Letters To ‘Surfers: Change is the most difficult thing a person can do-
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Editor’s Note:
Was just going through some mail and stuff- and saw a few comments that I thought were interesting and would like to share.
Frank
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Various thoughts on or “About Circuit Surfers”
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From Dan,
Change is the most difficult thing a person can do’. Yet you are quite right that a perfusionist needs to be open to it, even if it means dragging one’s psyche along by the scruff if its crazy neck.Personally, right now I am more excited than I have been in years. I am looking retirement in the face after 41 years of call and check lists (which gives me a chance to plug Atul Gawande’s Checklist Manifesto belongs in every perfusion library) but am also looking at Maquet’s compact ECMO gimmick.
That caused our Director of Surgery to go apoplectic until I explained that I have been trying for almost 40 years to get someone interested in ECMO using stuff we have laying around. We put a Centrihead pump in an old Datascope balloon base, bolted a mast to it, hung a Quadrox off the mast and we can pop a CDI unit on it and we are ready. We use a left heart bypass pack and make a very minor modification.
The goal is insert, stabilize and ship; but still, new and neat. We have an Impella we are aching to use; we’ve been through a trial run of the AngioVac down in IR, and baby sat a couple of ablations. Now we just show up with a cell salvage device rather than a whole primed CPB system like the first time, but it was something new. Oh, and we have almost abandoned the concept of using a cell salvage device for the endo-AAAs.
The only really onerous thing is we have is a new guy who wants vacuum assist available for every case. I still maintain a hard shell is ten times as dangerous as a collapsing bag. If I had been using hard shells for the past 31 as I did for the first 10, I’d probably have pulled the plug long ago. This is something I believe.Which leads me to the idea of vetting’ information on the internet. First, there is a wonderful talk which may still be on TED.com by the co-founder of Google concerning correcting bad information.
My personal example is Ullyses S Grant. Try looking up his middle name and see what a historical mess is.Second, Michael Shermer just published a book called The Believing Brain’. In it he proposes that brains are born to believe; that many are predisposed to believe certain things; that we can change’ our minds; and that science needs to be done properly in order for it to be valid.
Recommended to those who insisted on believing anything, in spite of the evidence. Full of great experiments, like the invisible gorilla. Neuroscience is where heart surgery was fifty years ago, only without the cowboys, which is not to say that some of the proponents lecturing and writing out there are not pretty colorful in their own way.
Just a few random thoughts. Keep up the good work.
Dan
