About Silcenced Superheroes

I can’t help but look at this photo of myself in the OR, now many years ago, and think about how the face mask reminds me of a muzzle. The New Oxford American Dictionary defines “muzzle (v.) to prevent (a person or group) from expressing their opinions freely”. Surgical residency is full of this. The important thing is to keep your reflections and ideas tight to your chest. At the end of the day, everyone has to show their cards.

Check out Dr. Nisha Mehta’s reflections on being a woman physician in the 20 teens.

“Guilt is useless. Determination is important” – on being a physician with little kids.

Just as pregnant women are at increased risk of domestic violence, breast feeding healthcare workers are at increased risk of losing their jobs.

Do not despair, my friends. Change is on the horizon. Approaching faster than we think.

What Is It?

Case courtesy of A. Prof Frank Gaillard.

This is an example of arachnoiditis, or adherence of the lumbar nerve roots to the thecal sac. There are two primary etiologies of spinal arachnoiditis: infection and inflammation. Some patients have a history of spinal meningitis, others a history of prior spine surgery, intrathecal drug delivery or intrathecal hemorrhage. Patients can experience leg pain, sensory changes or motor weakness. When assessing for arachnoiditis, look for I) clumping or distortion of the lumbar nerve roots, 2) nerve roots adherent to the thecal sac resulting in an “empty thecal sac sign”, 3) nerve roots and thecal sac clumped together centrally within the spinal canal. Presently, there is no good treatment for arachnoiditis. Intrathecal drug pumps may help with pain.

What Is It?

Case courtesy of Dr. Alexandra Stanislavsky

This is a coronal CT demonstrating a left occipital condyle fracture. Condyle fractures usually occur from high energy, non-penetrating trauma to the head and neck. Of patients presenting with an occipital condyle fracture, approximately 63% will have other neurological deficits, usually involving CNs IX, X, and XI. There are three types of condyle fractures according to the Anderson Montesano Classification: Type I) minimal fragment displacement, Type II) associated with other basilar skull fractures, Type III) avulsion fracture with displacement of fragments.