The Wicked Problem of Surgical Failure
Or: Why the Best Surgeons Cannot Escape Variance, and What That Teaches Us About Learning in Complex Systems 1. The Ether Dome and the Statistician On October
Writing
Essays on surgical failure
Signed posts on variance, training, guilt after a complication, and why a single outcome cannot grade a surgeon. The full list is on the blog.
The Endless Residency
Why Surgical Training Never Really Ends 1. A Simple Procedure Early in my residency, I placed a suprapubic tube. It is a routine procedure, the sort every
The Paradox of Becoming Better at Surgery
Why a surgeon's numbers get worse as the surgeon gets better: case mix, Simpson's paradox, the Knicks' last shots, and a standard that never settles.
The Red Beads
A single complication cannot grade a surgeon. Deming's red beads, M&M, and why surgical quality lives in the distribution, not in one bad outcome.
Master the Eggs
Mastery means knowing which details carry the operation. A lesson from the bedside, where a missed step nearly put a patient on the floor.
The Second Cut: DeBakey, the Shah, and the Hubris of the Comforting Explanation
1. The Legend, the King, and the Hostile Abdomen On March 28, 1980, in a military hospital on the banks of the Nile, Michael DeBakey removed a spleen the size