AWS BLOG

When Disaster Strikes

By Dr. Minerva Romero Arenas

#HoustonStrong #HurricaneIrma #FuerzaMéxico #PRstrong #VegasStrong

Our world has been in the midst of what seems like an endless series of tragedies. This blog started out as an idea to write about how I was inspired and proud of the goodwill shown by my fellow Houstonians (and other Texans and neighbors) in the aftermath of hurricane Harvey. Much like this love letter. Much like my colleague’s reminder to look for the helpers when disaster strikes. However, it quickly became a seemingly insurmountable task. Just as I was trying to pen a few lines, another disaster was brewing in the Atlantic. Then the earthquakes hit México. Another set of hurricanes. Yet another mass shooting.

Staying safe. Trying to help. Then trying to keep up with everyone’s safety and figuring out how to help in the aftermath. Donate. Volunteer. Meteorological maps seemed like something that could only have come out of a Hollywood blockbuster. I can’t imagine that I would find it essential to follow @NWSNHC, @SismologicoMX, or @weatherchannel? And if I never have to sleep with an eye open for flash flood warnings or tornado warnings… it may be too soon.

To be quite honest, there were a lot of days the past 6 weeks that seem like a blur.

Thankfully, I had my work to help keep my mind (and hands) occupied! I am thankful for the teamwork shown at our hospital, where 1 in 3 employees were affected. Colleagues swam to work, camped out for days unable to assess the safety of their own families or homes, and everyone who boldly came back to offer relief as soon as it was reasonable to do so. It was amazing to see the “good neighbor” spirit that was showcased from Houston to the world – an example to be seen again in tragedy after tragedy.

On a personal note, I have found a way to turn these events into a positive by taking time to reflect on everything. I have made more time than before to actually consider important questions like, am I okay? Am I putting my best effort to live a meaningful life? How can I be part of the solution? Have I done everything I can to help others?

I am thankful for the human spirit and solidarity that continues to shine through disaster after disaster. I am thankful more of our ACS leadership continues to engage in meaningful discussion about firearm injuries. Most of all I am thankful for my colleagues, friends, and *my family* – their compassion, determination, and strength is truly inspiring and figuratively and literally helped me “weather the storm.”

A message from the AWS Blog Team: This is the first in a series of blogs from surgeons who wish to share their experience during these trying times. If you wish to share your story, you may email blog@womensurgeons.org.

Minerva A. Romero Arenas is an Endocrine & General Surgeon joining the faculty at the University of Texas Rio Grande Valley. She completed a fellowship in Oncologic Surgical Endocrinology at the UT MD Anderson Cancer Center in Houston, TX. She completed her General Surgery Residency at Sinai Hospital of Baltimore. She received her MD and her MPH from The University of Arizona College of Medicine and the Zuckerman College of Public Health in 2009. She studied Cell Biology and French at Arizona State University as an undergraduate.
Her interests include surgical oncology & endocrinology, global health, health disparities, quality improvement, and genomics. A native of Mexico City, Mexico, Dr. Romero Arenas is passionate about recruiting the next generation of surgeons and is involved in mentoring through various organizations.
She enjoys fine arts, films, gastronomy, and sports. She enjoys jogging, swimming, and kickboxing. Most importantly, Dr. Romero Arenas treasures spending time with her family and loved ones.


Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author, and are not necessarily the opinion of the Association of Women Surgeons.

 

So you want to be a Surgeon in the United States? 6 Tips to Succeed as an International Medical Graduate (IMG)

By Sristi Sharma

Congratulations! Your ambition of becoming a surgeon in the United States has finally brought you to this country. You have left your family, your life and everything behind to train in an environment that is completely new to you. You know that you have a steep learning curve ahead of you-be it clinical, personal or social. So how do you navigate this new phase of your career?

