Today, when I was assisting a surgical resident in the Philippine General Hospital do a thyroidectomy (part of my surgical education program), a medical intern who was also assisting in the operation, asked me, “sir, what or who do you consider as a good surgeon”?
I tried to recall what I wrote before and answered her. Aside from answering her directly, I promised that I will retrieve my writing before and send it to her.
Here it is – retrieved it – a 2018 writing. I still maintain my answers. However, I will add another quality which I told the intern today. The surgeon must have a patient-centered care management quality. I will provide links to my writings on patient-centered care management. See below.
Here are some qualities that I admire in surgeons when they do their operations in the operating room (with the assumption that the outcome is good and there is adequate anesthesia):
Finesse
Speed and without too many unnecessary moves
Decisiveness
Cost-effectiveness
Here are the some qualities that patients usually admire surgeons when the latter do procedures when they are awake (with the assumption that the outcome is good and there is adequate pain control):
OLETE stands for Online Learning cum Evaluation Test Exercise.
Basically, OLETE is an online test and/or exercise that has for its objectives the simultaneous promotion of learning and evaluation of the learners or students. Between the two objectives, promotion of learning is intended to be more important in my design for the OLETE. The evaluation is intended to be more of a self-evaluation of the student to reinforce his learning. Although the teacher-facilitator can use the OLETE to evaluate the pretest competency status (as will be reflected in the first attempt) and achievement in the subsequent attempts of the students, it is not the intention in the design of the OLETE to identify which students to flank or which to recognize. The goal is that all the students get the perfect score at the end of the OLETE which in turn assumes that they all have achieved the learning objectives using the test and/or exercise as the evaluation tool.
History:
Over the years, I have been trying to find an efficient way of education for all staff of a hospital or of a class. I thought of OLETE in July 2011 and then concretized the concept in July 2012 when I used it in Manila Doctors Hospital when I conducted a seminar on crisis communication management. In September 2012, I used OLETE for Ciudad Medical Zamboanga, another hospital I was helping. I used it in the National Training Course for Safe Hospitals in Sri Lanka on September 22 to 24, 2014; in Zuellig Family Foundation’s Maternal Death Control Program in Zamboanga Peninsula in 2015-2016; in Salubris Medical Center in 2016; in Zamboanga City Medical Center Earthquake Business Continuity Program in 2017; in UP College of Public Health and UP College of Medicine; in my Patient Empowerment Program; etc. As of 2022, I still use it.
I will continue to use it using an Internet freeware (I have used QuizStar in 2016 and Google Form – I have confined myself to Google Form).
I personally think the OLETE offers an efficient educational strategy in organizations and hospitals in which one can be confident, if not assured, of learning of all staff with minimal cost and loss of time from services.
Here are the rationales of the OLETE:
There is active learning just by answering the questions in the test and/or doing the exercise.
There is enhancement or reinforcement of learning by repeating the test and/orexercise until a perfect score is attained.
Simultaneously, there is evaluation of baseline knowledge and subsequent ones.
All the abovementioned activities are done online for efficiency purpose – quick feedback on the correct answers and quick knowledge of results of the test and/or exercise.
There are several advantages of the OLETE over a traditional paper-and-pen test and /or exercise.
Lesser cost – no paper and ink expenses; lesser human resource needed for checking the test and /or exercise.
Minimal loss of time from services (of hospital staff who need to man the posts) as they can take the OLETE during off-duty hours.
Ensure that all students achieve all the intended learning objectives through a perfect score. In the traditional testing method, the teacher-facilitator usually does not have a good follow-up on the items which were not correctly answered by the students.
Can facilitate the re-certification processes (can be used again with some modification if needed as a re-certification test after 2 to 3 years).
Ease of documentation and archiving of the test and /or exercise and its results.
For all the reasons that I presented above, I am advocating the use of OLETE as an educational strategy in organizations and hospitals to ensure maximal and efficient learning of all staff in the knowledge domain. The OLETE is not designed for learning cum evaluation of skill competency. However, it can complement the skill learning and evaluation if formulated in the style of a “table-top exercise.”
These past 3 nights, I attended novena mass for the dearly departed through Zoom. On the first night, the sound system was bad. I commented and gave advice to the people in charge. I have learned the trick after I attended a zoom necrological services of another dear friend in June 2022. The sound system was also bad.
This is the trick.
Place a gadget (android phone, Ipad, or laptop with zoom) from afar to have a view of the event. Mute this gadget. See 1st picture frame below.
Have another gadget and place it near the speaker or microphone. Unmute the zoom app. This is where the sound with go through. See 2nd picture frame below. The sound should be clearly and loudly heard.
In this particularly event, there is a choir singing during the Mass. If one wants to hear the singing of the choir clearly and loudly, one may place another gadget near the choir. Unmute the zoom app to catch the sound of the singing choir. Just make sure there will be no echo between two unmute zoom apps (one for the singing choir and one for the priest). If there is, one has to mute the app not been used. Example, during the choir singing, unmute the apps near the choir and mute the apps near the priest. When the choir is not singing, mute the apps near it and unmute the apps near the priest.
There are so many ways of keeping the hard copies of medical records by patients.
Here are just some samples.
In the end, it is the choice of the patients and/or relatives. What is most important is to keep them and safeguard them.
