Interview with Surgeon Notes
These are my raw notes with Beatriz Leong, a resident surgeon.
General Surgery Resident at USC
Alina 18 months
Dailin 12 years
What do you think about the concept of an Artificial Womb?
“ I don’t think it’s going to take off”
Pregnancy is a very unique process
It’s made that you build this bond with the child.
-> There’s going to be bonding issues with that.”
I don’t recommend it.
It’s not going to be accessible, it’s too expensive. Not going to be a future.
Perhaps for a high-risk pregnancy.
I can imagine that people would still use it. Like in concierge medicine. Family doctors are expensive. They’ll do everything for the patient. The ethics are more blurred. Not accessible to everyone.
What do you think about universal healthcare?
The way things are going, I doubt it.
Heathcare-> a lot of countries believe its a human right
make it univerally available
but in this country, capitalism makes it difficult. Implementing universal healthcare
private insurance companies
individidualism-> people want unique & special
-> one of the things that will continue
people are living longer and developing new diseases
Like what?
“Everything will be patient centered” The pharmacies will be closer. Everything should communicate together, hard changing in many levels training, uncomfortable-> Electronic health records, having to work, electronic is harder?
Electronic documentation takes more time.
Electronic healthcare some systems fo well. Most don’t implement changes
Noew computers can access indefinitely, so there’s more litigation. Patients feel convenience at fingertips, physicians in the future will have more of this.
50 years more accountable for everything
* patient its a simpler process, family physian, patients want more specialists. That makes the cycle worse
New Diseases
-> Advanced types of cancers
-> Incidental things, clinically involved
-> Go to the ER, want CT Scan
->PAtients request imaging
-> Find abnormalities small tumors for example
**People are now more worried about small things in their bodies that would not
**Problem: too much scanning and exposure to radiation (how would we fix that?)
Do you think that robots will be able to diagnose and doctors will not have to do it?
Web MD. For quick diagnosis “I don’t think there is a percentage of error. I don’t think a machine or robot will be able to diagnose with absolute certainty and take that judgement.”
** Doctors will still be needed to help discuss the options with the patient, as it is an emotional encounter.
What is the emotional connection? Is it much better if a doctor gives the message? The doctor can read them and empathize with them.
What would you do if this was your mother?
I do think medicine will become more accessible, diagnosis, treatment options
Patients will live longer
“Certain element of comfort to have someone go through it with you”
What happens in a really good connection?
Most of meds truly want to help people
its really difficult to have the discussion with people
**The goal of a doctor is to help people (Intrinsic purpose) innate drive
People would see someone that they are comfortable with, and will drive far to go to them. Seeing a doctor has value over typing symptoms.
What kinds of diseases will exist in an aging population?
Atherosclerotic disease (From fats)
Lifestyle diseases
Dementia
Parkinsons
Toxins
Air quality
Defibrillators connect to your phone and surgeon etc, we can talk and communicate easily.
What changes in healthcare for the elderly?
Education does not equal training physicians for the future
large deficit of physicians in the beginning
more sub speciality services
not enough experiences
Ends up affecting the poor and uneducated
Personal health care
heart failure services
pacemaker
Longevity healthcare
Age is a pretty strong factor, hearts are older
** its important for patients to be dedicated to their health and be self-driven needs to start early
*habits are difficult to break
Nanotechnology what do you know about it?
I worked on nanodelivery mechanisms.
We are a long way from it
We have magnetic beads with specific surface peptides.
Certainly will happen
Big Pharma
“Med start ups are bough out by a bigger company.”
Startups will be bought by doctores
small companies dont have resources to run randomized clinical trials
Clinical trials
Realistically only the NIH
Gov running slower development, not develop as quickly because only patients stand to gain for it.
People dont have trials
Big pharma is capitalism things being overprices, we developed technology to be advanced
** its what motivates people to create more solutions, like with investors. If it is government run it is too slow.
What do you think of my vision of a UBI?
Its quite a big socialist idea
This country attacks communist socialist
I don’t foresee it
State level may work, people will pay more taxes, will provide them with basic
People will pay more taxes,
I already have to pay 30% of my income because of my tax bracket
Provide them with basic salary
do strongly believe we don’t take care of our elders and sustain our jobs.
What do you think about the universal income
People inherently compete, get more money, vicious cycles
Certain percentage of population
top 1% will get it
Its not sustainable
What do you think about the universal income?
A person at UPS and me will make the same amount of money in 40 years
Whats a better solution? What is more feasible?
Making jobs and education that are invaluable to society more afforable know plenty of jobs that never go away. There are so many people that can become amazing Doctors, teachers, surgeons, debt is impossible
Cuts out so many people. We still have a huge teaching deficit
Make jobs like this (teaching jobs) more attractive more money less debt
Recruit more at high schools.