There are unique challenges that come with being an IMG in the States. Here are 6 tips that will help you become the best surgical trainee you can be:

  1. Be good…no excellent…at what you do! Know your subject inside out and practice your surgical skills . Challenge yourself to learn more everyday. There is no substitute for hard work, and as a foreign medical graduate you will have to work even harder to prove yourself everyday.
  2. Learn the system: Do everything you can to understand the system you are trying to enter. Surgery is a very fast paced specialty and it is unforgiving to those who are slow to catch up. The goal for foreign medical students intending to start their residency should be to be at the same level as a US 4th year medical students. You are not necessarily behind on the clinical knowledge, however the medical students here know how the system works-right from electronic medical systems to how patient care works. To get upto speed familiarize yourself with the lingo. Observe how everyone behaves in their work environment. It does not matter what country you come from, things are different in the United States. As a trainee, you need to be able to hit the road running when you start. Your preparation will go a long way.
  3. Find a mentor: A common piece of advice you will get right from the beginning is to “find a mentor who can guide you”. I cannot stress this enough. Your life will become much easier if you find someone who has been in the same place as you recently. It may be a student from your country who has successfully matched into a residency program or an attending who now has a successful setup. This person may not necessarily be the mentor you are looking for, but they will be your first step to finding one. Ask questions, ask for help. Many people want to help and will even go out of their way if you just ask them. This is especially helpful as you start talking to your potential mentors. The surgeons you meet are busy people who wear multiple hats in their careers and personal lives. They are open to mentoring you as long as you prove that you are in this for the long haul. You are also not limited to one person. You should work with several mentors to achieve your goals. Your motivation will show through in your actions.
  4. Value your uniqueness: One of the worst pieces of advice I received when I first landed in this country was, “make sure you do not tell people what you went through in India. The clinical community will not appreciate it and will think you are not adequately-trained and incompetent”. For the next 3 months I wallowed in doubt and self-hatred. It showed in my interactions with people. I came across as an under-confident individual who was unsure of herself. Very quickly I realized that my approach was wrong. My experiences were unique, and for the most part doctors and surgeons were curious to hear about how I practiced medicine back home. At institutes such as Hopkins and Harvard, I have been working with and learning from the surgeons who share my goal of making the surgical systems better in my country. At every step they want to learn about my experiences to effectively understand the changes that are needed. This experience has taught me it is very important to find a mentor who will appreciate your unique experiences and will encourage you to learn new things while being yourself.
  5. Speak up and take a risk. While working towards my MPH at Hopkins, I was looking for a job. I had heard that one of my professors was looking for a student to help out with his project. But his requirements for the job were very specific. I didn’t have the technical skills that were needed for the job but I had enrolled in classes to learn them at the very moment the job was being advertised. The fear of not getting the position was crippling and I hesitated even to approach the professor. When one of my friends heard about my dilemma she gave me advice that has completely changed my life. She said to me, “You may not get the job if you ask him, but if you do not ask you will definitely not get the job”. Since then, I have made this my mantra. There have been many moments when I have been turned away, but there have been many more when people have gone out of their way to help me out. All that stood between me and them was my willingness to ask for help. It is by speaking up I have found the best of my mentors. Oh and for those of you still wondering-I did get the job!
  6. Don’t fake it. Insincere stories, praises, gifts and fake accents? Just…no!

Being a foreign medical graduate in the US is tough. Being a foreign medical graduate AND a surgeon in the US is even tougher. So, if you want to be a good resident and a successful surgeon, work hard, reach out for help, be genuine and embrace your uniqueness.


Sristi Sharma MD, MPH is a General Surgery Resident at University of Colorado, Denver. She is a previous Paul Farmer Global Surgery Research Associate, Harvard Medical School, a graduate of Johns Hopkins University and a proud alum of Sikkim Manipal University, India. She is an passionate about advocating for global surgery. She was born in the Himalayas and is a Gorkha to the core.

Twitter: @drsristisharma

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

 

Sepsis: A Surgeon’s Perspective

By Lillian Erdahl, MD

Around 1.5 million people suffer from sepsis and at least 250,000 die due to it each year in the United States. The majority of these individuals-7 out of 10-were recently treated in a healthcare setting and many of them have chronic diseases requiring frequent medical treatment.1 As a surgeon, I have witnessed how rapidly the process of sepsis can overwhelm a patient’s organ systems. Early, aggressive treatment of the infection and supportive care of the patient is not always enough to reverse the cascade of organ failure leading to death.

