi: 10.1200/JCO.24.00393. Epub 2024 Aug 27. PMID: 39190853.
4. Motoyama S, Yamamoto H, Miyata H, Yano M, Yasuda T, Ohira M, Kajiyama Y, Toh Y, Watanabe M, Kakeji Y, Seto Y, Doki Y, Matsubara H. Impact of certification status of the institute and surgeon on short-term outcomes after surgery for thoracic esophageal cancer: evaluation using data on 16,752 patients from the National Clinical Database in Japan. Esophagus. 2020 Jan;17(1):41-49. doi: 10.1007/s10388-019-00694-9. Epub 2019 Oct 3. PMID: 31583502; PMCID: PMC6976551.