If you, like me, live in Arizona, you are exposed to intense solar radiation nearly all year, but especially in the summer.  Exposure to solar radiation is one of the major risk factors for melanoma. Melanoma is a cancer, which most often appears on the skin.  It is a cancer of the melanocytes, the cells that produce brown pigment.  It can appear anywhere in the body there are melanocytes.  The most common area affected, other than the skin, is the eye. Melanoma is forty times more common in whites than in blacks.  Men are more likely to develop it than…

The surgical stapler is an important tool.  Rather than spend substantial time sewing body parts together during abdominal, thoracic or bowel surgeries, surgeons can use a stapler to close up wounds and attach body parts.  Removable staples are also used to pull together scalp wounds or other skin wounds under tension.  On the other hand, if the stapler malfunctions, it can cause grave damage to the patient up to and including death. For many, many years the Food and Drug Administration (FDA) has maintained a public database of reports of problems with medical devices.  The database is called Manufacturer and…

“Time is brain” is what neurologists and neurosurgeons say to emphasize the importance of seeking prompt treatment in the event of a stroke. There are two types of strokes and they can both be terrible.  The first type is the hemorrhagic stroke. As its name implies, it occurs when a blood vessel in the brain begins to bleed.  Sometimes, the bleed can be small but, at other times, it can be a full-on hemorrhage.  Blood is very irritating to the tissue of the brain.  Its presence can damage the brain and prevent it from functioning properly.  It can cause other…

It is late May 2020 in the Imperial Valley of California.  The sun is high and hot.  Temperatures exceed 110 degrees.  The Novel Coronavirus is also running hot.  The only two hospitals in the entire Imperial Valley are swamped with sick Covid patients.  They have more patients than they can possibly treat.  They need to find hospitals that can take some of their patients.  When they call other Southern California hospitals, they find some are more interested in making sure they get paid than they are in helping out in a time of need.            …

I am sure most of you remember the children’s game of Telephone.  You get a group of people and the first tells a secret to the second.  The second repeats the secret to the third person, who tells it to the fourth and so on until everyone has been told.  Then you compare the secret the first person told with what the last person was told.  There is almost always a big difference.  The message gets garbled and mangled as it goes from person to person.  Like it or not, the game of Telephone accurately describes what happens in your…

The Caesarian section can be a life saver for both the mother and her baby.  There are a number of conditions which can develop during pregnancy or during the delivery process which require that the baby be delivered by C-section.  Among them are shoulder dystocia, fetal distress, failure of the labor to progress, malposition of the baby and a baby too large for the pelvis of the mother.  But Caesarian section is not risk free and the evidence is that it is being used when it is not necessary.  This is a serious problem. So what are the risks of…

One consequence of our lengthening life spans is that we are wearing out our original equipment.  Our knees and hips were not intended to last 60 or 70 years.  They certainly weren’t intended to support the heavy bodies so many of us now have.  Our remote ancestors were lucky to have anything at all to eat.  You didn’t find any fatties on the savannas in prehistoric Africa.  All of this has made joint replacement, especially hips, an important and lucrative field for orthopedic surgeons. The hip replacement is a wonderful surgery.  It has improved the lives of many people who…

For quite a few years now, we have been bombarded with references to “pre-existing conditions.”  All politicians seem to promise that they will protect the voters from losing coverage for pre-existing conditions.  A review of the record and of the facts of insurance coverage show that many of these politicians are not telling the truth.  In order to understand the issue and to determine who is telling the truth and who is not, a brief review of the elements of insurance is in order. Insurance is a means of spreading the risk.  For example, we know that a certain number…

There are certain events which are never supposed to happen.  They are called “never” events.  One of them is the foreign object left behind in the body of the surgical patient.  Prior to the adoption of procedures and checklists requiring multiple counts of instruments and sponges, this used to be a more significant problem.  Today, this complication occurs only once in many thousands of surgeries. A lot of thought has gone into preventing foreign objects from being left behind at surgery.  In the first place, all surgical instruments and sponges are counted before the surgery begins.  They are counted again…