Watching a person get sicker despite doing everything you know how to do is both humbling and incredibly disheartening. With all the advanced technology and modern precision medicine we have, we are still fighting single-celled organisms that can kill us from within. I imagine all healthcare providers feel the pain of being unable to successfully intervene against a deadly disease. It never gets easier for me to tell a family that their loved one is getting sicker even though I am doing everything I can to treat his or her illness.

September is Sepsis Awareness Month which is a good time to talk about what we can do to prevent sepsis and sepsis-related mortality.

  1. Infection Prevention: A number of interventions in both healthcare and domestic settings can help with infection prevention. Basic hand-washing with soap and water prevents the spread of infectious agents from one individual to another. In the hospital, a number of interventions have been shown to reduce infections including central line catheter insertion protocols. Surgeons are often making decisions about when to insert and remove central venous or urinary catheters. We must recognize and commit to preventive measures each time we interact with a patient.
  2. Early Recognition of Sepsis: Recognizing sepsis early is the first step to early treatment. Early signs and symptoms include fever, chills, tachycardia, confusion, and shortness of breath. Patients who are immunocompromised may not manifest typical signs and symptoms, so a high index of suspicion is an important part of identifying sepsis in these high-risk patients.
  3. Early Goal-Directed Therapy of Sepsis: Early recognition must be followed by early goal-directed therapy in order to impact the mortality related to sepsis, especially in cases of severe sepsis and septic shock. There have been many studies of how exactly to manage sepsis and septic shock, but it is clear that early antibiotics, source control, and supportive therapies directed at maintaining perfusion and oxygenation improve mortality.2
  4. Education of Health Care Providers and the Public: The aim of Sepsis Awareness Month is to drive ongoing discussion and education on many levels. The CDC has a campaign which includes education on how to prevent, recognize, and treat sepsis. You can visit their website for resources that might be helpful during the month.3

References
1. Sepsis. Centers for Disease Control and Prevention https://www.cdc.gov/sepsis/index.html
2. Rivers E, Nguyen B, Havstad S, et al. Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med. 2001;345:1368-1377
3. Getting Ahead of Sepsis. https://www.cdc.gov/sepsis/get-ahead-of-sepsis/index.html


Lillian Erdahl practices Breast and General Surgery at the University of Iowa Hospitals and Clinics where she is an Assistant Professor of Surgery as well as the Iowa City VA Medical Center. Her career pursuits include medical student and surgical education as well as improving breast cancer prevention and diagnosis. She enjoys cross-country skiing, yoga, cooking, gardening, and traveling with her husband and two children.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

 

For When the Pipe Bursts

By Shree Agrawal

Approximately half of matriculated medical students identify as female with numbers in surgical training steadily increasing to potentially also account for half of postgraduate trainees. Unfortunately, these figures are still dismal for underrepresented minorities, who at the medical school level may, at best, represent one in twelve students. I can only hope this changes for my underrepresented peers in my lifetime as we continue to redefine the culture of medicine.

Within AWS and in medical training, the metaphor of “building a pipeline” represents creating greater access and entry to medicine among women and underrepresented minorities. In this context, I often wonder about the students and trainees who currently have the courage to enter fields in which the majority is homogenous. Advances in gender equality and diversity representation within other fields of medicine, such as pediatrics, OB/GYN, psychiatry, and geriatrics, has not yet translated to inclusion in leadership and academic positions. I believe mentorship is key to addressing this paucity of diverse role models.

This brings me to some of the great posts I have recently seen on Twitter about mentorship within academic surgery. My feed has been populated with retweeted clips, links, or visual abstracts from Dr. Caprice Greenberg’s address, “Sticky Floors and Glass Ceilings”, Dr. Keith Lillemoe’s address, “Surgical Mentorship: A Great Tradition, But Can We Do Better for the Next Generation?”, and “Characteristics of Effective Mentorship for Academic Surgeons: A Grounded Theory Model,” by Drs. Amalia Cochran, William B. Elder, and Leigh A. Neumayer. In 2017, I view these pieces to be the first sign of preparation for when the pipeline to surgery eventually bursts.

