Cold Steel: Canadian Journal of Surgery Podcast

This week we were joined by an icon of surgery, Dr. Ken Mattox. Dr. Mattox talked to us about the evolution of trauma surgery, the development of the Trauma textbook, the Las Vegas Trauma, Critical Care, and Acute Care Surgery Conference, and why he thinks we need to challenge the status quo.

Links:

1. Trauma textbook: https://www.amazon.ca/Trauma-Seventh-Kenneth-L-Mattox/dp/0071663517

2. Top Knife: https://www.amazon.ca/Top-Knife-Craft-Trauma-Surgery/dp/1903378222

3. Comment on trauma care systems in Saudi Arabia: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2931788/

4. Trauma, Critical Care, and Acute Care Surgery (TCCACS) Las Vegas course: https://www.trauma-criticalcare.com/tccacs/home/

5. Quiet Zone Facebook group: https://www.facebook.com/groups/538557893206223/

6. Randomized trial of pneumatic antishock garments in the prehospital management of penetrating abdominal injuries. https://pubmed.ncbi.nlm.nih.gov/3578970/

7. Extreme Ownership: How U.S. Navy SEALs Lead and Win. https://www.amazon.ca/Extreme-Ownership-U-S-Navy-SEALs/dp/1250067057

View full episode transcript: http://canjsurg.ca/cold-steel-episode-80-kenneth-mattox/ 

Bio (from https://www.bcm.edu/departments/surgery/meet-our-team/history-of-leadership/kenneth-l-mattox-m-d):

Dr. Kenneth L. Mattox is a distinguished service professor at Baylor College of Medicine and formerly chief of staff and surgeon-in-chief at Ben Taub Hospital, where he has worked since 1973.  One of his most remarkable contributions was his work in establishing and developing the internationally renowned Ben Taub Hospital Emergency Center and Trauma Center. Dr. Mattox is past President of the American Association for the Surgery of Trauma and Secretary-Treasurer of the Michael E. DeBakey International Surgical Society. He previously chaired the Mayor's Red Ribbon Committee to address the Houston Fire Department Emergency Medical Service. He sat on the Hospital Subcommittee of the Mayor's Special Task Force on the Medical Aspects of Disaster. Currently, Dr. Mattox serves as a consultant to the Center for Biologic Evaluation and Research of the FDA.

Dr. Mattox has served on the Board of Directors of the Rotary Club of Houston, Doctors’ Club of Houston, Wayland Baptist University, the American Association for the Surgery of Trauma, the Southeast Texas Trauma Regional Advisory Council, the American College of Surgeons Board of Governors, and serves as Chairman of the Board of the John P. McGovern Museum for Health and Medical Science.

Leena Yousefi is a multiple award winning family lawyer and founder of YLaw in Vancouver, BC. We asked her to come on the show to talk a difficult subject: divorce. Leena has some really insightful comments on some of the factors that specifically seem to play a role in physician divorce, as well as some of the advice she gives her clients who unfortunately end up going through a divorce.

YLaw website: https://www.ylaw.ca/
YLaw twitter: https://twitter.com/ylawfamilylaw?s=20
Leena Yousefi featured on BBC: https://www.bbc.com/news/business-52481276

Bio (from YLaw website): 

Leena (Ronak) Yousefi is a multi award winning family lawyer, accredited mediator and the founder of YLaw, the fastest growing female-led law firm in Western Canada.

She has been chosen as one of the Top 25 Most Influential Lawyers in Canada, one of  Business in Vancouver’s Top 40 under 40, and voted as the #1 top-rated Vancouver Divorce Lawyer in BC*. She has won over 90% of her family law cases from 2013 to present*.

In 2020, she was named by Lexpert as the only family lawyer in Canada to become the Rising Star of the legal profession.

Dr. Brian Cameron is a pediatric surgeon at McMaster University in Hamilton, Ontario. He has dedicated himself both to pediatric surgery and to global surgery, and has worked around the world in resource-limited settings. This was a particularly memorable episode for us because Dr. Cameron retires this year! This episode was a chance for us to ask him about his career, his life story, and of course, global surgery. Congratulations again to Dr. Cameron on his well-earned retirement!

Links:

1. Establishing disability weights for congenital pediatric surgical conditions: a multi-modal approach. Poenaru D, Pemberton J, Frankfurter C, Cameron BH, Stolk E. Popul Health Metr. 2017 Mar 4;15(1):8. doi: 10.1186/s12963-017-0125-5. PMID: 28259148 Free PMC article.

