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PRODUCED BY AND FOR MEMBERS OF THE DEPARTMENT OF SURGERY December 2015 | Archived Issues

FDA Warns About SGLT2 Inhibitors, Contrast Media

Pharmacy Focus

A review by the U.S. Food and Drug Administration has resulted in additional warnings on the labels of sodium-glucose cotransporter-2 (SGLT2) inhibitors about the risks of too much acid in the blood and of serious urinary tract infections. Also, the FDA is advising that rare cases of underactive thyroid have been reported in infants following the use of contrast media containing iodine for X-rays and other medical imaging procedures. 


Mark Your Calendar


Surgery Grand Rounds

Click the "read more" to see information about upcoming Surgery Grand Rounds.


Grand Rounds

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Education Schedule

Click the PDF links below to see the Department of Surgery's education schedule.

Education Schedule - December 2015 (PDF)  


Surgery Scheduling

Click the "read more" for hours and contact information for surgery scheduling.

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A Skill for the Year Ahead

By Harry C. Sax, MD
Professor and Executive Vice Chair, Department of Surgery

Columns around the holidays often focus on the accomplishments of the past year and hopes for the next 12 months. We certainly have much of which to be proud, as well as personal goals for next year.

At the same time, this year multiple aspects of our world are in disarray. From the uneasiness of our own security, to a volatile economic environment, to increasing scrutiny of how we care for our patients, it would be easy to become discouraged. It may seem that we will never again see "the good old days." Yet, mankind has endured multiple challenges over the years and, especially in medicine, there is a quality that guarantees our success:

Resilience.

Today we hear of resilience in the streets of Paris and the women's schools in Afghanistan. As healthcare providers, every day we see the inherent resilience of the human body and spirit. We drive blood counts to close to zero to eradicate leukemia, then give a small aliquot of normal cells to engraft and bring a patient back from near death.

Daily, surgeons induce significant trauma on a human and the body heals our interventions, restoring health. We can all recall specific patients who required multiple procedures and therapies and refused to give in to their disease, as well as those who failed after what seemed like a minor intervention. The difference is resilience.

Resilience isn't limited to patients. Providers are exposed to some of the greatest joys and the deepest depths of despair imaginable. We commit to extended periods of training, often in lieu of sleep or other basic needs, in an effort to gain the skills to provide the best possible care to our patients. As we practice, we often have our decisions questioned by those who have never been in our situation. Economic factors are changing rapidly, and what worked before may now not. It would be easy to get discouraged and become passive.

Yet we don't, because a basic tenet of the surgical mindset is to move ahead in the face of adversity. From the first day of internship, we honed our resilience, and these skills will carry us forward. When times become even more challenging, there are additional steps we can take to succeed and focus on a fulfilling career and life. I certainly don't profess to have all the answers, but from both my own experiences and that of experts several facts are clear.

  • Connections are key. Nurture relationships with your colleagues, family and friends outside of medicine. Get involved with a civic or faith-based organization. Be willing to accept help from others.
  • Change is a part of living. We would never have seen the advancements in medicine if it weren't for the willingness to change from pre-existing dogma. We may find that certain goals are no longer attainable, yet new and different opportunities open up. To try to change things over which you have no control is a sure formula for failure and frustration. Wisdom comes from knowing what you can control and change and accepting what you can't.
  • You must take care of yourself. What we do is physically and emotionally taxing. Find a physical activity that you enjoy and commit to it regularly. Take the time for self-reflection. Thinking through situations ahead of time makes them less stressful when you are confronted with them and builds resilience.
  • Try to maintain a hopeful outlook. In a Scandinavian study that Bruce Gewertz, MD, commonly cites, optimistic people lived longer than an age- and health-adjusted cohort of those with a more pessimistic outlook on life. Focus on what you see as your goals rather than the things that you fear. As you solve problems, you will begin to trust your instincts and see the glass as half full.
  • Remember that this too will pass. Often in the midst of a crisis we are subjected to highly stressful events. We may feel that whatever mistakes we made are now insurmountable barriers. Resilience grows with recognizing that there will be a future and circumstances will improve. One of the benefits of age is that you will experience this cycle more than once and a predictable rhythm develops.
  • Don't be afraid to reach out. It is no surprise that the holidays have higher rates of depression, suicide and substance abuse. Often the things we've lost become more real when we aren't with family and loved ones. The inevitable year end self-reflection can spin into dysfunctional thoughts. As healers we often don't allow ourselves to accept help. True strength is knowing when you are vulnerable.

In these challenging times, I am firmly convinced that there will be tremendous opportunity to find greater strength and resilience both within ourselves and as a community.

Every best wish for a healthy, happy, and fulfilling new year.