As more diverse medical students develop interest in surgery, dynamic and supportive mentorship becomes even more essential. From Drs. Cochran, Elder, and Neumayer’s work, four major themes for effective mentorship emerged: the need for multiple mentors at different points in a professional lifetime, mentors who provide strategic advising, who are unselfish in their attitude, and engage with diverse mentees. In addition to these basic principles, self-awareness of implicit bias and efforts to reduce its effect, as stated in Dr. Greenberg’s talk, is paramount in effective mentoring, especially of non-traditional mentees.

In medical school, this may translate to finding a mentor who is willing to meet often and create plans for successfully matching or perhaps engaging in academic research. An unselfish attitude may be a sincere interest in helping achieve one’s potential, regardless of institutional interests or personal/professional gains for the mentor. Finding mentors who engage with diverse mentees does not mean identifying faculty members who represent similar backgrounds, but finding someone who understands distinct challenges faced by students from wide-ranging backgrounds. A single mentor may not be able to espouse all of these characteristics, but finding individuals who can contribute in each area facilitates personal and professional development.

What are your strategies for identifying and establishing effective mentee-mentor relationships in your medical training?


Shree is a fourth year medical student at Case Western Reserve University, where she also completed her bachelors of science degree in biology. Currently, she is completing a clinical research fellowship in genitourinary reconstruction at the Glickman Urological and Kidney Institute at Cleveland Clinic and serving as the Chair of the AWS National Medical Student Committee. Shree is passionate about research surrounding patient decision-making and medical education. In her free time, she enjoys blogging for AWS, practicing yoga, and boxing.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

Golden August

By Camila R. Guetter

Created in 1992 by the World Alliance for Breastfeeding Action (WABA), the World Breastfeeding Week completed its 25th edition this year. During the first week of August, campaigns and partnerships take place in order to support and raise awareness on the importance of breastfeeding. It is an international effort that currently involves 150 countries.

This year, to celebrate World Breastfeeding Week’s 25th anniversary, the Brazilian government announced the expansion of this campaign from a single week to a whole month dedicated to the cause, the Golden August. Initiatives include public talks and events, community meetings, advertising on the media, and illuminating monuments and buildings with golden lights. All in an effort to spread even more knowledge and awareness about breastfeeding in Brazil.

The name “Golden August” relates to the fact that breastfeeding is the gold standard for newborn feeding. Compared to Pink October initiatives for Breast Cancer, it intends to make society aware that breastfeeding is a primary preventive measure for many diseases, for both mom and child.

As I  go through my OB/GYN rotation in medical school, I now understand the extent and importance of the benefits of breastfeeding. For mothers, breastfeeding contributes to postpartum weight loss [2,3]. It has also demonstrated risk reduction on ovarian cancer [4], endometrial cancer [5,6], and aggressive inflammatory and invasive forms of breast cancer [7,8].

When it comes to the newborn, breastfeeding plays an important role in the development of the dental arches [9,10], speech, and breathing. It is also a protective factor for allergies [11], infections [12,13,14], gastrointestinal illnesses [13] such as gluten intolerance, obesity [15], and reduces neonatal mortality [16]. Last but not least, it contributes to the effective bond between mother and child. Another recent blog by Nickey Jafari highlights more the benefits of breastfeeding.

Given all the well-known benefits of breastfeeding to both mother and newborn, the WHO recommends exclusive breastfeeding for at least the first six months after the birth of the newborn. Nevertheless, this practice still encounters many barriers worldwide, mainly due to lack of information. Globally, only 38% of newborns receive breast milk until six months of age. The goal set by WHO is to increase this number to 50% by 2025.

Discrimination and criticism over breastfeeding in public is still a major issue in Brazil. In this regard, the Golden August has partnered with public and private companies to empower their employees who are new mothers. Some companies now offer special rooms for breastfeeding, showing recognition of its importance. They offer private and adequate environments for mother-infant interactions and bonding as well as for pumping breast milk, if needed, during work hours. These conditions may lead to less work absenteeism as they improve the ability for women to return to their work routine more easily. They also maintain breastfeeding as a unique and special experience, as it should be.

Happy Golden August to all parents out there!


