Cold Steel: Canadian Journal of Surgery Podcast

Dr. Teresa Purzner MD PhD FRCSC is a clinician scientist neurosurgeon with a special interest in neuroncology and general neurosurgery.  She completed her residency training at the University of Toronto, and her PhD training at Stanford University.  Her lab, run jointly with her husband Dr. James Purzner, is focused on interdisciplinary approaches to identifying novel drug targets for brain cancer as well as the translation of promising new drug targets into human-ready therapeutics.  Her work has led to the identification of a critical new drug target in the brain tumor medulloblastoma – a discovery that she has since translated into a novel drug for both brain cancer and skin cancer, currently being tested in phase 1 and phase 2 clinical trials.  This work has resulted in her being named a Stanford Interdisciplinary Graduate fellow, Biox fellow and SPARK fellow, and has earned her both national and international recognition including the Annual Award of the American Academy of Neurological Surgery, the K.G. McKenzie prize for Basic Science Research, AANS Louise Eisenhardt Award and the Neurosurgery Research and Education Fellowship.

She is a mom, an entrepreneur, and design-thinker, having created her own baby food company as well as redesigned the Integrated Brain Tumor Program. 

Links:

1. Integrated Brain Tumor Program: https://surgery.queensu.ca/administration/announcements/integrative-brain-tumor-program-achieving-best-class-patient-outcomes
2. https://www.ibtp.ca/purzner-lab
3. https://www.theglobeandmail.com/business/economy/article-how-a-neurosurgeon-used-her-entrepreneurial-background-to-revamp-a/
   
   

Dr. Patrick Murphy is a trauma and acute care surgeon at Medical College of Wisconsin. In this episode we discuss his recent paper, “Understaffed and overworked: The stark reality of acute care surgeon staffing in the United States, an Eastern Association for the Surgery of Trauma multicenter study.” This conversation turned into more than just a discussion around workforce planning, but also around how surgeons are compensated and surgical culture.

Links:

1. Murphy, Patrick B. MD, MPH, MSc; Coleman, Jamie J. MD; et al; The ACS Staffing Authorship Group. Understaffed and overworked: The stark reality of acute care surgeon staffing in the United States, an Eastern Association for the Surgery of Trauma multicenter study. Journal of Trauma and Acute Care Surgery ():10.1097/TA.0000000000004700, July 4, 2025. | DOI: 10.1097/TA.0000000000004700 
2. Murphy PB, Nahmias J, Bonne S, Coleman J, de Moya M. Defining the acute care surgeon: American Association for the Surgery of Trauma (AAST) panel discussion on full-time employment, compensation and career trajectory. Trauma Surg Acute Care Open. 2024 Sep 30;9(1):e001500. doi: 10.1136/tsaco-2024-001500. PMID: 39363886; PMCID: PMC11448165.
3. Murphy PB, Coleman J, Karam B, Morris RS, Figueroa J, de Moya M. A national study defining 1.0 full-time employment in trauma and acute care surgery. J Trauma Acute Care Surg. 2022 Apr 1;92(4):648-655. doi: 10.1097/TA.0000000000003504. PMID: 34936589.
4. Murphy PB, Coleman J, Maring M, Pokrzywa C, Deshpande D, Al Tannir AH, Biesboer EA, Morris RS, Figueroa J, de Moya M. Early career acute care surgeons' priorities and perspectives: A mixed-methods analysis to better understand full-time employment. J Trauma Acute Care Surg. 2023 Dec 1;95(6):935-942. doi: 10.1097/TA.0000000000004037. Epub 2023 Jun 15. PMID: 37418689.
5. Smith RN, Freedberg M, Bailey J, DeMoya M, Goldberg A, Staudenmayer K. The importance and benefits of defining full-time equivalence in the field of acute care surgery. Trauma Surg Acute Care Open. 2024 Jul 4;9(1):e001307. doi: 10.1136/tsaco-2023-001307. PMID: 38974220; PMCID: PMC11227842.
6. Robinson C, Lawless R, Zarzaur BL, Timsina L, Feliciano DV, Coleman JJ. Physiologic stress among surgeons who take in-house call. Am J Surg. 2019 Dec;218(6):1181-1184. doi: 10.1016/j.amjsurg.2019.08.023. Epub 2019 Sep 19. PMID: 31570199.
7. Adi Kumar on Cold Steel: https://open.spotify.com/episode/52Hg2cCLGLZejD0QSfI9le?si=xSHFcSrPRdOOZ_RT_QWsAA 

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