2. Procedural skills training for Canadian medical students participating in international electives. Margolick J, Kanters D, Cameron BH. Can Med Educ J. 2015 Apr 20;6(1):e23-33. eCollection 2015. PMID: 26451227 Free PMC article.

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.

7. Lancet commission on global surgery: https://www.thelancet.com/commissions/global-surgery

8. Bethune Roundtable: https://www.cnis.ca/what-we-do/public-engagement-in-canada/bethune-round-table/

9. Morad Hameed Trauma system app: https://www.em-consulte.com/article/859211/the-electronic-trauma-health-record-design-and-usa

10. Masters of Global Surgical Care at UBC: https://www.grad.ubc.ca/prospective-students/graduate-degree-programs/master-global-surgical-care

Bio ( from https://www.ccghr.ca/q-brian-cameron/):

Dr. Brian Cameron is a Professor of Pediatric Surgery at McMaster University and a pediatric surgeon at McMaster Children Hospital. He is the director of both the McMaster International Surgery Desk and MacGlObAS. His research interests include global surgical research and education.

This week we have a treat for our listeners – two episodes with Dr. Colin Schieman. Dr. Schieman is a thoracic surgeon at the University of Calgary and the current program director for the thoracic surgery program. We discuss a key issue in modern surgical training – are direct entry programs good or bad for training and trainees? Dr. Schieman also gives his approach for intra operative teaching. 

Don’t forget to check out our bonus episode this week, where Dr. Schieman gives us his approach to lung nodules and lung cancer screening!

Links:

1. Scott Gmora: https://soundcloud.com/cjs-podcast/e05-scott-gmora-on-surgical-training

2. Thoracic surgery training in Canada: https://www.jtcvs.org/article/S0022-5223(16)31423-4/pdf

3. General thoracic surgical training in North America: Contrasting general thoracic surgery residencies in Canada and the United States. https://www.sciencedirect.com/science/article/pii/S0022522318318579?via%3Dihub

Bio:
Dr. Colin Schieman is a Clinical Associate Professor at the University of Calgary in the section of thoracic surgery. He did medical school, residency, and thoracic surgery fellowship at the University of Calgary. He then went on to do additional thoracic surgery training at Mayo Clinic, and subsequently practiced at St. Joseph's Hospital in Hamilton, Ontario. He came back to the University of Calgary as Assistant Professor in 2016, and is now the Program Director for the Thoracic Surgery Fellowship program.

E77 Masterclass With Colin Schieman On Lung Nodules And Lung Cancer Screening by Canadian Journal of Surgery

Dr. Peter Angelos (https://twitter.com/pangelos1?s=20) is an endocrine surgeon at the University of Chicago and is really one of the founders of the field of surgical ethics. We ask him to define for us the term “surgical ethics” and chat about a number of important ethical issues such as informed consent, paternalism, and the limits of disclosure. 

Links:

1. SOUTHWESTERN SURGICAL CONGRESS EDGAR J. POTH MEMORIAL LECTURE. Surgical ethics and the challenge of surgical innovation. https://www.americanjournalofsurgery.com/article/S0002-9610(14)00457-7/fulltext

2. Dr. Angelos’s column on MD Edge: https://www.mdedge.com/authors/peter-angelos-md-phd-facs

3.The personal dimension of informed consent: https://www.mdedge.com/surgery/article/79179/personal-dimension-informed-consent

4. David Urbach on the word “leaks”: https://soundcloud.com/cjs-podcast/e17-david-urbach-on-checklists-wait-times-in-the-time-of-covid-and-medical-devices

5. Tim Pawlik: https://soundcloud.com/cjs-podcast/e26-tim-pawlik-on-surgical-regret-leadership-and-academic-success

6. The Right Choice? Paternalism, Autonomy, and the Incidental Finding. https://www.mdedge.com/surgery/article/88487/right-choice-paternalism-autonomy-and-incidental-finding 

7. How was your night, Doc? The limits of disclosure in preop. https://www.mdedge.com/obgyn/article/77752/how-was-your-night-doc-limits-disclosure-preop

8. How to Solve Ethical Conflicts in Everyday Surgical Practice: A Toolbox. https://link.springer.com/chapter/10.1007%2F978-3-030-05964-4_29

Bio (from https://www.uchicagomedicine.org/find-a-physician/physician/peter-angelos)

Peter Angelos, MD, PhD, is a highly regarded surgeon who has extensive experience in surgery of the thyroid, parathyroid and adrenal glands. He is also an expert in treating endocrine cancers, including thyroid, parathyroid and adrenocortical cancers, as well as islet cell tumors of the pancreas.