Camila Guetter is a fifth year medical student at Universidade Federal do Paraná, Brazil. In her third year, Camila received a scholarship to study at UCLA. Subsequently she became a research student at Beth Israel Deaconess Medical Center (Boston, MA) on pancreatic cancer, HPB surgery outcomes, and patient education materials. Camila is passionate about pursuing a career in academic surgery and is currently a Teaching Assistant for Principles and Practice of Clinical Research, a Harvard T.H. Chan School of Public Health course. She currently serves as International Representative for the 2017/2018 AWS Medical Student Committee. Outside of medicine, Camila enjoys playing tennis, playing the piano, and traveling.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

 

 

AWS Day of Service 9/9/17

By Simin G. Roward

Being a medical student is challenging: between studying, rotations and research, it seems there isn’t enough time for everything. Often, it’s easy to lose track of why we chose this profession in the first place. Community service and engagement are put on hold amidst other pressing responsibilities. The goal of the AWS National Day of Service is to designate a day on which medical students from all over the country would come together with residents and attendings and make service to others a priority.

The members of AWS are compassionate, humanistic leaders, who chose the field of surgery because of the ability to make lasting improvements in people’s health and to provide a vital service to communities. These positive characteristics were exemplified in last year’s AWS National Day of Service event, where students nationwide provided much needed services and donations to their community. These service events differed from state to state- some schools put on educational sessions with high school and middle school girls to talk about medical school or to provide mentorship to students from disadvantaged backgrounds. Other schools organized clothing drives to provide supplies for shelters helping domestic abuse survivors or immigrant .

Each service event was specific to the needs of the community: in Washington, students raised funds for a local non-profit organization after it had been broken into and vandalized. In Arizona funds were raised to provide pre-employment TB testing to refugee women. In Texas, cookies were baked with the residents of the Ronald McDonald house, and students in North Carolina helped girl scouts earn badges by teaching them First Aid. Students in DC spent the day packing meals at a local food shelter and Boston students volunteered at a clinic for the homeless.

The participating schools should be proud of the events they organized and the important contributions they have made to their communities. The spirit of volunteering and community service are well aligned with the mission of the Association of Women Surgeons. As the AWS day of service will become an annual event, each year will build on the strengths of the previous year. This year’s AWS National Day of Service is September 9th, 2017, please contact us for additional resources or questions about participating!

Pictures:

 

 

 

 

 

 

 

 

USUHS put together bags of food donations at Food for ALL

 

 

 

 

 

 

 

University of Texas Medical Branch  hosted a Valentines cookie baking event at Ronald McDonald house

 

 

 

 

 

 

 

Paul L Foster School of Medicine (Texas Tech-El Paso)-organized a clothing drive for Anunciation house, a migrant shelter

 

 

 

 

 

 

 

 

 

University of Arizona- Fundraising for pre-employment TB testing for Syrian refugees

 

 

 

 

 

 

 

Boston Chapter-Hosted a game night with patients from their clinic


Simin G. Roward is a recent graduate of University of Arizona college of medicine.  She is currently a general surgery intern at University of Texas at San Antonio and she is planning to pursue a career in pediatric surgery.  She served as the community service chair for the Association of Women Surgeons during the 2016 school year and began the AWS day of service event. Her interests include global health, running marathons, traveling and participating in community service.   

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

Breast is Best, Supporting Mothers Is Better

By Nickey Jafari

My rotation in obstetrics & gynecology (OB/GYN) was full of emotional moments, and the first time I witnessed a mom breastfeed her baby was one of my favorites; in a culture that so overtly sexualizes women’s bodies, it reminded me that breasts had evolved for the purpose of nurturing a new human life. Of course, breastfeeding is not always easy, and the decision to breastfeed is a deeply personal one for a woman. Mothers who are unable or unwilling to breastfeed should never be shamed for it. However, the health benefits for both mom and baby are plentiful. We should seek to strike a balance between educating people on the myriad of reasons to breastfeed, while not making women feel pressured to do so.

The World Health Organization recommends exclusive breastfeeding for at least 6 months and reiterates well-known benefits, such as reduction in gastrointestinal illnesses for baby, increased neonatal immunity to infections, and reduced newborn mortality. For mothers, the WHO states the reduction in risks of both breast and ovarian cancers as other reasons to breastfeed. Some of the contraindications to breastfeeding can be found here, and include galactosemia and untreated, active tuberculosis.

