Leaving a beautiful scar

first_imgWindsurfer Gonzalo Giribet and pianist Vijay Iyer have also been featured in Practice, a series of profiles zeroing in on the makings of performance.A surgeon’s knot seems a simple thing, tied to keep the insides in and the outside out.But a simple knot can be harder — and more vital — than it looks. A surgeon tying a knot isn’t like the rest of us tying our shoes, unless you sometimes tie with one hand or clutch your laces with surgical instruments.For physicians who’ve delved into the mysteries of loops, throws, and ears, square knots are routine and, with an extra overhand turn, become surgeon’s knots, less likely to slip. Only when they’re mastered can they be used in procedures, where knowledge of anatomy and disease are also crucial, where a knot too loose can cause a wound to leak and one too tight can kill the tissue it encircles.“I learned by practicing constantly as a medical student,” said Terry Buchmiller, an assistant professor of surgery at Harvard Medical School and Harvard-affiliated Boston Children’s Hospital. “The nurses would let us take the extra suture that wasn’t used during an operation. They’d always slide it to the medical student so we could grab it and go back and just sit and doodle [with it] and tie knots at home.” By now, the many steps behind a successful surgery — including knot-tying — are mostly second nature to Buchmiller, who specializes in the delicate work required on small children, newborns, and, when necessary, fetuses in the womb.But in the beginning, surgery was exactly as music had been.Growing up in Cupertino, Calif., Buchmiller first picked up the violin at 7, spending hour upon hour practicing the scales and finger positions. By high school she’d performed in two symphonies. She was a music major in college, practicing five or six hours a day to master a piece: the perfect placement of her fingers, the just-so angle of the bow, the bouncing arpeggio stroke, the tremolo’s fluttering repetition. As a member of the Longwood Symphony Orchestra, the memory of those sessions is more a feature of action than reflection.“At one point, in high school, I played three to four to five hours a day; during college, as a music performance major, sometimes five to six hours a day. So it was a tremendous amount of focus on that skill.”But it was a focus held in balance. Buchmiller had taken up her pediatrician on his offer to follow him around and observe his work. She was 15 when she saw her first surgery, at the University of California at San Francisco. She was always fascinated by the ability to fix what ailed people.“That interest never waned,” Buchmiller said. “I never had to decide what to do when I grew up.”‘You walk in and there’s a performance, that one-time performance for that patient.’Though the two may seem opposites, medicine and music have pulled her along instead of apart, Buchmiller said. The way of practice taught to her by music was mirrored in medicine: Break the complex down to its composite parts, learn those parts through intense practice, and then put them together into a greater whole.“The traditional way surgery and music is taught, the way that I learned both, was to focus on the individual building blocks, each individual skill, and then learn the big picture. Very scientific and very logical at the beginning and putting in the emotional part and the nuances only when your fingers know what to do, when your hands know what to do.”Even after years of performing general surgery, there was still plenty to learn, as Buchmiller realized when she arrived at Children’s Hospital in 1995 to begin her fellowship in pediatric surgery.“I could tie knots perfectly for a general surgeon, but now let’s try some on a baby. You’ve been through nine years of general surgery training and then you were told … well, that you had an opportunity to learn to be gentle all over again. That philosophy — because we do work on babies and children — that delicacy is paramount is something that is still ingrained in my head. Every time I go into the operating room, I still hear that voice from my mentor, and maintain a critical eye for not only my fellows’ and my residents’ hands, but mine as well.”But medicine is more than craft. The surgical skills that seem important to her today aren’t physical tricks or manipulations of the scalpel, but qualities of mind: focus and teamwork.“I think one is stamina. There’s no question that the ability to stay focused is a huge piece of surgery. This intense focus — I mean, hours can go by. Music may not [require] the same stamina, musical concerts are usually for a finite time, but I think the team-building skills are fairly similar.“Whether or not you’re the head of a surgical team in the operating room or if it’s just you and a pianist, or you as part of a symphony orchestra, it’s a team.”An operation requires a unit just as a symphony requires individual musicians. Each individual has to master specific skills, whether it’s administering anesthesia or playing certain notes, for the group to realize its goal.“If you really look at the way a conductor rehearses a symphony, they break the parts down and they drill [musicians] in the parts and then, only when we know the mechanics of it, can the conductor really be free to put the whole together to make the music, interpret the music,” Buchmiller said.“Our conductor’s always trying to embed in our … heads, ‘Please don’t wait until the last week to learn the notes because I want to make the music and I can’t make the music until you all really know the notes.’”Years of playing the violin helped shape Buchmiller’s approach to medical training.Then there are the notes of the operating room, individual acts by doctors and nurses and even by increasingly sophisticated machines, beeping and whooshing and tracing bright lines. These notes, punctuated, if all goes well, by the perfect knot, will never be played in quite the same way again, but the patient will live with them forever.“You walk in and there’s a performance, that one-time performance for that patient,” Buchmiller said. “You want the scar to be beautiful, because the kids are going to have that for, God willing, 70 or 80 years.”last_img read more

