Cold Steel: Canadian Journal of Surgery Podcast

Dr. Keith D. Lillemoe received his undergraduate education at the University of South Dakota and his MD from The Johns Hopkins University School of Medicine in 1978. He served his surgical training at Hopkins and joined the faculty there in 1985, rising to the rank of Professor of Surgery in 1996.  He served as Associate Program Director for the Hopkins Surgical Residency from 1993 to 2003 and Vice-Chairman of the department from 1997 to 2003.  He was recognized with the Hopkins Department of Surgery Faculty Teaching Award on five occasions.  In 2003, he was appointed the Jay L. Grosfeld Professor and Chairman of the Department of Surgery at the Indiana University School of Medicine.  In May 2011, Dr. Lillemoe was appointed to the position of Surgeon-in-Chief and Chief of the Department of Surgery at the Massachusetts General Hospital and the W. Gerald Austen Professor of Surgery at the Harvard Medical School.

Dr. Lillemoe’s clinical research interests are in pancreatic cancer, IPMNs and other benign pancreatic disorders and biliary tract injuries.  His bibliography lists over 500 journal articles and 140 book chapters.  He has served as a visiting professor over 120 times and has spoken nationally and internationally on over 500 occasions.  He is the former Editor of one of the leading surgical texts Surgery: Scientific Principles and Practice and is Editor-in-Chief of Annals of Surgery.

We spoke to him about his training, equity & diversity in surgery, bile duct injuries, and being the Editor-in-Chief at one of the biggest journals in the world.

Links:

1. American Surgical Association meeting address: https://www.youtube.com/watch?v=lDiYB1sIqpg

2. Bile duct injuries on Behind the Knife podcast: https://behindtheknife.org/?p=2398

3. Safe cholecystectomy consensus conference: https://journals.lww.com/annalsofsurgery/Abstract/9000/Safe_Cholecystectomy_Multi_society_Practice.94547.aspx

4. Visual Abstracts: https://www.surgeryredesign.com/resources

Dr. Mohit Bhandari is a orthopaedic surgeon and trialist at McMaster University. To say he is productive is an understatement; he is in the top 10 most cited orthopedic surgeons in the world. He is the recipient of numerous accolades, including the Order of Canada. In our conversation, we discuss everything from his career track to productivity to social media to the characteristics of "hyper-performers".

Links:

1. Dr. Bhandari's instagram: https://www.instagram.com/mobhandari/?hl=en

2. Bio page: https://surgery.mcmaster.ca/bio/mohit-bhandari

3. Characteristics of highly successful orthopedic surgeons in CJS: http://canjsurg.ca/wp-content/uploads/56-3-192.pdf

4. "Confounding: What is it and how do we deal with it?" paper in CJS: http://canjsurg.ca/wp-content/uploads/55-2-132.pdf

5. "Think Bigger" Lecture: https://www.youtube.com/watch?v=9kXbKp5e-28

Dr. Jane Lemaire in an internist at the University of Calgary and is national expert on the topic of physician wellness. In our conversation we talked about physician burnout, resiliency, and some strategies to help us cope during these incredibly challenging times.

1. Dr. Lemaire's interview with Canadian Society of Internal Medicine: https://cjgim.ca/index.php/csim/article/view/388/1004

2. Well Doc Alberta: https://www.welldocalberta.org/

3. Physician and Family Support Program: https://www.albertadoctors.org/services/pfsp

4. Wallace J, Lemaire J, Ghali W. "Physician wellness: a missing quality indicator". Lancet review paper: http://medicine.uams.edu/wp-content/uploads/sites/7/2012/10/Physician-Wellness-A-Missing-Quality-Indicator.pdf

5. Dr. Lemaire's nutrition paper, "Physician nutrition and cognition during work hours: effect of a nutrition based intervention" : https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2929232/

6. Paper in CJS "Mental toughness in surgeons: Is there room for
improvement?": http://canjsurg.ca/wp-content/uploads/2019/11/62-6-482.pdf

7. Paper in CJS "Surgeons and Astronauts: so close, yet so far apart": https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2552938/pdf/20080800s00003p247.pdf

8. Cold Steel episode with Scott Gmora on surgical training: https://soundcloud.com/cjs-podcast/e05-scott-gmora-on-surgical-training

Dr. Matt Kaminsky is a trauma and critical care surgeon at Cook County Hospital in Chicago. He talks about what it is like to be at a high volume trauma centre like Cook County, and shares with us his pathway to getting there.