Given all its benefits, breastfeeding is a public health priority. The CDC Breastfeeding Report Card 2016 shows that most mothers do want to breastfeed, but rates of exclusive breastfeeding through 6 months are as low as 22.3% throughout the U.S. Barriers to Breastfeeding in the United States frames the issue of expectations on breastfeeding very well – “even though breastfeeding is often described as “natural,” it is also an art that has to be learned by both the mother and the newborn”. Thus, education on breastfeeding techniques, such as the best way to achieve a proper latch, should be provided to moms. Empathy and encouragement go a long way, too. I remember on my pediatrics rotation, when we would check in on our new babies, a lot of moms would get frustrated if the process was not going smoothly because of this societal expectation that breastfeeding is an easy and innate process from the get-go. I noticed some moms who gave up because they felt like, since it was not going well, they were failing at being a mom, and others who switched to formula soon after because they were worried about their baby getting enough nutrition. Their decision did not come from any selfishness, but genuine concern for what is best for their child, and thus I always get upset, as someone who does enthusiastically promote breastfeeding and its benefits, when I see someone judge a woman who does not; we have no idea what her journey was. A little encouragement from clinicians to new moms that it is also “natural” for it to take some work, that they are doing a great job and should keep trying, that their milk amount will continue to increase after the first few days of colostrum, can make a world of difference.

Overall, there are far too many impediments to breastfeeding to address in a single blog post, but in addition to better education to new moms by their clinicians, they include changing societal norms and expectations, increasing social and family support, and creating work policies that allow women to breastfeed. Grace DeHoff wrote about her journey into motherhood as a medical student and touches on breast feeding time commitments. A great post about experiences pumping as a surgeon mom can be found here. The fact of the matter is that “many women face barriers to breastfeeding; poor breastfeeding environments where women work, live, and obtain health care are among the biggest barriers” (read more here). One critical policy area where the U.S. lags far behind other developed nations is the issue of maternity leave. The Family and Medical Leave Act only allows for up to 12 weeks of unpaid leave. The AWS maternity policy for surgeons in practice can be found here.

We can and should promote breastfeeding while not making women feel less than as mothers if it is not the best choice for them. We should be especially careful about promoting “breast is best” if we are not simultaneously working to create more flexible work policies, change societal expectations for new moms, and provide the tools that can allow women the chance to successfully breastfeed!


Nickey Jafari finished her third year of medical school at the University of Kansas this past spring and is currently pursuing her Master of Public Health at the Johns Hopkins Bloomberg School of Public Health.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

Fireworks on the Fourth

By Cheyenne “Cassie” Sonntag, MD MS

Say it with me: the Fourth of July.

Just saying those words fills your mind with fond memories of watermelon, BBQ, and warm summer nights spent with family and friends lighting sparklers and setting off toy caps. It’s a familiar story, relatable to most who read this – but one unfamiliar to me. Sadly, I spent a large portion of my childhood living in locations with strict fireworks restrictions due to dry desert climates. As such, my firsthand experience with fireworks and firework safety has been limited to setting up a proper picnic space in the park to avoid being trampled in the dark while still maximizing one’s view of a public show.

I was determined that this year would be different. My relocation to the lush lands of Central Pennsylvania for surgical residency and a favorable call schedule (about time!) has finally afforded me an opportunity to experience that all-American Fourth of July fireworks fantasy.

Excited for my first Fireworks Fourth, I visited the Pennsylvania State Police website to find out exactly what shenanigans I could pull off within legal limits. To my disappointment, I discovered that state law (specifically Title 35, Chapter 13A) prevents the use of consumer or display fireworks without a municipality permit and purchase at a Department of Agriculture licensed outlet. However, my Summer of Sparklers was saved as further reading revealed that “ground and hand-held sparkling devices”, “novelties” and “toy caps” as defined by the American Pyrotechnics Association Standard 87-1 are actually designated “non-fireworks” and can legally be sold at convenience stores and tent stands.