Dr. Angelos has a special interest in minimally invasive endocrine surgery, a type of surgery that is performed through small incisions. Minimally invasive surgery has many benefits for patients -- from less scarring and pain, to a shorter hospital stay and a quicker recovery.

An accomplished author, Dr. Angelos has published many journal articles and book chapters on his research into improving outcomes of thyroid and parathyroid surgery, minimally invasive endocrine surgery and best practices for thyroid cancer treatment.

Dr. Angelos is a recognized expert in medical ethics, and serves as associate director of the University of Chicago MacLean Center for Clinical Medical Ethics. He has written widely on ethical issues in surgical practice and how to best teach medical ethics to surgical residents.

He is past president of the American Association of Endocrine Surgeons.

Jessica Grossman is a digital marketer, actress and model. She also is a powerful advocate for patients with Crohns disease. She specifically has done so much to destigmatize what it’s like to live with a stoma, which is a surgically created opening that allows stool to exit the body into a bag. Her work with her website uncoverostomy.org has garnered widespread attention and is an incredible resource for patients with inflammatory bowel disease. In this episode, we explored what it’s like to live with a stoma, and what physicians and surgeons can do better when counseling patients who might have or need a stoma. 
Jessica's social media:

Instagram: https://www.instagram.com/jessgrossman/?hl=en
Twitter: https://twitter.com/JessGrossman?s=20

Uncoverostomy on Social Media:
Twitter: https://twitter.com/uncoverostomy?s=20
Instagram:  https://www.instagram.com/uncoverostomy/

Links:

1. https://uncoverostomy.org/
2. https://uncoverostomy.org/2021/04/22/the-covid-19-vaccine-whats-the-worst-that-can-happen/
3. https://uncoverostomy.org/2019/10/03/time-stop-showing-off-ostomy-10-years-uncover-ostomy/

In this episode we interview Dr. Lawrence Gillman, a trauma surgeon at the University of Manitoba. We start off talking about the course that he and Dr. Sandy Widder developed, the Simulated Trauma and Resuscitation Team Training (STARTT course). We also get his thoughts on mentoring in point-of-care and trauma ultrasound. Finally, and most powerfully, Dr. Gillman shares his experience having to cope with the love of his beloved wife Kerry, and the impact that has had on his family and his career.

Links:

1. S.T.A.R.T.T.: development of a national, multidisciplinary trauma crisis resource management curriculum-results from the pilot course. https://pubmed.ncbi.nlm.nih.gov/24158191/

2. Andy Kirkpatrick on Telementored Ultrasound: https://soundcloud.com/cjs-podcast/e06-andy-kirkpatrick

3. Strategies to improve communication in telementoring in acute care coordination: a scoping review. https://pubmed.ncbi.nlm.nih.gov/33253511/

4. Trauma Team Dynamics textbook: https://www.amazon.ca/Trauma-Team-Dynamics-Resource-Management/dp/3319165852

5. Cozi app: https://www.cozi.com/

Bio (from https://umanitoba.ca/faculties/health_sciences/medicine/units/surgery/8759.html):

Dr. Gillman completed medical school and surgical residency at the University of Manitoba. He subsequently completed a Masters in Medical Education at the University of Dundee followed by fellowship training in Critical Care Medicine and Trauma Surgery at the University of Calgary. He joined the Department of Surgery at the University of Manitoba in 2010 as an assistant professor and currently practices as an Acute Care/Trauma Surgeon and Intensivist.
Research Focus
Dr. Gillman’s research interests include point of care ultrasound, surgical education and crisis simulation. Specifically he is focusing on improving training in point of care ultrasound including redeveloping the credentialing process for the FAST (Focused Assessment with Sonography for Trauma) examination. Other work in this area focuses on validating the use of ultrasound to measure the optic nerve sheath diameter as a non-invasive way to predict intracranial pressure. On the surgical education side, he is working on developing a novel video game platform utilizing an endoscope as a controller to teach early endoscopy skills. Finally, Dr. Gillman is co-founder of the S.T.A.R.T.T. (Standardized Trauma and Resuscitation Team Training) Course, a national trauma crisis simulation course, and is working on developing and improving the course curriculum.

