Tunnels Found

Presidio, TX - 5 Mexican nationals were killed this morning emerging from a tunnel opening within the city of Presidio today. Police say the individuals, armed with rocket propelled grenades and automatic weapons, were confronted by two local farmers returning from the downtown market in the area of the mall. Emerging from the tunnel at the edge of the parking lot, a gun battle ensued when farmers John Smith and Bob McCall saw the men, dressed in camouflage, exit the tunnel opening.

Armed with 2 shotguns in the rifle rack of Mr. Smith's F250 Ford pick up truck, the farmers held the Mexican nationals at the tunnel exit until police arrived 4 minutes after the 911 call from Mr. McCall. Texas Highway Patrol, country deputies and city police responded with enough firepower to neutralize the invaders at the tunnel exit. All of the armed Mexican nationals were killed and no injury was sustained by the farmers or responding law enforcement officers.

During the gunfight that lasted approximately 15 minutes, the surrounding area including 2 schools and the mall were placed on secure lock down. It is apparent from the location of the tunnel as well as maps found in the possession of the Mexicans that the mall and one of the schools was to be the target of their invasion. The investigation continues to and has been turned over to the U.S. Border Patrol, Texas SBI and the FBI. 

"There is likely other tunnels to be located along the Texas-Mexican border" said Border Patrol Capt Sam Remington. The formerly unknown tunnel is confirmation that the nation of Mexico, and particularly the radicle fringe of the Mexican Anti U.S. Army (MAUSA), is likely to be a continuous concern for border citizens of the U.S. When asked for comment during his recent trip to Camp David, President Obama said he is considering sending Army and Marine troops into Mexico to flush out the MAUSA and it's tunnel system.

- Imaginary Press Release. But if you are in Israel, this scenario is your reality. Just imagine.

Surgery Leadership Lessons

Dr. Kevin J. Tracey is the president and C.E.O. of the Feinstein Institute for Medical Research of the North Shore. He spent a lot of time in operating rooms over his medical career and learned some leadership lessons from that experience:

"I've seen the best of management and the absolute worst of management.  The worst is when the team fears the leader, so when someone sees something going wrong, they're afraid to point it out. I've also seen the best. It's about clearly stating the purpose and asking people how they're doing and really listening if someone needs something different that day. If the operating team can accommodate the needs of that person without deviating from the plan, that person will be a better member of the team.

Too often I've experienced surgery teams that have little interest in the team members. It seems to be all about the surgeon, then about the patient and then everyone else…if there is time. And there usually is not. Teams are, by definition, made up of talented, qualified members and without member support and care, the team disintegrates into a dysfunctional anarchy. This is the worst of leadership where fear dominates and frustration abounds.

So has been my recent history and I am becoming more and more disgusted with the environment created by its leaders lacking leadership. It's really very simple: "accommodate the needs of [the team member] without [disrupting the plan of care for the patient]" What exactly is so difficult about that concept? Team members really don't need, want or ask for much. And why are so many surgeons being turned out of training not knowing this simple concept. 

It's not about you, really.

Just Ring the Bell!

"Why don't you just ring the bell?" - Anonymous Surgeon

He didn't really say that and tell that story did he? I may not want to work with this ego maniac any longer, but this has to be the funniest conversation I've ever been involved in. I'm speechless. But that didn't stop me from chuckling out loud.

The average United States Navy SEAL spends over a year in a series of formal training environments before being awarded Naval Special Warfare (SEAL) position.

In 2005 a 4-man SEAL team, deemed Operation Red Wing, is sent in to capture or kill a Taliban leader in Afghanistan. They were discovered soon after landing in the area and forced to fight a fierce, futile battle.  Most of the team and all of a chopper full of would be rescuers, are killed leaving a lone survivor. The lone survivor is Marcus Luttrell, Navy SEAL. One of my colleagues recently watched the movie depicting these events, “Lone Survivor”.

Because of its particularly challenging requirements to become a SEAL, many candidates begin questioning their decision to volunteer for this training and a significant number Drop (from the program) on Request (DOR). The tradition of DOR consists of dropping one's helmet liner next to a pole with a brass ship’s bell attached to it and ringing the bell three times. The training and the bell DOR event is captured and shown during the opening credits of the movie.

Now, surgery can be a difficult environment and challenging but it’s not SEAL school. And surgery is patriotic and something we do voluntarily, but it’s not SEAL school. And being a healthcare provider is challenging and giving to the community we serve, but it’s not SEAL school. There is no DOR process nor should there be. It’s a career, and a calling, but not a life or death gunfight.

So to use the “bell” ritual as representative of whether to work with someone or not in surgery is ridiculous at best. Maybe even psychotic. Individuals have nothing to prove to anyone in their medical career except to themselves and their patients. We don’t have anything to prove to other providers who for whatever reason feel they are vastly superior to everyone else around them. Sometimes excusing one’s self from the company of others is better for the team, and the patient. Really no reason to stay in that working relationship or prove anything to myself.

It’s not a matter of “sucking it up”, not "ringing the bell" and continuing to work with just anyone.  That should be reserved for firefights against the Taliban.