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Norman Bethune
Norman Bethune was a surgeon, medical inventor, tumultuous romantic, and advocate for the poor.
Book
The Mental Health of Minority and Marginalized Young People
In the next few years, my children will enter an important stage of their education and development, where they will learn how to build friendships, deal with problems, and lay the foundation of a personal values system. They and millions of their peers will start down the path to adulthood—each path different and filled with potential challenges. As a parent and as a physician, I am deeply concerned that some of the challenges and obstacles that this generation of young people face—the ubiquity of technology platforms, loneliness, economic inequality, and progress on issues such as racial injustice and climate change—are unprecedented and uniquely hard to navigate. The impact that these challenges are having on their mental health—their emotional, psychological, and social well-being—is devastating.Mental health is an essential part of overall health. It not only affects the ability of young people to succeed in school, at work, and throughout life but is critical to their overall well-being and to the health of our nation. Even before the COVID-19 pandemic, mental health challenges were the leading cause of disability and poor life outcomes among young people, with up to 1 in 5 children and adolescents aged 3 to 17 years in the United States having a reported mental, emotional, developmental, or behavioral disorder.1 Many mental health challenges first emerge early in life, and studies suggest that the average delay between the onset of mental health symptoms and treatment is 11 years.
Journal Article
The Value of Worker Well-Being
On average, employed US adults spend more than half of their waking lives working or engaging in work-related activities. The time spent at the workplace, the tasks performed there, and the work environment all affect overall health. We know many colleagues for whom their job is a great source of joy and fulfillment. They are passionate about their work and derive from it a strong sense of purpose and connection to others. However, we have also seen people working long hours under stressful conditions, which makes it difficult for them to spend time with their families and friends, balance work and non-work commitments, and pursue hobbies and other interests. Many are fatigued and some are burned out, which, in the case of medical staff members, can lead to serious medical errors. In this article, we discuss how work can influence an individual’s well-being and describe strategies that employers can use to help improve employees’ happiness and wellness.Traditionally, the discipline of worker health or occupational safety and health has focused on worker exposures to various workplace hazards. The field’s scope has broadened with time to include the concept of worker well-being, or the ability of people to address normal stresses, work productively, and achieve their highest potential.
Journal Article
Thoracic surgeons have better outcome profiles following esophagectomy: an ACS-NSQIP study
Summary
Background
Esophagectomy is still a complex operation with high morbidity. Controversy exists regarding the influence of a surgeon’s training track on perioperative outcomes. We aimed to investigate 30-day surgical complications for esophagectomy patients based on operations performed by thoracic surgeons compared to general surgeons in the ACS-NSQIP database.
Methods
Using the NSQIP targeted database, we analyzed patients who underwent esophagectomy between 2016 and 2021. These patients were categorized into two groups based on whether thoracic or general surgeons had performed the operation. Multivariable analysis was used when comparing 30-day perioperative outcomes between the two cohorts controlled for preoperative factors, including demographics, comorbidities, surgical approaches, neoadjuvant therapy, tumor staging, and pathology.
Results
A total of 3927 esophagectomy procedures were performed by thoracic surgeons, while general surgeons conducted 2855 cases. Procedures performed by thoracic surgeons had lower pulmonary complications (19.28% vs. 19.93%; aOR = 0.865;
p
= 0.03) and anastomotic leaks (14.82% vs. 15.9%; aOR = 0.855;
p
= 0.03) but higher bleeding events (11.36% vs. 9%; aOR = 1.335;
p
< 0.01) and reoperation rates (18.82% vs. 12.85%; aOR = 1.552;
p
< 0.01). Further, thoracic surgeon cases had a shorter operation time (358.9 ± 132.5 vs. 393.6 ± 139.7 min;
p
< 0.01).
Conclusion
Considering that pulmonary complications and anastomotic leaks are among the top three causes of mortality following esophagectomy, that antithrombotic therapy is the most significant risk factor for bleeding complications (as opposed to technical issues), and that general surgeons are less inclined to manage postoperative leaks through reoperations, thoracic surgeons may exhibit a more favorable outcome profile in esophagectomy. These differences should be properly addressed in the training of thoracic and general surgeons.
Journal Article
Food Insecurity
Here, Murhy discusses food insecurity as a public health issue. Food is a basic human need, and in food-insecure households, the need for food competes with the need for other basic human necessities such as medication, housing, utilities, and transportation. As food budgets are stretched, they may become barriers to adopting nutritious diets, which makes following recommendations in the 2015-2020 Dietary Guidelines for Americans a challenge for many people. Food security is a top public health priority for the nation. To promote more food security in American households, all must leverage multisectoral approaches across government, nonprofit, health care, and research to study and scale effective strategies.
Journal Article
The US Public Health Service Commissioned Corps Response During COVID-19
Three years into the COVID-19 pandemic, we honor and recognize the valiant and enduring service and sacrifice of the US Public Health Service (USPHS) Commissioned Corps and their families to our nation. As America’s health responders, Public Health Service officers defend our nation’s public health against threats large and small.1 Today, approximately 6000 Public Health Service officers support our nation around the clock.2 Through natural disasters, disease outbreaks, global public health emergencies, and humanitarian missions, they have stood by us and served in the midst of great suffering and loss.I was blessed to have the opportunity to join the USPHS Commissioned Corps in 2014, when I was sworn in as US Surgeon General, and again for a second term in 2021. It has been a great privilege and honor to serve alongside our officers and to immerse myself in the rich history of our service. My hope today and well beyond is that we celebrate their achievements while reaffirming our organizational and societal commitment to caring for them, as they continue to care for us all.
Journal Article
Matchless Organization
The essential reference about a surprisingly well-organized medical department Despite the many obstacles it had to overcome--including a naval blockade, lack of a strong industrial base, and personnel unaccustomed to military life--the Richmond-based Confederate Army Medical Department developed into a robust organization that nimbly adapted to.
eBook