Links:

-Next generation simulation: https://youtu.be/9ZM63l2fiEc

David Urbach is a bariatric surgeon and health services research at Women's College Hospital in Toronto, Ontario. We had a wide ranging discussion with him where we talked checklist, the impact of the word "cancer" on patient decision-making, wait-times in Canada in the face of COVID, and medical devices in surgery.

1. David Urbach and colleagues on "Introduction of Surgical Safety Checklists in Ontario, Canada": https://www.nejm.org/doi/full/10.1056/NEJMsa1308261

2. Is WHO’s surgical safety checklist being hyped? Commentary from David Urbach and Justin Dimick in BJS. https://www.bmj.com/content/366/bmj.l4700

3. Impact of the word "cancer" in thyroid nodules paper: https://jamanetwork.com/journals/jamaoncology/article-abstract/2728810

4. wait times in Canada. Dr. Urbach's Op-ed in "The Province": https://theprovince.com/opinion/op-ed/dr-david-urbach-how-to-shorten-hospital-wait-times-in-canada

5. Centralized intake system in Edmonton. Facilitated Access to Surgical Treatment (FAST) program in Edmonton: https://www.albertahealthservices.ca/findhealth/Service.aspx?id=1080550&serviceAtFacilityID=1125938

6. David Urbach Canadian Journal of Surgery editorial, "Heroes, citizens, and the shoulders of giants": http://canjsurg.ca/wp-content/uploads/2020/03/63-2-E118.pdf

Dr. Mary Brindle is a pediatric surgeon at the Alberta Children's Hospital in Calgary, Alberta. We had a unique discussion about the relationship between art and surgery, and how those two disciplines interact with each other. We also heard from Dr. Brindle about her work on updating the safe surgery checklist and her work on ERAS in pediatrics.

Links:

1. ROSCOE magazine. "Art and Surgery: A conversation between Mary Brindle and Andrew Seal: https://cags-accg.ca/wp-content/uploads/2018/10/Roscoe_II_2018_FINAL_pages.pdf

2. Dave Chang interview w/ Jerry Saltz on podcast "The Dave Chang Show": https://www.youtube.com/watch?v=YXIZY8iATv4

3. Revision of the WHO Safe Surgical Checklist: http://www.cspsteam.org/revision-of-the-who-surgical-safety-checklist

4. "Managing COVID19 in Surgical Systems" Annals of Surgery paper: https://journals.lww.com/annalsofsurgery/Citation/publishahead/Managing_COVID_19_in_Surgical_Systems.94654.aspx

5. Mary Brindle & colleagues. "Embracing Change: the era for pediatric ERAS is here": https://link.springer.com/content/pdf/10.1007/s00383-019-04476-3.pdf

6. Ariadne Labs: https://www.ariadnelabs.org/about-us/people/affiliate-members/mary-brindle/

7. The Ambassadors: https://www.nationalgallery.org.uk/paintings/hans-holbein-the-younger-the-ambassadors

8. J-M Basquiat: https://www.wikiart.org/en/jean-michel-basquiat

9. Mastery in surgery: https://www.journalacs.org/article/S1072-7515(16)31635-0/fulltext

10. Dr. Brindle's colleague David Haughton's website: https://www.haughton-art.ca/

11. Dr. Andrew Seal's website: https://thechangingpalette.com/author/seal45/

In this episode, we had the opportunity to talk to Dr. Shahzeer Karmali. Dr. Karmali is a minimally invasive and bariatric surgeon in Edmonton, Alberta. He gave us a masterclass on the common types of bariatric operations, post-op care, and gives an overview of bariatric complications. He also discusses his fascinating research of the impact of bariatric surgery on intra-cranial hypertension. Finally, he talks about how to navigate a relationship with industry.