Wanting to make sure I celebrate appropriately, I spoke with some of my co-residents about their experiences with fireworks to elicit product recommendations. While all expressed very clear favorites- from sparklers to bottle rockets- every person also related a “this one time” or a “just-missed” story as well. From a sparkler resulting in a singed pigtail and new haircut to a bottle rocket misfire that flew directly into a pile of unlit fireworks and sent a whole party ducking for cover, it was clear that even these designated “non-fireworks” could be extraordinarily dangerous. I certainly regret asking the opinion of a friend who incidentally spent the last Fourth of July on “hand call.”

The Consumer Protection and Safety Commission (CPSC) website and their Annual Fireworks Report estimated that in 2015, 11,900 fireworks injuries were treated by US emergency departments. Sixty-seven percent of these injuries occurred between June 19 and July 19, 2015, with children under 15 years of age representing a fourth of those injured. To my dismay, the report estimated that my beloved sparklers accounted for 1,900 emergency department treated injuries that year.3

It became clear to me that that the absolute safest way to enjoy fireworks this Fourth of July would be to once again set-up my picnic blanket and enjoy the public show. However, for those of you for whom the temptation to light a sparkler may prove just too strong, the following are a few resources with fireworks safety advice for all ages that are worth reading:

National Council on Fireworks Safety
National Safety Council

I wish everyone an amazing summer, and a safe and injury-free Fourth of July.


Cheyenne “Cassie” Sonntag, M.D., M.S. is a general surgery resident at the Penn State Milton S. Hershey Medical Center in Hershey, PA. Born in Colorado, she spent the formative years of her youth in Arizona before earning her B.S. in cell and developmental biology from UC Santa Barbara. Dr. Sonntag attended medical school at the Keck School of Medicine of the University of Southern California, where she also earned a Master of Science in Global Medicine. She is currently starting her second of two academic development/lab years a Penn State Hershey as a research fellow focusing on surgical simulation and surgical education. Cassie will be spending her Fourth of July once again observing the local public fireworks display, from a safe distance, on her picnic blanket.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

Life in an Instant

By Sasha Adams, MD

I am a multi-tasker. I thrive in chaos. Managing multiple projects, people, jumbled schedules – that’s when I’m on my game. And that’s a good thing, because I’m a surgeon, a wife, and a mother of 2 wonderful kids. I have an amazing husband who is an incredible stay-at-home Dad, but there is always more to do. So I multi-task: 2am waiting for my OR case to start, I jump on my phone and order diapers, confident that they will be delivered before we run out in 2 days. I check my emails (both work and home!) and rapidly respond while walking down the hall from the OR to my office. During morning checkout, I hear reference to a book I should probably read, and surreptitiously jump on my phone and order it for my Kindle app within a minute. Heading back to the office, I look at the calendar and notice the kids birthday party next weekend! Quickly I go online and order the gift so it’s delivered in time! All this while being on the go! Like I said, I thrive in chaos-#Ilooklikeasurgeon!! We live in a world where technology has made this possible: if you think of it – you can get it done, check it off your list, and move on to the next task. It’s all about instant gratification.

At work, however, I see a different kind of instant, and it is not gratifying. I’m a trauma surgeon so I see how in an instant, lives and families are changed forever. A moment of distraction while driving leads to an MVC, and they come to me, facing injury, or even mortality, the loss of loved ones, the shattered dreams of the future. I see the shock and pain in the eyes of the families that come wide-eyed to the ER, anxious and afraid to hear if their loved one is okay. As I tell them what has happened, I watch their well-planned, organized, happy world crumble around them. My heart breaks for them, and sometimes I cry with them. Some of their stories haunt me for years. In the Trauma Bay, there is no judgement, just resuscitation of the injured patient. But the stories unfold over the coming days. Yes – some are obviously intoxicated, but others seemingly innocent. Headed to /from work or dinner, some on the phone. “I never saw the other guy”, or “I just looked down for a second”. In 2014, over 400,000 people were injured from distracted driving, and over 3,000 were killed. 78% of them were on the phone, and although the “novice” drivers (15-19yo) get a lot of attention in the media, they are only 20% of the problem. The other 80% of us “experienced” drivers think we can just look down for a few seconds and we’ll be fine. But 4 seconds at 60 mph is the distance of a football field!

