May 2016

 

mnfl final

Task at hand: This week I’m once again thinking about decision making; specifically, decision analysis and how to achieve success in your decision making process. As you know, I like to borrow from the spheres of medicine, science and business when constructing my models and frameworks. When diagnosing a patient, physicians will investigate “associated factors” –  what are the related symptoms, history, or other issues that may be contributing to the suspected underlying diagnosis? Similarly, when looking at the decision or conflict at hand, spend some time deciphering the associated factors. These are always pertinent to the outcome you are trying to achieve.

 

Let me use a simplified example for you here. With spring in full swing, let’s say you are trying to decide on a particular plant for your garden. Our simplified desired successful outcome of this decision is to pick a plant that will not only grow – but thrive – through the seasons. Consequently, we can quickly deduce that the “associated factors” will include environment (weather, rain, soil quality), resource availability (how much time do you have to tend to the plant, what is your budget for seed), and appearance (do you want a pretty flower or a unique plant).

 

The best method I have found to uncover the associated factors of a particular decision is through visualization. The concept of “visualization” is common ranging from sports to cognitive-behavioral therapy. Here, I am ascribing visualization as an act to appreciate all the forces acting on your decision. I’m always surprised at how much I uncover through this process and realize that our decisions are heavily indebted to a lot of extraneous influences: it is usually not possible to remove these factors so one would be wise to figure them out!

 

I actually use a lot of visualization in surgery as well – many times, the surgeon’s view is compromised secondary to many possible factors. In these challenging instances, my visualization of the problem at hand and the role of my immediate environment allow me to continue without being deviated in a negative manner. So, next time you are pondering a difficult conflict – visualize the relevant associated factors – and give yourself some clarity on your way to success!

 

Medicine & Macula: The first US universal newborn ocular screening initiative was recently published in the journal Ophthalmology. It showed that fundus hemorrhages are common in healthy newborns, especially in those born by vaginal delivery (9 times more likely) and in forceps assisted delivery. While the long-term consequences of retinal hemorrhages on visual development remain unknown, it is important to have empirical knowledge that these are common. The issue of child abuse and shaken baby syndrome are a natural extension of this topic, and key points of differentiation (vitreous hemorrhage, retinal hemorrhages in multiple layers, traumatic retinoschisis) in the latter need to be emphasized.

Check out the study here

 

Gratis: Thanks to American Journal of Ophthalmology Case Reports for recently publishing our study on Delayed fungal endophthalmitis secondary to Curvularia.

Curvularia

Check out the paper here

 

 

Happy Memorial Day!

My best to you,

David Almeida

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choroidal rupture

Task at hand: This week I’m thinking about strategy. We all have some strategy – some series of actions we employ to achieve a desirable outcome. One question that I am frequently asked is, “What makes a strategy successful?” My answer usually is, “If it works, it’s successful!” I am joking, but only half so. Ultimately, your strategy has to work and you have to achieve your goals; otherwise, I would seriously consider switching strategies.

In today’s Sunday Surgical Scrub, I’m going to give you my two tenets of any successful strategy: Planning and Execution. I plan like an economist, but execute like a surgeon. In planning, you have to employ some sort of analysis; whether it’s a simple pro/con list or a formal SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis, you have to bring your decision out of your personal vacuum and into context and consequence. Then, when all planning is done, go out and execute it. A personal example for me is in surgery where there is absolutely no time for uneasiness or hesitation – one has to fix the problem at hand – and it has to work! Similarly, when you have devised your plan, go and execute! I don’t much care for extraneous pressures when the time for action has arrived.

Critiques I have heard of this strategy is that it lacks a “reactionary” component when the environment changes. My response to this query is that I will take a good decision today over a perfect one tomorrow every time (thanks General Patton!). I know too many smart and gifted people who have become trapped by the creation of the perfect plan. Napoleon Bonaparte wrote: “Take time to deliberate, but when the time for action has arrived, stop thinking and go in” – this beautifully summarizes the strategy.

So, no matter what goal you are trying to achieve, I say Plan and Execute! Don’t let time from one deviate the path of the other.

 

Medicine & Macula: A JAMA study released this week showed exercise is great at cancer prevention! The National Cancer Institute confirmed that exercise lowers the risk of many types of cancers. The study looked at 26 types of cancers in 1.44 million people and found that leisure-time physical activity was associated with lower risks of many cancer types. It is important to emphasize that most of these beneficial associations were evident – regardless of body size or smoking history – and thus should be encouraged for most people.

Check out the study here.

 

Gratis: Last week we launched the new website, davidalmeidamd.com, and I want to thank everyone for their support! Thanks to all the emails and interest in my research, speaking, medicine/ophthalmology/retina, and leadership – it was the main driver for the creation of the website. Let us now go and innovate together!

 

Always feel free to drop me a line with feedback or questions.

My best to you,

David Almeida

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Task at hand: This week I’m thinking about decision making, problem solving and conflict resolution. Before making any decision, you need to properly define or characterize what that decision is. In medicine, when elucidating a problem from a patient, a physician commonly describes the “character” of the problem; for example, what is the character of the pain? Is it a dull ache, sharp pain, or boring soreness? Continue reading Sunday Surgical Scrub: May 15, 2016

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Task at hand: This week I’m thinking about actions and experiences after being reminded of the Oscar Wilde words: “Experience is the name everyone gives to their mistakes”. In living one’s life, there is perhaps no better barometer of engagement than the merriment of the experiences one amasses over time. Fear of mistakes or failure are never an adequate reason to shy away from an experience that may allow us to learn and grow. In fact – seek out experiences that are outside of your comfort zone regularly – and you will be rewarded multiple fold. I have come to appreciate that, fear of mistakes is nonsensical, and instead, I urge myself to ask questions and then to test them in the many spheres of life. An empirical life allows the days to become a series of experiments and life a collection of experiences. Continue reading Sunday Surgical Scrub: May 8, 2016

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“Before each and every case, a surgeon scrubs and disinfects his hands. At the same time, he or she becomes solely focused on the task at hand – preparing to navigate a complex surgical path – and ready to confront any difficulties that lie ahead. Here, on the Sunday Surgical Scrub, I bring you what I’m pondering for the week ahead.”

David Almeida MD MBA PhD

Task at hand: This week I’m thinking about how we, as humans, interact with our environment. A large study of over 2000 participants found that the average human has an attention span of 8 seconds; contrastingly, this was 12 seconds in 2000 before the smartphone revolution. For comparison, goldfish are believed to have an attention span of 9 seconds. Many will argue that our ability to multitask has improved so these 4 seconds lost may not be as significant. Continue reading Sunday Surgical Scrub: May 1, 2016

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