Remembering My Time as as CardioThoracic n Vascular Resident :D

Obstacles Faced by the Resident

longer version n more pic in http://dickyscardiothoracicvasco.blogspot.com/

I have recently completed my cardiothoracic and vascular surgery (CTVS) residency. It not only taught me the techniques and art of surgery but also enriched me spiritually. T

The details of an ideal resident training programme will always be debated, and it’s not always possible to achieve the ideal. Residents will continue to expect many things from their course of instruction, and the demands of residency training will continue to create obstacles

Various hurdles and obstacles may arise in our lives; these may hinder our path of training. Most of them are either in the form of health and family related issues or at times various aspects of the hard and rigorous training which test the resident’s psychological strength. 

Nothing is more relaxing than a good sound sleep. Deprivation of sleep is a big enemy for all residents, but it is the call of the duty that keeps us awake for long hours. Residents should try to have a good sound sleep the night before their call day.

Almost all of us have one or another hobby, but most of us are not able to pursue it.

Reading popular books or magazines on technology of today or special reports on sports have a very positive impact on our thinking and behavior.

During residency which is difficult, demanding and exhausting, when the hours are long and days unpredictable, many times a negative thought comes into our mind. One might question why I chose this endeavor. But then thinking about the challenges, excitement, and rewards that lie ahead will help remind you that the choice was correct.

The whole idea of residency training should be not only to produce the best of surgeons but also the best of ‘humane’ surgeons. Let us all work together to accomplish this goal.

I will always be extremely grateful and thankfull to all my teachers who have always taught me the art and science of this specialty and encouraged me to realize my dreams. Many thanks to my great parents, sweet and caring wife and son, wonderful friends and colleagues, family members and all the staff of  the hospital who supported and loved me all throughout my CTVS residency.

Cardiothoracic surgeons are frequently given special respect. They are almost uniformly considered leaders among the surgical specialties. It will be our privilege to touch and mend the heart. The joys of being a Cardiothoracic and Vascular Surgeon will certainly greatly outweigh the frustrations and irritations that lie in the path of becoming one.

longer version n more pic in http://dickyscardiothoracicvasco.blogspot.com/

Creative Anti-Bullfighting Protest in Spain

Animal rights activists gathered in the Spanish town on Las Ventas, for a very original protest against the famous bull fights held there.
Organized by Equanimal, the protest had the participants strip to their underwear, lie down and cover themselves with fake blood, and corrida spears. It took place at the end of May and hoped to convince authorities that the Spanish people no longer support such a cruel and barbaric tradition as bullfighting.
The anti-bullfighting protest took place in Las Ventas because that’s where a large number of bulffighting events take place. Most bull fights are not even profitable anymore, they are sustain themselves through public grants

Kravmaga

Krav Maga (pronounced /ˌkrɑːv məˈɡɑː/; Hebrew: קרב מגע‎, IPA: [ˈkʁav maˈɡa], lit. "contact combat", "close combat" or "full contact") is an eclectic hand-to-hand combat system developed in Israel which involves wrestling, grappling and striking techniques, mostly known for its extremely efficient and brutal counter-attacks, as it is also taught to elite special forces around the world. ^[1][2] It was derived from street-fighting skills developed by Imi Lichtenfeld, who made use of his training as a boxer and wrestler, as a means of defending the Jewish quarter during a period of anti-Semitic activity in Bratislava^[3] in the mid- to late 1930s. In the late 1940s, following his immigration to Israel, he began to provide hand-to-hand combat training to what was to become the IDF, developing the techniques that became known as Krav Maga. It has since been refined for both civilian and military applications.^[4]

Some refinements include, but are not limited to, the incorporation of elements from traditional Asian martial arts.^[1]
Krav Maga has a philosophy emphasizing threat neutralization, simultaneous defensive and offensive maneuvers, and aggression.^[5] Krav Maga is used by the IDF Special Forces units and several closely related variations have been developed and adopted by law enforcement and intelligence organizations, Mossad, Shin Bet, FBI, SWAT units of the NYPD^[6] and United States Special Operations Forces. There are several organizations teaching variations of Krav Maga internationally.^[7][8][9

What is Minimally Invasive Cardiac Surgery Anyway?

Minimally invasive clearly means many different things to different people. Some people are obsessed by small incisions, to achieve surgical success then they may need much longer bypas times. Others are obsessed by off-pump surgery, in return they may need much larger incisions to achieve adequate re-vascularisation. Do we really understand the trade-offs? Is an on-pump strategy with a very low blood product useage actually worse than an off-pump strategy in a unit that doesn't cell save and therefore has a higher transfusion rate. (yes it is true, you can be on-pump and still have a very low blood product useage. You do have to CARE about your transfusion levels though!) I have been struck looking at photographs of lower hemi-sternotomy that you can achieve, with care, a full sternotomy through the same skin incision. It is difficult but you can do it. Do we all wear headlights? I find it very difficult to use a small incision without a headlight, the corollary could be no head light therefore big incision, could it not?

We have to remember that we do live in a competitive world, cardiologists and patients are pushing us down routes that we consider might not be in the best interests of the patient. Outcome, survival and long term quality of life must be our drivers. Where we do things well we must market. If we truly believe in what we do then we must take up the challenges to demonstrate that what we do, be it, on or off pump, maximally or minimally invasive is of the highest currently attainable quality, but that we continue to strive to improve. If there are problems that we have not yet solved then we must solve them. At the end of the day we will have to transform our skills to meet the challenges as they arise, always realising that we must keep improving as cardiac suregry develops.

Easy "The Commodores"

Know it sounds funny but I just can't stand the pain
Girl, I'm leaving you tomorrow
Seems to me girl you know I've done all I can
You see I begged, stole and I borrowed ... yeah ooh

Ooh, that's why I'm easy
I'm easy like sunday morning
That's why I'm easy
I'm easy like sunday mooooooooorning

Why in the world would anybody put chains on me?
I've paid my dues to make it
Everybody wants me to be what they want me to be
And Im not happy when I try to fake it yeah

I wanna be high so high
I wanna be free to know the things I do are right
I wanna be free just me oh baby uh

Me

A husband ,father of a son, CardioThoracic & Vascular Surgeon with special interest in Cardiovascular medicine/surgery, Trauma and Critical Care ,freelancer natural/landscapes photographer ,and a practisioner/trainer of realictic combat/self defense

First touch to self defence in 1980 in the art of Koga Ninjutsu.. Going every where from east to east.. and have a heart on realistic application of combat/defense.

Muaythai .. king of martial art simply just because the techniques so simple, & so adaptive

First touch a living human heart in 2003.. falling on it ever since. Still try but still confuse to understand this beating organ

Nothing coud replace my love to it.. and then came.. minimal invasif procedures.. thank God

First touch to F-1 Canon in 1988.. and be a canon freak ever since. Complete the manual & digital course in 1990 ,National Geographic. Love to take human, but put non human as a favorit object

15 - 50mm & 75 - 300mm.. always in my NG bag

Photoshoper never work best with me, keep as minimum,keep as nothing

Husband ,Father ,Surgeon ,Photographer ,Fighter ...... to be continue