So as I drive to work this morning, my mind starts running – what do I have planned today – meetings, cases, appointments, catching up on the ever-behind notes, wondering how many emails are waiting for me. I should check on the patient from yesterday. The To-Do list grows as I quickly become preoccupied with my day before I even arrive. The multi-tasker in me is awake and on the move! Suddenly my phone notifies me of an incoming email. What could it be this early in the morning? Can’t be good. As I reach for my phone, one of those faces come to mind – a life changed in an instant of distraction. I see the faces of the family looking at their loved one in my Trauma Bay, damaged, hurt, with an uncertain future. The multi-tasker in me takes a breath and pauses. I put down the phone. Now is the time to focus on driving. I turn on the radio and sing along, enjoying the sunrise over the Texas landscape and my 20 minutes of off-the-grid peace while I watch carefully for the other drivers who don’t have the benefit (or curse) of knowing what can happen when they aren’t focused on the road around them.

The chaos can wait.


Dr. Adams is a Trauma Critical Care surgeon at the McGovern Medical School in Houston, TX. In addition to her clinical duties at the Level 1 Trauma Center, she runs the Surgical Clerkship for rotating 3rd year medical students, and is an inaugural Society leader and advisor for the McGovern Society, mentoring 8-10 students per year throughout their med school career. Dr. Adams’ research is focused on improving the care of geriatric trauma patients, through earlier identification of those at increased risk, changes to inpatient care practices, and early rehabilitation efforts to improve long term outcomes.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.

Knocking on the Door of Disparity

By Danielle Henry, MD

Before the end of National Minority Health Month, I am compelled to take the opportunity to talk about how a disease I’m passionate about affects black women – breast cancer. National Minority Health Month gives us another chance, outside of October, to focus on breast cancer’s impact on the black community.

After being introduced to the Sisters Network by one of my patients, I gained a greater understanding of breast cancer’s impact on the black community. During one of the events I attended, “Stop the Silence”, there were women who traveled from near and far who were currently battling breast cancer, survivors of breast cancer, loved ones of those who previously passed away from breast cancer and simply supporters coming together to raise awareness. Many admitted that cancer was a taboo topic growing up, and went on to share personal stories of struggles, triumphs, and loss due to breast cancer. As a part of the event, we also walked door to door asking to speak with the women of the household to share breast cancer facts and invite them back to the event site for free mammograms. This part of the event stood out the most, as it took an active role of going into the community instead of passively waiting for them to present to the clinic.

Below is a list of statistics shared during the walk, in addition to a few others, which resonated with me on the topic of breast cancer:

  1. Among black women, breast cancer is the most commonly diagnosed cancer and the second most common cause of cancer deaths.
  2. Although the incidence of breast cancer is lower in black women, they have a 42% higher mortality than white women.
  3. Only 52% of breast cancers are diagnosed at a local stage in minority women.
  4. Twenty-two percent of breast cancers among black women are triple negative (loss of receptors for estrogen, progesterone, her-2-neu), which behave more aggressively, have a poorer prognosis and lack targeted therapy.

I am motivated both by my experience with this grassroots event, as well as the overwhelming data that shows disparity in black women, to address and shed light on this disparity. With National Minority Health Month and this blog offering a prime opportunity to bring awareness, the rest of the months can be spent “Bridging Health Equity Across Communities”. Through the Office of Minority Health, you can find many resources for working with minority populations related to education, prevention and treatment strategies.

Resources:
www.cancer.org
https://minorityhealth.hhs.gov

#NMHM17


Danielle Henry is a chief resident at Orlando Health General Surgery Residency Program and currently serves as the administrative chief resident. She is planning to pursue her passion with a career in breast oncology after residency. She completed her medical degree at Florida State University and undergraduate degree in Applied Physiology and Kinesiology at the University of Florida. She enjoys playing soccer, a good game of scrabble and time at the beach. She also enjoys community service projects and mentoring medical students.

Our blog is a forum for our members to speak, and as such, statements made here represent the opinions of the author and are not necessarily the opinion of the Association of Women Surgeons.