Some, a few, will make a summary and keep.
As I said, in the end, it is the choice or call of the patients and/or relatives on how they will keep the hard copies of the medical records. What is most important is to keep them and safeguard them.
Saw the following post by Dr. Alex Cerrillo from Zamboanga City.
I responded / commented in his Facebook.
Make my day!
I hope to hear more of this story in the future.
My advocacy – Compassionate Humanitarian Program – saving Filipino patients from unnecessary breast surgery – part of my Patient Empowerment Program also.
Reflection again – at age 73 and a half – June 24, 2022
Recalling this statement in Desiderata: “Take kindly the counsel of the years, gracefully surrendering the things of youth.”
There are so many technological advances in medicine and surgery that I honestly cannot really cope up with anymore. In the surgical world, there are so many new machines, new equipment, new instruments, and new technical procedures. Again, honestly, I don’t plan anymore to learn how to operate with these new technology.
I will gracefully surrender to the younger surgeons the technological advances in surgery, which is my specialty.
I have resolved to limit myself to and be contented with continuing and refining the principles and processes of contained in my ROJoson Patient Management Processes – offering medical and surgical services including advice that are rational, cost-effective, compassionate and patient-centered that can withstand the test of times despite the technological medical advances.
There are two other quotes which I like to remind myself of in this regard:
“I am in competition with no one. I run my own race. I have no desire to play the game of being better than anyone, in any way, shape, or form. I just aim to improve, to be better than I was before. That’s me and I’m free.”
ADVICE ON RETIREMENT Don’t switch off and be idle when you retire. You can still do things that are of interest to you, or you can get involved in things that are of value to your community, all at a pace you feel comfortable with.
May 8, 2022, 0745 am, when I was about to do my daily walking exercise, I saw a foot of a black cat in a box of shredded papers which we have provided as one of the resting abode of cats in our garage. There was no attached body.
At that time, I was wondering whose foot was this. I surmised maybe from a black kitten whom I have not seen for almost 2 days. I was wondering what happened to him or her – run over by a car on the street? I had to look at the street when I walked to get the answer.
I went about my walking exercise for about one hour (more than 3 kms) in the neighborhood streets. I did not find any scene of a cat being run over.
When I came back home from my walking exercise, when I was about to get equipment to do some gardening, I suddenly saw in another part of the garage a black cat “mutilated” with head practically detached from the trunk; with intestines exposed; with mangled feet; with some the flesh eaten out; etc. The “corpse” looked fresh, most likely “mutilation” occurring only recently (early morning or last night). A really gruesome picture of a dead cat. I identified the cat to be the small black kitten that I have not seen for 2 days.
I will not post the gruesome pictures.
My question: who killed the kitten? Is it another cat (the mother) or is it a big rat?
I searched the Internet. Yes, sometimes, an adult cat can kill a baby cat for survival. Yes, too, big rat can kill a baby cat. So which is which in this case?
I surmised it is the mother cat who mutilated and ate part of the body of the kitten. In the past, I have seen this mother cat brought to the garage a small chicken roaming in the street and ate it. In other occasion, she ate a dead bird. This cat is capable of eating other animals. Why a cat and not a rat? One, a leg of the dead kitten was in another area while the rest of the body in another area. I have experienced seeing different parts of the mutilated “corpse” scattered in different areas by this mother cat. Second, the fleshy parts have been eaten and devoured. Third, the body has been mutilated and mangled. I don’t think the rat will do all the above. The biggest rat that I have seen in the neighborhood is only one fourth of the size of kitten that was killed. The rat might bite and killed the kitten. It will take some time and effort to mangle the whole body and without being seen by the other cats in the garage (about 3 of them). The extensive devouring of the dead kitten would take some time, probably about 30 minutes. I don’t think the rat can do this especially in the early morning. Rats usually work in dark places.
Why would a mother cat eat her baby kitten? At first, I cannot believe she can do it. This mother cat has about 3 pregnancies in our garage. After delivery, she would take good care of her babies until they are independent already. She had a track record of providing motherly nursing care. That’s why I cannot believe it. After searching the Internet, knowing that she could, I started asking why? For survival? She wanted more foods to eat? Also in the past week, I noticed the black kitten to be “weak.” She might have died last night. After dying, the mother devoured her. This is another possibility.
I don’t know. I don’t have the exact answer.
I am doing this narration for my mental exercise – practicing writing a journal and trying to understand mysterious things in this world – to maintain my cognitive ability.
To those who read this, you are welcome to give comments. Thank you.
May 1, 2022 – Labor Day and Feast of St. Joseph the Worker
Today, May 1, 2022, and every May 1 of each year, we celebrate Labor Day as well as the Feast of St. Joseph the Worker.
Today, I meditate on the value of HARD WORK and LABOR as taught by the Bible, St. Joseph and other wise people.
If you are poor, work. If you are burdened with seemingly unfair responsibilities, work. If you are happy, work. Idleness gives room for doubts and fears. If disappointments come, keep right on working. If sorrow overwhelms you and loved ones seem not true, work. If health is threatened, work. When faith falters and reason fails, just work. When dreams are shattered and hope seems dead, work. Work as if your life were in peril. It really is. No matter what ails you, work. Work faithfully-work with faith. Work is the greatest remedy available for both mental and physical afflictions.
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