How to get there
Theres no guidance, nobody cares you have to do it yourself. degree and cannot use it. Education is not efficient.
**People feel the pressure to 4 years of university
There should be more vocational schools
You should not have to rack up so much debt and then go to vocational school.
What do you think about designer babies?
No professional exposure to designer babies
Genetically modified child, selecting beauty characteristics, the number of times things go wrong is inevitable, long term health pregnancy is rare enough
Health and convenience and safety. Highly unethical
amniocentesis
**People will be able to tell what disease their baby will have
many children are aborted in the first trimester. There are so many problems that can go wrong in the pregnancy. Healthy pregnancy is so rare that starting to modify a fetus is highly unethical.
Epigenetics
*Nearby coding material
DNA helix contracted, when its all together
You don’t know how this will affect everything
What if it does not work?
Possible with everyone
Physicians will say no
Concierge medicine-> Money eventually will allow it
New sports
* Be smart -> Genetically modified children will face bullying and be profiled with discrimination, It will put a target on the child
*Its like being adopted
People will discriminate against them
**GMC will struggle with identity problems
Women will have fetuses with birth defects.
Incompatible with life.
Women will be able to choose to abort a child.
What do you think about Artificial Wombs and Abortion?
I don’t know if it’s medically possible to separate the placenta fetus from a womb. The blood floor stops, Who is going to raise those kids? Taxpayers money. Homes I don’t know that not aborting the child will allow a child to have a better life because we cannot assume a child will be wanted and cared for. and I don’t know which one is better.
It’s worse hearing about an abused child.
It is the utilitarian approach? I don’t think that would work.
Aging populations should be comfortable and beauty.
It’s not the way it is. More fragiles, feasible to be other.
*****People want to feel young and free
Everyone will complain things will start to not feel right
Mother Foetal Attachment: As an outsider, and as a Mother
Medically largely emotional event to give birth. There is hormonal imbalance
Need hormonal injections to simulate it.
Massive rush of endorphines
Mutilate the body. You’re okay with pain to bring life. emotions trigger memories unlike anything you experience man and women.
Love makes you silling, and goofy
Going through the pregnanncy
Emotions trigger memories, unlike anything you experience. Man and women sense of doom.
Concept artificial womb situation
1. some upsides:
**A. Women in a male dominated field will be able to work while pregnant
B. Certain Value to not having to miss work
2. Medically cannot conceptualise how this would work
**3. Problem: Cannot leave child alone at home
4. Could have a pod center.
fetus is a parasite, womens hormones will be irregular
**5. its like how a penguin brings their eggs around****
How will society react to it?
1. people will be nice, curious and interested
2. People will want babies, everyone loves them
3. Its like having a surrogate
4. everyone has a right to have a baby
Aging
1. should be beautiful
2. everyone aging is fragile, wrinkles, shrinks,
feasible to be mobile longer.
In Urban homes
* people have less kids, 2 doctors no kids.
* population is aging because less epople have kids, elderly will work longer, people are developed and not have kids
More older people will have to work or less people?
**Keep skilled people in the workforce.
Hope this means more jobs for younger people. 15 year difference, level of expecation for work.
great depression -> Glad to have any job
not the case anymore
**raising people entitled to convenience will find that they are not as hardworking and just WANT to be rich and free.
9 months -> Breast feeding, drink milk and toddler different taste
Babies drink regular milk?
Every 3-4 hours she would have a bottle. She would eat a little bit then have a bottle.
What was it like to take care of her as a newborn?
Not too bad, it was like a whirlwind.
It’s a huge difference in responsibility.
Everything you do revolves around the newborn.
They don’t sleep well, they don’t eat well, they poo all the time.
Figure out how to get them to eat
How do you get them to eat?
I breast fed both of them. They had to learn how to latch on. It’s hard to get them to lat on and release, and they can give you sores. They need to breast feed and get milk (design product to help babies latch onto their mother’s breast)
She was getting jaundice and belerubin. She was getting dehydrated and yellow. She had to get a hospital thing, she had to feed her and pump to get enough milk.
Once she latches on, it’s not a problem. You just have to limit how long they feed. It’s soothing and it makes them fall asleep. People would supplement them with a pacifier and they would fall asleep like that. Once you get them on a good eating schedule you need to get them on a good sleeping schedule. Hopefully they take an hour nap and then you gotta clean them. With her, we would put her down not in our room and give her three hours to sleep and relax. She was never fussy and would fall asleep. When she was a couple months, she started to sleep 6 hours at 2 months, then 8 hours then all throughout the night. She could start sleeping at 3 months.