Female leaders doing ‘better job’ in virus crisis, says Lagarde

first_imgFemale leaders are doing a better job handling the coronavirus crisis, European Central Bank chief Christine Lagarde said Wednesday, praising them for their honest communication and for showing they cared.The differences in policies and communication were “quite stunning” in countries led by women, she said in an online interview with The Washington Post.”I am going to be extremely biased. I’m not going to be a central banker at this very moment but I would say that for myself, I’ve learned that women tend to do a better job,” she said. Lagarde, who is the ECB’s first female president, singled out German Chancellor Angela Merkel for praise.She cited Merkel’s science-based approach as an example of how “very honest, transparent” explanations on coronavirus data and infection rates helped members of the public appreciate why masks, social distancing and confinement measures were necessary.”It became very quickly sort of a common lingua franca, common knowledge that people would understand those scientific elements,” Lagarde said.The female leaders of Taiwan, Belgium and New Zealand had also “carried the water of bad news as well as the water of clear explanation and strong recommendations”, she added. Germany has weathered the coronavirus crisis better than many of its European neighbors, while Taiwan and New Zealand are considered success stories in the fight against the pandemic.By contrast, observers have noted that male, populist leaders like US President Donald Trump, Brazilian President Jair Bolsonaro and British Prime Minister Boris Johnson have struggled to contain the outbreaks in their countries.Former French finance minister Lagarde, 64, said leadership was about “being both responsible and accountable”. “It’s about caring as well… I think the caring dimension is something that [female leaders] managed to express well. And that was considered by viewers and voters probably as authentic.”center_img Topics :last_img read more

Baby cut from mother’s womb has opened his eyes

first_imgThe Chicago infant who was hospitalized in grave condition after being cut early from his mother’s womb has briefly opened his eyes the family is reporting.The family shared pictures of the moment on their Facebook page Sunday.Police say the infant’s mother 19-year-old Marlen Ochoa, who was 9-months pregnant at the time, went missing in April.An investigation later found that Ochoa had been communicating with 46-year-old Clarisa Figueroa on Facebook and that Clarisa invited her to her home with an offer of free baby clothes.Once Ochoa arrived to the home, Clarisa and her 24-year-old daughter Desiree Figueroa allegedly invited Ochoa inside and distracted her with photos of Clarisa’s late son. At some point Clarisa then grabbed Ochoa while her daughter used a cord so strangle her. Once Ochoa was unresponsive, Clarisa forcibly cut the baby from her womb and placed him in a bucket. She then called police and told them that she had just given birth and that the baby was not breathing.When authorities arrived, they reported that they noticed blood on Clarisa’s upper body, however, there was no other indication that she had just given birth.Investigators later connected Ochoa’s disappearance with Clarisa’s story when friends of Ochoa told authorities that she had been communicating with a woman online. Authorities then searched the Figueroa’s home and found Ochoa’s body in a trashcan with the rope still around her neck. A DNA test later proved that the infant who was brought to the hospital belonged to Ochoa.Clarisa and her daughter has since been arrested for the murder of Ochoa. Authorities also arrested Clarisa husband who they believed helped clean up and hide the body after the murder.Authorities reported that Clarisa told friends and relatives that she was pregnant and planned to raise Ochoa’s infant as her own after her 20-year-old son died of natural causes.Doctors are reporting that while the infant has opened his eyes, he still remains in grave condition and is still on life-support.last_img read more