Links:
1. Complications associated with laparoscopic sleeve gastrectomy for morbid obesity: a surgeon's guide. This is one of the top 10 highest viewed papers published in the Canadian Journal of Surgery. http://canjsurg.ca/vol56-issue5/56-5-347/
2. Complications associated with adjustable gastric banding for morbid obesity: a surgeon’s guide: http://canjsurg.ca/vol54-issue1/54-1-61/
3. Idiopathic intracranial hypertension and bariatric surgery: a systematic review: https://www.ncbi.nlm.nih.gov/pubmed/32195557

In this episode, we are joined by repeat guests Dr. Morad Hameed (@moradhameed) and Dr. Neil Parry to talk about how surgeons across the country have adapted to COVID. We also talk about the impact COVID has had on final year residents across the country. Finally, we discuss the basics of COVID management.

Dr. Morad Hameed is a trauma surgeon and intensivist at the Vancouver General Hospital (VGH) and an Assistant Professor of Surgery at the University of British Columbia (UBC). He is the Head of the UBC and VGH Division of General Surgery and is a Service Chief for Acute Care Surgery at VGH. 

Dr. Neil Parry joined the staff at London Health Sciences Centre and the Department of Surgery at Western in July 2003 as an Assistant Professor. He was promoted to Associate Professor in July 2010. He has served as the Medical Director of Critical Care, Victoria Hospital, LHSC and is currently the Director of Trauma for London Health Sciences Centre. He has held several leadership roles with the Trauma Association of Canada and is the Provincial Chair of the Committee on Trauma for the American College of Surgeons. 

Links:

1. SCCM Guide to COVID management for non-intensivists: https://sccm.org/covid19

2. UBC Reticulum. This online platform developed by BC surgeons has been utilized extensively by surgeons across the country to communicate about COVID. https://www.ubcreticulum.com/

3.  CBC News article on cancelled Royal College exams: https://www.cbc.ca/news/canada/hamilton/resident-doctors-certification-covid-1.5510028

4.  The Behind the Knife podcast (https://behindtheknife.libsyn.com/) has had some excellent episodes recently on ventilator & COVID management.

5. Surviving Sepsis Campaign: Guidelines on the Management of Critically Ill Adults with Coronavirus Disease 2019 (published March 2020) is available https://bit.ly/3dB9H2Z 

6. Traumacast also has an excellent episode on the management of COVID. https://open.spotify.com/show/1CnoyxwOXlARa9Kd69zsA)

7. Re-listen to our episode with Dr. Kirkpatrick on telementoring: https://soundcloud.com/cjs-podcast/e06-andy-kirkpatrick

Dr. Emilie Joos (@EmilieJoos) is a trauma surgeon at the Vancouver General Hospital.  She is also a Canadian leader in global surgery. We talked about the global response to the Haiti earthquake, challenges in global surgery, and advice to trainees interested in global surgery.

Links:

1. Surgical Response to Humanitarian Crisis in ROSCOE magazine: https://cags-accg.ca/wp-content/uploads/2018/10/Roscoe_II_2018_FINAL_pages.pdf

2. Dr. Joos's global surgery projects: https://internationalsurgery.med.ubc.ca/global-initiatives/projects/international-projects/

3. McGill Global Surgery webpage: https://www.mcgill.ca/generalsurgery/resident-information/global-surgery

4. Program for Global Surgery & Social Change (PGSSC):https://www.pgssc.org/

5. Lucille Tisdale: https://www.thecanadianencyclopedia.ca/en/article/lucille-teasdale

6. Sternotomy or drainage for a hemopericardium after penetrating trauma: a randomized controlled trial. South African trial: https://www.ncbi.nlm.nih.gov/pubmed/23604058

Dr. Philip Dawe is a trauma surgeon at the Vancouver General Hospital. He has a truly unique perspective having been both a military and civilian trauma surgeon. We talked to him about leadership, what we can learn from the military, and his path to becoming a trauma surgeon.

Links:

-A descriptive study of US Special Operations Command fatalities, 2001 to 2018: https://journals.lww.com/jtrauma/Abstract/2019/09000/A_descriptive_study_of_US_Special_Operations.24.aspx

-"Are morbidity and mortality conferences becoming a lost art?" http://canjsurg.ca/wp-content/uploads/2019/03/62-2-76.pdf