Dr. Clay Cothren Burlew is a trauma surgeon in Denver, Colorado. She is world-renowned for her work on pelvic packing as well blunt cerebrovascular injuries, among many other things. We caught up with her to find out how she manages stay so productive, and specifically to talk to us about pelvic packing and blunt cerebrovascular injury. 

Twitter: https://twitter.com/ClayBurlew?s=20

Links:

1. Treatment for blunt cerebrovascular injuries: equivalence of anticoagulation and antiplatelet agents.
Cothren CC, Biffl WL, Moore EE, Kashuk JL, Johnson JL.
Arch Surg. 2009 Jul;144(7):685-90.

2. Preperitoneal pelvic packing for hemodynamically unstable pelvic fractures: a paradigm shift.
Cothren CC, Osborn PM, Moore EE, Morgan SJ, Johnson JL, Smith WR.
J Trauma. 2007 Apr;62(4):834-9; 

3. Occam's razor is a double-edged sword: concomitant pulmonary embolus and fat embolism syndrome.
Cothren CC, Moore EE, Vanderheiden T, Haenel JB, Smith WR.
J Trauma. 2008 Dec;65(6):1558-60. 

Bio (from https://www.eventscribe.com/2020/AAST2020/fsPopup.asp?Mode=presenterInfo&PresenterID=931211):

Dr. Clay Cothren Burlew is a Professor of Surgery at Denver Health Medical Center/University of Colorado. Dr. Burlew grew up in San Antonio, Texas. She is a graduate of Amherst College, earning her degree in Biology magna cum laude. She attended medical school at UT Southwestern Medical School, where she was ranked 1st in her class and was elected to the Alpha Omega Alpha medical honor society. She completed her general surgery residency and Surgical Critical Care fellowship at the University of Colorado. At DHMC she is the Associate Chief of the Department of Surgery and the Director of the Surgical Intensive Care Unit. She is also the Program Director of the Surgical Critical Care Fellowship and the AAST-approved Trauma & Acute Care Surgery Fellowship.

Dr. Burlew is an active surgical investigator, educator, and clinician; she has received multiple awards in each of these areas including the J. Cuthbert Owens Award, the DHMC Award for Academic Excellence, the Bartle Faculty Teaching Award, the Eiseman Medical Student Teaching Award, the Academy of Medical Educator's award for Excellence in Mentoring, and the 2017 American College of Surgeons Travelling Fellowship to Australia/New Zealand. She serves on the Committee on Trauma for the American College of Surgeons, the Board of Managers for the American Association for the Surgery of Trauma, and is a Past-President of the Southwestern Surgical Congress. She is on the Editorial Board of The Journal of Trauma and Acute Care Surgery, The World Journal of Emergency Surgery, and Trauma Surgery and Acute Care Open, and reviews for an additional 15 journals in an ad hoc capacity. She has authored over 200 peer-reviewed articles and 70 book chapters. She has given over 100 national lectures and scientific presentations.

Dr. Mark Soliman (https://twitter.com/MarkSoliman?s=20) is a colorectal surgeon at Advent Health in Orlando, Florida. We got to talk to Dr. Soliman about his passion for robotic colorectal surgery and where he sees robotics going in the future. We then did a deep dive on the use of video in surgery, from how to edit surgical videos to how Dr. Soliman incorporates video into resident education!

Links:

1. Dr. Soliman's YouTube channel: https://www.youtube.com/channel/UChQEa8aXKsDLFA85in8YIUA

2. How to start a robotic program: https://www.sages.org/video/robotic-startup-tips-tricks-to-a-successful-start/

Bio (from AdventHealth website):

Mark Soliman, MD, FACS, FASCRS is a board-certified colon and rectal surgeon. He is the Medical Director of Colorectal Surgery for the AdventHealth Digestive Health and Surgery Institute and also the Department Chairman for Colorectal Surgery. A Florida native and a proud graduate of the University of Florida, he was part of an elite junior medical program through which he earned both his undergraduate and medical degrees with honors by age 23. After serving as Chief Resident at Baptist Health System in Birmingham, AL, he obtained his advanced subspecialty training in Colorectal Surgery at the Colon and Rectal Clinic of Orlando. Dr. Soliman is one of the most recognized colorectal surgeons nationwide in robotic colorectal surgical operations and has written nearly 50 book chapters, scientific abstracts, and manuscripts on this and its related fields. He is proficient in the Arabic language.