The dad’s cant do a lot, they can’t nurse, they can’t nurse them at night. Her husband would be awake during the day a lot and then at night she would be up. Eventually she started sleeping through the night.
The key is to sleep when they sleep. I can sleep anywhere. A lot of people can’t sleep anywhere. A lot of new moms struggle with being able to sleep right. You need to feed them so that they don’t get dehydrated.
It takes them 45 minutes to drink 2 oz,
30 mins get them to sleep
30 mins and do it all over again.
You got to figure out your routine. I would give her a bath, change her, wrap her, swaddle, put her in the crib and she fell asleep. She was so happy it worked. It was totally by accident but she was able to get the baby to go to sleep in the crib. ** you can teach baby sleeping habits.
Dailin was different. She would only sleep if you rocked her to bed, and she would sleep on her husband’s chest.
You seem to deal with that unending cycle pretty well huh?
The baby is so good.
What about when you were pregnant with her? What was the first trimester like?
We had a hard time to get pregnant.
The first one was easy but it was hard to have more babies.
She started medical school, and she could not have a baby at that time, so she went on birth control.
The next moment, she was able to have a child.
She wanted to have it with good timing, so that with work it would all go well together.
1st trimester “I was always nauseated. I was always throwing up.” In the OR she would go out, throw up then come back. “I was always tired” She only wants to sleep all the time. She just wants to go back to sleep. For like the longest time, I stopped six months before getting pregnant. I wanted to be healthy, I wasn’t drinking coffee or medications. Being a surgery resident and not drinking coffee its’s difficult.
*
*its hard you cannot take medication when pregnant.
By the time that you’re nine months you are so big and 30 pounds overweight, most people gain a lot more
2nd trimester is a nice medium period
You can’t lay on your back. IV & back pressure
sore and heavy. Bodies hormones get used to hormone levels. Not so big that your physically limited
3rd trimester is anxiety provoking. Winding down? There’s all these anticipatory emotions. When you are over that midway point there’s all this counting down. Holy shit am I ready. It’s been 12 years since we did this what are we going to do. It is definitely exciting.
I was not dialating. When the babies get 41 weeks, they grow a pound a week
The placenta starts to peel away on its own, there’s a lot of risk to the baby,
Baby has blankets she carrys around. Baby has her own language, basic more all done say thank you. Eat and drink, eating a lot, picky dimsum, eat everything.
Car seats: They hate it.
Some kids like it, some kids hate car seats and not being free
1. removeable car seats are easier
2. Toddler seat has to stay in the car. Struggles, difficult ot get out. Likes going in the cave and playing
*3. Fancy carseats don’t work, they need to be baby proof because babies will pop in it, throw up, throw chocolate, everything.
4. one arm is in and the other is out
5. she likes going in the car to play with buttons but she doesnt like sitting in the carseat
Stroller: She will not get into a stroller. a good stroller would be a jogging stroller.
What was it like to not be able to conceive?
I try to stay fairly positive & See the good.
Not let it affect my work
Supportive
What’s it like to have kids as a surgeon and working?
Residents usually don’t have kids because they are too busy.
before that nobody had kids, most of the nurses didnt have kids.
** The hardest thing was not being able to be home when having a bad day,
**Not being able to relax, hard to be away from them
* miss out and gone a lot. a lot of guilt is associated with that. WOuldnt be happy without being a surgeon and having kids
Nobody teaches you to be a parent.
-> Definitely a lot of pressure and judgement
**Children need a mom figure in their lives.
both parents work and still work
Premies
twins premature, babies not ideal
babies survive as early
What do they need
1. Breathing tubes that are tiny (half size of pen)
2. IV Access. cannullas in the heart and the big vein. Draw the blood out of the vein and into the heart.
3. In the umbillical artery (Hebrin to prevent it
4. Put a catherer in their blood to take care of them
5. Their skin is not mature enough as a barrier
6. Warmer -> Incubators
7. Babies don’t go home until they are a stational age.
8.dialysis the blood.
9. Babies are fed formula or try to get the mothers to pump their milk
10. PFO - open corrin Require many surgeries esophagus to fix that feeding tube (Suckle on a niple for 3 weeks.
There are so many problems that can go wrong with birth defects. I don’t know how this machine would work. I have no idea how I would have had a normal pregnancy
“you don’t think of all the negative aspects.”
What is that?
Freezing eggs
Ovulate, 2 or a handful of eggs
menopause chanves of reg is less
->U have all the eggs in your system
->Chances of having eggs are less
Invitro doesnt always work
New industry****
* Service to have frozen eggs, service to harvest eggs, service for storing eggs, service for getting the eggs back. Very expensive
*People desire to have children. ** Strong desire.
I dont get desensitized. patients affect her quite a bit
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